ermingarden: medieval image of a bird with a tonsured human head and monastic hood (Default)
Ermingarden ([personal profile] ermingarden) wrote in [community profile] agonyaunt2022-09-26 09:34 am

Ask Damon: Should I get my anti-vax friends' baby vaccinated without telling them?

My best friend is an antivaxxer (not only covid, all the vaccines). His wife is, too. They have a 9-month-old baby and they haven’t vaccinated him. I babysit for them every other weekend. Should I take the baby to get his shots without telling them?
— Anonymous


Anonymous: My feelings on vaccinations are well-documented. But just in case you’re unfamiliar, a quick refresh:

I think I’ve reached the threshold of intellect where I’m just smart enough to know that I’m not that smart. I have some gifts and some talents, I guess. But with medical science, I trust that the PhDs and MDs who’ve spent thousands of hours and hundreds of thousands of dollars to learn about it, and whose livelihoods are predicated on the retention and application of that knowledge, know much more about it than I’d ever know. And I’m not just talking about some faceless wall of anonymous white-coated professionals, but family and good friends. A neighbor. An ex-girlfriend. All medical doctors or science-related PhDs unanimous in their belief — no, plea — that everyone get vaccinated.

And look, I’m a Black American. My skepticism of our health-care system, based on my awareness of the profound racial disparities existing within it — historically, and presently — is justified. But, as I wrote in a New York Times essay last year, my desire to prevent more infection, sickness and death is a force greater than cynicism.

That said, I am also a parent of two small children. And if someone took them, against my will, to get vaccinated? Let’s just say that I was advised, by my editors, for legal-ish reasons, not to say what I’d do to that person.

What you’re suggesting is reckless, egregious and possibly even criminal. Forty-three states require a parent’s permission to vaccinate a child. The age where parental consent is no longer necessary depends on the state, and ranges between 15 and 18. But these laws are for teenagers who wish to get vaccinated, not adults who want to sneak their friends’ babies to the clinic.

Of course, if you believe that your friends are abusing their children, you have a responsibility to report them. But despite the fact that I do agree with you on the necessity of vaccination, and that your friends are acting dangerously, you’ve burrowed so deeply in the rabbit hole of self-righteousness that you’ve come up on the wrong side.

I was tempted to suggest that you attempt to sway them into getting vaccinated, but if an active pandemic that has killed millions of people — plus all of the social restrictions of being unvaccinated — hasn’t convinced them yet, I’m not sure what else would. Maybe an ultimatum, where you tell them you don’t feel safe around them anymore. You’d risk ending that relationship, sure. But I’d rather lose friends than commit a crime and lose my freedom.
cimorene: cartoony drawing of a woman's head in profile giving dubious side-eye (Default)

[personal profile] cimorene 2022-09-26 02:17 pm (UTC)(link)
The thing is that the law recognizes parental rights to decide their children's health care, including vaccination. Reporting them for not treating severe wounds or broken bones might produce governmental intervention, but non vaccination wouldn't. That said, there have been times, and there are places, I understand, where children are vaccinated regardless of their parents' wishes. So if LW thinks non vaccination itself constitutes abuse, they wouldn't be alone in that, and there's a moral and ethical argument to be made to that effect. The court isn't going to support you, but the LW might value the child's health more than the trust of its parents and be willing to break the law.
minoanmiss: Minoan style drawing of the constellation Orion. (Orion)

[personal profile] minoanmiss 2022-09-26 02:42 pm (UTC)(link)
I would be concerned that there was something in the baby's medical history that actually contraindicated vaccination (unfortunately validating the antivaxxer parents, sigh). One never knows.

As I said in my other comment, I think LW should play the long game.
cimorene: cartoony drawing of a woman's head in profile giving dubious side-eye (Default)

[personal profile] cimorene 2022-09-26 03:12 pm (UTC)(link)
That is a possibility. But of course, the amount of danger the baby is in vs the risk if vaccinated should probably be taken into account. In the case of covid, it's rarely fatal or even serious to children, so it would be wiser not to, bearing in mind that there could be contraindications. There are other illnesses that are significantly more dangerous to small children, but none that come with such a high risk of infection as covid currently has. That could change in the future, of course, if antivaxxers have their way...
Edited (word transposition) 2022-09-26 15:13 (UTC)
minoanmiss: black and white sketch of a sealstone image of a boat (aegean boat)

[personal profile] minoanmiss 2022-09-26 02:40 pm (UTC)(link)
Well, legally LW is not allowed to do this, and I also doubt a doctor would do so unless LW convincingly pulled off "this is my kid and this is why we haven't been your patients before now". Besides, childhood vaccinations are a set, not just one visit, which would make the logistics even harder.

I am ethically not certain if this is a case where bad parenting should be corrected by someone else or if this is a bad decision parents are allowed to make, but with both law and logistics against the LW, not to mention the possibility of elements of the baby's medical history the LW may not know, I would advise against this plan.

LW, cuddle the baby and whisper "when you're 15 I'll help you emancipate yourself and get your vaccinations."
cimorene: cartoony drawing of a woman's head in profile giving dubious side-eye (Default)

[personal profile] cimorene 2022-09-26 03:24 pm (UTC)(link)
I am ethically not certain if this is a case where bad parenting should be corrected by someone else or if this is a bad decision parents are allowed to make

This very issue is what makes me feel like this is a question for an ethicist, because that's what's bad about this answer, which boils down to "I am undecided whether vaccine denial constitutes abuse, but regardless, you shouldn't do it because the parents would definitely be angry."

If LW is asking for help choosing the most ethical course, then the parents' feelings aren't relevant unless they're likely to have further practical consequences. And whether denial of vaccinations constitutes abuse is very much the central issue, so ignoring it without even an attempt to consider how much danger the child might be in seems to miss the point completely.
minoanmiss: A little doll dressed as a Minoan girl (Minoan Child)

[personal profile] minoanmiss 2022-09-26 03:28 pm (UTC)(link)
The two of us are definitely doing more work on the central ethical question than the columnist did.
cimorene: Half the space is filled with a jumble of overlapping geometric shapes in a variety of colors (confetti)

[personal profile] cimorene 2022-09-26 03:29 pm (UTC)(link)
Haha, yeah.
melannen: Commander Valentine of Alpha Squad Seven, a red-haired female Nick Fury in space, smoking contemplatively (Default)

[personal profile] melannen 2022-09-26 04:00 pm (UTC)(link)
I ama actually curious here because if LW is regularly babysitting for two days at a time, and given their lack of concern for logistics, it's possible they have some sort of release paperwork allowing them to make medical decisions for the kid. Would that change the ethics for anyone I wonder?
minoanmiss: A detail of the Ladies in Blue fresco (Default)

[personal profile] minoanmiss 2022-09-26 04:42 pm (UTC)(link)

If LW actually has paperwork that says they can make medical decisions for the kid, they might legally get away with one vaccination (although I still think most doctors would say, "this baby is not my patient and I don't know their history so I won't vaccinate them") but then the parents will revoke the paperwork and the kid will have a very incomplete vaccine series. And of course I am not a lawyer -- I'm coming at this from my time in medical admin and reading charts.

melannen: Commander Valentine of Alpha Squad Seven, a red-haired female Nick Fury in space, smoking contemplatively (Default)

[personal profile] melannen 2022-09-26 06:12 pm (UTC)(link)
If it's a situation like [personal profile] conuly's below where the regular pediatrician is used to seeing LW, they could probably just bring them in, although you are right it would probably only work until the parents got the bill/insurance statement (but that might be months and several vaccines down the line, depending on how on the ball everyone is with paperwork.)

Ethically though? IDK, it certainly removes the "it's illegal" part of waiving the ethical question. And one vaccine in the series is still better than none.
Edited 2022-09-26 18:14 (UTC)
minoanmiss: A detail of the Ladies in Blue fresco (Default)

[personal profile] minoanmiss 2022-09-26 06:58 pm (UTC)(link)

Actually I'm not sure I'd say one vaccine is better than none. I am also not a doctor, but I am given to understand that working with the immune system can be pretty complex. We don't want to give the kid an allergy.

Also, there's a discussion below about how the appropriate people to decide whether or not to supercede the parents's judgement are the kind of people who work for CPS and other such governmental agencies, not a layperson like LW. I think there's a good point there.

melannen: Commander Valentine of Alpha Squad Seven, a red-haired female Nick Fury in space, smoking contemplatively (Default)

[personal profile] melannen 2022-09-26 07:15 pm (UTC)(link)
As far as I'm aware none of the standard childhood vax series (or Covid) are dangerous to stop partway though (I know this because several of mine *were* stopped partway through after I had a mild allergic reaction; with herd immunity where it was in the 80s, stopping them was less risky than even a teeny-tiny chance of a severe reaction after a second shot. Vaccinate your kids, people, I never finished my childhood TDAP series! But also there are enough reasons a kid might start but not finish a series that I don't think they would be mandated or administered the way they are if that was risky.)

But I'm certainly not siding with LW on the ethical question! Although I think even there, if LW has paperwork from the parents saying "We trust you to make medical choices for our child" that would add a different ethical dimension. (Ethically does that obligate LW to make the decisions they know the parents would make? Or does it obligate LW to make the best choices they can with the information they have?)

Like you said, calling CPS is the Godzilla option and it's unlikely they would do anything unless there's other medical neglect, but it would probably break trust with the parents on at least the same level as getting the vaccination if not moreso, so I hesitate to suggest that.

Honestly my suggestion would be to have a serious discussion with the parents in which you say you are uncomfortable continuing to babysit unvaccinated kids, because of the risk not just to them but that they might transmit diseases to others. Maybe you'll lose the babysitting job, maybe the parents will be willing to compromise (or you will but will at least have had a chance to say your piece).
Edited 2022-09-26 19:19 (UTC)
conuly: (Default)

[personal profile] conuly 2022-09-26 10:06 pm (UTC)(link)
Honestly, I also often brought the kids to the pharmacy, lots of different pharmacies depending on what was convenient. Literally nobody *ever* questioned "Yup, we're here for the flu shot", whether they'd ever seen any of us or not except... actually, except for the mass vax event where E got her first covid shot. And even then, she was already in high school. I bet if I'd just said "Oh, yeah, I'm her mom, we just have different last names" and E had backed me up they would've gone along with it. But as her dad was right outside we just called him and he came in and gave his ID instead. (She wanted me to hold her hand while she got vaccinated instead of anybody else, because, again - all her shots, literally all of them, after infancy were with me.)

I'm not sure if other shots would've been different, it's possible they'd scrutinize more closely if it was tetanus at the pharmacy instead, but... in my experience, people just are not nearly as stringent about this as we'd perhaps like them to be.

Again, I'm not at all recommending this, and if LW did something like this they'd have to pay out of pocket to avoid insurance problems. Just as well, not having insurance is consistent with not having an ID.
Edited 2022-09-26 22:08 (UTC)
adrian_turtle: (Default)

[personal profile] adrian_turtle 2022-09-26 08:54 pm (UTC)(link)
They are more likely to have permission to make decisions for the kid's emergency medical care. Or perhaps urgent care + emergency care. The babysitter can consent to treating an acute asthma attack, and call the parents who will decide about longer-term asthma treatment. Vaccinations are long-term preventative care. No doctor in the world would consider it an emergency to get a kid vaccinated against measles NOW, instead of waiting until next week or next month when it was convenient for the parents to bring the kid in. (I think the only vaccinations that are URGENT, that can't wait until Monday morning, are rabies and tetanus. I don't think we're talking about that sort of thing.)
melannen: Commander Valentine of Alpha Squad Seven, a red-haired female Nick Fury in space, smoking contemplatively (Default)

[personal profile] melannen 2022-09-26 09:49 pm (UTC)(link)
True, but it wouldn't be that unusual for a frequent carer to also have permission for things like taking the kids on routine doctor visits or follow-ups. (The usual thing to do would still be to check in with the parents before okay'ing any treatment changes! But the legal paperwork probably wouldn't specify.)
conuly: (Default)

[personal profile] conuly 2022-09-26 05:44 pm (UTC)(link)
I also doubt a doctor would do so unless LW convincingly pulled off "this is my kid and this is why we haven't been your patients before now".

Surprisingly easy to do.

I took my niblings to ALL their doctor's appointments from the time my sister went back to work, including to the ER several times for asthma attacks, and if I didn't correct those people, they just kept calling me "Mom".

They don't check IDs at the door. They do like to see the insurance card, and they always *claim* they look at a photo ID, but they never actually do. They can't really mandate that anyway, much though they'd like to, because 10% of all adult Americans don't have a photo ID. Citing this fact will get you out of having to show an ID in a large number of situations where people try to claim it's required, except for the very few cases where it is legally required. (Citation: Up until the pandemic, I was one of those Americans! It is a real hassle to get an ID if you do not already have a photo ID. I had to get a passport with an affirming witness.)

And all you have to do to explain why you're making an appointment at a new practice is say "I've recently moved" or "My previous doctor moved". They don't care enough to quiz you about the details.

...not that I'm saying that LW should sneak around and sneakily get the baby vaccinated, just that this is not really a barrier.
Edited 2022-09-26 17:49 (UTC)
minoanmiss: Minoan Traders and an Egyptian (Minoan Traders)

[personal profile] minoanmiss 2022-09-26 05:50 pm (UTC)(link)
SHEESH, people. They were far more lax than I was allowed to be, but then I worked inpatient.
conuly: (Default)

[personal profile] conuly 2022-09-26 05:53 pm (UTC)(link)
Got on a plane once with my niblings and no ID (see the edit in the previous comment) and TSA largely waved us through after simply asking the 5 year old to confirm my identity.

This was actually hilarious, because the 5 year old was grumpy as hell and answered "Who is this woman?" with "Why don't you figure it out?" but we did eventually get there.
conuly: (Default)

[personal profile] conuly 2022-09-26 10:11 pm (UTC)(link)
Yeah, I was standing there thinking "OH FOR FUCKS SAKE JUST TELL THEM I AM YOUR AUNT!" but of course I couldn't say that, could I?

This is exactly why, btw, I'd wanted my *mother* to be the one to bring the kids home. But no, Jenn had left a week earlier to get back to work, and *we* had to leave then because school was starting, and Mommy had extra vacation to spend with *her* mom.
lilysea: Serious (Default)

[personal profile] lilysea 2022-09-26 03:30 pm (UTC)(link)
I strongly feel that not vaccinating children [assuming no medical reason not to vaccinate] is child abuse. If it was up to me, vaccination (or a letter of medical exemption from a Dr) would be required to
a) enrol your kids in childcare, kindegarten, primary school, highschool
b) claim your kids as dependents on a tax return.

Having said that, I don't support LW stealth vaccinating, because if LW does stealth vaccinate and the child has a (quite rare, but nonzero) adverse reaction, the child may not get appropriate medical care in a timely manner if the parents don't know about the vaccination.
cimorene: cartoony drawing of a woman's head in profile giving dubious side-eye (Default)

[personal profile] cimorene 2022-09-26 04:28 pm (UTC)(link)
Same.
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[personal profile] neotoma 2022-09-26 05:45 pm (UTC)(link)
I'm glad the advice is "Holy fuck, no!" but more polite.

Because Holy fuck, no! You don't get to give non-emergency medical care to small children against their parents' wishes. The government can interfere if there is a reasonable suspicion of medical abuse, but not John Q Public, which the friend definitely is.

There is certainly a case to be made about mandating vaccines, but as it currently stands, this would be illegal, possibly immoral, and certainly ill-advised.
Edited 2022-09-26 17:50 (UTC)
minoanmiss: Theran girl gathering saffron (Saffron-Gatherer)

[personal profile] minoanmiss 2022-09-26 05:53 pm (UTC)(link)
So basically deciding whether or not to supercede the parents' wishes is not a job for a layperson but only for someone sutiably trained, such as perhaps a social worker or other governmental agent? That makes sense as an ethical line to draw. (I've been thinking about this question today. It's more interesting than tracking.)
finch: (Default)

[personal profile] finch 2022-09-26 06:48 pm (UTC)(link)
So basically deciding whether or not to supercede the parents' wishes is not a job for a layperson but only for someone sutiably trained, such as perhaps a social worker or other governmental agent?

Isn't that how most laws and regulations about kids' safety work? That's basically what CPS does already.
minoanmiss: A detail of the Ladies in Blue fresco (Default)

[personal profile] minoanmiss 2022-09-26 06:55 pm (UTC)(link)

When they approach a certain level, anyway. There are reasons that calling CPS is considered a Godzilla threshhold.

I was uncomfortable with just telling LW "no", because that seemed kind of dismissive of the baby's welfare, but I think it makes sense to tell LW "The appropriate people to decide this are CPS, not you. If you think this is that negligent, call them. Otherwise keep babysitting and be a good influence."

lilysea: Serious (Default)

[personal profile] lilysea 2022-09-27 05:02 am (UTC)(link)
Altho if LW was saying "this 13, 14, 15, 16, 17 year old who I know desperately wants an abortion but their parents will never allow it"

I would argue that it was ethical for LW to aid the teenager in circumventing their parents and accessing the abortion that they needed.

Ditto the morning-after pill/plan B.
Edited 2022-09-27 05:03 (UTC)
minoanmiss: Detail of a Minoan statuette of a worshipping youth (Statuette Youth)

[personal profile] minoanmiss 2022-09-27 05:18 am (UTC)(link)
Of course. In that case the teenager has said what they need and I think it's ethical to help them get it. Part of the question about the vaccinations is that we can't ask the baby.