Categories
General Lecture

Hazardous Attitudes

A few months ago I attended a medical conference organised by The Medical Student Journal Club in Slovenia. The conference consisted of debates between medical students, which is a great concept that I thought worked very well. Two medical students, usually from different countries, take on the same topic, one presenting the Pro side and the other the Contra side. They have a short Powerpoint presentation, after which the audience is invited to comment and ask questions. This was the third Pro et Contra congress I attended, having been an active participant each year since it was first organized. It was an easy decision to come back each year because it’s different than the medical conferences I’m used to. It takes place during the weekend, and it’s a perfect blend of learning about medicine in a more interactive way, sharing opinions with my peers and senior doctors, meeting medical students from different countries and having a nice time exploring Slovenia. Not to mention the organization is absolutely amazing, with every moment of our stay taken care of.

I realize most of the readers of this Blog are from the USA, and the likelihood of one of you visiting this medical congress in Slovenia is very low. I’d be happy if I got more people to attend the Pro et Contra congress; however that’s not what this post is about. Even though the debates at the last Pro et Contra congress were amazing, the opening ceremony involved a group of doctors performing a few popular song parodies on different medical hot topics, the audience participated in discussions more than ever before, and I went home with a prize for the best foreign speaker (a generous gift of Harrison’s manual of medicine), what made the biggest impact on me was the guest lecture given by a pilot, captain Tomaž Prezelj. Yes, a pilot gave a lecture at a medical conference, and it was simply superb. It is almost two hours long, but I advise you to take time out of your busy schedule to watch it. Captain Prezelj compares five different attitudes of pilots and the ways they can affect flight safety. The great responsibility, human nature, and high risk environment pilots work in easily translate to the experience of doctors and medicine. It’s all about human error. So, without further ado –

Categories
General Reflection

Can Empathy Be Taught?

As medical students, we are taught to examine patients, recognize symptoms, and treat diagnoses. We get lost in the sea of differential diagnoses and worries of exams. I always worried that I’ll never remember all the important facts, that I’ll miss an important sign or symptom or forget an essential part of treatment in an emergency situation. When I faced my real-life patients, I realized that I was indeed not ready. Surprisingly though, it wasn’t the lack of theoretical or practical knowledge that worried me anymore, but the fact that each patient required a different approach. Some patients are serious and to the point, others are full of witty remarks about not only their condition, but all sorts of topics. Some don’t want to know much about what’s happening to them, while others have countless questions. Their behavior might be a part of their usual personality, or it could be changed because they have found themselves in a new, often scary situation. I wanted to, had to, understand why each of my patients acted and thought the way they did, so that I could adapt my manner, make them more comfortable, find out more information, and finally, earn their trust.

In observing my seniors, doctors with years or decades of experience, I have noticed their style of communication with patients comes from every part of the spectrum. Some are empathetic and communicative, dedicating a large portion of their time to their patients; others are introverted, avoid communication with patients at all costs, or can even be patronizing and show little understanding.

In the past, medical education focused primarily on academic knowledge and practical skills. Today, however, the importance of doctors’ communication skills has obviously been recognized and integrated in our education. But can empathy be taught?

We can learn to shake a patient’s hand, to ask for permission before examining them, to perform other small actions that take little effort but make our patients much more comfortable. In order to better understand our patients, to get them to open up more easily and reveal parts of their medical history they would otherwise conceal, to treat them in the most individual manner possible, we need to empathize with them. I’ve seen my colleagues to whom this comes naturally, but I’ve also seen others whose attempts at empathy take a lot of effort and energy.

Because I am at the very beginning of my medical career, I realize my point of view might be naive. Still, at this point I believe I should focus on each patient. I should empathize and understand each individual fully before attempting to tend to his or her troubles, however much energy that takes. I am also worried about the possibility that this ability can be lost. I often wonder if the more reserved senior doctors have always been that way, or if their energy and will to empathize have been lost after seeing innumerable patients.

I don’t know if empathy can be taught in classes, but I do believe everyone can develop it. Unfortunately, I think the ability to empathize can also be lost. Ultimately, this social dimension of medicine remains different for each health professional, and their ability or will to empathize remains their choice, depending on how they choose to integrate their theoretical knowledge and experience with their personality.

Featured image:
empathy by Sean MacEntee

Categories
Lifestyle Public Health Reflection

Giving Blood

When my cousin mentioned that she wanted to give blood, I was happy because she voiced a wish of my own. I had wanted to donate blood for years, but I never met the eligibility criteria: either I didn’t weigh enough or I was anaemic. I had been fully eligible for over a year, but I kept postponing my donation for no reason other than the fear of facing the unknown alone. Having found another person to share the experience with, I was finally brave enough to follow through and donate.

I am a medical student, an aspiring Emergency Medicine specialist, an advocate of blood and organ donation, and I am fully eligible to give blood. Who better to donate than me? How can I expect other people, who are less aware of the need for blood products or the process of blood giving, to volunteer for this seemingly unpleasant act, without serving as an example?

Let me tell you, it was not a big deal. The whole experience was actually quite different from what I expected. I expected to be in pain, to feel dizzy and to have to spend a whole day preparing and recovering from giving blood. Here is what actually happened:

After a usual day of classes and a light lunch, we walked to the Croatian Institute for Transfusion Medicine, nervous but excited. We were met by very friendly staff, who responded to my nervous humour with witty jokes. I have to give them credit, because they made a big difference in my first experience. While they joked and kept the mood light, they were professional and reassuring.

The nurse who welcomed me didn’t believe I weighed enough, but a quick consult with the scale proved him wrong. After a quick check of my haemoglobin level and a small routine examination, I was given a questionnaire to fill out about my medical history, medication use, lifestyle and traveling.

It was encouraging to see that quite a few donation beds were taken. A few people seemed to be regular donators, as they chatted between themselves and with the staff, looking completely at ease. While waiting for a donation bed to clear, the staff chatted with me about medical university workload and our health system. After a very short wait, I was shown to a donation bed and got comfortable in a head-and-feet-up position. My cousin couldn’t give blood herself as she was anaemic, so she kept me company. I have to admit my eyes did widen at the sight of the 16 gauge needle, but a nurse inserted it in my cubital vein quickly, and I can’t say that it hurt.

I squeezed my stress ball to keep the blood flowing, had sips of water, and chatted with my cousin and the staff. As I watched the red fluid flowing from my vein to the bag, I didn’t feel faint, as I expected. I did have a weird sensation I can’t describe, which was probably psychological, but there wasn’t pain, sweating, dizziness or any other symptom I expected I would have due to my low blood pressure. It didn’t last more than five minutes, which is a lot quicker than I thought it would be. Even though I felt completely fine, I was advised to stay on the bed for a few more minutes just to rest.

After a friendly goodbye from the staff, and a present of a pen that looks like a syringe, I was shown to the cafeteria where I got a drink, a warm meal and a doughnut. I left the site feeling happy knowing my blood will help someone else, and elated with the enjoyableness of the experience.

For the rest of the day, I made sure to keep hydrated and have healthy meals, but otherwise I went about my usual business: I walked my dog, studied and went to the gym (exercise isn’t recommended straight after giving blood, but I was careful not to strain myself).

I realise that giving blood isn’t the first thing to pop into your mind when you imagine a perfect day, but it’s a quick and easy thing to do. It doesn’t take a lot of time and effort on your part, but it can make a big difference in someone’s life.
Find out more about donating blood, eligibility criteria, and how to get ready for a donation, with special notes for first time donors.

A few facts from the American Red Cross:

  • Every two seconds someone in the U.S. needs blood.
  • More than 41,000 blood donations are needed every day.
  • Although an estimated 38% of the U.S. population is eligible to donate, less than 10% actually do each year.

Give blood, save lives.

Featured Image:
Blood Donation Appointment in Calendar/Journal by Oliver Symens

Categories
General Lifestyle Opinion

Staying Alive

https://www.youtube.com/watch?v=n5hP4DIBCEE

https://www.youtube.com/watch?v=ILxjxfB4zNk

Have you seen these videos that promote hands-only cardiopulmonary resuscitation (CPR)? Unfortunately, they don’t appear to be as popular and catchy as the song they feature.

CPR is a basic life supporting activity that literally saves lives. Even though the majority of the public is familiar with the concept or CPR, most don’t feel confident in executing it when the need arises. This could be because there are not enough first aid courses. However, I think there is another important factor for consideration.

Media and the entertainment industry, especially films and TV shows, portray physicians performing CPR as a miracle. The setting usually includes a gasping patient whose ECG suddenly flat-lines; then the doctors run in, yelling ‘blue code’, and immediately applies defibrillator pads on the patient’s chest. There may be sparks, and the patient is usually shown to give a jolt, often waking up and becoming completely alert and fully recovered.

Following this highly romanticized portrayal of CPR, it’s not a surprise if non-health professionals decide to merely wait for heroic EMTs, paramedics or physicians. In fact, some may view CPR as a seemingly complicated procedure that requires special equipment with the ability to bring a dead person back to life.

I don’t expect medical TV shows to be completely accurate or to portray entirely realistic situations; nevertheless, the repetitiveness of this false portrayal of resuscitation sticks in the minds of viewers. The entertainment industry is not responsible for educating the general public, but even if they don’t portray CPR entirely accurately, they shouldn’t lead their viewers astray. Repetitively being exposed to on-screen resuscitation, people can come to believe that defibrillators are an essential piece of equipment, without which resuscitation isn’t possible and the best approach is to leave it up to health professionals. Furthermore, showing conversion of flat-line ECG into sinus rhythm implies that electricity can restart a human heart. With the amazing automated external defibrillators becoming more widely used, a non-health professional can use them without knowing which rhythms are convertible, but I still believe they need to be aware that flat-line ECG means there is no electric activity in the heart, and that electricity cannot reinstate it; all a defibrillator can do is give a jolt to an irregularly paced heart which will hopefully terminate the irregular rhythm, allowing the natural pacemaker to take over and reinstate sinus rhythm.

The media has a strong influence on all of us. While attempting to amuse the audience and gain financial reward, the media should still impart important and accurate life lessons.  Thanks to TV series and films, I don’t expect anyone would struggle to remember the emergency telephone number. Yet, because of the same media influences, many people would wait for an ambulance and their magical defibrillator instead of starting CPR themselves. Instead of giving false impressions about resuscitation, the media could play a large role in popularizing CPR as a simple, but vital action that can be performed by anyone, anywhere. Even though it is not the point nor purpose of the entertainment industry, this is an important message that can be relayed without requiring producers and actors going out of their way.

Featured image:
cpr mother & child by zen Sutherland

Categories
General Lifestyle Opinion

I Will Not Try To Fix You

Disability—The Oxford dictionary defines disability as “a physical or mental condition that limits a person’s movements, senses, or activities.”

Although some disabled people have medical ailments, the two conditions are not synonymous. While a disabled person might require medical attention, disability is defined by social barriers, not pathophysiology.

It is an umbrella term and includes impairments and activity limitations. Impairment is a problem in the body’s structure or function; activity limitation is a difficulty encountered by an individual in executing a task or action.

Disability is a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives. Overcoming the difficulties faced by people with disabilities requires interventions to remove environmental and social barriers.

Those with disabilities have capacities for motor, sensory, and cognitive tasks that differ from the “norm.” Each individual has different qualities and capabilities, but defining this “norm” is practically impossible. Society can create barriers that do not allow an individual to develop to his or her full potential. Likewise, society can remove disabling barriers. A wheelchair user cannot get into a building with steps at the entrance, but a ramp or a lift completely removes that particular barrier. Seated before a ramp, is an individual in a wheelchair disabled?

An individual with Down Syndrome can hold meaningful employment if provided with appropriate support. Down Syndrome itself is not a disability; it is a medical condition. An individual will experience specific barriers that emerge because of the relationship between impairments and societal barriers. The presence or absence of medical conditions can cause one individual to vary from another in terms of motor, sensory, and cognitive function, but an individual is only disabled when appropriate accommodations are not made.

As a societal construct, disability fluctuates in different settings. In a completely adapted home, or with adequate assistance, an individual might have no disability at all; while, in an environment without assistance, this person might become disabled.

Physicians treat medical conditions and, as such, they tend to focus on the “limitations” and “abnormalities” associated with disabled people’s conditions; heart disease, for example, in those with Down syndrome. Disabilities, however, are not medical conditions in and of themselves. The role of a physician is to assess the health of a disabled person, provide treatment for associated symptoms, and anticipate as well as prevent future complications. This can greatly improve a disabled person’s quality of life, and, in some cases, even prolong life. Fixing the disability is not in the doctor’s job description.

How do you, as a medical student, perceive disabled people? Do you feel as if medicine failed them by not being able to “cure” them?

Disability is not tragic; it is tragic that society doesn’t appreciate the abilities of disabled individuals.

Disabled people often report being patronized by medical staff, being described as having “a fate worse than death”, or carrying an “unhealthy gene”, as well as “suffering” from a condition. Consider the power of language. Great advances have been made in both medicine and technology, and even more in the public’s perception and understanding of disability.

Disabled people have more freedom, independence, and equality than they did previously, but there is further work to be done. Rather than making a distinction between disabled or not, physicians should be leaders in embracing diversity and independent living for all of their patients, including disabled people.

Dr. Chris Smith – a disabled associate professor of communication arts and sciences at Calvin College, USA – recently spoke about perceptions towards disabled people, stating that “the ultimate test of living in community is found in our willingness to change our minds about one another.”

People with disabilities have the same health needs as non-disabled people – for immunizations, cancer screening etc. They may experience a narrower margin of health, due to both poverty and social exclusion, and also because they may be vulnerable to secondary conditions. Evidence suggests that disabled people face barriers in accessing the health and rehabilitation services they need in many settings.

As future physicians, it is important to view disabled patients equally to all others, whilst acknowledging the barriers they face. When approaching your disabled patients, do not define them by their impairment, do not pity them, do not try to “fix” them; rather, appreciate their abilities, recognize them for their values and behaviors, support them to achieve their aspirations, and, most importantly, listen to them.

Featured image:
disability by Abhijit Bhaduri

Categories
General Opinion

Doctor Google

“I’ve got a headache.”
“Google it.”
“OMG, it might be a brain tumor!”

Have you overheard or participated in a similar conversation?

Doctors cannot avoid Doctor Google: it makes patients happy to have a virtually unlimited amount of information just one click away, easier and faster to access than ever before.  In turn, self-diagnosis annoys medical professionals.

As a medical student, I can see both points of view. Patients are often left hungry for a few more words, as the information they receive from doctors can be minimal at times. Where else should they turn for answers to their questions?  Patients enjoy reading about a new diagnosis, a diagnostic test they are about to go through, or exchanging experiences with other patients online.

The information that patients access, however, often raises more questions than it answers. It takes a certain amount of background knowledge to be able to sift through all the facts and tell what is true and relevant and what is not.

Doctors do not have all the answers, but they do know how to ask the right questions. Non-medical professionals have difficulty determining what is and is not important. This makes doctor Google dangerous: lay people are lost in a sea of misinformation and frequently prioritize facts inappropriately, leading to an incorrect diagnosis. When people fancy themselves doctors, most medical professionals lose patience. Yes, Google always has answers; however, the answers are always multiple, and most patients cannot critically evaluate the information they find. This is why patients need doctors.

Does this mean that the internet is bad? Doctors and medical students use the Internet. Resisting the shift towards electronic data would be antiquated as well as pointless. Electronic resources help physicians in numerous ways. They are used, for example, to check for drug interactions, find new treatment protocols, and read about cutting-edge research.

Still, some doctors seem to fear knowledgeable patients.  It is entirely possible that a patient will know more about his or her condition than a doctor. This is particularly common for patients diagnosed with rare conditions. This embarrasses some doctors. But why should it? In training, students and residents are taught that it is acceptable to tell a patient that you need to review the literature before making a treatment decision. Again, it is the ability to ask the correct questions and then find the answers that separates physicians from non-physicians.

While we should strive to provide our patients with as much information as we can, we shouldn’t limit their curiosity. In fact, directing patients to reputable web sites might be an appropriate answer to this multi-faceted dilemma.

Featured image:
Snide Google by Lucas

Categories
Clinical Opinion

Physicians in Pre-Hospital Emergency Medical Systems

Franco-German and Anglo-American models of emergency medical care differ. The first brings the physician to the patient on scene, while the latter brings patients to physicians in hospital. In a recent German study, physicians remarked, “Do we really have to study whether a high density of less qualified EMS personnel leads to similar or even better outcome than a system in which highly qualified physicians, providing better transportation stability, take care of the critically ill patient?” Are physicians needed in pre-hospital emergency care settings? If so, in what medical setting is such a system tenable?

On-scene time
Time is of such importance in medical emergencies and trauma that the term, “golden hour” has been designated to the period during which treatment is most likely to have a positive effect on a patient’s outcome. The two EMS models make an effort to treat the patients as soon as possible using different approaches. The Anglo-American model revolves around the “scoop and run” idea, bringing the patient to the physician in a hospital as quickly as possible. The Franco-German utilizes the “stay and play” concept, reflected in longer on-scene time. This time is not wasted though, and may even be considered better utilized as the physician is brought to the patient and can begin advanced and/or aggressive treatment on scene, improving the outcome and chances of survival. In the Anglo-American model, time is lost on many minor cases, because paramedics and EMTs must transport most patients to hospitals in order to be cleared by physicians, whereas in the Franco-German model, physicians can treat patients at the scene and decide which patients do not require hospitalization. Another factor that may prolong on-scene time in a negative way in the Anglo-American model is the skill level of paramedics and EMT. Lastly, there are situations with unavoidably prolonged pre-hospital time, for example when ambulating the patient may be difficult and transport to hospital delayed. In this case, the presence of a physician significantly improves survival rates. A large group of studies has demonstrated that the benefit of helicopter emergency medical service (HEMS) is not to be attributed to faster transportation, but rather to the presence of a physician.

Expertise and skill
The length of EMT and paramedic training programs ranges from a few months to two years depending on the policy of the country and the specific degree. EMTs are required to follow standard operating procedures, whereas physicians may, in certain circumstances, act autonomously. There is an ongoing debate on skills which paramedics should or should not be allowed to utilize. It has been found that there is a relatively high rate of misplaced endotracheal tubes in patients intubated by paramedics. Even with adequate training, skills deteriorate over time, as is the case with paramedics who mostly attend minor cases and do not regularly utilize practical skills such as endotracheal intubation, and intravenous drug administration. Physicians usually practice these skills in their hospital settings as well as in pre-hospital environment, allowing them more of a chance to practice their skills. In addition, specialists are more qualified to perform such skills in non-standard conditions.

Photo courtesy of Dr Gregor Prosen
Photo courtesy of Dr Gregor Prosen

Quality of care
Skills and expertise of EMTs and physicians reflect in quality of care. A large number of studies show a significantly better first hour and first day survival rate, a better functional outcome, as well as less time spent in intensive care unit in trauma patients; as well as survival of patients with acute myocardial infarction and respiratory diseases when treated by physicians. These results may reflect the higher level of expertise and the more profound knowledge of the physicians, as well as their ability to make clinical decisions and use aggressive treatment on scene. Studies have, however, found a difference in survival even when standard procedures were followed by both physicians and EMTs, such as in cases of cardiac arrest. Physicians administer a higher number of drug dosages per minute, they have shorter hands-off intervals and pre-shock pauses, and intubate a greater proportion of patients.

Issues
One of the biggest problems of maintaining a physician-based EMS is the financial “loss”. Is it worth overcrowding the Accident and Emergency (A&E) waiting rooms with myriads of “minor” patients who EMTs have to bring in, rather than clearing the A&E departments and allowing the staff to treat the more serious cases requiring advanced hospital equipment? Looking at the larger picture, survival of patients after CPR may be less costly in the Franco-German model than in the Anglo-American model. A study showed the expense of 0.7 euro per patient after CPR in Birmingham, compared to 0.17 euro in Bonn. Another problem, arguably more evident in the Americas than in the Europe is the litigious concerns. Many physicians who volunteer or work in ambulance services in the USA have malpractice insurance, which only covers their practice at their respective facilities, not in the pre-hospital environment, making them vulnerable to malpractice law suits. Some hospitals have overcome this problem by rewriting their insurance policies to include pre-hospital coverage for physicians working in those capacities.

While I support the involvement of physicians in pre-hospital emergency care, there remains a question of which physicians should be sent on the scene. Not all countries have enough physicians or adequate finances to allow all ambulances to be manned by anesthesiology or emergency medicine specialists, and instead send out newly qualified doctors with little experience. The right answer may lie between the two extremes: the use of both physicians and EMTs. For example, in Portugal dispatchers communicate with patients and decide whether to dispatch an emergency vehicle, as well as whether to man the vehicle with a physician and a nurse, or two EMTs.

Sources:
1 Timmerman A, Russo SG, Hollmann MW. Paramedic versus emergency physician emergency medical service: role of the anaesthesiologist and the European versus the Anglo-American concept. Current Opinion in Anaesthesiology 2008; 21:222-227.
2 Fischer M, Krep H, Wierich D, et al. Comparison of the emergency medical services systems of Birmingham and Bonn: process efficacy and cost effectiveness. Anasthesiol Intensivmed Notfallmed Schmerzther. 2003 Oct;38(10):630-42.
3 Garner A, Crooks J, Lee A, et al. Efficacy of prehospital critical care teams for severe blunt head injury in the Australian setting. Injury 2001; 32(6):455-60.
4 Osterwalder, J. J. Can the “golden hour of shock” safely be extended in blunt polytrauma patients? Prehospital Disaster Medicine 2002; 17(2):75-80.
5 Apodaca A, Olson CM Jr, Bailey J, et al. Performance improvement evaluation of forward aeromedical evacuation platforms in Operation Enduring Freedom. J Trauma Acute Care Surg 2013; 75(2 Suppl 2):S157-63
6 Katz SH1, Falk JL. Misplaced endotracheal tubes by paramedics in an urban emergency medical services system. Ann Emerg Med 2001 Jan; 37(1):32-7.
7 Klemen P et al. Effect of pre hospital advanced life support with rapid sequence intubation on outcome of severe traumatic brain injury: a prospective multicentre study. J Trauma. 2006.
8 Botker MT, Bakke SA, Christensen EF. A systematic review of controlled studies: do physicians increase survival with prehospital treatment? Scandinavian journal of trauma, resuscitation and emergency medicine 2009; 17:12.
9 Dickinson ET. The impact of prehospital physicians on out-of-hospital nonasystolic cardiac arrest. Prehosp Emerg Care 1997; 1(2):132-135.
10 Olasveengen TM, Lund-Kordahl I, Steen PA, et al. Out-of hospital advanced life support with or without a physician: Effects on quality of CPR and outcome. Resuscitation 2009;80(11):1248-52.
11 Fischer M et al. Comparison of the emergency medical services systems of Birmingham and Bonn: process efficacy and cost effectiveness. Anasthesiol Intensivmed Notfallmed Schmerzther 2003 Oct; 38(10):630-42.
12 Skow G. Docs On Ambulances. EMS World, 1 October 2010. http://www.emsworld.com/article/10319194/docs-on-ambulances?page=2
13 Page C, et al. Analysis of Emergency Medical Systems Across the World. Worcester Polytechnic Institute. MIRAD Laboratory, April 25, 2013.

Featured images courtesy of Dr. Gregor Prosen

Categories
Clinical General Opinion Public Health

Parents fight Croatian law enforcing mandatory child vaccinations | We don’t need no vaccinations, we don’t need no thought control

The Croatian constitutional court has made the vaccination of children a legal obligation. Their reasoning behind this law is that “a child’s right to health is more important than a parent’s right to choose (wrongly)”. Their words, not mine, although I do agree.

Vaccination has been a part of paediatric care in Croatia for years, and children have regularly been vaccinated throughout their education, although it has never before been officially mandatory. Now, parents have the potential of being prosecuted if they do not to vaccinate their children. In Croatia, children are vaccinated against the following: tuberculosis, diphtheria, tetanus, pertussis (DTaP), polio, measles, mumps, rubella (MMR), and hepatitis B. It was always said that vaccination was mandatory, but whenever I asked what to do with unvaccinated children, I was given vague answers. Nevertheless, the law now states that a parent’s failure to ensure the vaccination of their child will result in a fine and a visit from social services. A large group of parents, accompanied with some medical professionals, disagree with this and have called for a public discussion.

Photo courtesy of https://www.flickr.com/photos/jaccodeboer/
Photo courtesy of https://www.flickr.com/photos/jaccodeboer/

“Nobody wants to take the responsibility.”

This is an argument many parents have repeated when asked why they don’t want their children vaccinated. The majority of “modern” parents are best pals with Doctor Google, who has told them stories about apparently unnerving side effects of certain vaccinations. Furthermore, media dramatization and sensationalism add another factor in the vaccine debate.  Although the Internet and media in general can provide strong patient education, it can also provide highly biased information thereby providing harmfully improper patient education. Even though they are dramatic and stand out, articles reporting on a child developing a long term and/or life changing disorder or condition are quite rare. Reading such an article invokes fear in readers. Statistics are what matter in possible negative outcomes. How many stories about serious problems arising from a vaccinations exist? And how many children are vaccinated every day? And what are measles, mumps, rubella, polio, pertussis, and the other diseases like when they take hold of a child’s body?

Understandably, parents want to protect their children and don’t want their little ones to suffer any life changing side effects, short or long term. Before allowing for any vaccination, they want doctors to tell them with absolute certainty that no harm will come to their children from a vaccine. Surely parents would also like completely safe transport, but they are willing to put their children in a car, train, or plane because of the benefits of fast travel outweigh the small chance of an accident happening. It is impossible to expect doctors to claim that anything is completely safe, and “take responsibility“ if anything at all goes wrong. This is why there are patient consent forms and small directions in all medication boxes explaining possible side effects. If a parent asked me whether I would take responsibility for any possible side effects of vaccination, I would reply with another question: Would you, as a parent, take the responsibility of your child getting an infectious disease that could leave them with life changing consequences, or even possibly be a cause of death?

Although I would try and talk to people who refuse vaccination, if they continued to refuse I would respect their decision. In the end, I appreciate it is your right to decide what you want to do with your body. A friend of mine has pointed out to me that this law might limit the right of choice; therefore not allowing parents to make a choice about their children. I can see his point, and as I said, everyone should have the right to decide what to do with their body. However, this is a choice parents aren’t making about themselves, but about their children, who are too young to make an informed choice. Are their parents making an informed choice though? Do they have enough information to go against medical advice? Many countries don’t have a law about mandatory vaccination, and maybe those fighting against this law will manage to win, but I hope this whole debate will at least raise awareness and make people think about the importance of vaccination.

Featured photo courtesy of zsoolt