republished below in full unedited for informational, educational, and research purposes:

Although specific child welfare
guidelines vary from state to state, medical neglect of a child is
generally accepted as legitimate grounds for family intervention by
government officials working for Child Protective Services (CPS) and may
lead to parents losing custody of their minor child and/or losing the legal right to make health care decisions on behalf of their child.

Broadly defined as failure “to
exercise a minimum degree of care in supplying the child with adequate
health care,” medical neglect may also be expanded to include “parental
acts of omission in the care of their child” deemed to either actually
or potentially compromise the child’s health.1

A  new vaccine policy analysis, which was written by two obstetricians and a pediatrician and published in the American Journal of Public Health, examined past U.S. legal
decisions that considered whether vaccine refusal does, or should, fall
under the jurisdiction of medical neglect and, therefore, serve to
establish grounds for intervention by government officials in child
welfare agencies.1
The analysis, “Professional Responsibility and Early Childhood
Vaccination,” was authored by Frank A. Chervenak, MD, Laurence
McCullough, PhD, and Robert Brent, MD.2

Taking Threats to a New Level

Noting that in the current atmosphere
of increased vaccine hesitancy, pediatricians are struggling to find
ways to manage the resistance to vaccination in
their practice, the authors of this study suggest that vaccine refusal
may be accepted as medical neglect given that  “a child is exposed to
some potential risk of harm by a parental act of omission.”2 The
physician authors allege that many states do not go far enough to allow
CPS to intervene when vaccine refusal is the sole or primary reason for
the intervention.

Many parents consider this a radical
public health policy that constitutes a frightening assault on parental
rights, but some doctors, attorneys and mandatory vaccination proponents
maintain it is appropriate to force use of vaccines when parents
decline to adhere to the physician recommended childhood vaccine
schedule.3

Dr. Chervenak and his co-authors agree and take the position that
if informed parents continue to refuse vaccinations for their children,
it should be considered child neglect and those parents should be
reported to local child health protection agencies:

If parents remain
unpersuaded, their informed refusal becomes child neglect, because they
are refusing to authorize evidence-based, effective, and safe preventive
care required by the best interests of the child standard as a norm.
There is a strict legal obligation to report child neglect to the local
child health protective services agency.2

They further
argue that reporting vaccine refusers to government child welfare
officials could be viewed as an effective way to open up opportunities
for further education of such misguided parents, but they admit that
such reporting might cause the parents to lose trust in the doctor, who
would then lose any further educational opportunities.

They conclude that it may be better to use threats and coercion to dismiss children from a medical practice if their parents refuse vaccinations, as that could help sway the parents’ opinion.

We have seen numerous
steadfast refusers of vaccines come around to acceptance when faced with
a physician who feels so strongly about the benefits of vaccination
that he/she is willing to go to the extreme length of discharging a
family who refuses vaccination.2

State Versus Parental Rights

The idea of using physician coercion and government sponsored punishment of people who refuse vaccination is nothing new. More than a century ago in Jacobson v. Massachusetts, the 1905 U.S. Supreme Court majority affirmed the constitutional authority of state legislatures to mandate smallpox vaccination. The Court ruled that citizens do not have the right under the U.S. Constitution to be free at all times because there are “manifold restraints to which every person is necessarily subjected for the common good.” The judges said, “We do not perceive that this legislation has invaded any right secured by the Federal Constitution.”4

Although mandatory vaccination proponents like attorney Lawrence Gostin have cited the Jacobson v. Massachusetts ruling as “the most important judicial decision in public health,”5
human rights advocates like NVIC co-founder and president, Barbara Loe
Fisher, have called it a “morally flawed” legal precedent “that allows
government to commit human rights abuses.”6

In recognition of the scope of the 1905 ruling, the authors of
the vaccine policy analysis used that year as the beginning of their
survey period, following court cases up through 2016 to weigh legal
opinions on vaccine refusal as a definitive factor to determine child
neglect. They reported very few
cases, though they claim that most of those on the books did consider
vaccine refusal to constitute child neglect. They admitted that
differences in state vaccine laws make it difficult to compare the cases
or to know how they would have been handled today (only one of the
cases studied had been heard in the past 20 years).

The authors also expressed surprise
at the rarity of documented cases in the current atmosphere of
increasing vaccine hesitancy and proposed that, “Additional studies on
the practices and rationales of pediatric providers, other mandatory
reporters, and CPS caseworkers regarding this issue would be
elucidatory.”7

Dissenting Opinions Should Not Be Cause for Fear

Individuals declining to follow
one-size-fits-all vaccine policies and laws are not the first minority
in society to face prejudice and discrimination in the name of ‘the greater good.’ From compulsory sterilization of individuals deemed “unworthy of reproducing”8
to differences in attitude and availability of health care for
individuals depending on medical history, weight, age, race, gender,
social class, or sexual preference, those in the minorities continually
have to fight for equality and protection from medical policies and public health laws that raise their risk for being harmed.

Parents welcome open and mutually
respectful discussion with physicians about vaccination, and they should
not have to fear that they might lose children if they happen to
disagree with their doctor or public health officials about how to raise
them.

References:
1 Parasidis E, et al. Parental Refusal of Childhood Vaccines and Medical Neglect Laws. Amer J Publ Health 107(1):68-71. 2017.
2 Chervenak FA, et al. Professional responsibility and early childhood vaccination. J Pediatr 169: 305–309, 2016.
3 Fisher BL. The Vaccine Culture War in America: Are You Ready? NVIC Newsletter Mar. 8, 2015.
4 Gostin LO. Law, Ethics, and Public Health in the Vaccination Debates. Politics of the Measles Outbreak. JAMA 2015;313(11):1099-1100. doi:10.1001/jama.2015.1518.
5 Gostin LO. Jacobson v. Massachusetts at 100 Years: Police Power and Civil Liberties in Tension. Am J Public Health 2005; 95(4): 576-581.
6 Fisher BL. Forced Vaccination: The Tragic Legacy of Jacobson v. Massachusetts. NVIC Newsletter Nov. 2, 2016.
7 Parasidis E, et al. Parental Refusal of Childhood Vaccines and Medical Neglect Laws. Amer J Publ Health 107(1):68-71. 2017.
8 Cohen A. Buck v. Bell: Inside the SCOTUS Case That Led to Forced Sterilization of 70,000 & Inspired the Nazis. Independent Global News (transcript) Mar.  17, 2016.