Doctor urging other doctors to refuse to sign CO forms

[AM]

http://www.medicalobserver.com.au/news/its-time-we-objected-to-conscientious-objectors




HOW far are you prepared to go to engage with so-called “conscientious objectors” to childhood immunisation?

Provide written information? Gentle discussion? Robust debate? Ban the family from your practice?
Everyone has a line they will not cross. The line for informed consent gets very blurry when it comes to the proxy consent provided by parents on behalf of their children.
As GPs we are convinced of the merits of immunisation against the vaccine-preventable infectious diseases that were so feared by previous generations who did not have the benefit of effective treatments or prevention.
I hesitate to even mention groups such as the Australian (Anti-)Vaccination Network for fear of giving them more attention than they deserve, but given this is a filtered readership I feel I can mention the harm they are doing to public health with their misinformation campaign aimed at scaring parents away from immunisation.
The balanced carrot-and-stick approach has worked well in encouraging high rates of immunisation in Australia until now. We doctors have played our part with time-consuming record and reminder systems, and immunisation PIP incentives.
Parents have been encouraged through various government incentives to have their children fully immunised before starting school.
However, from 1 July the system changes. The PIP incentive for doctors has been scrapped and parents will need to document that they have fully vaccinated their child in order to receive the Family Tax Benefit Part A Supplement of $726.35 per child.
If parents want to claim the money, they have to demonstrate that their child is fully immunised, or have their doctor complete documentation that they are a conscientious objector.
Recently we saw the release of new guidelines on how not to get into a heated unproductive debate on vaccination with a “total refuser”.
This will prove to be a time-consuming and frustrating challenge if we are to truly judge whether someone is conscientious or simply misinformed.
GPs have been advised not to get into a game of “scientific ping pong” with parents who have strange and unfounded views on immunisation.
One of my colleagues told me last week that she intends to be a conscientious objector to conscientious objectors. I must say the idea appeals to me.
When parents request that she fills in the government form indicating the child is exempt on the basis of parents being conscientious objectors, she will politely indicate that is against her principles and advice, and will refuse to provide the documentation.
Of course this means that patients will go to another clinic or miss out on the financial incentive.
We are asked to provide documentation for all sorts of benefits to patients, from Centrelink disability forms to fitness-to-drive certificates, WorkCover assessments to disability insurance reports and Medical certificates for time off work.
On each specific occasion we have to assess the case on its merit and decide if we are ethically comfortable with providing that documentation.
I take my colleague’s point. Clinical contraindications are perfectly valid. But just because a patient decides they will refuse immunisation against the overwhelming weight of evidence for its benefits, doesn’t mean we have to get caught up in facilitating their financial incentive.
So the experts say don’t argue with parents who refuse vaccination. Right then. As long as they don’t argue with us about refusing to provide a Conscientious Objection Form.
Conscientious Objectors to Conscientious Objectors, unite!

[AM]

Please register, (it's very quick) and comment! They have to know that this approach will not be tolerated.

[headoverfeet]

Thanks AM will definitely do it!

[Smartiecat]

Let me preface this comment by saying you have a right to not vacc children this is your choice and should be protected.

However I do see where the author is coming from ... It is important to remember docs are independent medical professionals and not government paper pushers. They will have their own ethical medical opinions and shouldn't be necessarily be asked to compromise these just like you should not be forced to vacc your children.

(please remember I say this with much respect)

[biscotti]

Can I just add a quick, friendly and very general reminder - this is the pro non-vaxxing section and this is not a thread to debate vaxxing vs non-vaxxing.
Cheers,
Biscotti :)

[headoverfeet]

...

[AM]

Let me preface this comment by saying you have a right to not vacc children this is your choice and should be protected.

However I do see where the author is coming from ... It is important to remember docs are independent medical professionals and not government paper pushers. They will have their own ethical medical opinions and shouldn't be necessarily be asked to compromise these just like you should not be forced to vacc your children.

(please remember I say this with much respect)

In this case, the CO form that the GP's sign states that they have informed the patient of the pros and cons of vaxxing/non vaxxxing, then they sign.

That is as far as their involvement goes, that is their medical duty, NOT ramming their opinions down parents throats.

[Elijahs Mum]

Can you imagine if they then started refusing other basic choices based on their views- say the pill to unmarried women as it " was against their principals and advice" where does it end?

[SeymourTheBear]

GPs are independent, and have a right to not fill out any paperwork they disagree with i.e medical certificate, DSP claim forms as well as this.

[headoverfeet]

Can you imagine if they then started refusing other basic choices based on their views- say the pill to unmarried women as it " was against their principals and advice" where does it end?

Thanks I wrote a really long post about this but it got too emotional.

While doctors are able under the AMA code of ethics decline to treat someone they have to ensure there is another doctor available to do so. If someone declined to 'treat' me I wouldn't pay the bill as its against my ethics to pay someone for non-service.

[Nowhere]

So you dont get the money from centre link if your childs not vaxxed if they Medics dont sign the forms, If you made your decision not to vax your child due to it being what you think is best for them then the money is not important.

My child is vaxed yes but NOT according to the schedule as it didnt fit in with her due to illness and surgeries and what not, So we didnt get the money. Do i think we did the best thing for our child absolutely, Did we get the money No we didnt, Could I have used it, Sure. But was it a big factor in vaxxing or not heck no, so i dont care that I didnt get it

[Elijahs Mum]

We don't qualify for anything so I'm assuming I would not get the tax benefit thing anyway, money , or bribes of any kind would not get me to do something I did not think was right for my child , the only reason I got it signed was to stop Medicare sending me letters every month saying they need to update his immunisation status !

[Ffrenchknickers]

So you dont get the money from centre link if your childs not vaxxed if they Medics dont sign the forms, If you made your decision not to vax your child due to it being what you think is best for them then the money is not important.

My child is vaxed yes but NOT according to the schedule as it didnt fit in with her due to illness and surgeries and what not, So we didnt get the money. Do i think we did the best thing for our child absolutely, Did we get the money No we didnt, Could I have used it, Sure. But was it a big factor in vaxxing or not heck no, so i dont care that I didnt get it

We didn't get the MIA either. It actualy no lnger exists anyway. The problem is that they will withhold the ftb supplements from next financial year if you haven't got your form in. That is alot more money than the MIA. PP's are right, a doctor's duty is to explain the risks of not vaccinating (why it isn't their duty to explain the risks OF vaccinating I will never understand) NOT to refuse to sign a form. I sure as heck wouldn't be paying for an appointment with a GP only for them to refuse to sign the forms.

[VicPark]

If parents without medical training can refuse to do something medical because they don't believe it... Then surely doctors with medical training can refuse to do something medical related because they don't believe in it?

Or are parents the only one allowed to make a stand?

[Ffrenchknickers]

So then if you can't get a GP to sign a form ,the family should miss out on possibly much needed money?

Definitely the parents should be the only ones allowed to make a stand for their own children! The medical industry is not God.

[kimbo]

I had a GP refuse to sign my CO form for DS2. I didn't want him to have his 18mnth chicken pox vacc at the time. She said I can ask if another GP in the practice will sign it but she wouldn't.

[Luna Lovegood]

If parents without medical training can refuse to do something medical because they don't believe it... Then surely doctors with medical training can refuse to do something medical related because they don't believe in it?

Or are parents the only one allowed to make a stand?

...this is an information thread for people who are against vaxxing (hence the section it is in). If you would like to discuss this, then maybe start a thread else where?

[Hootenanny]

A conscientious objectors form is not to say that the Dr agrees with them, it is to say the parent is aware of the risks and objects to vaxxing, it's not rocket science!!!!!!!!!!
I expected better of Keryn Phelps, how about all those drs that think same sex relationships goes against their principles :rolleyes: since when do drs get to be the free thinking police

[delirium]

I'm a vaxxer... and I find this all so patronising. I remember a thread yonks ago about a chemist that refused to stock the MAP bc of his beliefs and I said that was ridiculous and wasn't his place to be making that decision for women. I was told it was his choice and women could go elsewhere.

I hold the same stance here. If they have given the parent vaxxing info, and the parent has made a concerted decision, IMO they have no right to withhold the CO form.

Vaccinations are not mandatory in this country and until they are drs should give info, but if the CO form is still requested I believe they should sign it.

[VicPark]

...this is an information thread for people who are against vaxxing (hence the section it is in). If you would like to discuss this, then maybe start a thread else where?

Sorry didn't see the section on my I phone.

[BornToBe]

Please read a CO form before you comment: http://www.medicareaustralia.gov.au/public/files/ma_conscientious_objection_form.pdf


I declare that I have explained the benefits and risks associated with immunisation to the parent or guardian of the child named, and have informed him/her of the potential dangers if a child is not immunised.

That is all the GP signs off on. It is not a parent asking for permission or seeking approval from the GP, it is a government form stating that the matter was discussed with a health care professional. That is all. Personal opinions have no weight.

I'm more interested in the "PIP incentive" mentioned: was that the payment given to docs for vaccinating kids? Interesting if that has been scrapped.

[delirium]

Yeah I was aware it's only about explaining info and noting they understand as opposed to giving permission, thus why I believe they shouldn't be allowed to withhold their signature.

[BornToBe]

I was popping the link up there for people who haven't read it. :)

[BornToBe]

If parents without medical training can refuse to do something medical because they don't believe it... Then surely doctors with medical training can refuse to do something medical related because they don't believe in it?

Or are parents the only one allowed to make a stand?

See this post doesn't make sense... unless doctors "don't believe in" discussing the benefits and risks of vaccinations with parents, and signing a form to prove they did so.

[Elijahs Mum]

Please read a CO form before you comment: http://www.medicareaustralia.gov.au/public/files/ma_conscientious_objection_form.pdf


I'm more interested in the "PIP incentive" mentioned: was that the payment given to docs for vaccinating kids? Interesting if that has been scrapped.

It was scrapped this year as the new changes to the family tax benefit payments is now the "incentive" for parents to get the vaccinations , apparently the Drs are not happy!

http://www.australiandoctor.com.au/news/latest-news/half-of-gps-predict-fall-in-vax-rates

[BornToBe]

Bum, I can only read half the article. Interesting though. Why would doctors not being paid extra to vaccinate, affect the rates of parents *choosing* to vaccinate? Most parents I've spoken to weren't even aware of the PIP. Will docs not try as hard to vax kids if they aren't making cash out of it? Surely that's not likely. Suuuurely....
Anyway I should start a new thread and stop hijacking AM's.

[Kimberleygal1]

If parents without medical training can refuse to do something medical because they don't believe it... Then surely doctors with medical training can refuse to do something medical related because they don't believe in it?

Or are parents the only one allowed to make a stand?

:highfive: Agreed

[Kimberleygal1]

GPs are independent, and have a right to not fill out any paperwork they disagree with i.e medical certificate, DSP claim forms as well as this.

Yes this exactly

[delirium]

The form isn't asking permission or for a value judgment from the dr though, it asking that the parent is aware of any risks... I liken it to asking to a JP to sight a signature then giving the JP the right to deny a person the right to marry etc. The JP doesn't have that right.

In this case the GP is just a second party verifiying the parent knows the info and risks nothing more.

[Ffrenchknickers]

Should you have to pay for the appointment if the doctor refuses to sign?

[AM]

Should you have to pay for the appointment if the doctor refuses to sign?

Absolutely not, and I'd refuse to pay point blank, and I'd report the doctor in question.

[Ffrenchknickers]

Yeah same. When I got ours done, I didn't even take my kids with me. The doctor had never seen the form before, said 'ok then' and signed all 5 of them;)

[lineyb73]

got my forms signed yesterday by a gp who said had I not brought the forms she would not even know where to start to look for them. Signed them with no fuss and did not even ask me why I have chosen not to vaccinate