Yes, I got too emotional, and typed in "top" when I should have typed in "bottom". My error.
Vaccine Awareness Week
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Yes, I got too emotional, and typed in "top" when I should have typed in "bottom". My error.
Why would the way the cancer is transmitted be relevant in a decision to vaccinate? While measles can be transmitted in a variety of ways, sexual contact would be among them. Is there a similar medical ethics challenge there?
Because it allows you to stratify risk based on exposure. If a 19 year old female isn't sexually active, and doesn't plan to be, I think it's important to inform her of what the vaccine is protecting against, rather than withholding that information in hopes of higher rate of administration. If you're withholding that information under the belief that you're invoking therapeutic privilege (a loophole to allowing patients their autonomy), then I find that problematic because treating people with Gardasil to prevent cancer is something that's happening more on the population level than on the individual level, and you can't really invoke therapeutic privilege when there's much less of a tangible benefit to an individual.
More to the question, how it's transmitted is (in my mind) an important part of informed consent.
19 year old not planning on being sexually active?
Whatever the 19 year old can plan what they want, their hormones have other plans.
And the 19 year old is a risk of a sexual assault that could result in HPV exposure and eventually cancer.
Whatever the 19 year old can plan what they want, their hormones have other plans.
And the 19 year old is a risk of a sexual assault that could result in HPV exposure and eventually cancer.
LogGrad98
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Freakin' snowflake
Sure, but my question is this: does that mean we withhold information about the vaccine? Should their autonomy be overridden, or subverted, because the information may change their decision?
Do you have evidence that information is being withheld? Obviously I don't want information withheld.
But you can get the vaccine at 12 years old and be covered for the rest of your life, right? Imminent plans for sexual activity isn't a rational reason to avoid getting the vaccine. Plans to be 100% monogamous with a partner who is 100% monogamous isn't a rational reason for not getting the vaccine. So I don't really get the passionate argument against the vaccine as though it's a vaccine for sluts.
Perhaps you need to go back and re-read what I've said, as I'm not sure where you've picked up those last couple sentences. We're conflating a number of issues here, and that's what I'm seeking to tease apart. We may have one view of a vaccine, and people may come to different conclusions, and my question is, is if it's appropriate to not actually provide true informed consent because we believe it may alter someone's decision. My example with the Gardasil is just that I have always seen it presented as decreasing risk for cancer, without stating that it is reducing risk for cancer secondary to sexually transmitted infections. Just my experience.
I've said I don't think information should be withheld.
On what do you base the argument that information is routinely being withheld in regard to that vaccine?
My experience. I've never seen it explained what type of cancer is being prevented (other than saying cervical cancer).
And you feel it is being done to intentionally mislead? Not saying that's necessary to object to the relevant info not being provided. Just want to know of you feel it is intentional because providing the info would result in fewer vaccinations?
I personally can't imagine it would change the total number of vaccinations by much at all.
I don't think it's some grand scheme, but I think saying something prevents cancer is an easy sell for people. I think saying something prevents cancer that only arises from sexually transmitted diseases would have people self-stratify, or at least be more hesitant to get it.
I mean, I could get Gardasil as a male, as it was recently approved in males and females up to age 45. Would I take it? No. Why not? Because everything is risk and benefit, even if the risk is small. I don't foresee any benefit, so it's pointless, even though one could pontificate all day on what they feel are the realistic scenarios in which I should get it.
My experience is the exact opposite. Everyone I know realizes that Gardasil prevents a type of sexually transmitted cancer, and there are many people in my area who have refused to let their children get the vaccine because they feel it gives their child "permission" to have premarital sex. My sister had her children get it, and she was criticized by friends and neighbors. This is why sex education in my state is inadequate. Many people here believe that information leads to negative action (i.e., sexual activity among teens). Statistics do not matter, apparently.
I personally do not understand why you would not want to help prevent your child (or yourself) from getting this type of cancer. Pretending you know what your child's sexual behavior will be within their lifetime, and the sexual behavior of those with whom they come in contact, is shortsighted.
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Perhaps I don't know enough about Gardisil, but my understanding was that the protection was life-long. I don't think a typical 19-year-old has sufficient knowledge of what her behavior will be at 29, much less the behavior of any future partners, to make that medically relevant.
Just because it's primarily sexually transmitted? Is the "sexually" the key part there?
Interesting that people are aware of what it prevents (or rather what it doesn’t), but the beliefs you mention would be one result of lower vaccination rates.
The answer to that question is only peripheral. The question I’m asking is if that’s justification to indirectly subvert autonomy via scarcity of information. But what exactly are you suggesting regarding her personal information informing her decisions not being medically relevant?
Only inasmuch as it relates to behavior and risk. This isn’t a moral argument (at least with regard to sexuality), if that’s what you’re alluding to. It’s like asking if you want to be vaccinated against rabies, not being told that it’s not something you need in America but if traveling somewhere like India or Africa. You could argue that people may never know when they could find themselves in Africa, but is it ethical to not paint that picture if doing so reduces vaccination rate?
There are two issues here. One is what’s best for public health. The other is the autonomy of the patient to make their decisions via informed consent. These two get conflated and the latter swallowed up by the former.
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