The ombudsman’s office explained that in accordance with Article 24, paragraph 1 of the UN Convention on the Rights of the Child, the state recognizes the right of every child to the highest available standard of health. The UN Committee on the Rights of the Child states in its comments to the Convention that children’s right to health includes not only timely and appropriate preventive and health-promoting measures, but also the right to grow and develop to reach their maximum potential and to live in conditions that ensure the highest standards of health.
In Latvia, issues affecting the treatment of people, including children, are regulated by the Law on Medicine and the Law on Patients’ Rights.
One of the basic principles of medical treatment that governs the relationship between the patient and the medical staff is informed consent. Informed consent to treatment means that the child or his parents (or other legal representatives) understand the health condition and the recommended treatment, the office explains. The patient has the legal right to receive all information regarding his health condition and treatment, because without this information it is impossible to make a fully informed choice and give informed consent to treatment.
The ombudsman has previously provided an explanation of the child’s right to receive information about health care in an understandable form.
According to Article 13 of the Law on Patients’ Rights, treatment of a child under the age of 14 is permissible if his parents (or other legal representatives) have been informed about it and have given their consent. The child has the right to be heard and, in accordance with his age and maturity, to participate in the decision-making process related to medical treatment. On the other hand, children from the age of 14 can independently give their informed consent to treatment. This arrangement has existed since 2010, when the Law on Patients’ Rights came into force.
The Office of the Ombudsman emphasizes that vaccination is considered medical treatment and is subject to the same conditions contained in Article 13 of the Law on Patients’ Rights – until the child is 14 years old, the parents (or other legal representatives of the child) make a decision on the child’s vaccination, while after 14 years age, this decision can be made by the child himself.
In Latvia, children must be vaccinated against 14 infectious diseases – against tuberculosis, diphtheria, tetanus, whooping cough, poliomyelitis, measles, rubella, epidemic parotitis, Haemophilus influenzae type b infection, hepatitis B, chicken pox, pneumococcal infection, rotavirus infection, human papilloma virus infection . It is determined by Section 3.1 of the Vaccination Regulations. subsection, specified in the office.
Although vaccination against certain diseases is mandatory for children, according to Clause 28 of the Vaccination Regulations, parents have the right to refuse their child’s vaccination. In that case, the medical practitioner is obliged to explain the importance of vaccination in the protection of individual and public health.
If the child’s parent does not change the decision to refuse vaccination, the medical practitioner must make the informed refusal from vaccination in writing, and the child’s parent must sign it.
If the laws and regulations allow the refusal of the child’s vaccination, the parent has acted within the framework of the legal framework in accordance with his conviction. Not vaccinating a child is not an illegal, culpable act (inaction) for which liability is provided by law – you cannot be punished for exercising your rights. It is possible to ensure the mandatory vaccination in another way – by receiving permission from the Orphan’s Court to vaccinate the child instead of parental consent.
In the meantime, it is the responsibility of the medical practitioner to inform the patients under care about the need for vaccination in a timely manner. The medical practitioner is responsible for performing all the necessary and possible vaccinations according to the patient’s state of health during the visit, according to the vaccination calendar.
The patient is not vaccinated if an absolute contraindication to vaccination (anaphylaxis) has been established after the use of the relevant vaccine or to one of the components of the vaccine. Vaccination of the patient may be delayed due to the patient’s health condition.
The Office of the Ombudsman states that vaccination, according to the definition of the term defined in the Law on Epidemiological Safety, is “a specific preventive measure to initiate or maintain the body’s immunity to an infectious disease by administering a vaccine.” Preventive measures fall within the scope of treatment. Treatment according to the definition of the term defined in the Law on Treatment is “professional and individual disease prevention, diagnosis and treatment, medical rehabilitation and patient care”. So vaccination is also a treatment, experts conclude.
The office explains that the first part of Article 13 of the Patient Rights Law stipulates that treatment of a minor patient up to the age of 14 is permissible if it is in his best interests and his legal representative has been informed about it and has given his consent. Both conditions must occur at the same time – vaccination is in the child’s interest and the parent has given consent. The first part of Article 14 of the same law regulates situations when the child’s parent refuses to give his consent to start treatment, but the doctor believes that the start of treatment is in the interests of this patient – permission for treatment based on a motivated application by the doctor, within three working days after the motivated application by this doctor can be granted by the orphan’s court. The jurisdiction to which the medical practitioner must apply in the orphan’s court is defined in the Law of Patients’ Rights.
So, in cases where the doctor believes that vaccination is in the child’s best interests, but the parents do not agree to the child’s vaccination, the doctor must apply with a motivated application to the orphan’s court, which can give consent instead of the parents. Using this option, the child’s right to health and life protection can be ensured, the experts of the office emphasize.
The ombudsman calls on you to be responsible for your health and that of your children, to be in close cooperation with the family doctor and to listen to his advice. “By vaccinating those who are allowed to vaccinate, we protect those who are denied such an opportunity for objective reasons,” the ombudsman emphasized.
It has already been reported that a four-year-old boy, who was not vaccinated against diphtheria, died after contracting diphtheria on September 16 in the intensive care unit of the Children’s Clinical University Hospital (BKUS).
The Center for Disease Prevention and Control (SPKC), upon receiving information about a confirmed case of diphtheria, has started an epidemiological investigation and organizing anti-epidemic measures – identifying contacts, organizing laboratory investigations and medical monitoring, the center informed.
Diphtheria was diagnosed in three children and one adult. All cases are interconnected. Epidemiological investigation and implementation of anti-epidemic measures are ongoing.
SPKC emphasizes that insufficient vaccination coverage creates a risk of outbreak of diphtheria and spread of infection. Diphtheria complications seriously threaten the health and life of especially unvaccinated patients.
SPKC reminds that vaccination against diphtheria is paid for by the state for every citizen of any age.
2024-09-19 00:17:45