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Angus Dawson

Publications and source records attributed to Angus Dawson.

8 recordsLinked to original sources
PubMed2005

Therapeutic vaccines: a solution to the prevention problem?

Therapeutic vaccines are likely to provide a significant and growing contribution to tackling some of the manifold health problems that face us in the future. However, despite these real benefits, I suggest the need for caution in relation to one possible ethical argument that could be used to support the introduction of therapeutic vaccination over preventive vaccination for contagious diseases where both types of vaccination exist. I argue that therapeutic vaccination will not solve what I call the 'prevention problem': that is, a perceived injustice in the distribution of benefits and harms arising from population-based preventive vaccination policies.

Communicable Disease Control↗
PubMed2005

The determination of the best interests in relation to childhood immunisation.

There are many different ethical arguments that might be advanced for and against childhood vaccinations. In this paper I explore one particular argument that focuses on the idea that such vaccinations are justifiable because they are held to be in the best interests of a particular child. Two issues arise from this idea. The first issue is how best interests are to be determined in this case. The second issue is what follows from this to justify potential interventions within the family in relation to such vaccinations. I argue that best interests must be characterised objectively in such situations and that this means that, in at least some cases, parental decision-making about vaccinating their children may be overridden.

Beneficence↗
PubMed2005

The determination of 'best interests' in relation to childhood vaccinations.

There are many different ethical arguments that might be advanced for and against childhood vaccinations. In this paper I will explore one particular argument that focuses on the idea that childhood vaccinations are justifiable because they are held to be in the best interests of a particular child. Two issues arise from this idea. The first issue is how best interests are to be determined in the case of childhood vaccinations. The second issue is what follows from this to justify potential interventions within the family in relation to such vaccinations. I argue that best interests must be characterised objectively in such situations and that this means that, in at least some cases, parental decision-making about vaccinating their children may be overridden.

Beneficence↗
PubMed2005

Some ethical issues arising from polio eradication programmes in India.

The World Health Organisation's programme for the eradication of poliomyelitis as currently practised in India raises many ethical issues. In this paper we concentrate on just two. The first is the balance to be struck between the risks and benefits generated by the eradication programme itself. The issue of risks and benefits arises in relation to the choice between two different vaccine types available for polio programmes: oral polio vaccine (OPV) and inactivated polio vaccine (IPV). OPV is the vaccine currently used in the eradication campaign in India. We argue that given the current risks/benefits profile of this vaccine, there is an urgent need to review the programme and take remedial action to address existing problems (at least in India). The second issue we discuss is the fact that there is little effort to gain the informed consent of the parents of vaccinated children, as they are not currently told about the potential limitations of OPV or the possibility of vaccine-induced harm. We suggest that such a policy might be justifiable, given the importance of polio eradication, but only if there is a system of compensation for vaccine-induced harm as part of the eradication programme itself. There is a real danger that if these issues are not addressed then public trust in the eradication programme and vaccination programmes as a whole will be lost.

Child↗
PubMed2004

Ethical principles for collective immunisation programmes.

Ethical issues arise in discussion of both the content and implementation of collective immunisation programmes. In this paper we propose and discuss seven principles that may guide reflection and debate in this controversial area. Whilst this paper is not intended to be a final and complete account of the relevant principles for collective immunisation programmes we hope that it can help stimulate more active discussion of these issues. Debate about these principles may help to make moral conflicts more explicit and open up the possibility of resolution. We argue that analysis and discussion of the ethical issues should be part of any justification of collective vaccination programmes.

Humans↗
PubMed2004

The Human Fertilisation and Embryology Authority: evidence based policy formation in a contested context.

This article briefly reviews the various papers contained in this volume. They were originally presented at a research work shop held at Keele University in the UK in February 2003. It is suggested that the different papers raise a series of related legal, social and ethical issues and can be collectively seen to demonstrate the fact that policy formation in relation to reproductive matters is highly contested. It is concluded that ethical policy formation in this area needs to be based on actual evidence of harm rather than assumed harm and that this therefore entails more empirical research into reproductive matters.

Advisory Committees↗
PubMed2004

Vaccination and the prevention problem.

This paper seeks to critically review a traditional objection to preventive medicine (which I call here the 'prevention problem'). The prevention problem is a concern about the supposedly inequitable distribution of benefits and risks of harm resulting from preventive medicine's focus on population-based interventions. This objection is potentially applicable to preventive vaccination programmes and could be used to argue that such programmes are unethical. I explore the structure of the prevention problem by focusing upon two different types of vaccination (therapeutic vaccination and preventive vaccination). I argue that the 'prevention problem' cannot be fairly applied to the case of preventive vaccination because such programmes do not just focus upon benefits at the level of populations (as is claimed by the prevention problem). Most such preventive vaccination programmes explicitly seek to create and maintain herd protection. I argue that herd protection is an important public good which is a benefit shared by all individuals in the relevant population. This fact can then be used to block the 'prevention problem' argument in relation to preventive vaccination programmes. I conclude by suggesting that whilst the future development and use of therapeutic vaccines does raise some interesting ethical issues, any ethical objections to prophylactic vaccination on the basis of the 'prevention problem' will not be overcome through the substitution of therapeutic vaccines for preventive vaccines; indeed, the 'prevention problem' fails on its own terms in relation to preventive vaccination programmes.

Coercion↗