Letter to the Standing Committee on the Legislative Assembly – Posted with permission from an Ontario RN concerned about Ontario Bill 87, Protecting Patients Act, 2017, Schedule 1 Immunization of School Pupils Act
Dear Honorable Committee Members: Please accept the following document for consideration when deliberating Schedule 1 Immunization of School Pupils Act.
Bill 87: A Registered Nurse’s Perspective
As a front line Registered Nurse with twenty-five years of experience, I am opposed to Bill 87, Protecting Patients Act, 2017, Schedule 1 Immunization of School Pupils Act, on numerous levels. I am guided by a duty to speak out against unjust policy that not only threatens the integrity and confidentially of patient relationships, but delivers an unnecessary fiscal drain to an already overburdened health care system.
Evidence, economics, and ethics are three key pillars of progressive health policy, with each pillar of equal importance.
Pillar of Economics:
Every day I witness the impact of budget restraints upon Ontario’s’ health care system. I see surgeries cancelled because of lack of staff and resources, vulnerable patients discharged home with complex care needs to be cared for by ill equipped family members, over used/aging medical equipment, vital medications delisted, nurses working without breaks, patients kept in hospital beds or hallways for days awaiting procedures…. sadly, I could go on. How therefore, does the province justify investing considerable funds to execute this component of Bill 87?
Bill 87s’ “education” sessions will be interpreted as patronizing and I suspect will result in nothing more than heated arguments. This Bill operates on a dated misconception that cognitive scientists have long recognized as the “backfire effect”. It is well known that challenging firmly held beliefs is counterproductive and risks such “backfire”. Parents who decline vaccines have strongly held beliefs (entitled to them under the Canadian Charter of Rights and Freedoms). Sessions, intended to educate about risks, will not only alienate, but will likely strengthen perceptions of vaccine concerned parents and reduce vaccination intention. Please see the evidence below to support that attempts to educate with “scientific” evidence to sway strongly held beliefs, have been failures.
Pillar broken: Economics – your plan won’t work and will waste valuable taxpayer’s money
Pillar of Evidence:
Vaccine hesitant parents are dedicated to protecting their children and perceive vaccination as a more significant risk than not vaccinating. These parents are not societal outcasts; they are largely highly educated professionals from high socio-economic brackets who do not accept the prevailing discourse on this matter. This should concern and not anger you. What has the government/public health officials done to undermine their trust? Our government should be engaging vaccine hesitant parents and addressing their concerns such as denial of vaccine injury, use of selective science, and troubling conflicts of interest with pharmaceutical companies, etc. if they wish to truly fortify public trust in vaccination.
Pillar Broken: Evidence. Vaccine hesitant parents do not accept public health evidence as transparent, honest or compelling.
Pillar of Ethics:
I am further concerned that Bill 87 operates on a coercive level to vaccine hesitant parents who may not be of a privileged class. How will single parents, rural residents, ESL, new Canadians, or those with lower levels of education etc. who decline vaccination interpret and manage these educational requirements? How are you ensuring vulnerable demographics will not feel coerced or intimidated by authority figures? What are future ramifications to the public trust by doing so?
The most disturbing facet of this bill however is the threat upon the sacred confidentially of a health record. Mandated public reporting of vaccination status is alarming. This is truly not becoming of our Canadian values and warrants caution as to the precedent this sets to the confidentially of all Canadians.
Pillar Broken: Ethics – It is unethical to coerce vulnerable members of society, to betray confidentially and to penalize Canadians for exercising their Charter Rights to choice
Conclusion:
Bill 87 fails to uphold the pillars of good health policy. The Bill fails on economics, evidence and ethics. What we really need is transparent, bipartisan discussion. Scapegoating and questioning the rights of vaccine hesitant parents is not the means by which to accomplish that.
I thank you for your time and consideration in securing progressive health policy guided by the Charter entitlements of the citizens of Ontario and encourage you to consider the above elements of such policy when finalizing your decision.
Ontario RN [Name removed for posting]
References:
Nyhan B., Reifler J., Richey S. & Freed G.L. (2014). Effective Messages in Vaccine Promotion: A Randomized Trial., Pediatrics, http://pediatrics.aappublications.org/content/pediatrics/133/4/e835.full.pdf
Crowcroft et al (2015). Do we need a better approach to making vaccine recommendations? The British Medical Journal. Retrieved at http://www.bmj.com/bmj/section-pdf/891046?path=/bmj/350/7995/Analysis.full.pdf
Kahan D.M., Peters E., Wittlin M., Slovic P., Ouellette L.L., Braman D. & Mandel G. (2012). The polarizing impact of science literacy and numeracy on perceived climate change risks, Nature Climate Change, 2 (10) 732-735. http://scholarship.law.gwu.edu/cgi/viewcontent.cgi?article=1298&context=faculty_publications
McRaney, D. (2014) The Backfire Effect. A Celebration of Delusion. Retrieved at https://youarenotsosmart.com/2011/06/10/the-backfire-effect/
Skurnik I., Yoon C., Park D. & Schwarz N. (2005). How Warnings about False Claims Become Recommendations, Journal of Consumer Research, 31 (4) 713-724. http://www.rcgd.isr.umich.edu/news/Skurnik.Yoon.Park.Schwarz.2005.jofconsumer resh.pdf
Schwarz N., Sanna L.J., Skurnik I. & Yoon C. Metacognitive Experiences and The Intricacies of Setting People Straight: Implications for Debasing and Public Information Campaigns, Advances in Experimental Copyright 2007, Elsevier Inc. Social Psychology, 39 127-161. https://pdfs.semanticscholar.org/41cc/3eeed553e733f7378446ee6205fcea420cac.pdf