TY - JOUR
T1 - Human papillomavirus vaccination and respect for children's developing autonomy
T2 - Results from a European Union wide study
AU - Martakis, Kyriakos
AU - Alexander, Denise
AU - Schloemer, Tamara
AU - Blair, Mitch
AU - Rigby, Michael
AU - Schroder-Back, Peter
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This project has received funding from the European Union?s Horizon 2020 research and innovation program under grant agreement no. 634201.
Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/ or publication of this article: This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement no. 634201.
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/9
Y1 - 2019/9
N2 - Children's rights to autonomy of choice are differently expressed throughout Europe. We explored differences regarding expressions of respect for children's autonomy throughout Europe, using the procedure of human papillomavirus (HPV) vaccination offer as indicator. We used a mixed methods approach, utilizing an expert survey within the frame of "Models of Child Health Appraised" (MOCHA), among all 30 European Union (EU) and European Economic Area states. A questionnaire was designed using vignettes regarding the vaccine provision. Thirty MOCHA country agents were invited to respond from June 2017 to April 2018. In total, 28 country agents responded. We studied the following themes: (i) provision of informed consent, (ii) parental and medical paternalism, (iii) relevance of the child's chronological age or maturity, and (iv) vaccination programs targeting boys. These are being handled differently across the region. We explored associations of these implemented practices with the national vaccine coverage rate across Europe. We used the processes of HPV vaccination to study child's autonomy, the paradigm change toward libertarian paternalism and issues of sex-equity. Interestingly, greater respect for children's autonomy tends to be associated with medium or high vaccination coverage rates and lower respect with lower rates. Respect and empowerment seem to have practical as well as moral benefits. Identifying and transferring the most suitable ethical approaches is crucial and should be strengthened.
AB - Children's rights to autonomy of choice are differently expressed throughout Europe. We explored differences regarding expressions of respect for children's autonomy throughout Europe, using the procedure of human papillomavirus (HPV) vaccination offer as indicator. We used a mixed methods approach, utilizing an expert survey within the frame of "Models of Child Health Appraised" (MOCHA), among all 30 European Union (EU) and European Economic Area states. A questionnaire was designed using vignettes regarding the vaccine provision. Thirty MOCHA country agents were invited to respond from June 2017 to April 2018. In total, 28 country agents responded. We studied the following themes: (i) provision of informed consent, (ii) parental and medical paternalism, (iii) relevance of the child's chronological age or maturity, and (iv) vaccination programs targeting boys. These are being handled differently across the region. We explored associations of these implemented practices with the national vaccine coverage rate across Europe. We used the processes of HPV vaccination to study child's autonomy, the paradigm change toward libertarian paternalism and issues of sex-equity. Interestingly, greater respect for children's autonomy tends to be associated with medium or high vaccination coverage rates and lower respect with lower rates. Respect and empowerment seem to have practical as well as moral benefits. Identifying and transferring the most suitable ethical approaches is crucial and should be strengthened.
KW - Child health
KW - Europe
KW - papillomavirus vaccines
KW - personal autonomy
KW - vaccination
KW - vaccination coverage
KW - CARE
U2 - 10.1177/1367493519852476
DO - 10.1177/1367493519852476
M3 - Article
SN - 1367-4935
VL - 23
SP - 343
EP - 357
JO - Journal of Child Health Care
JF - Journal of Child Health Care
IS - 3
ER -