Generations of Maori children and state wards were vaccinated without their
parents' consent in baby-boomer inoculation programmes against typhoid and
polio.
The policy continued even after the Cabinet became concerned that public
health officials administering the vaccines might be vulnerable to assault
complaints.
Their reaction was to secretly indemnify the nurses and doctors against legal
claims from parents.
The Ministry of Health said yesterday that it did not know when the indemnity
ended but said it had certainly been overtaken by legislation respecting
patients' rights.
The policy has been revealed in a Herald investigation into the defeat of
polio and other deadly diseases in the 1950s and 1960s.
Doctors at Auckland Hospital used stillborn foetuses in their research of the
polio virus as they fought to understand a disease that was paralysing children,
closing schools and forcing travel bans.
In research that would be controversial today, doctors used human foetuses
and monkey kidneys in laboratory studies to find prevalent strains of the polio
virus.
In the late 1950s and early 1960s, doctors switched their attention to new
vaccines and attacked the diseases with spectacular success.
But policies that underpinned the success of the vaccination programmes
included practices that modern-day health authorities would not get away with.
Documents held in the National Archives show child welfare officials decided
parents of state wards would not have to be asked before a child was vaccinated.
"Immunisation against these diseases is a widely accepted practice and it is
considered reasonable to proceed with it," said a 1962 government paper.
Changes were also written in so that if a parent did object, the objection
could be over-ridden.
The 2002 Department of Child, Youth and Family handbook states that consent
to immunise children in its care should be obtained from guardians.
Other archived documents show Maori children were vaccinated against typhoid
for more than 20 years without their parents' consent.
"For an effective coverage, departmental officers have not sought the consent
of individual parents ... relying instead on the agreement of tribal elders,"
said a memo to the Cabinet in March 1950.
"No law cases or accidents in inoculation have occurred but objections from a
few parents create uneasiness from time to time." The concern was that the nurse
or doctor could be accused of common assault.
The Cabinet approved a recommendation that public servants be legally
protected, but decided the policy should be kept secret.
"It need be known only by senior officers in the health and education
departments," said the memo. Another memo recommended against legislative
changes that would appear to discriminate against Maori.
Health and Disability Commissioner Ron Paterson said this week that he was
not surprised health officials had been so paternalistic, but he did not know
they had been concerned about legal risks of not having parental consent.
"I'm surprised they would have perceived that as a significant legal risk and
it does suggest a greater appreciation of the need to seek consent than I would
have thought," he said.
"It is extraordinary to hear about a Cabinet decision to give indemnity but
not to publicise the fact that was happening."
Mr Paterson said patients today were guarded by the provisions of informed
consent, even in the public health field.
"There's a recognition now that someone who is offering a vaccine should give
very full information about potential risks, and that is clearly the process
that the ministry is working through now in relation to the meningococcal
vaccine."
The director of public health, Dr Colin Tukuitonga, said officials were
carefully following ethical and legal guidelines in the introduction of the
meningococcal vaccine, which is being tested in Auckland.
Society's attitudes had certainly changed since the postwar years, when there
was a belief the state knew best. "For [Maori and state wards] perhaps the
attitude might have been either they don't know or the state is doing something
in their best interest," said Dr Tukuitonga.
"It's akin to the removal of Aboriginal children in Australia."
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YOUR HEALTH CARE PROVIDER.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
"What's the point of vaccination if it doesn't protect you from the unvaccinated?"
-- Sandy Gottstein
"Who gets to decide what the greater good is and how many will be sacrificed to it?"