Would You Fire A Client Who Doesn’t Take Your Advice? Here’s What Doctors Are Doing…

What do you do when a client consistently refuses to take your advice?  It’s a knotty problem for many lawyers as to whether they should keep those disagreeing clients and try to bring them around or simply dump them.  This article, Feuding Over Vaccines, (Sandra G. Boodman, Washington Post, November 8, 2005) discusses how pediatricians are dealing with the same issue.  According to the article, an increasing number of parents are refusing immunization for their children, citing risk of autism or other issues.  At the same time, virtually all pediatricians strongly support immunization thus putting them at odds with patients who don’t.  Some doctors feel so strongly about their position that they have dismissed patients whose parents refuse to have their children vaccinated.  The article discusses the attendent ethical issues that a decision to dismiss a patient may raise (e.g., that the child will go without medical care) as well as ways to try to convince parents to take another approach.

8 Comments

  1. Supremacy Claus on November 9, 2005 at 5:44 pm

    Carolyn: Docs get sued no matter what because one Gulfstream jet is just not enough. There is no recourse. Why? The lawyer has dealt itself total immunity from any accountability to adverse third parties.
    Here is a doctor sued for not forcing the patient to take the advice, for not committing false imprisonment, kidnapping, and for not stealing the clothes of the patient. It took 5 years to get out of it.
    http://www.endonurse.com/articles/581feat3.html
    Obviously, confidence is needed between the patient and the doctor. If the doctor is advising such a bottom line vaccination, and the parents refuse, the confidence is lacking. They should seek another doctor elsewhere or visit their alternative health provider. No responsible pediatrician will advise not getting the vaccination schedule even with thimoseral. Older pediatricians, especially, saw devastating brain damage consequences from these diseases before the vaccines were available. The increase in autism coincides with the onset of increased educational funding and bullying by irresponsible lawyers.
    From Wikipedia on Measles.
    “Complications with measles are relatively common, ranging from relatively common and less serious diarrhea, to pneumonia and encephalitis. Complications are usually more severe amongst infants and adults who catch the virus.
    The fatality rate from measles for otherwise healthy people in developed countries is low: approximately 1 death per thousand cases. In underdeveloped nations with high rates of malnutrition and poor healthcare, fatality rates of 10 percent are common. In immunocompromised patients, the fatality rate is approximately 30 percent.”



  2. Supremacy Claus on November 9, 2005 at 5:44 pm

    Carolyn: Docs get sued no matter what because one Gulfstream jet is just not enough. There is no recourse. Why? The lawyer has dealt itself total immunity from any accountability to adverse third parties.
    Here is a doctor sued for not forcing the patient to take the advice, for not committing false imprisonment, kidnapping, and for not stealing the clothes of the patient. It took 5 years to get out of it.
    http://www.endonurse.com/articles/581feat3.html
    Obviously, confidence is needed between the patient and the doctor. If the doctor is advising such a bottom line vaccination, and the parents refuse, the confidence is lacking. They should seek another doctor elsewhere or visit their alternative health provider. No responsible pediatrician will advise not getting the vaccination schedule even with thimoseral. Older pediatricians, especially, saw devastating brain damage consequences from these diseases before the vaccines were available. The increase in autism coincides with the onset of increased educational funding and bullying by irresponsible lawyers.
    From Wikipedia on Measles.
    “Complications with measles are relatively common, ranging from relatively common and less serious diarrhea, to pneumonia and encephalitis. Complications are usually more severe amongst infants and adults who catch the virus.
    The fatality rate from measles for otherwise healthy people in developed countries is low: approximately 1 death per thousand cases. In underdeveloped nations with high rates of malnutrition and poor healthcare, fatality rates of 10 percent are common. In immunocompromised patients, the fatality rate is approximately 30 percent.”



  3. John Feeney on November 9, 2005 at 6:20 pm

    Why not just raise the rates. At some point they will get the message or they can drop you and the next one in-line can hear the compliants about raised rates over advice. And the pattern starts anew…



  4. John Feeney on November 9, 2005 at 6:20 pm

    Why not just raise the rates. At some point they will get the message or they can drop you and the next one in-line can hear the compliants about raised rates over advice. And the pattern starts anew…



  5. Brad Jensen on November 10, 2005 at 9:56 am

    The doctor should always do what is best for the patient. Ethically, it could be best to refuse to treat the patient. There are plenty of doctors,a nd the parents can go find another one. But the doctor’s action in refusing to treat the child without vaccination can have the effect of bringing to the parents’ attention just how servious the decision to not vaccinate is.
    Also, an unvaccinated child increases the risk to all the other patients of the doctor that the child may come in contact with, both inside and outside the doctor’s office.
    If the parents do not accept the doctor’s theory of treatment, then it is unethical for the doctor to continue the doctor/patient relationship.



  6. Brad Jensen on November 10, 2005 at 9:56 am

    The doctor should always do what is best for the patient. Ethically, it could be best to refuse to treat the patient. There are plenty of doctors,a nd the parents can go find another one. But the doctor’s action in refusing to treat the child without vaccination can have the effect of bringing to the parents’ attention just how servious the decision to not vaccinate is.
    Also, an unvaccinated child increases the risk to all the other patients of the doctor that the child may come in contact with, both inside and outside the doctor’s office.
    If the parents do not accept the doctor’s theory of treatment, then it is unethical for the doctor to continue the doctor/patient relationship.



  7. Robert Williamson (Constructio on December 2, 2005 at 8:10 pm

    For me the answer turns in part on how involved I will be in implementing the course of action that’s contrary to my advice.
    I will not let a client dictate how I practice law…means and methods are my call not the clients.
    Similarly, if a client’s rejection of my advice will result in me being required to defend the indefensible I will usually pass.
    But when it’s the client that’s following through with the action at issue then I tend to be more understanding and tolerant and give them the benefit of the doubt.



  8. For me the answer turns in part on how involved I will be in implementing the course of action that’s contrary to my advice.
    I will not let a client dictate how I practice law…means and methods are my call not the clients.
    Similarly, if a client’s rejection of my advice will result in me being required to defend the indefensible I will usually pass.
    But when it’s the client that’s following through with the action at issue then I tend to be more understanding and tolerant and give them the benefit of the doubt.



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