Ar dėl sprendimo neskiepyti savo vaiko, kilusių komplikacijų, tėvams gali grėsti baudžiamoji atsakomybė už vaiko sveikatos sutrikdymą?

Nors daugelyje šalių vakcinų teisinis reguliavimas yra tik rekomendacinio pobūdžio, nuolat netyla diskusijos kokią atsakomybę tėvai neša prieš visuomenę ir prieš patį vaiką, rizikuodami, atsisakius vakcinuoti, pakenkti jo sveikatai, suardyti kolektyvinį imunitetą. Lietuvoje bei daugelyje kitų valstybių galiojantys įstatymai nenumato, kad už vaiko sveikatos sutrikdymą, renkantis neskiepyti savo vaiko, tėvams gali kilti atsakomybė. Nors atskiros valstybės yra numačiusios įvaraus pobūdžio sankcijas už atsisakymą skiepyti vaikus privalomais skiepais, tačiau paprastai jos „nesiekia“ baudžiamosios atsakomybės ribų. Tai, kad stokojama praktikos atsakomybės taikymo, atsisakius vakcinuoti vaiką, kontekste, neabejotinai lemia šios temos aktualumą bei iššaukia diskusiją. Pirmojoje dalyje aptariama vakcinacijos reikšmė ir vaiko teisės į sveikatos apsaugą turinys, apžvelgiamas nacionalinis teisinis reguliavimas. Šiame skyriuje akcentuojama vakcinacijos reikšmė bei jos įtaka visuomenės sveikatos apsaugai, pabrėžiama vaiko teisė būti sveikam, gauti šiuolaikinės medicinos garantuojama imunoprofilaktiką. Taip pat yra apžvelgiami teisinio vakcinacijos reglamentavimo pagrindai ir požiūris į tai, ar vakcinavimas turi būti privalomas, kaip buvo siekiama įtvirtinti privalomo vakcinavimo institutą nacionalinėje teisėje. Sekančioje darbo dalyje nagrinėjamos vakcinavimo atsisakymo priežastys ir tėvų pareigos rūpintis vaikų sveikatos apsauga santykis. Keliamas klausimas ar vaiko nevakcinavimas (ko pasekoje sutrikdoma jo sveikata) gali būti laikomas vaiko nepriežiūra. Analizuojama kokios pagrindinės atsisakymo vakcinuoti priežastys, kurios iš jų atskirose šalyse yra laikomos „pateisinamos“ atsisakant vakcinuoti vaiką. Trečioje darbo dalyje nagrinėjamas tėvų atsakomybės klausimas, kai yra atsisakoma vakcinuoti vaikus, pastarųjų galimybė kreiptis į teismą ir prisiteisti žalą. Atsižvelgiant į pasirinktų šalių pavyzdžius siekiama išsiaiškinti kokia atsakomybė kyla tėvams, atsisakiusiems vakcinuoti vaikus, kiek veiksmingos yra griežtos sankcijos bei baudžiamosios atsakomybės taikymas už privalomo vakcinavimo „ignoravimą“, atskleidžiama, jog sankcija vakcinavimo kontekste taip pat turi ir pozityviąją pusę (pozityviosios sankcijos). Aptarus pastaruosius klausimus bei iškeltas problemas ištirta kokios priežastys bei sąlygos leidžia taikyti teisinę atsakomybę tėvams, kokie yra atvejai, kada jie gali būti traukiami būtent baudžiamojon atsakomybėn.

The World Health Organization has recognized vaccines as one of humanity’s greatest inventions in helping to prevent catastrophic diseases. Thanks to the vaccine, smallpox has disappeared in the world, polio is ending, and there is a rapid movement towards the eradication of measles and rubella. However, large amounts of conflicting information lead to people choosing to ignore the importance of vaccination and not vaccinate their children when in doubt about the need for and benefits of vaccination. Although the legal regulation of vaccines in many countries is only of a recommendatory in nature, there is a constant lack of debate about the responsibilities that parents have towards society and against the child himself, at the risk of damaging his health and destroying societies’ collective immunity. The legislation in Lithuania and many other countries do not provide that parents may be held liable for the child's health disorder if they choose not to vaccinate their child. One of the most severe sanctions for refusing to vaccinate children is regulated in France. Parents who refuse to vaccinate their children with the mandatory vaccination can receive a fine of € 3,750 and a 6-month prison sentence. Although individual states have provided various sanctions for refusing to vaccinate children with compulsory vaccination, however, they generally do not "reach" the limits of criminal liability. Although the toughest sanctions are envisaged in France, it is noteworthy that perhaps the biggest debate in scientific terms is in US jurisprudence. It is quite controversial: „The American Academy of Pediatrics advises physicians to respect the refusal of parents to vaccinate their child after adequate discussion unless the child is put at significant risk of harm“ , but in other hand several states allow minors to legally agree to take care of their health, to make health care decisions, agree to be vaccinated (or not), despite parental objections. As long as the legislation allows for the refusal to vaccinate children with compulsory vaccination, not only based on medical exceptions or in countries where vaccination is only recommendatory, parents do not have a clearly defined and regulated obligation to vaccinate children. Until the obligation isn’t clearly defined, it is difficult to apply criminal liability to parents because both the causation and the fault itself are hard to prove. Criminal law is a heavy-handed tool, it should be used as an ultima ratio only. The lack of practical application of the responsibility in the context of refusing to vaccinate a child undoubtedly determines the relevance of this topic and provokes a discussion. The first part of the thesis discusses the meaning of vaccination and the content of the child's right to health care, reviews the grounds of national legislation. This chapter emphasizes the importance of vaccination and its impact on the protection of public health, emphasizes the child's right to be healthy, to receive immunoprophylaxis, which is guaranteed by modern medicine. It also reviews the grounds of legislation for vaccination and the approach to whether vaccination should be compulsory, as to how it was intended to enshrine the institution of compulsory vaccination in national law. The next part of the thesis examines the reasons for refusing vaccination and its relation between parents' responsibility to protect children's health. In this part, the question is raised about whether or not child neglect can be considered if parents refuse to vaccinate a child and due to this, his or her health was harmed. It analyzes the main reasons for refusing vaccination, which of the individual countries are considered as “justified" by refusing to vaccinate a child. The third part of the paper deals with the issue of parental responsibility when refusing to vaccinate children, the possibility for the latter to go to court, and to pay damages. The examples of selected countries aim to clarify the responsibilities of parents who refuse to vaccinate children, the effectiveness of severe sanctions, and the criminalization of "ignoring" compulsory vaccination, and reveal that sanctions in the context of vaccination also have a positive side (positive sanctions). Examination of all the issues raised has clarified what reasons for the legal liability can be applied to parents, and what are the cases in which they can be prosecuted. There is an opportunity to talk about criminal liability against parents who decide not to vaccinate their children, with a focus on discouraging and harming the child. However, the application of criminal liability on parents who do not vaccinate a child raises significant, it accommodates itself more questions than answers. As the practical analysis shows, in most of the criminal cases brought against parents for the death or injury of a child, the parents acted with obvious negligence: they did not feed a child for a long time, did not provide medication to him, and etc. Parents who decide not to vaccinate a healthy child against a disease that, incidentally, is rarely or completely extinct (thanks to vaccinations), are less accused, culpable and their guilt in such actions is even more difficult to find.