Carl von Clausewitz was a Prussian general and military theorist who famously said: “War is a mere continuation of politics by other means,” (“Der Krieg ist eine bloße Fortsetzung der Politik mit anderen Mitteln”). I leave the full parsing of its meaning to other military strategists. But, the quote serves as a useful segue to discuss how divorced parents sometimes use the medico-legal playing field to continue their battles.
The Kagens were divorced in 2012. They were awarded joint legal and physical custody. As defined by their divorce judgment, neither parent was allowed to make major medical decisions relating to the children without consulting the other.
Mom discontinued the daughters’ vaccinations when they were 3 and 5 years old respectively – long before the couple’s divorce. She asserted she maintained religious objections. She contended Dad shared those concerns. (Dad claimed he was blindsided by his ex-wife’s religious reformation and was unaware his kids had not received updated vaccines until 5 years later.)
Over Mom’s objections, Dad secured four vaccinations for their eldest daughter in February, 2013. Mom then filed a motion with the circuit court to prevent any further unilateral action by the father.
The lower court excluded statements from government agencies supporting the benefits of vaccinations. These statements were submitted by the father to buttress his position. One these documents were excluded, the circuit court concluded that without supporting evidence, a change in course of conduct by Mom was not in the children’s best interests.
Michigan appellate court overruled.
Mom’s documents were deemed by the court to be inherently untrustworthy. Mom submitted a Wikipedia article detailing a list of vaccine ingredients. The court ruled that anyone can update or edit a Wikipedia article. Mom submitted an article entitled, “Should Mickey and Minnie Mouse Be Vaccinated?” from Dr. Brownstein’s Holistic Medicine Blog. The court held that a blog by its very nature is not akin to a formal and official statement presented by a government agency. An article from a doctor unconnected to any scientific study does not share the characteristics of trustworthiness necessary to be admitted. The court reached a similar conclusion for the snopes.com article – “On Gardasil.” Other articles were similarly rejected.
What did pass the court’s filter? The father’s information from the CDC, FDA, and NIH’s National Center for Complementary and Alternative Medicine. The mother’s information from the National Vaccine Program Office and the CDC was also allowed. While warning readers of the potential risks associated with vaccinations, it revealed that severe and even moderate risks are rare and far outweighed by vaccine benefits. A letter from the children’s pediatrician recommended vaccinating the children and clearly enumerated which vaccinations the eldest daughter had yet to receive and were recommended specifically for her. The mother never argued that the children had ever experienced an allergic reaction to a vaccine. No evidence indicated that either child had a compromised immune system or a history of seizures which might have cautioned against the administration of vaccinations.
The court ruled Dad could control the vaccination schedule.
Sometimes divorced parents have legitimate philosophical differences on how to care for their children. Sometimes those philosophical differences contribute to their divorce. In this particular case, if the children had received vaccines according to the recommended schedule through the age of three, they would likely have already received baseline protection against the dangerous childhood diseases. A simpler path before bringing in lawyers and spending oodles of money might have been to obtain blood antibody titers demonstrating immunity. That, of course, is the desired outcome of vaccinations. This would not have addressed the issue of influenza vaccines (which did not appear to be the issue being litigated). And it would not have addressed the issues of Gardasil or meningococcus – which typically are addressed late teens.
Maybe the battle over a medical issue was beside the point.
Anyway, as a physician, be careful about getting sucked into the drama of divorced parents. Sometimes, it’s unavoidable. But, it’s a vortex that can create a fair amount of collateral damage.
Kagen v. Kagen, 2015 WL 4254993 (Mich.App., Jul. 14, 2015)
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The subplot to the Kagen case is not so much about politics and warfare but about cultism. For some, fueled the Mrs to a desire to be oppositional to ideas, practices and culture. We generally think of this in terms of religion. However, in Western society in particular, we have witnessed cultism take other forms. One of them is the practice of medicine.
The anti-vaccination movement has this quality and has, as its creed and messengers, information and spokespersons who, for their own motives, promote a counter-narrative. They talk about risks as if all risks have the same meaning. There is also no consideration to the effect an individual decision has on others. It is individualism to the detriment of others. Which, as we all know is contrary to good public health policy.
To the court’s credit, it saw the fallacy of Mrs. Kagan’s position on vaccination and ruled accordingly.
But what about cults? Well, there is some redemption. The famous psychologist Philip Zimbardo (who many of us who lived in NYC warmly remember) opined: “A good cult delivers on its promises. A good cult nourishes the needs of its members, has transparency and integrity, and creates provisions for challenging its leadership openly. A good cult expands the freedoms and well-being of its members rather than limits them.”
Great article Dr. Segal, thank you again for so many wonderful articles that she’d light to your eyes and remind us of this bleeped up system.
One problem here, because I am watching ..”a friend” go thru a divorce, is , it’s not about vaccines and what’s right or wrong but rather “CONTROL”. My “friend”, I have watched his agony as his wife uses the children as “pawns” and NOT donwhat is in the best interest of the children, but to piss off her ex and stir up a fight over “control” and create..THE WAR.
We must remember the children are the innocent party here, and I admire the father for being smart enough and scientific enough to present evidence based medical literature supporting his view. Should she Ex NOT have complied , WOULD HE HAVE HAD A CASE OF MEDICAL NEGLECT? How (typically) would a judge address punishement for not following his decision that the father may give the vaccines at the doctors office.? A contempt like this 297@: result in what kind of puniahement to the mother?
My OVERALL point and I saw it weekly or more in practice is …. we have to educated parents, STOP USING THE CHILDREN AS PAWNS, BARGAINING. CHIPS, and a MEANS TO STIR THE POT AND PISS OFF THE EX. IT IS NOT THE CHILDRENS FAULT.
Dr. Segal or others, how should we best counsel parents in situations like this to do what’s best for the children? Showncases suxh as rbis, send to counseling ,give OUR opinion, blow it off and tell them to talk to their lawyers ? Could we help remedies such as this in our office based on sound scientific evidence , and what in the best interest of the children or whar, pass off to their lawyers , crank up the bill etc ???
I
I am curious to see how primary care docs (and ANPS and nurses )mahouts best guide matters like this in which we know it’s likely not about the vaccines, or religion, but rather a control and pissin’ context at the kids well being?
Sincerely,
mark MD
In your efforts to survive at being a physician, you may not have the opportunity to evaluate the maelstrom of societal changes raging about you. What physician has the time to look at YouTube?
One massive change has been 3rd Wave feminism which has taken over universities, popular Media and Hollywood. In essence modern feminism insists that females can have everything all together, including a powerful career, family and married life. Somehow these feminists have not correctly calculated the number of hours available in a day.
This has led to many changes, but most common, much later child-birth and single motherhood. It is not surprising that there would be an increase in autism in such children as well as other “unexpected” child-development problems.
Most people who decry vaccination of children are well-educated females, in which they have an unconscious need to “deflect” the results of their own personal choices and find someone else to blame. In addition, they view “Big Pharma” as just another form of the “male patriarchy” which has in the past and still “conspires” against females. Or so they believe.
It is impossible to describe the myriad of changes raging about you in a short post. If you want further information, I encourage you to open up YouTube and read about a phenomenon occurring over much of the developed world: MGTOW (Men Going their Own Way).
As a physician, you will be encountering the effects of 3rd Wave feminism; and you may also encounter it in your own personal life. I promise you it will be a revelation.
Michael M. Rosenblatt, DPM
In my opinion, the woman above was brainwashed into her “religious beliefs,” and she is dragging her husband into court simply because she has “a bug up her butt” and wishes to cause him grief and aggravation. It is the wise physician (and dentist) who stays out of this drama.
Dr. Mark: what is a “rbis” and a “mahouts”? I realize you were typing quickly and didn’t reread what you wrote, but I’m at a loss as to what you intended to say here.
Dr, Rosenblatt: It is always a pleasure to read your contributions. I generally find them to be quite thoughtful and inciteful. However, I appear to be one of those feminists to which you refer (although I never considered myself as such.) I married at 35 and had my children at 38 and 40 1/2. Thank G-d we deal with rn of the mill stuff (such as ADHD, executive functioning difficulties, etc.) I, however, do not despise Big Pharma as being a “male patriarchy” out to get me. No. Rather, I despise Big Pharma for being the huge money-making pill-pushers that they are. I agree that there are very many life-saving meds now available. There are also many meds that they change one inactive ingredient so that a drug can remain a brand-name, rather than generic, and therefore, grossly overpriced. There are many drugs that should be investigated but aren’t because it wouldn’t generate enough profit. And then there are those generics that are pushed but aren’t effective because there’s an inactive ingredient that prevents the drug from being adequately mixed (ie., prednisolone drops).
Feminism has little to do with this case. Spitefulness does.
Dr. Segal: Thank you, once again, for an interesting case to demonstrate a point. I’m so glad that I stumbled upon your site years ago; I learn a great deal here and enjoy my time here immensely.
–CHS, DDS
With increased global travel, vaccines are important for preventing rare diseases from spreading here in the States. The increase in “mandatory” vaccines from 2011 -2017 is staggering, and some like Guardasil and HepB, may be unnecessary as recommended. The hospital wanted to vaccinate our newborn daughter with HepB before leaving the hospital 6 years ago, and we refused.
In the above scenario, I believe both parents wanted what’s best for the child – many mothers are petrified by vaccines, especially when pediatricians typically schedule multiple per visit. Ever seen the ads on the inside cover of the Journal of Pediatrics? Always for a vaccine like Rotavirus. Increased vaccines for Pharma profit? Nah:)