The legal definition of a patient and the corresponding duties of the physician have been debated in state courts for over a century, and many aspects of the question are still unresolved.
Rather than turning away children whose parents refuse to have them vaccinated, pediatricians should engage the parents in discussion about the importance and safety of vaccination.
Patients who use drugs intravenously may be at high risk for relapse, but their situation is no more futile than that of persons with diabetes and coronary artery disease who smoke and frequent all-you-can-eat buffets.