Ethics Dilemma 1
docx
keyboard_arrow_up
School
Capella University *
*We aren’t endorsed by this school
Course
INTRO
Subject
Health Science
Date
Jan 9, 2024
Type
docx
Pages
8
Uploaded by JudgeFinch1879
Apply Ethical Principals 1
Applying Ethical Principals
Fatima Lainez
NHS-FPX4000 Developing a Heath Care Perspective
Dr. Tyler Strudivant
Capella University
July 2021
Apply Ethical Principals 2
Applying Ethical Principals
One of the many roles of health care providers is to educate patients and make sure they receive quality care. In order to provide quality care, providers use a code of ethics that consists of four fundamental principles- autonomy, beneficence, nonmaleficence, and justice. The code of ethics aids healthcare providers and administrators in providing guidance in complex medical situations in which the right answer is not always clear. Overview of the Case Study
Jenna and Chris are new parents to a baby girl named Ana and are at their pediatrician’s office for a well visit. The baby is five days old and they are discussing goals of care with their doctor. They disclose to Dr. Kerr that they are against vaccinating the baby. They indicate they have done extensive research on the topic and joined a community that educates on mommy-
blogs. They feel the information they have acquired is enough for them to conclude that vaccines
are a leading cause of Autism and they do not wish to vaccinate baby Ana. Dr. Kerr goes over risks and benefits of being vaccinated with the parents. She outlines the VAERS program and how it allows parents and providers to report negative side effects of vaccines - ranging from mild to severe. She goes on to speak about the overwhelming evidence of decreased mortality in children over the last century thanks to vaccines. Dr. Kerr also educates the parents on herd immunity and how it not only protects Ana but in turn, protects children with illnesses that compromise their immunity and prevent them from getting vaccines. However, regardless of her attempts to provide Ana’s parents with scientifically proven evidence
of the importance of a vaccinated community, they decline to vaccinate Ana. Now, Dr. Kerr is
Apply Ethical Principals 3
left with an ethical dilemma - carry out her moral obligation as the child’s doctor or consider the
parent’s wishes.
Evaluation of Ethical Dilemmas
In this case study, Dr. Kerr faces an ethical dilemma due to Anna’s parents refusing to vaccinate her. Dr. Kerr, as a health professional feels a moral obligation to do what is best for Anna and convince her parents to change their minds about vaccines. Although she respects Anna’s parents’ right to make decisions for their child, she believes this is the wrong decision. Dr. Kerr provided the parents with evidenced- based vaccine information. However, they believe
what they have researched on mommy- blogs. Judging that this misinformation Anna’s parents have decided to use to make their decision, Dr. Kerr feels the need to change their mind. Vaccine Hesitancy on the Rise
From January 1
st
- December 31
st
2019, there were 1,282 cases of Measles reported in 31 states. (Measles Cases and Outbreaks 2020). This demonstrates a disease that was virtually eradicated with the help of vaccine and is making a slow but sure come back due to vaccine hesitancy. The question remains, how can healthcare providers educate and build trust in vaccines again? No medication is fit for every person, it is impossible to produce medications to have zero side effects. With the development of VAERS, healthcare providers and the public themselves can report side effects they have seen or experienced after the administration of vaccines. This creates transparency but also creates fear as people experience true adverse reactions or coincidences happen which are then linked to the vaccine. People are opting out of even sending their children to school and home schooling them to avoid the vaccination rules that apply to school age children. Current efforts by state legislatures to curb climbing rates of nonmedical exemptions are focused on increasing
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
Apply Ethical Principals 4
the burden would-be exemptors face to exempt. Notably, however, exemption rates have continued to rise even in states that limit nonmedical exemptions to those with religious objections, as well as in states with more difficult exemption processes. (Constable, C., Blank, N.
R., & Caplan, A. L. 2014). There is little clear guidance for providers to follow as to what to do when parents refuse to vaccinate. Also, in the United States, there is no strict rules that every state follows, in some states it may be considered neglect and, in another state, not. A 2013 District of Columbia court held that failure to vaccinate did not constitute neglect, regardless of whether the refusal was based on a sincere religious belief. In the 3 New York cases, parents opposed vaccination on religious grounds, and the sincerity of their beliefs was determinative. The courts did not find the parents’ religious beliefs to be sincere in the 1967 and 1992 cases and, therefore, determined that the children were neglected; in the 1975 case, the court found the
parents’ beliefs sincere and the child not neglected. In addition, the 1992 case involved a parent’s refusal of the measles vaccine during a measles epidemic. Although the court determined that this refusal constituted neglect, it ruled that it would not force vaccination because the epidemic had subsided at the time of adjudication (Parasidis, E., & Opel, D. J. 2017). Mandates or Education: Solution The Code of Ethics consists of four main principles. First, autonomy or the principle that everyone has the right to make his or her own choices. This forms the basis of informed consent in the physician- patient relationship. Second, beneficence or acting with the best interest of the patient in mind. This principle is the basic premise that healthcare providers have the duty to be of benefit to the patient as well as take positive steps to prevent harm. Third, nonmaleficence or the principle to “above all, do no harm” as stated in the Hippocratic Oath. Fourth, justice which
Apply Ethical Principals 5
emphasizes fairness and equality among individuals (Levitt, D. 2014). There is no black and white solution to this problem. Strict mandates and government enforced rules tend to make people feel their rights are being violated. More education and scientific studies geared to help educate the public are not enough. All states offer medical exemptions. Currently, religious exemptions to vaccination are granted in 48 states and Washington, D.C. Separately, 20 states allow philosophical, or personal-belief, exemptions--19 states explicitly offer this option. Pennsylvania extends the religious exemption to include any "strong moral or ethical conviction similar to a religious belief", effectively rendering it a philosophical exemption. Only two states, Mississippi and West Virginia, do not allow either type of nonmedical exemption (Constable, C.,
Blank, N. R., & Caplan, A. L. 2014).
People will go as far as claiming false religious exemption.
The court can do little to prove this at this moment. Vaccine hesitancy is on the rise and poses a huge ethical dilemma for health care providers. Autonomy gives the right to the patient to make his or her own choice but the question remains whether not vaccinating a child should be considered medical neglect. Vaccine refusal may not cause immediate harm to the child but may at some point, cause the child to acquire a disease which has been completely eradicated due to vaccines. It also affects the community, as more people decide to not vaccinate, fully eradicated diseases will make a come back and infect the vulnerable population. There are few ways to deal
with this situation as vaccine refusal does not clearly meet the criteria to involve CPS in a way that would be beneficial in mandating vaccines. There have been cases where the court has been involved and medical neglect has been deemed but no action is taken to vaccinate the child. Conclusion
The answer leans towards stricter mandates and education combined. A non-political medical leader that represents the Code of Ethics and the intention to build a healthy community
Apply Ethical Principals 6
rather than push political agendas is needed. This leader should make a clear and very publicized
separation from politics. Patient education regarding the importance of vaccines needs to be mandated in the health care world, even with licensed midwifes and holistic doctors. Doctors or healthcare providers of any sort that push anti-vaccine rhetoric should face disciplinary action. Mandates regarding vaccines should be enforced with home schooled children as well as public school. In a time where we face a public health crisis, strict mandates are the solution and should
be utilized for the sake of our community.
Your preview ends here
Eager to read complete document? Join bartleby learn and gain access to the full version
- Access to all documents
- Unlimited textbook solutions
- 24/7 expert homework help
Apply Ethical Principals 7
References
Constable, C., Blank, N. R., & Caplan, A. L. (2014)
. Rising rates of vaccine exemptions: Problems with current policy and more promising remedies.
Vaccine,
32(16), 1793-1797. doi:http://dx.doi.org.library.capella.edu/10.1016/j.vaccine.2014.01.085
Levitt, D. (2014).
Ethical Decision-Making in a Caring Environment: The Four Principles and LEADS. Healthcare Management Forum, 27(2), 105–107. https://doi.org/10.1016/j.hcmf.2014.03.013
) Parasidis, E., & Opel, D. J. (2017)
. Parental Refusal of Childhood Vaccines and Medical Neglect Laws.
American journal of public health,
107(1), 68–71. https://doi.org/10.2105/AJPH.2016.303500
Measles Cases and Outbreaks
. (2020). CDC. https://www.cdc.gov/measles/cases-outbreaks.html