Ethical Case Study-To Vaccinate or Not

Ethical Case Study-To Vaccinate or Not

Nurses and other healthcare providers usually face different ethical dilemmas in their practice. Ethical dilemmas in healthcare entail patient autonomy versus beneficence and non-maleficence. When faced with such dilemmas, the focus should be shifted toward providing quality patient-centered care and professionalism. This paper analyzes an ethical dilemma and develops a possible solution.

Summary of the Case Study

The case study is titled “Incident 10: To Vaccinate, or Not?” (Media Capella.edu, n.d.). Chris Smith and Jenna Smith are the parents of a five-day-old baby, Anna. Anna was born without any complications. As such, her parents decided to raise her naturally. This entails breastfeeding for six consecutive months, adopting organic foods, and not vaccinating Anna. The Smiths report that their research revealed that the potential harms of vaccination outweigh the potential benefits. According to them, vaccines increase the risk of autism. They admit that they sought their information from online mommy–blogs.

Dr. Angela Kerr, the Smiths’ pediatrician, reassures them that vaccines are safe. According to Dr. Kerr, the Vaccine Adverse Event Reporting System (VAERS) allows all stakeholders to monitor and report any adverse effects associated with vaccines. Data from VAERS indicates that vaccines do not increase the risk of autism or any other developmental problems. The VAERS upholds transparency and is accessible to the general public. Dr. Kerr notes that vaccines may be contraindicated in immunocompromised children.

Furthermore, an increase in the unvaccinated population will reduce herd immunity and predispose children to vaccine-preventable illnesses. Dr. Kerr recommends that Anna receive childhood immunization because it offers numerous benefits. However, the Smiths reiterate that they do not want to vaccinate their daughter.

The Ethical Decision-Making Model

The ethical decision-making model allows nurses and other healthcare providers to make plausible ethical decisions. The model entails moral awareness, judgment, and ethical behavior. Moral awareness enables individuals to recognize and acknowledge a moral issue (Media Capella.edu, n.d.). To achieve moral awareness, individuals should know the impact of their actions on the well-being of others. On the other hand, moral judgment enables individuals to formulate the best solutions to ethical issues. These solutions are backed by moral justification. Moral judgment is accomplished by evaluating the potential consequences of a decision (Media Capella.edu, n.d.). Lastly, ethical behavior allows individuals to execute their moral judgment. In this scenario, Dr. Kerr demonstrated moral awareness by identifying a moral issue in failing to vaccinate Anna. Dr. Kerr demonstrated moral judgment by embracing evidence from the VAERS. Her moral judgment guides her ethical behavior. To accomplish this, she should uphold healthcare ethics and involve other stakeholders.

The Factors that Contributed to the Ethical Problem

Various factors contributed to the ethical problem. Firstly, the decision by the Smiths to raise their daughter naturally caused the moral issue. They define raising a child naturally as breastfeeding for six consecutive months, adopting organic foods, and avoiding vaccines. Secondly, the Smiths did not authenticate the credibility and reliability of the source of their information. They claim that they have researched the benefits and risks of vaccines. However, further probing reveals that they sought information from online mommy–blogs.

Peer-Reviewed Journal Articles

Kasi et al. (2021) report that vaccination protects children and the public from various diseases. The CDC recommends vaccination against fourteen preventable diseases by the age of two years (AmericasHealthRankings.org, 2022). Data from 2020 reveals that approximately 75 percent of eligible children in the USA had received all recommended vaccinations (AmericasHealthRankings.org, 2022). In the USA, the CDC plays a key role in vaccine safety. The accomplish this, the CDC established the VAERS (CDC.gov, 2022). VAERS allows the public, healthcare providers, and manufacturers to report all suspected adverse effects associated with vaccination (CDC.gov, 2022). The reporting is transparent and unbiased. For example, vaccination led to the elimination diseases such as polio and tetanus from the USA (CDC.gov, 2022). The sources are credible and reliable. Firstly, the sources are credible organizational websites. Secondly, the sources are current and accurate peer-reviewed journals. The credentials of the authors of the sources are credible, and the information is generalizable.

The Effectiveness of the Communication Approaches

In this context, Dr. Kerr, the pediatrician, utilized active listening. Notably, she listened intently, embraced appropriate turn-taking, and avoided interruptions. Furthermore, she embraced active listening by giving candid feedback. Listening intently and limiting interruptions allowed the pediatrician to understand the perspective of the Smiths regarding vaccination. It enabled Dr. Kerr to learn that the Smiths did not use scholarly and credible sources to research vaccines. Dr. Kerr provided candid feedback by explaining the safety of vaccines based on well-documented evidence from the FDA and CDC. This feedback equipped the Smiths with pertinent information regarding vaccines.

Further, active listening promotes patient engagement (Kwame & Petrucka, 2021). As such, patients recognize that they are important stakeholders in the decision-making process. Patient engagement is likely to facilitate the implementation of the best ethical decision.

The Effectiveness of the Approach Used by a Professional

Dr. Kerr used active listening in an attempt to address the ethical dilemma. Active listening enabled her to understand the perspectives and opinions of the Smiths about vaccines. This provided an opportunity for educating the Smiths via candid feedback. Active listening enabled Dr. Kerr to avoid potential altercations with the Smiths, which would result from dismissing their beliefs about vaccines. Dr. Kerr used this technique to provide detailed information regarding vaccine safety and potential contraindications. Dr. Kerr’s argument was backed with credible evidence. Educating patients enables them to understand the moral issue better to facilitate decision-making. On the other hand, active listening creates a therapeutic relationship and increases the likelihood of addressing the moral issue (Kwame & Petrucka, 2021).

Ethical Principles to a Possible Solution to an Ethical Problem

In this context, the pediatrician faces the ethical dilemma of autonomy versus beneficence and non-maleficence. Autonomy is embraced by allowing patients and their families to make key decisions regarding their treatment (Varkey, 2021). Beneficence and non-maleficence are embraced by executing activities that benefit the patients and avert harm (Varkey, 2021). Dr. Kerr and the healthcare organization should work with Child Protective Services (CPS) to address this. CPS enforces federal and state policies and procedures to evaluate whether a child’s fundamental rights have been breached (Stopitnow.org, n.d.). As such, Dr. Kerr’s moral judgment and decision will promote Anna’s well-being.

Conclusion

Ethical dilemmas are common in the healthcare setup. Healthcare providers should embrace the ethical decision-making model to make morally sound and ethical decisions. Furthermore, they should embrace healthcare ethics in their decision-making process. In this context, the pediatrician faces the ethical dilemma of autonomy versus beneficence and non-maleficence. Involving Child Protective Services will enable her to make the best decision.

References

AmericasHealthRankings.org. (2022). Public Health Impact: Childhood Immunizations. https://www.americashealthrankings.org/explore/annual/measure/Immunize_b/state.

CDC. (2022). Diseases You Almost Forgot About (Thanks to Vaccines). https://www.cdc.gov/vaccines/parents/diseases/forgot-14-diseases.html.

Kasi, S. G., Shivananda, S., Marathe, S., Chatterjee, K., Agarwalla, S., Dhir, S. K., Verma, S., Shah, A. K., Srirampur, S., Kalyani, S., Pemde, H. K., Balasubramanian, S., Parekh, B. J., Basavaraja, G. V., & Gupta, P. (2021). Indian Academy of Pediatrics (IAP) Advisory Committee on Vaccines and Immunization Practices (ACVIP): Recommended Immunization Schedule (2020–21) and Update on Immunization for Children Aged 0 Through 18 Years. Indian Pediatrics, 58(1), 44–53. https://doi.org/10.1007/s13312-021-2096-7.

Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing, 20(1), 1–10. https://doi.org/10.1186/s12912-021-00684-2

Media Capella.edu. (n.d.). Ethical Case Studies. https://media.capella.edu/CourseMedia/nhs4000element18655/wrapper.asp

Stopitnow.org. (n.d.). What is Child Protective Services? https://www.stopitnow.org/ohc-content/what-is-child-protective-services.

Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119.

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Consider the ethical dilemma the healthcare professional faces in the selected case study. Pay particular attention to details that will help you analyze the situation using the three components of the Ethical Decision Making Model (moral awareness, moral judgment, and ethical behavior).

Note: The case study may not supply all the information you need for the assignment. In such cases, you should consider various possibilities and infer potential conclusions. However, please be sure to identify any speculations that you make.

Incident 10: To Vaccinate, or Not?

Jenna and Chris Smith are the proud parents of Ana, a 55–day–baby girl born without complications at a Community Hospital. Since delivery, the parents have bonded well with Ana and expressed their desire to raise her as naturally as possible. For the Smiths, this means breastfeeding exclusively for the first six months, making their baby food using pureed organic foods, and not allowing Ana to be vaccinated.

The Smiths are educated and explain they have researched vaccines and decided the potential harms they caused far outweigh any benefits. They point to the rise in autism rates as proof of the unforeseen risk of vaccines. Their new pediatrician, Dr. Angela Kerr, listens intently to the Smiths’ description of their research, including online mommy–blogs that detail how vaccines may have caused autism in many children. The Smiths conclude by resolutely stating they’ve decided not to vaccinate An despite the medical community’s recommendations.

Dr. Kerr states that while vaccines have sparked controversy in recent years, she strongly recommends that Ana become fully vaccinated. Dr. Kerr explains that vaccines have saved the lives of millions of children worldwide and have been largely responsible for decreases in child mortality over the past century. For example, the decreased incidence of infection with the potentially fatal Haemophilus influenzae type b has resulted from routine immunization against that bacterium. Similarly, epidemics such as the recent measles outbreak are usually associated with individuals who have not been vaccinated against that pathogen.

Dr. Kerr goes on to endorse the general safety of vaccines by informing Ana’s parents that safety profiles of vaccines are updated regularly through data sources such as the federal government’s Vaccine Adverse Event Reporting System (VAERS). The VAERS, a nationwide vaccine safety surveillance program sponsored by the Food and Drug Administration and the Centers for Disease Control and Prevention, is accessible to the public at https://vaers.hhs.gov/index. This system allows transparency for vaccine safety by encouraging the public and healthcare providers to report adverse reactions to vaccines and enables the federal government to monitor their safety. No vaccine has been proven casual for autism spectrum disorder (ASD, or any developmental disorder. On the contrary, many studies have shown that vaccines containing thimerasol, an ingredient once thought to cause autism, do not increase the risk of ASD.

Finally, Dr. Kerr reminds the Smiths that some children in the general population have weakened immune systems because of genetic diseases or cancer treatment, for example. It may not be medically feasible to vaccinate such children. Other children are too young to receive certain immunizations. Instead, these children are protected because almost all other children (and adults) have been vaccinated, decreasing their exposure to vaccine–preventable illnesses (VPIs). This epidemiological concept is known as “herd immunity.” As more parents refuse immunization for their healthy children, the rate of VPIs will increase. This puts vulnerable children at significant risk of morbidity and mortality. Routine childhood immunization contributes significantly to the health of the general public by providing a direct benefit to those vaccinated and by protecting others via herd immunity. Dr. Kerr concludes by stating that after considering the risks versus the benefits of immunization, most states require vaccinations before children can attend school. However, parents may decide not to vaccinate under specific circumstances, which vary by state.

Jenna and Chris Smith confirm their understanding of what Dr. Kerr has explained but restate that they do not want Ana vaccinated now. Dr. Kerr is perplexed as to what to do.

Develop a solution to a specific ethical dilemma faced by a healthcare professional by applying ethical principles. Describe the issues and a possible solution in a 3-5 page paper.

Introduction
Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Instructions
Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma a healthcare professional faces. In your assessment:

Access the Ethical Case Studies media piece to review the case studies you will use for this assessment.
Select the case most closely related to your area of interest and use it to complete the assessment.
Note: The case study may not supply all the necessary information. In such cases, you should consider various possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
Include the selected case study using APA style and format in your reference list. Refer to the Evidence and APA section of the Writing Center for guidance.
Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
Identify who is involved or affected by the ethical problem or issue.
Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
Apply the three components outlined in the Ethical Decision-Making Model media.
Analyze the factors contributing to the ethical problem or issue identified in the case study.
Describe the factors that contributed to the problem or issue and explain how they contributed.
Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
In addition to the readings provided, use the Capella Library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
Review the Think Critically About Source Quality resource.
Assess the credibility of the information source.
Assess the relevance of the information source.
Discuss the effectiveness of the communication approaches present in a case study.
Describe how the healthcare professional in the case study communicated with others.
Assess instances where the professional communicated effectively or ineffectively.
Explain which communication approaches should be used and which ones should be avoided.
Describe the consequences of using effective and non-effective communication approaches.
Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
Discuss the key lessons this case provides for healthcare professionals.
Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
Describe the proposed solution.
Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within the organization.
Discuss how likely it is the proposed solution will foster professional collaboration.
Write clearly and logically, using correct spelling, grammar, punctuation, and mechanics.
Apply the principles of effective composition.
Determine the proper application of the rules of grammar and mechanics.
Write using APA style for in-text citations, quotes, and references.
Determine the proper application of APA formatting requirements and scholarly writing standards.
Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.