Ethical Dilemma Assignment_3

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1 Ethical Dilemma to Vaccinate or Not? Dawn Precious Paul Baptiste Capella University NHS-FPX4000: Developing a Healthcare Perspective Dr. Jeanie Kaeberle September 22, 2023
2 Ethical Dilemma To Vaccinate or Not? Summary of the Case Study and Analysis The case study entails the Smiths, new parents to a 5-day-old infant called Ana, who are unsure about vaccinating their child because of their beliefs, including concerns about vaccines that cause autism. Ana's pediatrician, Dr. Kerr, suggests vaccination and stresses the importance, benefits, safety, and herd immunity issue. Regardless of her recommendation and advice to the parents, the Smiths remain firm on their decision not to vaccinate their baby Ana. Jenna and Chris Smith claim to raise their child as naturally as possible, including exclusive breastfeeding for six months, preparing food from organic sources, and not vaccinating Ana. The reason behind all these perceptions about vaccination is that the Smiths have researched and read online mommy-blogs that maintain that vaccines pose potential risks to infants that outweigh their benefits. For instance, the couple mentions concerns about vaccines that cause autism, citing the rise in autism rates and cases. However, Dr. Angela Kerr suggests that Ana should be fully vaccinated and highlights the life-saving benefits of the vaccine and their importance in reducing child mortality. For instance, Dr. Kerr mentions Haemophilus influenza type B and the current measles outbreak as evidence of vaccine efficacy. In this case, the ethical dilemma revolves around the parent's autonomy and right to make medical decisions for their child versus Dr. Kerr's duty to protect the child's health and the public health benefits of vaccination (Capella University, 2018). Analyzing the Ethical Dilemma in the Case Study Looking into the article by Weber (2008) on the update on autism and childhood vaccines, vaccination stands out as the cornerstone for public health. Vaccines are responsible for preventing countless diseases and saving lives. However, deciding to vaccinate a child can
3 sometimes be fraught with ethical dilemmas in cases where parents choose not to vaccinate their child based on personal perceptions, beliefs, and misinformation. Despite the dilemma in the case, Dr. Kerr underscores the importance and safety of vaccines, explaining the regular safety of intensive care conducted through the Vaccine Adverse Event Reporting Systems (VAERS). She also gives the vaccine-autism link that explains and reassures that vaccines with thimerosal do not increase the risk of autism spectrum disorder (ASD). Reflecting on Dr. Kerr's point of view on vaccination, it is evident from the background of vaccines containing thimerosal that was used in vaccines in the 1970s to prevent bacterial growth and included that the FDA concluded that the vaccines had a very low amount of mercury that was not likely to be harmful (Weber, 2008). In this case study, the controversy surrounding thimerosal and autism, as claimed by the parents, as the scientist suggested that low maternal methylmercury exposure could be dangerous to infants. However, the FDA Modernization Act of 1997 conducted an assessment and ordered the removal of thimerosal-containing vaccines, although there was no evidence of its harm to children (Weber, 2008). It is also evident that reports and studies have consistently found no association between autism and MMR vaccines or thimerosal-containing vaccines. For this reason, Dr. Kerr's recommendation is evidence-based and linked to scientific research from a broad spectrum of information. Effectiveness of Communication Approaches Present in the Case Study The viability of communication approaches for the situation study is portrayed by Dr. Kerr's reasonable and enlightening correspondence with the Smiths regarding Ana's vaccination. She employs effective communication approaches by providing evidence-based information, addressing the Smiths' concerns, and emphasizing the benefits of vaccination. Dr. Kerr effectively conveys the benefits of vaccination, emphasizes evidence-based medicine, and
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4 addresses the Smiths' concerns about vaccines causing autism. She maintains a respectful and non-confrontational tone, which promotes open dialogue. While the Smiths eventually choose not to immunize Ana, Dr. Kerr's methodology guarantees they are very much educated, making the decision made a viable correspondence act in a difficult circumstance. Above all, she respects parent's autonomy while trying to educate them on the safety of vaccines and their implication for public health. Effectiveness of the Approach used by the professional in a case study concerning the Component of Ethical Decision-Making Model In the case study, Dr. Kerr adopts an approach that aligns with the ethical decision- making model, which revolves around three main components: moral awareness, judgment, and ethical behavior. She displays moral awareness by recognizing the dilemma between parental autonomy and the professional duty to protect Ana's health. In addition, her moral judgment is based on advocating for vaccination by using evidence-based information to discourage misconceptions and stress the benefits of public health. Dr. Kerr also respects the Smith's autonomy while in her line of duty, avoiding confrontation and focusing on educating them. The approach taken by the professional could lead to Smith's considering vaccination and ensuring that Ana is protected. It might also maintain their trust and perception of public health. In contrast, an ineffective strategy may lead to defensive parents, strained relationships, and continued vaccine hesitancy. Application of Ethical Principles to Solution of the Case Study The moral issue introduced for the situation concentrates on the complex interplay between parental autonomy and the pediatrician's obligation to safeguard the child's well-being and general health. While parental autonomy is central, medical care professionals, directed by
5 moral standards and ethical principles, should advocate for practices that defend the well-being of children and society overall. The major principles that guide healthcare professional decision- making in an ethical dilemma include autonomy, beneficence, nonmaleficence, and justice. The principle of autonomy is maintained by respecting the Smiths' right to settle on medical service choices for their child, Ana. Jenna and Chris Smith, as educated parents, have investigated vaccination and decided against it in view of their interests about likely harms, including an apparent connection between vaccines and autism system disorder (ASD). As a pediatrician, Dr. Kerr acknowledges their autonomy and right to decide on Ana's healthcare. This respect for parental autonomy aligns with the ethical principle of autonomy, asserting that individuals have the right to make decisions about their lives and medical treatment. On the other hand, the principle of beneficence maintains the responsibility to do good and promote the patient's well-being. In this case, Dr. Kerr advocates for vaccination to promote Ana's health and protect her from vaccine-preventable diseases. She presents scientific evidence highlighting the life-saving benefits of vaccines, counters misconceptions, and emphasizes their role in reducing child mortality and morbidity. Her decision to educate and safeguard the patient's health aligns with the ethical principles. Healthcare professionals are obliged to the principle of nonmaleficence and should avoid causing harm and minimize potential harm to patients. Dr. Kerr adheres to this principle by providing evidence-based information to counteract the Smiths' concerns about vaccine safety. She also maintains that vaccines, including those that contain thimerosal, do not have adverse effects and risk of autism, rendering their information a common misconception. She acts according to the ethical principle of nonmaleficence by ensuring that Ana is not exposed to risks or harm.
6 Conclusively, justice in medical ethics entails fair distribution of healthcare benefits, burdens, and resources. Dr. Kerr appeals to the concept of herd immunity, stressing that vaccines protect vaccinated persons and safeguard those who cannot obtain vaccines for some medical reasons. She emphasizes the effectiveness of routine childhood immunization in upholding public health, especially for vulnerable individuals with weak immunity. This action aligns with the principle of justice that ensures healthcare interventions are distributed equitably, promoting public health equity. Conclusion Healthcare professionals often face ethical dilemmas that require critical thinking and informed decision-making guided by ethical principles. Applying these ethical principles facilitates a thoughtful and ethical resolution to a complex and sensitive healthcare issue, even though the Smiths ultimately retain their autonomy in making the final decision for a patient. For instance, Dr. Kerr effectively navigates the four major ethical principles discussed regarding parental autonomy: upholding vaccination to protect Ana's health and general well-being, staying away from misinformation to forestall harm, and accentuating the principle of equity and justice in medical services.
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7 References Weber CJ. Update on autism and childhood vaccines. Urol Nurs. 2008 Aug;28(4):290-1. PMID: 18771165. Capella University (2018). NHS-FP4000 Exemplar Sample Ethical Case Study. Capella Website: xxx.