Assessment 3- Applying Ethical Principles Incident 10: To Vaccinate Or Not?
Capella University
NHS FPX 4000
9th April 202
Introduction
Healthcare practitioners often face ethical issues every day which will require them to reconcile nursing practice with their personal values and professional obligations. The nursing code of ethics was developed to ensure that all nurses are guided on decisions they make whenever they are faced with an ethical dilemma (America Nurses Association, 2023). For a nurse, it is also important to incorporate their moral values and ethical principles whenever they decide on what to do in a particular patient situation. The ethical principle consists of four areas that include autonomy, beneficence, no maleficence, and justice.
Cases study Summary
This selected case study involves a 5-day-old baby called Anna who is born to her parents Chris and Jena. The parents have their individual cultural beliefs where they plan to raise their child in a natural lifestyle. This means that they do not believe in prevention vaccines and that only organic food and constant breastfeeding will ensure their child grows up safe and healthy (Capella, n.d.). The parents being very educated, have done research regarding vaccines from online blogs, and are very concerned regarding the increased cases of autism and report that vaccines can cause a child to develop the condition (Capella, n.d.).
Dr. Kerr who is the visiting pediatrician is well aware of the controversy surrounding the use of vaccines and acknowledged the parents’ concerns. She, however, provided the parents with education on the positive side of vaccines and how they help prevent medical issues and mortality among children across the globe. She even provided an example of the recent measles outbreak for lack of vaccination and shared with the parents the positive side of vaccination such as the reduced cases of Haemophilus influenza B where vaccination cleared the said bacteria. She also provided the parents with an overview of vaccine safety, and information from trusted institutions such as the federal government Vaccine Adverse Events Authority system (VAERS) (Center for Disease Control, 2023), which is also backed up by the Center for Disease Prevention (CDC) and the Food Drug Administration (FDA) (Center for Disease Control, 2023).
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Analysis of the Ethical Issue
The ethical issue in this case study is related to the principle of autonomy, according to this principle, Dr. Kerr has the freedom to take an independent and active role regarding the decision-making of Ana’s case. For autonomy to occur thus, it means that Dr. Kerr needs to fully inform the parents and make them understand the implications of an ethical decision, since this is going to impact the child’s health outcome. Often when it comes to issues related to children, the pediatrician, and the child, may not have the first authority to make informed consent, since this is not only about meeting the medico-legal requirements of healthcare but looks at the issue of freedom to choose and ensuring involvement of the child parents.
The dilemma here is that as much as Dr. Kerr would want to exercise autonomy and that she has informed the parents of the importance of having their child vaccinated, including the implications of not having her vaccinated; the parents still chose not to vaccinate their baby. Here Dr. Kerr has to choose between medical paternalism and respecting the autonomy of the parents since they are the ones required to give the first consent, even though she knows the implications of not vaccinating. During childhood development, vaccination is very important and includes protecting the child against the varicella virus which is a contagious and very deadly virus. Approximately 4.2 million children face severe complications that lead to 4200- death per year. Based on this evidence, Dr. Kerr insists that Ana should receive the vaccine as this is the right thing to do, she already informed the parents regarding the consequences of not vaccinating their child using scientific evidence and explained to them the risks and benefits of not being vaccinated. She also confirmed their understanding and fears about vaccination and demystified the fears.
Use of Ethical Decision-Making Model
According to the ethical decision-making model, these areas should be looked into and that includes; moral awareness, moral judgment, and ethical behavior. The three areas are important when it comes to analyzing the ethical dilemma faced by Dr. Kerr and ways to go about it. The moral awareness component is about acknowledging that there is an ethical dilemma, in which moral judgment is about the actions that one will take to choose between what is right and what is wrong in such a situation (RegisteredNursing.org Staff Writers, 2016). Ethical behavior is about taking the right steps to meet the said dilemma. Based on the case study, Dr. Kerr is morally aware that there exists an ethical dilemma where Ana’s parents refused to have their child vaccinated, so Dr. Kerr used her moral judgment to listen to the couple’s reasoning regarding their beliefs and provide the required science-based facts on the issue of vaccines, in this case, she will apply ethical behavior.
Effective Communication Approaches
Throughout the process, Dr. Kerr presented a good communication process, she was respectful, she first listened to the parents’ concerns during the interaction, and she also appreciated their research on vaccines and their reasoning and acknowledged their fears. Later she provided the parents with evidence-based data from trusted institutions, and she did that without dismissing the parents’ concerns (Gaines, 2023). Dr. Kerr also effectively explained to the parent why she felt it was important for Ana to be vaccinated without forcing the decision on them, this was important as it helped them establish a common ground. In most cases, when a healthcare professional loses the patient’s trust, it often leads to poor decision-making from the side of the patient. By using communication skills, Dr. Kerr was able to fulfill her duty as a medical provider, even though the parents still refused to have their child vaccinated.
At this point then the Dr. had to use the ethical principle of beneficence which is a principle that looks at a ‘do not harm‘ approach to ethical dilemmas (Gaines, 2023). With this principle, Dr. Kerr will have to compromise between the harm and benefit of having the child vaccinated, where she will have to be biased toward the best interest of the child. Under this principle, Dr. Kerr has an upper hand in decision-making and might be required to engage the parents in high-risk therapy, where she honored the parent’s decision not to vaccinate Ana.
Resolving the Ethical Delimma by Appling Ethical Principles
In the case study, the ethical principles that Dr. Kerr resolved were autonomy and beneficence. She honored the decision of Ana’s parents not to vaccinate their child and granted them the right to autonomy, since in cases where underage children are involved, parents have the right to decide on their child’s health even when it is against the advice of a medical professional.
Conclusion
Applying ethical principles during an ethical dilemma is very vital in ensuring that both the professional requirements of the healthcare provider and that of the patient are met. The ethical decision-making model is a very important guide that can assist healthcare provided in coming up with a solution without compromising ethical principles. In this case, Dr. Kerr, applied two ethical principles of autonomy and beneficence to arrive at a decision not to vaccinate the child and respected Ana’s parents’ wishes.
References
America Nurses Association. (2023, February 17). Why ethics in nursing matters. ANA. https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/why-ethics-in-nursing-matters/
Capella. (n.d.). Ethical Case Studies. media.capella.edu. Retrieved April 7, 2023, from https://media.capella.edu/CourseMedia/nhs4000element18655/wrapper.asp?sso=true
Center for Disease Control. (2023). The vaccine adverse event reporting system (VAERS) request. CDC WONDER. https://wonder.cdc.gov/vaers.html
Gaines, K. (2023). What is the nursing code of ethics? Nurse.org. https://nurse.org/education/nursing-code-of-ethics/
RegisteredNursing.org Staff Writers. (2016, July 1). Ethical practice: NCLEX-RN. RN Programs – Start Your Journey as a Registered Nurse. https://www.registerednursing.org/nclex/ethical-practice/