Introduction
During their medical career, health professionals are often presented with moral dilemmas. There are protocols and recommendations for resolving some issues, but, in other cases, only ethical principles can serve as guidelines. Therefore, it is important to develop moral standards which can be applied in various critical and sensitive situations. The basic principles of autonomy, justice, beneficence, and non-maleficence are widely considered to be the framework for moral dilemmas that occur in medical practice (Stanford University, n.d.). It might also be relevant to consult with the ethical decision-making model’s components: moral awareness, moral judgment, and moral behavior.
Overview of the Case Study (Incident 10)
Jenna and Chris Smith are parents of a newborn baby who refuse to vaccinate their daughter, Ana (Capella University, 2020). They are college-educated and claim that they have thoroughly researched the issue. They want to raise their child as naturally as possible, and they are also concerned with unforeseen risks of vaccination, for instance, that it may cause autism.
Their new physician, Dr. Kerr, attentively and patiently listens to their arguments, and then, presents her own. She states that vaccination has contributed to a decrease in child mortality, preventing many potentially fatal diseases. She also explains that safety profiles of vaccines are regularly updated and controlled by the federal government’s Vaccine Adverse Event Reporting System (VAERS). This organization has a website that promotes transparency regarding the recommended vaccines. Dr. Kerr also emphasizes that there is no evidence that any vaccine has ever caused autism or any other developmental disorder.
Moreover, she employs the argument of the greater good, explaining that vaccination helps to prevent the spread of many inflectional diseases by creating herd immunity. It might be particularly crucial for children who cannot be immunized due to some medical conditions. However, even after listening to Dr. Kerr’s arguments, the Smiths persist with their refusal to let their daughter be vaccinated.
Analysis of the Ethical Issues in the Case Study
The moral dilemma in the presented case study is that Dr. Kerr should respect parents unwillingness to vaccinate Ana, but she also has to consider the child’s interests, which, in this case, appear to contradict her parents decision. Moreover, since vaccination allows to create herd immunity, preventing high levels of disease spread and mortality, Dr. Kerr also has to keep in mind the idea of the greater good which demands to vaccinate as many children as is medically possible. Autonomy, one of the fundamental ethical principles of health care, implies that a patient has the right to decide what to do with their body after having been provided with all the necessary information (Stanford University, n.d.). In the case study, the patient, Ana, is a child, so this decision has to be made by her official caregivers – parents. Therefore, Dr. Kerr cannot discard their opinion.
On the other hand, another basic ethical rule which medical workers are expected to follow is beneficence, which requires that a patient’s well-being should be the priority (Stanford University, n.d.). If her parents persist with their refusal, Ana can develop severe conditions which may affect her entire life. Moreover, the principle of non-maleficence demands that no harm should be done by the actions of a medical professional. However, if Dr. Kerr allows the Smiths not to vaccinate Ana, it may endanger not only her but people, particularly children, around.
Using the Ethical Decision-Making Model to Analyze the Case Study
There are three basic components of the ethical decision-making model. The principle of moral awareness implies acknowledging the ethical character of the dilemma. This requires establishing who are the parties involved and understanding how one’s decision can affect their welfare. Moral judgment demands that a person, having considered the established ethical norms, resolves what would be an ideal outcome in the situation. Then, they are expected to determine the ways how it can be achieved, and make the necessary steps, pursuing ethical behavior.
In the case study, Dr. Kerr understands that while it is essential to respect the parents autonomy, she should do her best to provide for the child’s health and well-being. Therefore, her moral judgment is that vaccinating Ana would be the best option, so she tries to convince her parents to give their consent, thus, making a moral action. However, despite her efforts, the Smiths remain firm in their decision.
Effectiveness of Communication Approaches in the Case Study
While communicating with Anas parents, Dr. Kerr stays calm and professional. Before expressing her position, she attentively listens to the Smiths arguments. Then, she explains why immunization is safe and important. By providing parents with all the necessary information regarding vaccines, Dr. Kerr stays in line with the recommendations of recent research. It is suggested that sanctions for those who refuse to vaccinate their children should be the last resort – educational methods must be used to their full capacity first (Di Pietro, Poscia, Teleman, Maged, & Ricciardi, 2017). Denial of providing care for the child may only exacerbate the situation undermining already fragile trust between parents and medical institutions.
However, despite Dr. Kerrs efforts Anas parents still refused to vaccinate their daughter. The issue might have lied in the overwhelming abundance of scientific information provided. Therefore, creating a better foundation for such arguments can be advisable. On the other hand, Dr. Kerrs patients and attentiveness can be considered exemplary.
Resolving the Ethical Dilemma by Applying Ethical Principles
To resolve the issue, Dr. Kerr employed the tactics of persuasion. Her careful consideration of Anas parents position showed her respect and is likely to contribute to the maintenance of a confidential relationship with them. Unfortunately, her arguments failed to convince the Smiths to change their decision.
However, it might be advisable to continue the attempts. Some studies indicate that it is beneficial to stick to the CASE (Corroborate, About me, Science, Explain/advise) method. About me, part suggests that health professionals explain why they are qualified to advise vaccination mentioning the research they have done into this issue (Jacobson, Sauver, & Rutten, 2015). This can create the necessary basis for providing scientific information. In the corroborate and explain/advice parts, it might be important to make some personal statements, such as, “We all care for Ana’s well-being!”. It might also be useful to ask another health professional to talk to the Smiths, giving them additional perspective. Communicating with Anas parents separately can also prove to be effective.
If all arguments are exhausted, and caregivers are still persistent in their refusal to vaccinate their child, it might be useful to remind them that all US states demand children become immunized to attend public school, though some make exclusions for medical, religious, and philosophical reasons (Adewale et al., 2019). However, it is necessary to be careful with resorting to any further sanctions. It is important to maintain trust between parents and their medical advisors.
Conclusion
All healthcare professionals must be aware of the fundamental principles of medical ethics and the main components of the ethical decision-making model to base their decisions on these standards. However, it might also be relevant to consult with the recent recommendations provided for some particular cases, such as parental vaccine hesitancy. While maintaining the respect of a patient’s autonomy, medical workers should act in the interest of their well-being and public health.
References
Adewale, O., Cooper, C., Felix, P., Mitchell, A. K., Savage, J., & Mase, W. A. (2019). The ethics of parental refusal to vaccinate: Costs, community safety, and individual rights. Journal of the Georgia Public Health Association, 7(2), 98-103.
Capella University (2020). Incident 10: To vaccinate or not? Exemplar sample ethical case study. Web.
Di Pietro, M. L., Poscia, A., Teleman, A. A., Maged, D., & Ricciardi, W. (2017). Vaccine hesitancy: Parental, professional and public responsibility. Annali dell’Istituto Superiore di Sanità, 53(2), 157-162.
Jacobson, R. M., Sauver, J. L. S., & Rutten, L. J. F. (2015). Vaccine hesitancy. In Mayo Clinic Proceedings (Vol. 90, No. 11, pp. 1562-1568). Elsevier.
Stanford University (n.d.). Medical Ethics 101. Web.