Introduction
Every day healthcare professionals face ethical dilemmas that require them to incorporate their moral values and ethical principles in making the right decisions. In their ethical decision-making, healthcare workers must apply the four primary ethical principles: justice, non-maleficence, beneficence, and autonomy (Brown, 2020). Using these principles, they can make complex decisions involving patients. Therefore, by applying ethical principles, this paper seeks to develop solutions to the ethical dilemma that Dr. Kerr faces in the case study “Incident 10: To Vaccinate, or Not?”.
Overview of the Case Study
The case study presents the case of a 5-day-old baby girl, Ana, whose parents are Jenna and Chris Smith. The parents are committed to naturally raising their child and have decided against vaccinating her. The Smiths believe that the potential risks associated with vaccines outweigh any benefits and cite the increasing rates of autism as evidence. They have conducted extensive research on vaccines, relying heavily on online sources such as mommy blogs that suggest a link between vaccines and autism (Capella University, n.d.). However, Ana’s pediatrician, Dr. Angela Kerr, recommends fully vaccinating Ana. Dr. Kerr emphasizes the crucial role vaccines have played in saving millions of children’s lives globally and reducing child mortality rates over the past century. She assures the Smiths that vaccines are generally safe and have not been proven to cause/result in ASD or any other developmental disorder (Capella University, n.d.). Dr. Kerr also stresses the importance of routine childhood immunization in promoting public health by directly benefiting those who receive the vaccine and providing herd immunity to protect others. Despite understanding Dr. Kerr’s explanations, the Smiths remain adamant in their decision not to vaccinate Ana, which poses an ethical dilemma for Dr. Kerr. (Capella University, n.d.).
Ethical Issues Analysis
The case study raises several ethical issues regarding vaccination, parental autonomy, and the physician’s duty to protect the child’s health. To begin with, one ethical issue in this case study is whether or not to vaccinate Ana. The Smiths have decided not to vaccinate their child, while Dr. Kerr recommends full vaccination. It is crucial to note that according to Nguyen et al. (2022), parental hesitancy to vaccines has proven to be a barrier to their children’s immunization, resulting in a greater risk for diseases that are preventable through a vaccine. Vaccination effectively prevents and controls infectious diseases, but it carries some risks (Nguyen et al., 2022). Parents are expected to make informed decisions about their child’s healthcare, but their decision should be based on scientific evidence rather than misinformation. In this case, the Smiths have based their decision on online mommy blogs, making them believe that vaccines have potential harms that far outweigh any benefits. On the other hand, Dr. Kerr has presented evidence-based information on the benefits and safety of vaccination.
Another ethical issue in this case study is parental autonomy. Ana’s parents have the obligation and right to make decisions about their child’s healthcare, but this right is not absolute. Parents should act in their child’s best interests and make informed decisions based on scientific evidence (Salter, 2012). In this case, the Smiths have decided not to vaccinate their child based on their beliefs and research, which may not be based on scientific evidence. Dr. Kerr must provide the Smiths with accurate and evidence-based information on vaccination, but the ultimate decision rests with the parents.
A third ethical issue in this case study is the physician’s duty to protect the child’s health. Physicians have a professional and ethical obligation to promote their patients’ health and well-being, especially vulnerable and dependent children (Brown, 2020). In this case, Dr. Kerr is concerned about Ana’s health and recommends full vaccination to protect her from vaccine-preventable illnesses. However, the Smiths have refused vaccination for their child, which may put Ana’s health at risk. Dr. Kerr may need to consider her duty to report the parents’ decision to refuse vaccination to the appropriate authorities, such as child protective services, if she believes Ana’s health and well-being are at risk.
Ethical Decision-Making Model
According to Small & Lew (2021), the ethical decision-making model has three main components: “moral awareness, moral judgement, and ethical behavior.” Moral awareness involves recognizing that an ethical issue is present and identifying the key stakeholders involved. In this case, Dr. Kerr has a moral awareness that there is an ethical issue at hand. This is because the Smiths have made a decision that could potentially harm their daughter and the broader community. The second element of the model is a moral judgment, which involves assessing the available options and making a decision based on ethical principles (Small & Lew, 2021). Dr. Kerr exercises moral judgment by listening to the parents’ reasoning and beliefs and offering them science-based facts regarding the benefits of vaccines. The final element of the model is ethical behavior, which involves implementing the chosen course of action in a manner consistent with ethical principles (Small & Lew, 2021). In this case, Dr. Kerr has recommended that Ana be vaccinated, but the Smiths have chosen not to follow this recommendation. While Dr. Kerr may not be able to force parents to vaccinate their children, she can continue educating them on the benefits and possible risks of not vaccinating. In addition, she can ensure that the parents have access to accurate information and resources to help them make informed decisions.
Communication Approaches
In the case study, the communication approaches the parents, and the pediatrician used effectively conveyed their perspectives on vaccination. The Smiths expressed their desire to raise their child naturally and their research-based decision not to vaccinate Ana. Dr. Kerr effectively explained the benefits and safety of vaccination and the potential risks of not vaccinating while respecting the Smiths’ autonomy as parents. However, despite effective communication, the issue remained unresolved as the Smiths refused to vaccinate their child. This highlights the limitations of effective communication in situations where deeply held beliefs and values clash with scientific evidence and recommendations.
Application of Ethical Principles
One possible solution to the ethical issue presented in this case is for the pediatrician to respect the Smiths’ autonomy while also fulfilling their duty to protect Ana’s health. The principle of autonomy acknowledges the parents’ right to make decisions about their child’s healthcare, but the beneficence principle requires the pediatrician to act in the best interests of Ana (Varkey, 2021). The pediatrician can provide the Smiths with more information about the safety and benefits of vaccination, encourage them to reconsider their decision, and offer to address any concerns they may have. Suppose the Smiths still refuse to vaccinate Ana. In that case, the pediatrician can continue to provide care for Ana and monitor her health while also taking steps to ensure that Ana is not a risk to other vulnerable children who cannot be vaccinated. This approach upholds the ethical principles of autonomy, beneficence, and non-maleficence.
Conclusion
In conclusion, the ethical dilemma in the case study highlights the tension between parental autonomy and a physician’s duty to protect a child’s health. By applying ethical principles and utilizing effective communication approaches, healthcare providers can navigate such situations and promote the well-being of their patients while respecting their autonomy. Ultimately, the child’s best interest should remain the top priority in any healthcare decision-making process.
References
Brown, J. P. (2020). Ethical dilemmas in healthcare. In Safety ethics (pp. 67-82). Routledge.
Capella University. (n.d.). Incident 10: Vaccinate or Not? Ethical Case Studies. Retrieved March 20, 2023, from https://media.capella.edu/CourseMedia/nhs4000element18655/wrapper.asp
Nguyen, K. H., Srivastav, A., Lindley, M. C., Fisher, A., Kim, D., Greby, S. M., … & Singleton, J. A. (2022). Parental vaccine hesitancy and association with childhood diphtheria, tetanus toxoid, and acellular pertussis; measles, mumps, and rubella; rotavirus; and combined 7-series vaccination. American journal of preventive medicine, 62(3), 367-376.
Salter, E. K. (2012). Deciding for a child: a comprehensive analysis of the best interest standard. Theoretical medicine and bioethics, 33, 179-198.
Small, C., & Lew, C. (2021). Mindfulness, moral reasoning, and responsibility: Towards virtue in ethical decision-making. Journal of Business Ethics, 169, 103-117.
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28.
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