Resolving ethical dilemma facing a healthcare professional
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Resolving ethical dilemma facing a healthcare professional
The case study presents Dr. Angela Kerr with a situation that is hard for her to decide because in taking each course of action she must transgress a moral principle. One course of action for Dr. Kerr to choose is to follow-up and make sure that Ana receives full vaccinations, which is the right thing. Even though that decision may hurt the Smiths, it would protect the child from harm that would arise from vaccine-preventable illnesses (VPIs). As Dr. Kerr explains, vaccines have protected millions of children across the globe from preventable deaths as well as preventable health complications that arise from VPIs. The other course of action for Dr. Kerr is to buy Smiths’ school of thought of not vaccinating Ana. Even though the decision may impress Ana’s parents it would be the wrong decision as it would potentially harm Ana. Besides, the ethical dilemma surrounds what is legal because it is a requirement in most states to vaccinate children before they can attend school (Colgrove, 2019). The choice of the parent not to vaccinate their child is only plausible under specific circumstances, which vary by state.
Ethical decision model
Allaa, Amani, and Rayan (2019) argue that three components form the basis of ethical decision-making. These are moral awareness, moral judgment, and ethical behavior. Judging from moral awareness, Dr. Kerr must appreciate the ethical aspect of her decision. Moral awareness should be the first step for Dr. Kerr to acting ethically. This is the responsibility for everyone in keeping ethics in their frame of reference when critical decisions must be made. Secondly, considering the moral judgment in this scenario, Dr. Kerr must make a judgment that has moral content for best evaluation of whether or not to ensure Ana is vaccinated. However, Dr. Kerr’s moral judgment faces philosophical disputes as Dr. Kerr may make judgments based on feelings and emotions. Regardless of the surrounding feelings and emotions, Dr. Kerr’s moral judgment should be guided by the first component, which is moral awareness. Thirdly, the concept of ethical behavior demands Dr. Kerr to be honest, fair to self, and the parent of Ana. Equity must characterize the relationship between Smiths’ reasoning and the professionally accepted code of ethics in the medical arena.
Facts leading to the ethical issue
The case study presents facts that lead to an ethical issue where Dr. Kerr has to choose between two alternatives that appear to be superficially right (ethical) but when examined more closely, one alternative is right while the other is unethical. One alternative for Dr. Kerr is to buy Smiths' idea of not vaccinating Ana. The fact surrounding this alternative is that the Smiths are well educated at least through the college level and their research on vaccines has left them convinced that vaccines do more harm than any proven benefits to the recipient. Precisely, they attribute the rise in autism to vaccines and support their argument with details from mommy-blogs. The second alternative for Dr. Kerr to vaccinate Ana also has facts to support it because it follows the recommendations of the medical fraternity to vaccinate children fully. This is guided by the extensive research and safety profiles that receive regular updates through the Vaccine Adverse Event Reporting System (VAERS). This system is accessible to the public and allows public and health providers to report any reactions to vaccines. So far, Dr. Kerr is fully aware that there is no proof for any vaccine in causing autism spectrum disorder (ASD) or any other disorder.
While both alternatives are based on some researches, the research by the medical community is extensive and monitored by a system that is wide in scope (Allaa, Amani & Rayan, 2019). That adds more weight to the recommendation by the medical community to vaccinate children fully as opposed to the narrow research by the Smiths.
The most affected party in this ethical dilemma is Ana because of the consequences of not receiving the vaccination. The consequences go beyond emotional and become critical in that they may claim Ana's life (Allaa, Amani, and Rayan, 2019). The Smiths are also involved in the ethical issue especially after listening to Dr. Kerr’s explanations on how vaccines have saved millions of children worldwide. Dr. Kerr is also at the center of the ethical problem because the decision Dr. Kerr makes might determine whether life will be saved or lost.
Factors that contributed to the ethical issue identified in the case study
Lifestyle
Smiths indicated that their lifestyle might influence the health of Ana. They desired to raise Ana as naturally as possible by ensuring exclusive breastfeeding for the first six months, making their baby food and not allowing Ana to be vaccinated.
Smiths’ Perception of Ana’s health
The Smiths’ perceived how well Ana had developed. Ana was not weak, she was strong throughout the five days and they had so much confidence in her, which may have given them a reason to ignore Vaccination.
Vaccine components
The Smiths had doubts about the components of the vaccines. They perceived the components as poison injected and therefore no value addition associated with vaccinations. They argued the potential harms outweighed any benefits. They went ahead in pointing out that autism was one of the unforeseen risks of vaccines.
Smiths’ Social environment
The Smiths narrated to Dr. Kerr their social experiences through their research that included online mommy-blogs, which detailed how autism in many children may have resulted from vaccines (Allaa, Amani, and Rayan, 2019).
Several academic peer-reviewed journal articles are relevant to the ethical issue in Smiths’ case study. For instance, one research studied the factors that influence decision-making processes by parents concerning vaccination. The participants in the study were parents visiting anthroposophical child welfare centers (Colgrove, 2019). As a result of many parents becoming more disparaging regarding childhood vaccination in the recent past, the research focused on the probable factors that led to the trend. The study suggested that parents might be critical or even refuse vaccination for their infants due to anxiety about the likely side effects or wrong perception that the vaccine-preventable diseases do not pose serious threats. Some also lack trust in hard immunity (Colgrove, 2019). These factors combined reflect why the Smiths are adamant in having their daughter vaccinated.
The effectiveness of the communication approaches by Dr. Kerr present in the case study
Dr. Kerr has proven that providing proper care for patients goes beyond performing procedures. Dr. Kerr communicated with Smiths professionally as a crucial component of discharging her professional duty. Such a strong communication strategy is enriching to Ana’s health literally and psychologically for her parents. While Dr. Kerr considered the importance of communication to Smiths regarding the importance of vaccination, the safety of Ana was her top reason. In the absence of adequate communication, death was a likelihood. An instance where the professional effectively communicated was in her response to the Smiths. Dr. Kerr did not brash the Smiths’ argument but rather begun by admitting that vaccines have certainly sparked controversy in recent years. However, she strongly recommended that Ana become fully vaccinated and went ahead to explain to the Smiths how vaccines have saved the lives of millions of children worldwide.
According to Kristin, Lynne, Meslin, and Zimet (2016), some of the effective communication approaches that can apply in such a scenario include the timely exchange of information between the health provider and the client or the family of the clients. This was the case involving Dr. Kerr and the Smiths. The communication must be two-way and can be spoken, written, or non-verbal. Two-way communication refers to engaging the client in the decision-making process as well as care planning. In addition to a lack of two-way communication, ineffective communication between medics and their patients would arise if the health professional, the patient, or the parent, lack adequate education about medications. Lack of complete follow-ups instructions and wrong information given by the medics also entail ineffective communication.
Effective communication approaches enrich patient's health while ineffective communication negatively influences the wellbeing of the patient (Kristin, Lynne, Meslin and Zimet, 2016).
In response to the ethical dilemma in the case study, Dr. Kerr took appropriate actions to listen and offer informed advice to the Smiths regarding the importance of vaccination. Dr. Smith managed her professional responsibilities well even though even after the Smiths agreed with her, they were not ready for a vaccine at that moment, which perplexed Dr. Kerr. She had done most of what she could considering that she is a medic who is well informed about the statistics and facts surrounding global immunization. To some degree, she managed to convince the Smiths on why they should have their daughter vaccinated.
The key lessons this case study provides for health care professionals are that health workers play a central role in the success of immunization programs. Health workers must have positive attitudes and practice good communication skills as these two attributes are crucial for both the caregiver and their clients in accepting both the old and the new vaccines (Colgrove, 2019).
Proposed solution
All that Dr. Kerr did right from listening to the Smiths analogy against vaccinating their daughter to offering informed advice on why they should have Ana receive full vaccination using effective communication was recommendable. On a sad ending, Dr. Kerr felt completely baffled because Jenna and Chris Smith not wanting Ana vaccinated at that time even after they confirmed their understanding of what the Medic had explained. At that juncture, in the best interest of Ana, it is recommendable to apply ethical principles and provide a solution that would have Ana vaccinated and thus protect her from vaccine-preventable illnesses. Dr. Kerr must continue to make follow-ups to make sure Ana is vaccinated with the consent of her parents. The ethical principle supporting such a follow-up is that the vaccine will protect the health of Ana and protect the health of the public through herd immunity. This will be the only way to have Ana vaccinated because many states offer a “philosophical” exception to mandatory vaccination unless it is a requirement by the federal government. According to Colgrove (2019), the federal government would only make vaccination a mandatory requirement if failure to vaccinate leads to a substantial risk of extreme harm to public health. Such follow-ups integrated with community education on the importance of vaccination would make such professionals more effective in their service delivery. Dr. Kerr should also share her experience with other medics within the Health Care as well as outside the facility to create more awareness among other medics and possibly reason with them on better ways to handle such scenarios.