Applying Ethical Principles Essay

Applying Ethical Principles Essay

Applying Ethical Principles Essay

            Florence Nightingale, the founder of modern nursing, commented that nursing is a reputable and ethical profession. Therefore, operating within the set ethical framework limits nurses from facing legal cases that have been on the rise in healthcare setting. Healthcare professionals often face ethical issues in their line of duty, requiring them to use moral decisions and values to solve these ethical problems (Rainer et al., 2018). Failure to apply ethical principles in solving ethical issues might result in adverse consequences for the healthcare worker. The consequences include license revocation, loss of public trust, and legal cases. These ethical principles have been significant in the past and are also accepted in the care field. Healthcare professionals use these principles when faced with complex decisions involving patients. Therefore, the purpose of this assignment is to address the ethical issue facing Dr. Kerr on the stand of Jenna and Chris Smith concerning immunizing their 5-day-old daughter.


Overview of the Case Study

            The case presented is about Jenna and Chris Smith, who are the biological parents, Ana. Ana is a 5-day-old baby who was born in the community hospital without presenting any complications at birth. The family was happy to receive the newborn, and they had a good time bonding with Ana. In their mind, they would do anything possible to make their baby safe because she was the only reason they could smile as family. For this reason, they believed that approaching the safety of Ana through the natural method would reduce the risk of infection in their baby. Therefore, the parents were against vaccinating Ana, citing the increased risk of autism arising from these vaccines. The natural choice selected the Smiths included breastfeeding the baby for the first six months and making their own food out of pureed organic foods for the baby.

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            The Smiths are intellects who had carried out research on vaccines. Their findings prove that these vaccines increase risk of autism, and they do not see the value that the vaccines would have on their baby; instead, the vaccines would cause potential harm. Ana’s parents have used the increase in autism rates as proof of the unanticipated risks of these vaccines. Their pediatrician, Dr. Angela Kerr, listened to their argument and the reason why they would not want their child to be vaccinated. In her experience and professionalism in healthcare, Dr. Kerr starts by agreeing about the controversies of these vaccines in recent years. However, she further explains that the vaccines have saved millions of children and reduced the mortality rate over the past century. The doctor iterated that the decreased rate of infection caused by the deadly Haemophilus influenza type B, is an outcome of the frequent immunization against the bacterium. Again, the increased cases of measles are also linked to unvaccinated individuals.

            Dr. Kerr further clears the controversy linking autism and immunization by explaining that the safety profiles of all vaccines are regularly monitored. The federal government has a system called Vaccine Adverse Event Reporting System (VAERS) that is responsible for constant updates of the vaccine data. This system also conducts a nationwide safety surveillance program sponsored by the FDA and the CDC through a special link available to the public. This system allows transparency for vaccine safety and encourages the public and healthcare providers to report adverse reactions to vaccines. No vaccines have proven to be causing autism spectrum disorder or any other developmental disorder. Again, in many studies, vaccines containing thimerasol were thought to cause autism, but it was later confirmed that it does not increase the risk of autism.

            Dr. Kerr also reminds the Smiths of the risks of exposure they would be bringing to the unvaccinated children. Some children in the general population have weak immunity arising from genetic conditions or cancer treatments. It is not advisable to vaccinate these children because of their condition. Other children are too young to receive certain vaccines. However, these children are protected because all other children and adults have been vaccinated, reducing exposure to the vaccine preventable-illness (VPIs). An increase in the number of parents refusing immunization for their healthy children would increase the rate of VPIs, putting vulnerable children at risk of infection. Despite this elaborate explanation, Jenna and Chris only confirmed that they understood the doctor’s explanation but still restated that they did not want Ana to be vaccinated at that time. Dr. Kerr is short of additional explanations that might convince this couple to vaccinate their child. She is out of options and wonders how she would handle the case.

Analysis of Ethical Issues in the Case Study

            In this case study, Jenna and Chris are the main factors leading to the ethical dilemma. Ana is still a 5-day-old child, unable to make her own decisions concerning health. The health and choice of the Smiths would define the direction that this issue would take. Jenna and Chris refused to immunize their baby at 5-day old, citing the adverse effect that the vaccine would have on their child, as explained in the study done by Migriño et al. (2020). As Dr. Kerr oversaw the risk and danger, they might be exposing their baby. She offered to explain the entire scenario citing examples and cases to prove that the vaccines would save the baby more than exposing her to additional risks.

            Dr. Kerr respects the decision of the parents; however, she is concerned with the serious health implication that would face Ana. She is also concerned with the lives of other children who cannot be vaccinated based on underlying conditions. However, the parents maintain that vaccinating their child at 5-day old would expose their child to increased risks of autism (Migriño et al. (2020). They would rather depend on the natural breastfeeding for six months and adopt pureed organic food after six months as this would save their child.

Using the Ethical Decision-Making Model to Analyze the Case Study

            The ethical decision-making model focus on three main components. They include moral awareness, moral judgment, and ethical behaviors. These components can be significant in analyzing the presented case study. Moral awareness is about the familiarity of the healthcare professional with the existing ethical dilemma (Rainer et al., 2018). This component explains to the healthcare professionals that they will be facing various issues that would limit their ability to save a situation. Moral judgment is the choice of what is good from the wrong when faced with an ethical dilemma. Moral judgment and awareness would affect the ethical behavior of a nurse. Ethical behavior addresses the action that healthcare professionals would take when faced with an ethical issue in the line of duty.

            Dr. Kerr’s moral awareness is reflected by her explaining the circumstances surrounding the case of Ana. She shares her wide professional knowledge with the parents to convince them of the positive health outcome that they would have on Ana by agreeing to be vaccinated. Her moral judgment is reflected by her decision to provide enough proof to the Smiths on the importance of vaccinating their child (Rainer et al., 2018). Besides, she counters the overall thinking overshadowing the decision of the parents that vaccines increase the risk of autism. Dr. Kerr believes that vaccinating Ana is the right thing to do, and that is why she engages the parents to change their minds.

            Dr. Kerr’s ethical behavior would define the action show would take to resolve the case. The actions depend on the four main ethical principles that govern the ethical conduct of healthcare professionals. Autonomy, beneficence, nonmaleficence, and justice are the main ethical principle she should be abiding by as a healthcare professional (Rainer et al., 2018).

Effectiveness of Communication Approaches in the Case Study

            The communication between a patient and a physician requires active listening and understanding from both parties (Salehi et al., 2020). Dr. Kerr listened to Jenna and Chris regarding their fear of vaccinating Ana. The pedestrian also learns that Jenna and Chris have been undertaking their private study about the vaccines, where they ascertain that it has caused more harm than good. The doctor also learns that Jenna and Chris understood the issues from her explanation and agreed to the facts relayed by the doctor. Dr. Kerr understands Jenna and Chris’s love for Ana and how they would not risk harming her by any means. Therefore, active listening assists the pediatrician in understanding the concerns of Jenna and Chris concerning vaccination.

            Dr. Kerr is aware that deciding to offer Ana vaccination without the consent of her parents would be a violation of the right to informed consent as a healthcare worker. Dr. Kerr is keen not to indulge in a legal dispute between her and Ana’s parents and decides to offer them the information that would change their minds (Salehi et al., 2020). The entire communication between the doctor and the Smiths is geared toward unveiling the benefits of vaccination to Ana and the entire community. The doctor maintains transparent communication to dispel doubts about Ana’s parents. Therefore, she respects the concerns of Jenna and Chris but stresses the need to allow Ana to get vaccinated. The doctor communicates the issue to the parents in an effective manner, ensuring that they both understand the risks and value of their decision on the child.

            During the discussion, Jenna and Chris discuss their findings on the increased rate of autism caused by the vaccination. Dr. Kerr agrees with the findings they had done and confirms that the component that was believed to be increasing the risk of autism was not increasing the said risk as studied by other scholars (Salehi et al., 2020). Dr. Kerr involves Jenna and Chris in an expert opinion based on her pediatrician experience. The doctor thought that Jenna and Chris would change their decision on vaccinating Ana by explaining the risks they would expose to Ana and other children in society. However, Dr. Kerr was unable to convince Jenna and Chris as they maintained their original idea of no vaccination even after receiving the expert opinion.

Resolving the Ethical Dilemma by Applying Ethical Principles

            The four main ethical principles play a significant role in solving ethical dilemmas facing healthcare professionals. These principles include autonomy, beneficence, nonmaleficence, and justice. Autonomy requires the healthcare professional to accept and understand the patient’s beliefs and values, beneficence focus on advocating for patients’ welfare, nonmaleficence prohibits healthcare workers from harming the patient, and justice is about treating a patient with utmost fairness (Rainer et al., 2018).

            Two major principles are involved in this case. The ethical dilemma is caused by the conflict between principles of autonomy and beneficence (Rainer et al., 2018). Dr. Kerr is preserving the autonomy of Ana’s parents by respecting their decision and the background research they have been doing on immunization. On the other hand, Dr. Kerr is acting for the welfare of Ana by explaining to her parents how the vaccination would reduce adverse health risks to the child. The doctor and Ana’s parents have a difference on the issue of vaccination. While the doctor has limited power to undertake the basic medical intervention right for the child, the parents are against such options. Therefore, Dr. Kerr must adhere to the autonomy principle and offer professional advice even though the parents are likely to refuse such options.

            Dr. Kerr could consider involving a second party in the solution to this dilemma. For instance, approaching Child Protective Services, which is a social agency run by the government to counsel and support families in promoting child welfare, could resolve the dilemma (Slack & Berger, 2020). Dr. Kerr is obligated to help Ana get vaccinated as part of their professional role as a healthcare worker (beneficence) by seeking the intervention of Child Protective Services. Although this option would be overriding the patient’s autonomy, the doctor would be working in the interest of Ana and her future life.


            Ethical dilemmas are part of professional practice, and it requires health care professionals to act with the utmost care that would aid in adhering to the four principles of care ethics. In the case study, Dr. Kerr has to choose between respecting the parents’ decision on no vaccination on Ana or helping Ana seek vaccination owing to the increased risk of infection on Ana. The proposed solution entails upholding two main ethical principles, which are autonomy and beneficence, in resolving Dr. Kerr’s ethical issue.


Migriño Jr, J., Gayados, B., Birol, K. R. J., De Jesus, L., Lopez, C. W., Mercado, W. C., … & Tulagan, G. (2020). Factors affecting vaccine hesitancy among families with children 2 years old and younger in two urban communities in Manila, Philippines. Western Pacific Surveillance and Response Journal: WPSAR, 11(2), 20.

Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review. Journal of Clinical Nursing, 27(19-20), 3446-3461.

Salehi, Z., Najafi Ghezeljeh, T., Hajibabaee, F., & Joolaee, S. (2020). Factors behind ethical dilemmas regarding physical restraint for critical care nurses. Nursing Ethics, 27(2), 598-608.

Slack, K. S., & Berger, L. M. (2020). Who is and is not served by child protective services systems? Implications for a prevention infrastructure to reduce child maltreatment. The ANNALS of the American Academy of Political and Social Science, 692(1), 182-202.

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