How a Multidisciplinary Team Can Promote Vaccinations for Children

Applying Ethical Principles: To Vaccinate or Not Vaccinate

Case Study Summary

In the case study, “To Vaccinate or Not Vaccinate,” a young, college-educated couple, Jenna and Chris Smith, are adamant that they do not want their newborn child vaccinated for what they regard as highly valid reasons. Despite the best efforts of the couple’s pediatrician, Dr. Angela Kerr, to convince the Smiths to have their newborn vaccinated, the couple maintains that they have reviewed the scientific evidence as well as reports from other parents and their cost-benefit analysis convinced them that vaccination was not in their child’s best interests. The purpose of this paper is to apply the three components of an ethical decision-making model to this ethical dilemma, together with a proposed solution to the situation that will result in the baby being vaccinated.

Stakeholders Involved or Affected by the Ethical Problem

First and foremost, the newborn is the principal stakeholder in this ethical dilemma, with a lifetime ahead of it that will be fundamentally affected in one way or another depending on the outcome of any intervention to persuade the Smiths to have it vaccinated. Following closely behind the newborn are the parents, of course, who also have a lifetime investment in the wellbeing of their child. Next on the list of stakeholders are the clinicians who are confronted with this ethical dilemma and finally the general American public, who are referred to abstractly as “the herd.”

Application of the Ethical Decision-Making Model to This Ethical Dilemma

Moral awareness: The first stage of the ethical decision-making model involves the recognition that an ethical dilemma exists. In this case, the ethical dilemma is the refusal of the Smiths to have their newborn vaccinated based on what appears to be specious reasoning.

Moral judgment: The next stage of the ethical decision-making model concerns making a determination as to what courses of action are right or wrong. Clearly, this is a far more challenging stage that simply recognizing the existence of an ethical dilemma, and determining the optimal decision in the Smiths’ case is complicated by the need to respect the parents’ autonomy and decision not to vaccinate their child.

Ethical behavior: The final stage of the ethical decision-making model involves taking positive steps to achieve the desired ethical outcome. In the Smiths’ case, this decision would be to attempt to change the parents’ minds with respect to having their newborn vaccinated as recommended by the medical and scientific communities.

Description and Analysis of the Contributing Factors of the Ethical Problem

Although the case study does not specify, it appears that the infant is this couple’s first child. Therefore, statistically, this child is likely the only one this American couple will ever have, and it is reasonable to suggest that the “vaccination to promote herd immunity for the greater good” using their precious baby will invariably fall on deaf ears. This case study points out that the couple is college educated and they have performed at least what they regard as their due diligence research concerning the efficacy and safety of the regimen of vaccines mandated for American children today.

The fact that the Smiths have given greater credence to the empirical observations reported by parents over the mountain of scientific evidence concerning these issues, however, is a good place to start the process of convincing them that vaccinating their baby is in its – and their – best interests. Clearly, though, persuading this young couple to have their baby vaccinated is going to be a tough sell, and health care practitioners must have the full range of facts at hand in order to have a chance, including most especially those discussed further below.

Application of Relevant Peer-reviewed Research to the Ethical Problem

Although the Smiths’ fear of vaccinations causing autism in their child are ill-founded, their fear is still very real which represents the primary obstacle to achieving the desired clinical outcome. In addition, the Smiths’ decision not to vaccinate also overlooks the protections these drugs provide over individuals’ lifespans. For instance, according to Odone et al. (2015), “Immunization is one of the most successful and cost-effective primary prevention tools; it is estimated that, globally, immunizations prevent between 2 and 3 million deaths every year” (p. 73).

Likewise, although the case study is silent concerning any specific social, religious or cultural issues that may have affected the Smiths’ decision not to vaccinate their child, it is important for clinicians to identify and take these issues into account when formulating persuasive strategies to convince parents to vaccinate (Rafi et al., 2021). In sum, the primary intention of communicating this information to the Smiths is not to bully or scare them into compliance, but rather to ensure that they fully understand the gravity of any decision concerning vaccinating their newborn.

Effectiveness of the Communication Approaches in the Case Study

Although Dr. Kerr took special care to communicate all of the legitimate reasons in support of having newborns vaccinated, including the demonstrated safety and efficacy of vaccines, the multiple ways they are analyzed, the fact that vaccinations are typically required for children’s admission to schools and the need to promote herd immunity in the general population, she did not emphasize the lifelong protections vaccinations provide nor did she enlist the assistance of a multidisciplinary healthcare team which could have brought different views in support of vaccination to bear on this ethical dilemma. The consequences of this failure may have significantly contributed to the Smiths’ decision not to vaccinate their child.

Effectiveness of the Approach Used by a Professional to Deal with the Ethical Problem

In realty, Dr. Kerr generally satisfied her professional responsibilities and dealt with this ethical problem appropriately, if incompletely and unsuccessfully. Her ultimate decision, however, to simply remain “perplexed” rather than formulate a strategy and take positive steps as outlined in the ethical decision-making model was completely ineffective in achieving the desired clinical outcome.

Description of the proposed solution

As noted above, the case study reports that both parents are college-educated and, having attended school for much of their lives, they are therefore presumably vaccinated themselves. They should be firmly reminded by a multidisciplinary healthcare team that their vaccinations made it possible for them to survive into adulthood in order to conceive this child in the first place. In addition, the Smiths should be made aware of the same lifelong protections that they have enjoyed that vaccinating their newborn child would provide. Finally, the Smiths’ reliance on the empirical observations and reports from other parents contained in blogs should be countered with pro-vaccination reports from similar sites that also draw on parents’ positive feedback concerning vaccinating their children. This multifaceted strategy would have a decent change at changing the Smiths’ minds about vaccinations while also fostering professional collaboration in a multidisciplinary healthcare setting.