This paper examines a case study in which a college-educated couple refuses to vaccinate their newborn child despite their pediatrician's efforts to persuade them otherwise. Applying a three-stage ethical decision-making model — moral awareness, moral judgment, and ethical behavior — the paper identifies the key stakeholders affected by the dilemma, analyzes the contributing factors behind the parents' refusal, evaluates the effectiveness of the communication approaches used, and proposes a multidisciplinary strategy to help change the parents' minds. Peer-reviewed research on vaccine efficacy and the influence of religious and cultural factors on vaccination decisions is incorporated throughout the analysis.
In the case study "To Vaccinate or Not Vaccinate," a young, college-educated couple — Jenna and Chris — are adamant that they do not want their newborn child vaccinated, for what they regard as highly valid reasons. Despite the best efforts of their pediatrician to convince them otherwise, the couple maintains that they have reviewed the scientific evidence as well as reports from other parents, and that 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 dilemma, together with a proposed solution aimed at ultimately resulting in the baby being vaccinated.
First and foremost, the newborn is the principal stakeholder in this ethical dilemma, with a lifetime ahead that will be fundamentally affected one way or another depending on the outcome of any intervention to persuade the parents. Following closely behind the newborn are the parents themselves, who also have a lifetime investment in the wellbeing of their child. Next on the list of stakeholders are the clinicians confronted with this ethical dilemma, and finally the general American public, referred to abstractly as "the herd."
Moral awareness: The first stage of the ethical decision-making model involves recognizing that an ethical dilemma exists. In this case, the ethical dilemma is the refusal of the parents to have their newborn vaccinated based on what appears to be specious reasoning.
Moral judgment: The next stage concerns making a determination as to what courses of action are right or wrong. This is clearly a far more challenging stage than simply recognizing the existence of an ethical dilemma. Determining the optimal decision in this case is further complicated by the need to respect the parents' autonomy and their 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 this case, that means attempting to change the parents' minds with respect to having their newborn vaccinated, as recommended by the medical and scientific communities.
"Parental fears, autism myths, and vaccine efficacy evidence"
"Critiques pediatrician's communication gaps and missed steps"
"Multidisciplinary strategy to change parents' minds"
Odone, A. et al. (2015, January). Effectiveness of interventions that apply new media to improve vaccine uptake and vaccine coverage. Human Vaccines & Immunotherapeutics, 11(1), 72–82.
Rafi, M., Khan, A., Ahmad, K., & Khan, A. (2021). How religious and cultural doctrines affect child vaccination: An analysis of parents' understanding of child vaccination. Journal of Hospital Librarianship, 21(4), 307–318.
To Vaccinate or Not Vaccinate. (n.d.). [University]. Retrieved from
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