Classmate Lesli Response (3): -summarize a historical ethical dilemma in public health

Classmate Response-Lesli- Topic 6 DQ 2

Vaccines save lives, increase quality of life, and reduce economic hardship. Children, the elderly, and individuals with chronic illness reap the most benefit from living in areas with high vaccination rates. Vaccines however are not a subject free from controversy. Research, development, mandates, and vaccine hesitancy due to distrust are all current ethical dilemmas surrounding immunizations. Public health nurses are key stakeholders in creating transparent and ethical practice environments concerning immunizations through education and informed consent.

As recently as 1991 the Centers for Disease Control and Prevention (CDC) admitted to unethical research practices in Los Angeles involving African American and Latino Children.(Cimons, 1996) Children are a protected group in research. Minorities are also known to be a vulnerable population in research. Research and medical communities both have an ethical obligation to protect the Human Rights of these groups. These two minority groups did not give informed consent to have their children receive an unlicensed Measles vaccine.(Cimons, 1996) The parents were not specifically told the vaccine was unlicensed or experimental. A brochure given to the parents stated that the vaccine had been given to millions of children outside the United States.(Cimons, 1996)  That statement can be interpreted as misleading.Some basic elements of informed consent include: self-determination, the right to refuse, and explanation of risk in terms that are understood by the participant.(DeNisco & Barker, 2016)

Public Health Nurses are able to build relationships with communities, health care providers, researchers, and legislators to create environments that are transparent, focused on education, and informed consent.These goals can be achieved through well planned vaccine campaigns. These campaigns should focus on providing education to parents, the vaccine hesitant, lawmakers, and health care providers.(Communicating Effectively About Vaccines: New Communication Resources for Health Officials, 2010) These campaigns should provide education on vaccines that empowers and reassures them they are making the best choices for their children.(Communicating Effectively About Vaccines: New Communication Resources for Health Officials, 2010) These campaigns should also encourage health care providers to sit and take time to educate parents and address concerns about vaccines. This type of vaccine education should begin with the Ob/Gyn visits pre-pregnancy.(Communicating Effectively About Vaccines: New Communication Resources for Health Officials, 2010) Public Health partners should provide evidence of transparent statistically proven benefits of vaccine efficacy. We must also reinforce information should be obtained from valid reliable sources such as licensed health care professionals and public health organizations such as the CDC. Public health nurses can also provide first hand testimoney to lawmakers to ensure proper regulations are mandated along with funding. Lastly, we must accompany consent forms with up to date vaccine information sheets that list risks and benefits in plain language. Through these initiatives we can build trusting relationships within the community.

References

Cimons, M. (1996, July 17). CDC Says It Erred in Measles Study. The Los Angeles Times. https://www.latimes.com/archives/la-xpm-1996-06-17-mn-15871-story.html

Communicating effectively about vaccines: new communication resources for health officials [PDF]. (2010). Association of State and Territorial Health Officials. https://astho.org/Programs/Immunization/Communicating-Effectively-About-Vaccines–New-Communication-Resources-for-Health-Officials/

DeNisco, S., & Barker, A. (Eds.). (2016). Advanced practice nursing: essential knowledge for the profession (3rd ed.). https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.php

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Solution

Classmate Lesli Response (3)

I agree with you that vaccine hesitancy is one of the main issues that can result in ethical dilemmas in public health. New vaccines are always met with a significant level of distrust and suspicion from the general public. Health caregivers administering new vaccines, including public health nurses, might therefore be tempted to overstate the thoroughness of trials, efficacy, and even the length of time that a vaccine has been administered since it was approved. Past cases such as the administration of unlicensed measles vaccine in Los Angeles in 1991 show the ethical tightrope that healthcare caregivers have to maneuver in order to convince the general public to take newly developed vaccines (Williamson, & Glaab, 2018).

The ideal and ethical way to deal with vaccine hesitancy is through patient education and emphasis on informed consent (Williamson, & Glaab, 2018). By deciding to overstate the efficacy of clinical trials and the length of time that a vaccine has been approved, public health nurses will act unethically and go against the right of informed consent among patients. Therefore though public health nurses have a role in ensuring that they protect the health of their communities, they should not do so at the expense of the rights of patients. Public health nurses should avoid misinformation and manipulation of data and information related to vaccines, including the length of trial, efficacy, and how long a vaccine has been approved. Therefore, public health nurses should utilize patient education to cultivate informed consent in their target communities and populations (Williamson, & Glaab, 2018). Promoting informed consent can go a long way in dealing with the challenge of vaccine hesitancy in populations such as in the present Covid 19 pandemic.

References

Williamson, L., & Glaab, H. (2018). Addressing vaccine hesitancy requires an ethically

consistent health strategy. BMC medical ethics, 19(1), 84. https://doi.org/10.1186/s12910-018-0322-1