Ethicsof Child Immunization
Ethicsof Child Immunization
of What Is Known About the Issue Many children, especiallythose in poor neighborhoods rarely receive immunization. This ismajorly because of the beliefs of the child and parent with regard toimmunization of children between age 2 and 9. The school-goingchildren have a higher likelihood of being immunized. In such cases,schools must have care providers who favor state and local healthorganizations (Salmon et al., 2004). Immunizing children havereceived mixed reactions among parents and care providers. Some seeit as a great way of keeping children from getting preventablediseases. Others see it as an unnecessary pain to the children. Thisis usually because of the many injections involved, which arepainful. To improve the reception of immunization among children, itis important to understand the ethical issues surrounding thepractice and various intervention measures. Understandingimmunization and its effectiveness is a key consideration in the moveto promoting the idea among mothers and other caregivers. There aremany dangerous diseases like polio that can be prevented by simpleimmunizations. However, the process involves too many shots that arevery painful for children. It is not easy for a child to bear thepain of, for instance, two shots on the legs and two on the arms, atotal of four injections at a time. Parents also find it hard tounderstand why their children have to take all those injectionsinstead of a single one. Taking care of children when they are inpain after the injections is also very tough for parents. So theissue involved is the pain fet by the child, the beliefs, values andcoping mechanisms of the parents and the views of the caregivers(Austvoll-Dahlgren, & Helseth, 2011).
EthicalDimensions of the Issue It is ethically right to keep allchildren safe from diseases. All diseases that can be preventedthrough immunization should be prevented at all costs. However, ifthe means for preventing them involves the inflicting of anunbearable pain on the children, and trouble in care provision forparents, it becomes an ethical dilemma. Every child has the ethicalright to a pain-free growth. Putting a child through pain in the legsand arms every month is therefore ethically unjustifiable, even ifthe intent is right. Due to the nature of the parents’ professions,it is also ethically unjust to make children more dependent on themyet they also have their jobs to attend. Most parents end up failingto take their children for immunizations because they are busy andcannot afford the time to care for a child in pain (Niederhauser &Markowitz, 2007). Others put off the idea of immunization becausethey do not see the need. Once children have received theimmunizations given to them when they are still months old, theyassume all diseases have been prevented and there is no need to putchildren through the pain once more. In many cases, many children endup receiving exemptions to the immunization services provided tochildren at school. This is often the case in schools where careproviders are not in favor of the state and local healthorganizations (Salmon et al., 2004).
Relevanceof the Issue to Health Professions The issue of reluctance totake children for immunizations is relevant to the healthprofessionals since it is their duty to prevent diseases fromclaiming the lives of all individuals at all costs. Immunization isone way in which the health of a population can be safeguarded. Sinceit is useless to immunize adults against certain diseases due to thehigh likelihood that they have already got the diseases, immunizingchildren is a very important strategy. However, health care providersunderstand that the claim of women whose shots are too many and makesit tough to cope with children in pain. It is understood among healthcare professionals that keeping children safe from diseases are animportant aspect of their profession. If immunization is discouraged,for whatever reason, it translates to poor healthcare provision andthus failure of the healthcare professionals.
Pointsof Consensus and Difference Concerning the Issue Parents, careproviders and healthcare professionals agree that children should beprotected from diseases at all costs. They also agree thatimmunization is one of the most effective steps in accomplishingthis. However, there are also points of differences. First, someparents believe that they do not have to take their children forimmunization once they are older than two years. This is because themothers have already used up their maternity leave and therefore havetheir jobs that require their attention. Parents also believe thatchildren do not need the many injections that they receive during theservice provision (Niederhauser & Markowitz, 2007). Due to theirrestlessness and inability to cope, many parents also just shy offfrom taking their children to the clinics or allowing them to receivethe service delivered to schools. The health care providers disagreewith them on the issue of the amount of injections that the childrenshould receive. They believe that all the prescribed injections areimportant and no child should be exempted from any. They also believethat proper parental care involves making sacrifices as a parent totake care of the needs of the family, including taking children forimmunization (Megel, Heser, & Mathews, 2002). It is the belief ofthe professionals that the parents need to take time off to see tothe needs of their children. Some parents fear that theingredients used in making the vaccines and other medicines used inimmunizations may be harmful and unethical. Some even believe that itis a form of genetic engineering since there are genes of otheranimals that are used as ingredients. Some other parents also havethe fear that their children can catch diseases or suffer fromadverse side effects of the many different shots given. This isanother very potent point of difference that has proven hard tohandle for the nursing professionals (Niederhauser & Markowitz,2007).
RelevantEthical Analysis Vaccinations and immunizations to childrenare still legally determined in many states. This has an inhibitoryrole in the nursing profession. In principle, it is still not up onthe nurse or the healthcare professional to determine the dose of thevaccine to administer to the child, how many shots to give at a go,or even whether a child needs a particular vaccine or not. Nursesonly have the duty to implement what has been legally determined. Thenurses end up being faced with a dilemma of choosing betweenpromoting their professional autonomy with regard to their scientificexperience and abiding by the orders from their authorities. Thisoften leads to ethical dilemmas since the professional is obligedboth legally and ethically to enforce public policy. According toethical theory, the other dilemma is that patients have the ethicalright to autonomy. This means that, in the case of children, mothersand caregivers have the right to choose what kind of injection andthe amount that their children receive. Nurses are expected by thestandards of practice to obey the choice of the mothers. On theirpart, this translates into failure. Therefore, the nurses and otherhealthcare personnel have an ethical obligation to ensure theimplementation of the immunization and vaccination procedure, buthave to obey the autonomy of the patients at the same time.
PersonalNursing Professional’s Response to the Issue Armed with theknowledge of the ethical issues surrounding the provision ofimmunization services to children, an individual nurse can take somebold steps to ethically handle the case. The nursing professional canoffer training on immunization and the requirements to the parentswho bring their children to clinics (Austvoll-Dahlgren & Helseth,2011). One other way of reaching the parents is by training theirchildren on the need for vaccination and immunization. The childrencan also be sent home with letters to their parents explaining theissues surrounding the service and why they should take theirchildren to hospitals and clinics to be immunized. Campaigns can beheld by the nursing professionals to promote immunization (Wallace,Ryman, & Dietz, 2012). These strategies can help in promotinginformed decision making among parents. The professional can thushave an opportunity to discuss with parents some of the things theymight have heard, seen or read in the news. The discussion may beused in critically appraising the information that the parents haveregarding immunization and providing them with sources of informationthat are reliable. The parents are then provided with copingmechanisms. The professional can also prepare the child forimmunization through encouragement. To minimize anxiety aboutinjections among children, they can be promised rewards if they arebrave. After the immunization, the children should be rewarded withimpressive gifts. This can help in changing their views aboutimmunization and the injections. The nurse can also work togetherwith lay workers in promoting immunization awareness and acceptanceamong children and parents. According to research, lay people aremore effective in promoting a better view of the injections among thechildren and parents (Whittaker, 2002). Another strategy is tointegrate immunization in other routine health care services(Wallace, Ryman, & Dietz, 2012).
Conclusion Thereis a critical ethical dilemma regarding the provision of immunizationto children, which can only be solved if the nursing professional canengage in parent and child education in order to foster informeddecision making. The ethical dilemma is concerning the fact thatimmunization is legally dictated and nurses have no way ofcontrolling it, yet they are expected to obey the autonomy of thepatient, in this case, the parents. In many cases, the parents do notwant to take their children for immunizations because of the pain andpotential adverse effects involved.
Austvoll-Dahlgren,A., & Helseth, S. (2011). Public health nurses’ barriers andfacilitators to the use of research in consultations about childhoodvaccinations. ScandinavianJournal of Caring Sciences,26(2),271-278. doi:10.1111/j.1471-6712.2011.00928.x
Niederhauser,V. P., & Markowitz, M. (2007). Barriers to immunizations:Multiethnic parents of under- and unimmunized children speak. Journalof the American Academy of Nurse Practitioners J Amer Acad NursePractitioners,19(1),15-23. doi:10.1111/j.1745-7599.2006.00185.x
Megel,M. E., Heser, R., & Mathews, K. (2002). Parents` Assistance ToChildren Having Immunizations. Issuesin Comprehensive Pediatric Nursing,25(3),151-165. doi:10.1080/01460860290042585
Salmon,D. A., Moulton, L. H., Omer, S. B., Chace, L. M., Klassen, A.,Talebian, P., & Halsey, N. A. (2004). Knowledge, Attitudes, andBeliefs of School Nurses and Personnel and Associations WithNonmedical Immunization Exemptions. Pediatrics,113(6).doi:10.1542/peds.113.6.e552
Wallace,A. S., Ryman, T. K., & Dietz, V. (2012). Experiences IntegratingDelivery of Maternal and Child Health Services With ChildhoodImmunization Programs: Systematic Review Update. Journalof Infectious Diseases,205(Suppl1). doi:10.1093/infdis/jir778
Whittaker,K. (2002). Lay workers for improving the uptake of childhoodimmunization. BrJ Community Nursing British Journal of Community Nursing,7(9),474-479. doi:10.12968/bjcn.2002.7.9.10659