The Case of Mia Masterson (No 4 Wellbeing street) Promoting mandatory vaccination

The first ethical issue is associated to autonomy of parents where they must be allowed to decide the best practice for their child, not under the influence of any healthcare provider. The first ethical issue is associated to autonomy of parents where they must be allowed to decide the best practice for their child, not under the influence of any healthcare provider. The Public Health Act 2010 also requires all children to be completely vaccinated, prior to enrolment at a childcare centre (New South Wales, 2010).

Running head: HEALTHCARE
Health across the lifespan
Name of the Student
Name of the University
Author Note

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Case Study 1: Mia Masterson (No 4 Wellbeing street)
1. Promoting mandatory vaccination in this case is associated with a range of conflicting
legal and ethical issues. Legal compulsion of the parents David and Julian will
impinge on their human rights to decide what is appropriate for their child. Mandatory
vaccination is a prerequisite to ensuring the health and wellbeing of children, since it
aims to perpetuate herd immunity (Pierik, 2018). Reluctance of the parents to
vaccinate their child shows noncompliance to the strict vaccination requirements and
might often result in violation of the No Jab, No Pay policy. It might also ban
enrolment of Mia in child care centres and preschools (Trent, Zhang, Chughtai &
MacIntyre, 2019). The first ethical issue is associated to autonomy of parents where
they must be allowed to decide the best practice for their child, not under the
influence of any healthcare provider. Though the intention is to protect the child from
any communicable diseases (beneficence), forcefully vaccinating her against the wish
of her parents might lead to some kind of harm, thus violating the principle of non-
maleficence (Gill, Kukreja, Mannan, Gill & Singh, 2018).
2. The No Jab, No Pay policy had been introduced by the Australian government in
2016, and it mandated welfare payments of families based on the vaccination status of
children. While Victoria mandates complete immunisation for children attendance,
the National Immunisation Strategy for Australia 2013–2018 by the Australian
government also focuses in enhancing immunisation coverage through efficient and
secure vaccine supplies (Department of Health, 2016). The Public Health Act 2010
also requires all children to be completely vaccinated, prior to enrolment at a
childcare centre (New South Wales, 2010). The World Health Organisation provides
essential vaccines free of charge to all children, infants, adults and adolescents who
are eligible.

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3. The primary action would be to educate the parents about the benefits and safety of
vaccines, with the supposition that the educational mediations will encourage both
David and Julian towards vaccine acceptance. The parents will be asked to seek
consultation from a physician whom they can trust, and share their concerns with.
They will be provided data and facts for explaining the negative correlation between
vaccination and autism and will also be explained that diagnosis of autism in their
niece was not a consequence of immunisation (Bennett, Webster, Goodall &
Rowland, 2018).
4. As a registered nurse, it is imperative to communicate effectively with the parents
about vaccines and persuading them to immunise their daughter. Parents generally
consider healthcare professionals as the most trusted information source, in relation to
vaccines, even in presence of vaccine hesitancy. Hence, while discussing vaccines for
their daughter, efforts will be taken to use the presumptive approach. The strong
recommendation for vaccination will be clearly stated using anecdotes and scientific
evidences. The importance of immunisation, in relation to protecting children from
potentially life threatening illnesses will also be explained, in addition to sharing
personal experiences (Rezza, 2019). Trust establishment will form an essential
component of the holistic approach and efforts will be taken to address the fears,
concerns and beliefs of the parents about vaccines. A willingness will be displayed
towards their concerns and any kind of misconception related to vaccine injury will be
clarified using evidences.
Case study 2: Taylah Dennison (No 8 Wellbeing Street)
1. In Australia, consent for clinical treatment of patients who are aged less than 18 years
are typically provided guardians or parents in Australia, and while providing consent,
parents are typically obliged to act in a manner that is regarded in the best interest of

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their children (Sawyer, Reece, Sawyer, Hiscock & Lawrence, 2019). Hence, if
Taylah’s parents are not informed about her being affected with sexually transmitted
disease, there might occur a legal dispute regarding consent for treatment. The desire
of Taylah for independence and privacy, balanced with the notion that she is not
completely matured gives rise to ethical issues of confidentiality and consent. The
issue of consent arises while deciding if Taylah is competent to make treatment
decisions, notwithstanding permission from her parents. Confidentiality issues can be
accredited to the fact that Taylah wants to confide information about her sexual life,
which she does not want to disclose with her parents (Ford, English, Dowshen &
Rogers, 2016). However, considering the diagnosis of Chlamydia infection, her
parents must be made aware of her health.
2. The Australian High Court supports Gillick competence and has made it a part of the
case law. This law decides whether a child aged less than 16 years has the right to
consent to medical treatment, without prior knowledge and approval of parents
(Zimmermann, 2019). Moreover, minors aged 14 years or more are provided the right
to consent, depending on their maturity level, understanding of the intended treatment,
the severity and impact of treatment. In New South Wales and South Australia, the
legislation also establishes a Gillick-esque norm of competence, nonetheless
safeguarding the simultaneous agreement between parent and children aged 14-16
years.
3. Considering the fact that the Federal law protects the right of adolescents to privacy, it
is essential to show compliance to these laws. However, Chlamydia being a sexually
transmitted infection, has the chance if spreading from the client to her partners, and
there remains a high chance of recurrent infection (Öhman, Rantsi, Joki-Korpela,

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Tiitinen & Surcel, 2019). Thus, Taylah will be advised to bring her parents along, for
a session considering her age, maturity, and risky sexual lifestyle.
4. With the aim of providing holistic care to the client, the first step would focus on
educating her on the negative effects of risky sexual behaviour that commonly
includes unprotected intercourse, illicit usage of drugs and alcohol, and multiple sex
partners. Taylah will be explained that not only does such behaviour increase the
change of acquiring sexually transmitted infection, as in this case, or pregnancy, but
also increases the likelihood of cervical cancer, HIV/AIDS, infertility and ectopic
pregnancy (Unemo et al., 2017). She will be advised to initiate discussions with her
parents, about her being diagnosed with Chlamydia, following which all three of them
will be provided the assurance that administration of antibiotics will help in curing the
infection. Her parents will be recommended to keep a close vigilance on her sexual
behaviour, while spending more time with her and preventing substance abuse. In
addition, in order to prevent further spread of the infection to her partners, she will be
advised not to engage in any sexual encounters, until the infection has been treated.
Case study 3: Jacob Scanes (No 14 Wellbeing Street)
1. An analysis of the case study suggests that Jacob has been a witness to domestic
violence against his mother, by her partner. Considering the fact that domestic
violence has been identified as a serious health issue, mandatory reporting of such
instances is necessary for preventing potential threat or harm to the victims. However,
since the incident has been reported by a child, as young as Jacob, mandatory
reporting might threaten the reputation and dignity of the family and might also result
in arrest of the potential perpetrator. Ethical issues in this case are related to informed
consent, threat to confidentiality and non-maleficence. Laws that require mandatory
reporting will severely compromise informed consent of the victim since the matter

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has been disclosed by Jacob and not his mother. Therefore, it is the autonomy of the
victim that needs to be taken into consideration while reporting incidents of violence
to the police and other government officials (Berns, 2017). Taking into consideration
the fact that domestic violence is a sensitive topic, the victim might not want to
disclose that she has been abused and might not even mention about the health
consequences or injuries that she had to endure. Thus, taking actions against this
abuse related incident would directly threaten her confidentiality and privacy
(Iyengar, 2016).
2. The Family Law Act 1975 encompasses orders and arrangement about maintenance
and care of children and also determines where a child will live and who will be
responsible for making decisions about welfare of the child (Abc.net.au, 1975). The
Intervention Orders (Prevention of Abuse) Act 2009 provides protection to people
from violence by limiting the action of the perpetrator and encouraging the perpetrator
to seek rehabilitation services (Government of South Australia, 2018).
3. The primary action would focus on fostering a good relationship with Jacob in order
to get a sound understanding of his family dynamics, their socioeconomic status and
relations with one another. Efforts will be taken to establish contacts with his mother
in order to determine the truth of Jacob’s statements, following which the incident
would be reported to the state authority, depending on severity of the incident
(Carlson, Wittrup, Moylan & Ortiz, 2019).
4. Owing to the fact that children who witness domestic violence are at an increased risk
of suffering from a range of psychiatric disorders at a later stage in their life, child
intervention will be delivered in combination with parent intervention. Though
Jacob’s mother might initially hesitate to participate in such therapy, both of them will
be provided counselling services, in order to help them adjust to the surroundings and

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address their fears. Narrative therapy will form a core component of this holistic
approach (Lee, 2017). Jacob’s mother will also be made aware of the existing policies
and legislation on domestic violence in the state that she can utilise if again subjected
to such untoward actions from her partner (Gabriel et al., 2017). She will also be
assisted to identify the red flags, following which she can seek assistance from the
local helpline numbers.

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