FXP 4000 - Ethical Considerations: Measles Outbreak and Vaccination

This case study explores the ethical challenges faced by Piper Banks, the medical director of Open Arms, a non-profit clinic, during a measles outbreak in an urban community. The outbreak primarily affected unvaccinated children, exacerbated by the spread of anti-vaccination misinformation. The assignment analyzes the situation through the lens of ethical decision-making, emphasizing the importance of education, communication, and respecting cultural values while upholding ethical principles of nursing such as justice, beneficence, autonomy, and non-maleficence. The solution focuses on educating parents, religious leaders, and the anti-vaccination group about measles and its effects, and the importance of vaccination. It also addresses the need to balance the right to choose with the responsibility to protect public health. The case highlights the need for healthcare professionals to make ethical judgments, provide vaccinations, and educate the community. The paper uses ethical principles and academic peer-reviewed journal articles to analyze the case and provide a solution.

Running head: FXP 4000 1
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Name of Author
Institution of Affiliation
Date of Submission

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Case Study Overview
Piper Banks works as a medical director for an organization known as Open Arms. Open
Arms is a non-profit clinic and wellness center that provides its services to the low-income
convalescents in an urban neighborhood. Last summer, the area was affected by a severe
outbreak of measles. Due to the outbreak, many people were affected by the illness, and there
were 78 confirmed cases. Moreover, out of the 78 confirmed measles reports, 73 cases were of
children who had not yet received the vaccine. Furthermore, the children were all located in the
city’s East African immigrant community. The main issue affecting Piper is the fact associates of
the anti-vaccination program were supplying fliers and talking the affected families. This is even
though one of the primary goals of Piper’s organization (Open Arms) is to eradicate fear and
misinformation that the anti-vaccination group has been dispersing in the area for almost ten
years.
Moreover, the information provided by the anti-vaccination specifically promotes the
purported vaccine-autism relation. In a way, the data may seem right to the community because
there is a high incidence of autism in the area. Despite her frustration, Piper is determined to
convince parents to protect their children by letting the clinic administer the measles mump
rubella vaccine.
Using the Ethical Decision-Making Model
According to the ethical decision model nurses should be cautious when implementing
care, "Is the right thing the same decision for everyone? Obviously not. We are all influenced by
multiple factors in our decision-making (McCarthy & Gastmans, 2015)." Now for the case of
Piper Banks, she knows that education is vital to help the affected persons change their mind.
Moreover, Piper Banks should find a way to educate the anti-vaccination group on the

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importance of the vaccination program. Furthermore, Piper Banks should find a way to
communicate with the people and more importantly the anti-vaccination group on the causes of
autism and the treatment procedures. Now, Nasra (an intern at the clinic) stated that an Imam
told a woman in a blunt manner that if the woman cares for her child, then she should vaccinate
the child. Although this statement is true, it may bring fear to the parents and therefore, Piper
should organize a way in which even the religious leaders are taught on how to educate their
congregation about measles in a way that won’t bring fear. This will help since religious leaders
will help spread moral awareness of the condition to their congregation. As stated by (Parahoo,
2014), spreading the awareness of the issue under concern is key to getting the solution.
Furthermore, Nasra stated that the anti-vaccination group was trying to set up measles
parties to deliberately expose unvaccinated children to children with measles. Communication is
critical due to the fact that if Nasra had not shared the information, Piper would not have known
what was going to happen and find a way to prevent it. Now, in this case, the main issue is that
the parents and the anti-vaccination group may not know that measles is highly contagious; as
such, it should not be treated lightly. Moreover, Nasra also stated that “I wonder how many
parents would make different choices if they could actually see the effects of these diseases.”
Therefore, the critical thing that Piper should do is to educate both the parents, children, and anti-
vaccinators on the effects of the measles disease (Mallari, & Tariman, 2017). Additionally, as a
way of education, Open Arms should create posters and call for public meetings as a means to
spread the news on the disease.
Additionally, since Felicia Cruz (the clinic pediatrician) stated that most of the parents
are still very nervous but are more open to believing the vaccination than ever, Piper banks
should explain to the parents about the fact that many of the affected children were not

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vaccinated. In doing so, Piper Banks should allow the parents to decide for themselves if their
children will be given the vaccination. This is because even though it is legal to administer the
vaccine, it is not morally upright to force them (Preshaw et al., 2016). Moreover, there are some
people whom their cultural values do not acknowledge pharmacological medicine, and therefore,
their rights should be respected.
Now, after spreading the news and making the moral judgment, Piper Banks should
administer the medication while adhering to the ethical principles of nursing (Cannaerts,
Gastmans, & Casterlé, 2014). Piper should administer the medication to everybody who is
willing to be given the medicine. This will include even individuals from the anti-vaccination
group. In doing so, Piper Banks will have up hold all the ethical principles of nursing (justice,
fairness, beneficence, autonomy, and nonmaleficence) while also helping the people in need
(Kangasniemi, Pakkanen, & Korhonen, 2015).

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References
Cannaerts, N., Gastmans, C., & Casterlé, B. D. D. (2014). Contribution of ethics education to the
ethical competence of nursing students: Educators’ and students’ perceptions. Nursing
ethics, 21(8), 861-878.
Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an
integrative review. Journal of advanced nursing, 71(8), 1744-1757.
Mallari, M. G. D., & Tariman, J. D. (2017). Ethical Frameworks for Decision-Making in Nursing
Practice and Research: An Integrative Literature Review. Journal of Nursing Practice
Applications & Reviews of Research, 7(1), 50–57.
McCarthy, J., & Gastmans, C. (2015). Moral distress: a review of the argument-based nursing
ethics literature. Nursing ethics, 22(1), 131-152.
Parahoo, K. (2014). Nursing research: principles, process and issues. Macmillan International
Higher Education.
Preshaw, D. H., Brazil, K., McLaughlin, D., & Frolic, A. (2016). Ethical issues experienced by
healthcare workers in nursing homes: literature review. Nursing ethics, 23(5), 490-506.