NURS FPX 4000 Assessment 3 Applying Ethical Principles

NURS FPX 4000 Assessment 3 Applying Ethical Principles

Applying Ethical Principles

With healthcare continuously evolving several challenges and flaws can arise. Any approach towards addressing these issues requires an ethical solution that makes use of moral principles when going through any sort of decision-making. Ethical principles concern all the rights of the people making any decision fairer and more acceptable by several diverse communities.

Overview of the Case Study

The Smiths, Chris Smith, and Jenna Smith are the subject of the case that is under study. They have a five-year-old daughter Ana. Ana was born without any problems or complications (Capella University, n.d.). The parents have had an excellent bond with the baby and they wish to raise her naturally with organic materials and nurse her in the initial six months. They also create food for the baby with pure organic ingredients and have refused any vaccinations for the baby. Parents are college educated and have carried out enough research on vaccines to be able to conclude that the risks outweigh the benefits. They tell their pediatrician, Dr. Angela Kerr, that despite the recommendations from the medical community to vaccinate Ana they have refused to do so (Capella University, n.d.). Dr. Angela Kerr is confused about what to do after she has an empathetic conversation on how vaccines have sparked controversy, she goes on to endorse the general safety of vaccines explaining how the data is updated regularly and that there are systems that are transparent about vaccine safety. She also explains how no vaccine has been proven to cause Autism Spectrum Disorder (ASD) (Capella University, n.d.).

Analyzing Ethical Issues in the Case Study

Ana’s parents not willing to vaccinate her is an ethical issue as this can increase the chances of Ana getting a vaccine-preventable disease that could be fatal and also impact her herd immunity. There are both demographic and psychological factors that cause vaccine hesitancy. These factors could be related to the trust in science, social norms, and beliefs or attitude toward vaccination (Damnjanović et al., 2018).
Code of Ethics by the American Nurse Association have published four important principles of ethics that are beneficence, non-maleficence, justice, and autonomy (Gaines, 2022). While dealing with the Smith family case, Dr. Angela Kerr has to respect the autonomy of the parents when deciding that their child should be vaccinated after carrying out research. However, the major issue with autonomy can be a misunderstanding or inappropriate information which may cause a hindrance to autonomy (Rus & Groselj, 2021). The other principle of nonmaleficence requires the provider to not cause any harm to the patient, the ethical issue can be the harm that can be caused to the patient by not providing a vaccine after respecting the autonomy. The issue can also be the side effects of the vaccine that have the potential to be there in case the parents agree for Ana to be vaccinated. The other issue is with the beneficence that recommends the provider to work towards the welfare of the patient which is in their best interest (Rus & Groselj, 2021). The provider would have to keep in mind herd immunity and also establish a relationship with the parents to take positive steps for the welfare of the patients. The element of justice also plays a role as the control of infectious diseases through vaccination is a common good that provides distributive justice (Rus & Groselj, 2021). Dr. Kerr is concerned about the health of the baby due to the attitude of the parents who believe vaccination can cause harm because not vaccinating the baby can cause even more harm.

Using the Ethical Decision-Making Model

The ethical decision-making model that can be used in scenarios like these is James Rest’s theoretical framework. This ethical decision-making model has about four components that are moral behavior, moral judgment, moral action, and moral motivation. Moral sensitivity is also important during ethical decision-making as it gives Dr. Angela the ability to recognize that there is an ethical issue in the situation. Moral motivation emphasizes the intention of Dr. Angela to choose a moral option rather than the other choices when making a decision. Moral action is the courage and boldness of the doctor to make a moral decision in such a scenario. The decision she makes will reflect her moral judgment. As it is mentioned before these four ethical principles must be applied while taking a decision:

  • Beneficence
  • Justice
  • Non-maleficence
  • Autonomy

Effectiveness of the Communication

It is important to have enhanced communication with the patients and their family members by involving them and keeping them in the loop with all the decisions. Active listening must be maintained to hear the concerns and make them feel heard. Informed consent is important when it comes to making ethical decision-making. Getting help for Ana would be violating the rules of informed consent (Loh et al., 2002).

It is important that Dr. Angela Kerr is empathetic when listening to Ana’s parents and shows respect for their beliefs and values. To engage them in an appropriate decision the doctor must present all the studies and information that are evidence-based to the parents by being respectful of their emotions. The communication should be transparent to not leave anything behind that may cause misunderstanding. 

Application of Ethical Principles

The most important ethical principle to be applied, as discussed before, is the code of ethics of the American Nurse Association. The four principles of autonomy, non-maleficence, beneficence, and justice ensure that all the decision being made is fair, and unbiased acts toward the welfare of the patients and involves the patients and family in decision-making by recognizing their rights (Gaines, 2022). It is difficult for Dr. Angela Kerr as she has to respect the autonomy but at the same time make a decision that is appropriate for the child as not vaccinating can cause harm. But also at the same time, there is a need to ensure that the decision to vaccinate does not cause any harm to baby Ana. An ethical equilibrium can be found when making decisions that analyze the contribution towards herd immunity and also bear the responsibility towards child safety and bear respect towards the parent’s beliefs (Rus & Groselj, 2021).

Conclusion NURS FPX 4000 Assessment 3 Applying Ethical Principles

It is important to remember the four principles of the code of ethics when making decisions that can be perplexing. It is important to have efficient communication when explaining information to convince the parents with the help of evidence while respecting their beliefs, listening, and being empathetic towards them.


Damnjanović, K., Graeber, J., Ilić, S., Lam, W. Y., Lep, A., Morales, S., Pulkkinen, T., & Vingerhoets, L. (2018). Parental decision-making on childhood vaccination. Frontiers in Psychology9

Gaines, K. (2022). What is the Nursing Code of Ethics?

Khursheed, U., Sehar, S., & Afzal, M. (2019). Importance of ethical decision making; application of James Rest Model. Saudi Journal of Nursing and Health Care02(12), 427–430.

Loh, W. Y., Butow, P. N., Brown, R. F., & Boyle, F. (2002). Ethical communication in clinical trials. Cancer95(11), 2414–2421.

Rus, M., & Groselj, U. (2021). Ethics of vaccination in childhood—A framework based on the four principles of biomedical ethics. Vaccines9(2), 113.

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