Polio is an infectious disease caused by a virus living in the throat and intestinal tract (CDC 2014). There has been a worldwide campaign to eradicate polio in most countries of the world. There are two types of vaccines administered, namely, Inactivated Polio Vaccine (IPV) and Oral Poliovirus Vaccine (OPV) (CDC 2014). There are however challenges where some parents have refused to have the vaccine administered to their children citing various reasons. That creates a blow in the fight against polio.
This article looks at the refusal of parents to have their kids administered with the polio vaccine. The paper will also focus on ethical issues regarding this scenario. It will also concentrate on the legal implications regarding this issue.
The rationale for the parents
The parents who refuse to have their children administered with the polio vaccine give various reasons to justify their refusal. These reasons range from religious to medical beliefs. There are those who refuse to have their children to get their children get the vaccine citing religious beliefs (Barnard et al. 2008). They cite their faith as a reason for not accepting their children receive the vaccine. Some of these parents claim that doing so is going against their beliefs. They claim that their faith can heal them and their children.
There are those who give medical reasons for their refusal. There are those who argue that injections could do more harm than good for children (Parenting 2015). This justification is, however, false since research shows that a child can receive about twenty-three jabs by the time they are two years old (Parenting 2015). Others believe that vaccines can overwhelm the child’s immune system (Ibid). That is further from the truth because children receive more challenging issues to their immune system than vaccines do.
Some parents believe that since polio is an infectious disease, then as long as other children are vaccinated, theirs are safe (ibid). That however puts a threat to the children since they are more prone to the disease than those who are not infected. There is also the danger of this attitude making it impossible to attain the goal of eradicating the disease, or rather wipe it out completely. Such beliefs make health care provision difficult since if parents were to cooperate, it would be possible to eradicate the disease completely (Mason 2010).
There is the idea that major illnesses have disappeared, and this includes polio for many parents and therefore there is no need for immunization (Parenting 2015). That also poses another problem since for the polio vaccine to be completely eradicated; it is not the parents who should determine whether it has been destroyed or not. The medical practitioners should be the ones to ascertain this fact and recommend an end to the administration of the polio vaccine. Discontinuing the administration could place a threat to the campaign that is aimed at eradicating the disease.
Some parents believe that the vaccine causes other conditions including autism and other disorders (Parenting 2015). The belief is however based on coincidental occurrences rather than clinically proven studies. It is believed that the onset of autism coincides with the age at which administration of polio vaccine is done, and, therefore, many came to the belief that the vaccine causes autism (Parenting 2015).
The other misconception surrounding polio vaccine is that the child may get the disease the vaccine is meant to eradicate (Parenting 2015). That is further from the truth because these vaccines have gone through all the tests necessary for them to be accepted as vaccines. They, therefore, are meant to serve the purpose for which they were made; this is a prevention of diseases. Therefore, they can be the same to cause the same diseases they are meant to prevent.
Other beliefs that are used to justify the parents’ refusal of their children to get the polio vaccine are that the vaccine contains preservatives that are dangerous to their children. The vaccines should not be given to children who have a cold, the belief is that children who have a cold will be overburdened by the vaccine since their immune system is already being overworked fighting the cold. In addition, there are those who believe that it is best to wait until the child is older (Parenting 2015).
Ethical theories on polio vaccine
There are several challenges facing health care including ethical issues. Some of these ethical issues relate to human rights, law, finance, management and provision (Leathard&Mclaren 2007). About polio vaccine administration, these questions must be addressed to achieve the desired results of the goals set while administering the vaccine. These ethical issues are discussed in moral values, namely, beneficence, non-maleficence, autonomy and justice (Leathard&Mclaren 2007).
The freedom of individuals, in this case, the parents, can be a major challenge to the administration of the polio vaccine. The question to be asked is whether the parents’ right to autonomy should be allowed to bring harm to others, in this case, their children. In dealing with this question, a legal issue arises (Beauchamp & Childress 2009). Individuals should enhance the efforts of states in the provision of health and social care through cooperation. However, if some of these respective parents are unwilling to cooperate with the health care practitioners, what should be done? There are suggestions that there should be restrictions on individual autonomy to prevent harm to others. Parents who refuse to allow their children from being administered with the polio vaccine no matter their justifications are placing these children in harm’s way. In this regard, legislation should be passed to protect these children from the dangers caused by polio (Taylor et al. 2007).
A report by World Health Organization (WHO) indicates individual protection as one of the ethical issues that should be considered before administration of a vaccine (WHO). Individuals should consent to the administration of the vaccine if their autonomy is to be respected. There is a need for individuals to be given adequate information regarding the benefits and the risks the vaccine poses so that they may make informed decisions (WHO). In doing so, there is the need to understand that some of these people may not understand the terms and issues involved in the whole process of the vaccine administration. There is the belief that vaccine should be optional unless the situation is critical and is deemed to cause serious harm. In this regard, the wider right of protecting a whole community rather than concern for individual rights overrides individual autonomy (WHO).
When it comes to children, the nature of the risk involved determines to what extent parents’ may refuse their children to be immunized (WHO). The right for parents to deny their children to be vaccinated may be respected when the risk is low. However, if the risk to the child is high, the parent’s authority over the child’s rights may be curtailed in the interests of the child (WHO). This scenario can also be used when the child’s guardian or parent is not available during an emergency. That is done to protect the interests of the child and the interests of the wider community (WHO).
However, on ethical grounds, in case the right to individual autonomy is violated, it follows that such individuals should be appropriately compensated if there are any side effects experienced through the vaccine (WHO). It should be noted that they were not for the vaccine in the first place and, therefore, their rights should be respected. Therefore, if even after their refusal to allow their children to be vaccinated they experience the side effects; it would be proven their reservations were correct. Therefore, compensation would be the best course of action to take.
That regards the role of the governments and the international community to avail care aimed at preventing those diseases that can be avoided as well as deaths to those who mostly need this care (WHO). Vaccines must be made available by governments against contagious diseases, especially during emergencies because transmission of the infectious diseases is possible than in other times (WHO). Individuals themselves must cooperate with the government and other institutions efforts to provide care during these times.
It is, therefore, paramount that individuals, including parents of children who require administration of polio vaccine cooperate with the government’s efforts to provide vaccines. They should not refuse their children from getting the vaccine since by doing so they are not only putting the child in danger but also the whole community. In as much as it is the government’s responsibility to avail the polio vaccine to individuals, it is also the duty of such persons to cooperate with the agents chosen to administer the vaccine (Cowburn 2005).
The principle of beneficence operates on humanitarian grounds. Some believe that providing assistance during a crisis would lead to the overdependence on aid. It should, however, be looked at regarding saving lives rather than just being charitable (WHO). Vaccines offer long-term protection against diseases and, therefore, offering help during times of crisis would provide a long-term solution to contagious diseases.
In regards to humanitarian assistance offered on vaccines, WHO and United Nations for Children’s Fund (UNICEF) have five requirements for good donation practice (WHO), namely, “suitability, sustainability, informed particular persons, supply and licensing.” (WHO). Emergencies and other exceptional settings, however, provide occurrences when these requirements can be overlooked.
Nonmaleficence refers to a situation where humanitarian assistance is geared towards avoiding or minimizing harms (WHO). Therefore, humanitarian aid in vaccines is directed towards reducing transmission of diseases. In this regard, the vaccines should be administered before people are exposed to germs that cause the said disease. The risk of transmission of the disease is the one that justifies whether the vaccine is to be administered or not.
Under this principle, the likelihood of magnitude is determined by four variables, namely, “the nature of the illness and attendant local epidemiological and environmental characteristics; the probability of transmission; disease severity and illness duration” (WHO). The benefit of the vaccine is a factor that is considered when determining whether the vaccine is to be administered. If the emergency or crisis occurs just after a major vaccine drive has been completed, then, under this principle, there is no need to go ahead with the administration of the vaccine (WHO).
The goal of this principle can be hampered by the parent’s refusal to have the child vaccinated. In this case, the child is exposed to what is referred to as individual harm (WHO). Therefore, Measures should be placed to protect this child against the harm that may be caused by their parent’s refusal to have them administered with the vaccine. The parents’ rejection can also be social in nature. In this case, their refusal brings about a situation where there are people who are susceptible to diseases, and there is the risk of an outbreak. On ethical grounds, these respective parents are obligated morally to have their children receive the polio vaccine to prevent harm to others (WHO). In this regard, even if the parents do not believe in the vaccine, they should consider the interest of the others in the community and therefore allow their children to be vaccinated against polio.
In this case, therefore, the ethical ground is that individuals in the community have an obligation towards themselves as well as towards the community. The children should not be exposed to individual harm by their parent’s refusal to have them administered with the polio vaccine and also, the community interests overrides their refusal to have their children receive the vaccine. They are mandated to have the community protected against the harm caused by polio by having their children immunized against polio no matter what justification they may have regarding their refusal to have their children administered with the polio vaccine. The legal issue, therefore, is how this moral obligation should be met (Barnard et al. 2008). Should legislation be passed to force such parents to allow the immunization process to continue for their children?
Justice has to do with fairness especially in resource allocation in regards to availing of vaccines to those who need them. The underlying principle is that there should be a fair distribution of scarce resources (WHO). In this regard, there should be prioritization of the most susceptible groups in the distribution of the polio vaccine. However, this should not discriminate against the less vulnerable areas since justice demands that they also receive the services. Therefore, they should not be denied access to vaccines on account that the vaccines have been distributed to the most susceptible areas.
In applying the principle of justice, the efforts towards polio vaccine administration look at the cost effectiveness of the process and the benefits that will be achieved through the process. It should be remembered that vaccination is a cost-effective measure in dealing with diseases since it offers long-term solutions in disease prevention. Therefore, it would be unjust for parents to refuse their children from receiving the vaccine because exposing them to risks when the vaccines have already been provided to prevent diseases interferes with their health. Exposing them to danger would be somehow denying them their right to health.
Under this principle, priority should be given to children since they are the ones who are more vulnerable than other groups as far as contagious diseases requiring vaccination are concerned. Therefore, when parents refuse their children from getting the vaccine, they are placing the burden of diseases not only on themselves but also on the whole community. It should be noted that it is unethical for a child to die from a condition that is preventable.
Procedural justice calls for transparency in decision making where communities that are affected are involved in the whole process (WHO). That means that parents of the children who are to receive the polio vaccine should be involved in decision-making during the vaccine administration exercise. In this regard, there is the need for a legal framework to guide the implementation of vaccination programs (WHO).
Ethical and legal implications for practitioners
The professionals need to be aware of their legal position during the administration of vaccines (NHS). That is also a moral question. These legal concerns regard guidelines for vaccine delivery, storage, and stock control. The storage of the vaccines must follow the required guidelines so that there is assurance that these vaccines do not endanger the lives of those who are receiving the vaccines. The practitioners should follow the guidelines set by the medicine control boards in their areas. They should not be accused of negligence in the course of administering the vaccines. They should also be aware that they need the consent of the individuals to whom the vaccines are being administered.
Practitioners should be able to know how to respond to emergencies. Their concern should be saving lives and preventing communicable diseases from spreading. In doing so, there is need to familiarize themselves with existing legislation in the administration of vaccines. In doing so, the ethical issues regarding how they should balance the legal issues and the moral issues should also be considered while looking at the administration process of these vaccines.
The practitioners should be able to identify situations where vaccinations could be denied. That includes contraindications, for instance, where the child is under age and cannot receive the designated vaccine. The practitioners should be able to advise their clients accordingly especially in situations where the media has given negative reports. They have the duty to assure the patients of their safety in regards to the vaccine. The practitioners should be armed with facts when dealing with the patients so that they can dispel fears that may arise from false reports. Many parents would refuse to allow their children from receiving the polio vaccine based on the reports they receive from the media. For instance, where parents receive reports that the vaccines may result in other complications, they may be reluctant to allow their children to receive the vaccine. In such circumstances, the practitioners should have the facts necessary to dispel the fears of their patients.
On the ethical ground, the professionals should know how to respond in case parents refuse their children from receiving the vaccines. The question is whether they should use force or not. They should know the legal action they should take in such cases. They should closely work with law enforcement agencies since vaccination is not just a question of individual protection against diseases but also protection for the whole community. While doing so, individual autonomy should be taken into account. The practitioners should be aware to what extent this freedom should be allowed and in what circumstances it can be curtailed without jeopardizing their legal situation. It should be noted that a legal suit might be initiated against them in regards to the process of vaccine administration.
Ethical and legal questions determine the administration of polio vaccine. Parents who refuse the administration of the polio vaccine to their children have a justification for so doing. They have a right to individual liberty. However, this privilege is subject to the interests of the child and the interests of the larger community. The argument is that the individual freedom should not put at risk the interests of the whole community or the interests of the child.
Certain ethical principles need to be considered. These include those that have to do with doing good, beneficence, and those that have to do with prevention of harm to individuals and communities; this is the principle of nonmaleficence. There is also the principle of autonomy that requires individuals to consent to the vaccine administration process and finally the principle of justice.
All these factors have both legal and ethical implications for practitioners in health care. Therefore, the professionals need to familiarize themselves with these consequences in the course of their work. They are concerned with the provision of health care, and they should offer the best to their clients.
The parents also should be aware that they have the individual obligation towards the well being of their children health. Therefore, the decisions they make should be for the best interest of the children. They should make decisions that will ensure that their children’s health is best-taken care of rather than depending on baseless myths that put their children at risk. They should be able to get the facts right and make the right decisions for their children.