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A common dilemma or conflict in healthcare
The US has proposed a mandatory influenza vaccination exercise for healthcare workers in an attempt to counter the increasing number of new annual infections and deaths arising from the disease (Babcock, Gemeinhart, Jones, Dunagan & Woeltje, 2010). The US justifies this move by citing the medical and ethical frameworks that guide nurses and other healthcare professionals in their practice. Initially, the vaccine was voluntary in most facilities, but the number of healthcare providers who take the vaccine has remained low.
This aspect has prompted the US government to make the vaccine mandatory to all healthcare workers to increase the number that gets the vaccine. Most nurses do not understand the benefits that accrue from such vaccinations (Zimmerman, 2013). Therefore, the majority of the nurses think that the benefits do not outnumber the risks posed by the vaccine (Backer, 2006). Additionally, nurses claim that the vaccine only offers protection from the influenza virus, but it does not offer a solution to other upper respiratory tract infections, which are also common (Miller & Ross, 2010). This aspect has been cited as the key reason why most healthcare workers are opposed to the vaccine despite the tireless efforts by the government to increase the uptake of the vaccine.
Nurses are ethically bound to reduce the risks to patients in the course of dispensing their mandate, and thus they are under obligation to take such vaccines in a bid to reduce the risk of infecting patients during treatment (Isaacs & Leask, 2008). However, despite the mobilization efforts by the government and the Centers for Disease and Control and Prevention (CDC) to encourage healthcare workers to embrace the vaccine, the resistance has remained high and only a few nurses turn up for the vaccination (Stewart, 2009). Following the mandate of the vaccine, healthcare workers have launched legal battles against the government citing violation of their rights as accorded by the Fourteenth and First Amendments (Willis & Wortley, 2007). A review of the medical ethical code of conduct justifies the mandate, the government, and various medical institutions that have mandated the vaccine.
The choice that I recommend for APRN and its ethical justification
The medical field has its ethical code of ethics that governs the conduct and relationships amongst the involved stakeholders. Therefore, healthcare professionals have to abide by the provisions of the code in the course of dispensing their mandated duties. Also, Ahmed, Lindley, Allred, Weinbaum, and Grohskopf (2014) maintain that vaccinating healthcare professionals ensures that the risk inherent to a patient during treatment is maintained at the lowest levels possible. This provision has been used as a justification for the mandatory vaccine since the vaccine is meant to reduce the chances of healthcare workers infecting their patients with the disease in the clinical care context. Therefore, making the vaccine mandatory is congruent with the medical profession code of ethics and the order should remain (Pitts, Maruthur, Millar, Perl & Segal, 2014).
Additionally, healthcare professionals are under an obligation to ensure that the community’s healthcare needs are prioritized. This provision entails providing quality and effective healthcare to all people without prejudice. In line with this obligation, clinicians are thus bound to accept the vaccine in a bid to achieve their mandated duty of ensuring that the community remains healthy and that the risk of infecting people is lowered to achieve this objective.
Lastly, the Mandatory influenza vaccination is constitutional as the law mandates the government to ensure that public welfare is maintained at all costs (Starke, 2010). Therefore, the government can limit individual rights to protect the welfare of the public. In this context, the government is legally obliged to overlook the personal rights of the healthcare professionals and mandate the vaccination to protect the interest of its citizens. Clinicians have cited the infringement of their rights to self-will and the freedom of religion as the key driving forces towards the rejection of the vaccine (Finch, 2007). However, these rights are individual and since the vaccine is meant to protect the interest of the public, the move to mandate it is justified.
The theory that I used to justify my answer to the conflict
Many ethical theories can be used to justify the legality of the mandatory influenza vaccine, which has been imposed by the US government in efforts to control the spread of infectious disease (Steckel, 2007). However, in this paper, I used the utilitarianism theory since it best fits this context due to the emphasis that it places on the utility of the results. The theory advocates the course of action that derives the maximum benefits to the people on the receiving end (Gandjour, 2007). The theory is applicable in major decision-making cases where the decision revolves around establishing the best course of action to adopt. The theory emphasizes the consequences or the results of a certain course of action (Riley, 2010). The decision that leads to the maximum benefits to the beneficiary of such an undertaking is adopted and all the other decisions are ignored. The theory is useful in decisions involving conflicting interests since it only requires the assessment of the results to establish the decision with the maximum benefits.
The relationship of the theory to my answer
The utilitarianism theory justifies the reasons why health workers should be vaccinated against infectious diseases. Firstly, clinicians are obliged to avoid exposing patients to undue risks in the course of dispensing their duties (Poland & Jacobson, 2007). In line with the utilitarianism theory, the decision would be to mandate the vaccination to reduce the risks of infecting the patients. Since the objective of the theory is to maximize the outcome, the vaccine would be effective in reducing the risk to patients who are the beneficiaries of the decision in this case. Therefore, vaccinating the medical staff maximizes the benefits to patients since they will obtain quality health care devoid of exposure to risks of new infections from the healthcare providers.
The theory is also congruent with the clinicians’ code of ethics provision, which requires the provision of quality healthcare to all people without discrimination. Quality healthcare for all people cannot be achieved without the nurses having to undergo the vaccination. Lastly, the government seeks to maximize healthcare benefits to the public by mandating the vaccine. The constitution allows such undertakings if they are in the interest of the public. The utilitarianism theory also advocates the prioritization of public needs as opposed to individual rights. Therefore, for the benefit of the majority, viz. the public, in this case, the mandatory influenza vaccination should be maintained.
References
Ahmed, F., Lindley, M., Allred, N., Weinbaum, C., & Grohskopf, L. (2014). Effect of
influenza vaccination of healthcare personnel on morbidity and mortality among patients: systematic review and grading of evidence. Clinical Infectious Diseases, 58(1), 50-7.
Babcock, H., Gemeinhart, N., Jones, M., Dunagan, C., & Woeltje, K. (2010). Mandatory Influenza Vaccination of Health Care Workers: Translating Policy to Practice. Clinical Infectious Diseases, 50(4), 459-464.
Backer, H. (2006). Counterpoint: in favor of mandatory influenza vaccine for all health care workers. Clinical Infectious Diseases, 42(8), 1144-1147.
Finch, M. (2007). Point: Mandatory influenza vaccinations for all health care workers? Seven reasons to say “no.” Clinical Infectious Diseases, 42(8), 1141-1143.
Gandjour, A. (2007). Is it rational to pursue utilitarianism? Ethical Perspectives. Journal of the European Ethics Network, 14(2), 139-158.
Isaacs, D., & Leask, J. (2008). Should influenza immunization be mandatory for healthcare workers? No. British Medical Journal, 337, 2140-42.
Miller, C., & Ross, W. (2010). Mandated influenza vaccines and health care workers’ autonomy. Virtual Mentor, 12(9), 706-710.
Pitts, S., Maruthur, N., Millar, K., Perl, T., & Segal, J. (2014). A systematic review of mandatory influenza vaccination in healthcare personnel. American Journal of Preventive Medicine, 47(3), 330-40.
Poland, G., & Jacobson, R. (2007). Protecting patients from harm: Legislating vaccinations for healthcare workers. American Journal of Preventive Medicine, 32(6), 544-546.
Riley, J. (2010). Mill’s extraordinary utilitarian moral theory. Politics Philosophy Economics, 9(1), 67-116.
Starke, J. (2010). Recommendation for mandatory influenza immunization of all health care personnel. Pediatrics, 126(4), 809-815.
Steckel, C. (2007). Mandatory influenza immunization for health care workers-an ethical discussion. Workplace Health & Safety, 55(1), 34-39.
Stewart, A. (2009). Mandatory vaccination of health care workers. New England Journal of Medicine, 361(21), 2015-17.
Willis, B., & Wortley, P. (2007). Nurses’ attitudes and beliefs about influenza and the influenza vaccination: A summary of focus groups in Alabama and Michigan. American Journal of Infection Control, 35, 20-24.
Zimmerman, R. (2013). Ethical analyses of institutional measures to increase health care worker influenza Vaccination Rates. Vaccine, 31(52), 6172-6.
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