Ethical Impact of Healthcare Policy
To some the principals of ethics and politics may not always go hand in hand, however they are deeply intertwined in healthcare policy. The definition of ethics is individualized by each person’s unique set of life experiences. Ethics can be viewed as descriptive (what is right and good), theoretical (what is the justification for what is right and good), and normative (how can we act in accordance with what is right and good) (Petrini, 2010). Health policy affects the public in a profound manner influencing many topics related to a person’s quality of life and even a person’s survival. When policy makers support a health policy, they must take into accordance the varying views of ethics and try to form policies that are ethical to most people. Because every person has a different ethical view, instating health policies may conflict with personal beliefs. The healthcare policy may force a person to act against their ethical standards in order to stay in accordance with the laws.
Role of Ethics Surrounding the Low HPV Vaccines Uptake Rates
Since the wide spread public use of immunizations in the United States, there has been a profound decrease in the number of cases of vaccine preventable diseases which inspired vaccine policies. Nationally to address the ethical issue of the barrier of the cost of immunizations the Centers for Medicaid and Medicare Services started the Vaccines for Children (VFC) program. The VFC provides immunizations to eligible children at no cost (Centers for Disease Control and Prevention [CDC], 2016a). Although some guardians resist immunization policies, which not only places individuals at risk but also the community at risk. This has left the medical and public health advocates struggling to balance the ethics of honoring individual beliefs and the health of the community (Hendrix, Sturm, Zimet, & Meslin, 2016). This ethical struggle lead to the National Childhood Vaccine Injury Act of 1984, in which all healthcare providers are required to give potential vaccine recipients a Vaccine Information Statement. This document provides basic information about a vaccine risk and benefits and is intended to help guardians make an informed decision (CDC, 2015). Furthermore, the providers ethical predicament of handling vaccine hesitant parents influences the statewide health policies regarding public health announcements and funding for provider education regarding communication about immunizations.
The HPV vaccines in particular have met public resistance from both guardians and healthcare providers because of the ethical conflict of recommending a vaccine that prevents a sexually transmitted disease (STD). Ethical obligations include religious concerns that a vaccine that protects against a STD contradicts abstinence-based messages and that the vaccine may encourage early sexual relations (The College of Physicians Philadelphia, 2016). Additional ethical concerns regarding the HPV vaccines are centered around the newness of the vaccine. All CDC recommended immunizations are subjected to years of research and must pass safety standards prior to the introduction of the immunization. Prior to the introduction of three HPV vaccines in 2006, the vaccines went through years of research testing that included thousands of male and female participants however because the immunizations are intended for a vulnerable population, some resistance is met (CDC, 2016b). Some argue that it would be unethical not to vaccinate all eligible adolescents because of the HPV proven efficacy. Four years after the introduction of the vaccine, the quadrivalent type of HPV infections decreased in teenage girls by 56% (CDC, 2016b). While others argue that the long-term consequences of the immunizations are still unknown therefore it would be unethical to administer the product to children. While many childhood immunizations are mandated in order for children to attend school, due to these ethical influences surrounding the HPV vaccine, there was language added to the footnote of the state budget stating the HPV vaccine will never be required to attend school in Arizona (D. Davis, personal communication, January 18, 2017).The ethical debate of the HPV vaccines in Arizona resulted in the vaccines only being recommended by adolescent’s healthcare providers and no state statutes regarding this vaccine. The role of ethics surrounding the uptake of the HPV vaccine in Arizona plays an influential part in the policy decision making regarding new immunization policies.
Centers for Disease Control and Prevention. (2015). History of Vaccine Safety. Retrieved from: https://www.cdc.gov/vaccinesafety/ensuringsafety/history/index.html
Centers for Disease Control and Prevention. (2016a). Vaccines for Children Program (VFC). Retrieved from: https://www.cdc.gov/vaccines/programs/vfc/about/
Centers for Disease Control and Prevention. (2016b). HPV Vaccine Information for Clinicians. Retrieved from: https://www.cdc.gov/hpv/hcp/need-to-know.pdf
Hendrix, K. S., Sturm, L. A., Zimet, G. D., & Meslin, E. M. (2016). Ethics and Childhood Vaccination Policy in the United States. American Journal of Public Health,106(2), 273-278. doi:10.2105/ajph.2015.302952
Petrini, C. (2010). Ethics-Based Public Health Policy? American Journal of Public Health,100(2), 197-198. doi:10.2105/ajph.2009.181511
The College of Physicians Philadelphia. (2016). Ethical Issues and Vaccines. Retrieved from: http://www.historyofvaccines.org/content/articles/ethical-issues-and-vaccines