Week Three Case Study: Healthcare Obligations: Personal vs.
In a typical year in the United States, the public is urged to get flu shots as a means of protection
against influenza. A report published by an influenza expert at the British Columbia Centre for
Disease Control found that the 2014-2015 rate of effectiveness for flu shots was 23% in the U.S.,
and that the shots offered no significant protection in Canada. A related finding published by
researchers at the National Institutes of Health documented that, although the percentage of seniors
who received flu shots in recent decades rose from 15% to 65%, the deaths caused by influenza
among the elderly continued to climb during this period. These researchers concluded either the
vaccine failed to protect the elderly against mortality
and/or the vaccination efforts did not
adequately target the frailest elderly.
More recent research has tried to develop a method to assess in advance whether a given flu
vaccine would have any protection benefit. A report published in 2016 in the journal Nature
Immunology used a blood assay and identified a correlation between persons with a certain pattern
of gene expression and the likelihood that such persons would experience adverse events after
receiving a flu vaccine. If this assay could be made economical, and included in blood tests
typically done in annual physicals, it could reduce the number of suits filed with the federal
Vaccine Injury Compensation Program. With these reports in mind, consider the following case:
Dr. Jones works in a hospital and she recently became aware of all the above reports. She belongs
to the American Medical Association (AMA), which strongly recommends that everyone receive
flu shots each year. Moreover, her hospital recently informed her that she herself must take annual
flu shots or risk termination of her hospital privileges or employment. Dr. Jones, however, is aware
of the AMA Code of Ethics, which states that patients have a right of self-decision regarding their
health care, and that this right can only be effectively exercised if the patient possesses enough More recent research has tried to develop a method to assess in advance whether a given flu
vaccine would have any protection benefit. A report published in 2016 in the journal Nature
Immunology used a blood assay and identified a correlation between persons with a certain pattern
of gene expression and the likelihood that such persons would experience adverse events after
receiving a flu vaccine. If this assay could be made economical, and included in blood tests
typically done in annual physicals, it could reduce the number of suits filed with the federal
Vaccine Injury Compensation Program. With these reports in mind, consider the following case:
Dr. Jones works in a hospital and she recently became aware of all the above reports. She belongs
to the American Medical Association (AMA), which strongly recommends that everyone receive
flu shots each year. Moreover, her hospital recently informed her tha
t she herself must take annual
flu shots or risk termination of her hospital privileges or employment. Dr. Jones, however, is aware
of the AMA Code of Ethics, which states that patients have a right of self-decision regarding their
health care, and that this right can only be effectively exercised if the patient possesses enough
information to enable an informed choice. She feels a moral obligation to inform her senior
patients that she has reservations about the efficacy of flu shots for their age group and why.
Since the AMA and the Centers for Disease Control and Prevention are strong proponents of
annual flu shots, if Dr. Jones gives contrary advice to her patients, this could jeopardize her
standing with the AMA, in addition to her employment at her hospital. Furthermore, her hospital
administrator and other health officials are concerned that if doctors advise patients about the
relative ineffectiveness of, and potential injury from, flu vaccines, this could feed public doubts
about the efficacy or safety of other vaccines. Such doubts could increase public opposition to new
state laws that aim to promote herd immunity by mandating certain vaccinations.
While the case of Dr. Jones is based on the actual experiences of a medical doctor, her name and
identifying details have been changed. This case study reflects the key ethical dilemmas the doctor faced
In a 2-3 page double-spaced essay, view the attachment and address the questions below related to the case
study. Use a minimum of two outside references as well. First, do you think Dr. Jones should discuss her
reservations about flu vaccines with her senior patients? Why or why not? Do you believe Dr. Jones has a more
outstanding moral obligation to her family to protect her job security or to the recommendations of the AMA Code
of Ethics, which encourage physicians to help patients exercise their right of self-decision by providing them
with enough information to enable an informed choice? Explain your reasoning.
Even if flu shots provide protection less than one-fourth of the time, is it ethically permissible for Dr. Jones to
decide that protection for some patients is better than none? And, on that basis, choose not to discuss the
potential benefits and harms of flu shots with her patients? Explain. Do you think the AMA should promote open
discussions about the efficacy of flu vaccines and support the development of blood tests that could predict that
efficacy? Why or why not? What are the potential outcomes? Both the AMA Code of Ethics and the World Health
Organization endorse the primary right of self-decision of all patients regarding their health care. However, to
foster herd immunity. the bill SB 277 was recently passed in the state of California, mandating multiple doses of
vaccinations for all students entering kindergarten. Do you think there is a way to reconcile these two opposing
ethical goals? Explain.
W Week Three Case Study Healthcare Obligations Personal vs Institutional.docOctober 27 2018, 10:27 AM,