Question

1. The state required vaccination for all citizens as a mean to control the measles outbreak. Which ethical principle is this? Write the legal issue?

Answer 1

THE ETHICAL PRINCIPLE FOR VACCINATION AS A MEAN CONTROL TO MEASLES OUTBREAK IS : BENEFICENCE PRINCIPLE

Beneficence:The international community and national governments have a collective duty of care to ensure that effective,affordable measures for preventing unnecessary illness and death are available to those most in need

According to the duty of care based on principle of beneficence government must make vaccines available against the most contagious diseases.

In addition to the duty of care ,institutions and individuals must abide by the rule of rescue which is "the imperative " to rescue identifiable individuals facing avoidable death.

This is influenced by urgency of the situation,the consequences of doing nothing,the feasibility of preventing serious consequences and the sacrifice required of the responding individual or agency.

Humanitarian emergencies occur often enough for timely access to an assured supply of vaccine to be necessary,since certain vaccine preventable diseases have serious outcome including death.

Global and local communities,including governments and non government organisations are morally obligated to ensure this supply.

A higher standard care is needed during public health crisis because of immediate threat to life.

Humanitarian assistance has traditionally been seen as charity in keeping with the principle of beneficence,but owing to the growing human rights focus,it has come to be viewed as an obligation.

Those who are able to help are obligated to ensure that the rights of affected individuals and population are respected and promoted.

From human rights perspective,vaccination equitably promotes and protects public health.

Irrespective of the principles underlying humanitarian assistance,vaccine donations can ensure timely access to vaccines during emergencies.

Although WHO and United Nations Children's Fund (UNICEF)have agreed on five requirements for good donations practice i.e.

• suitability
• sustainbility
• informed key persons
• supply
• licensing

they aknowledge that in exceptional circumstances,including emergencies these requirements can be overlooked .

The other ethical principles are :

• Non maleficence
• Distributing justice
• Procedural justice
• concent
• research

CONCLUSION:

Ethical considerations are vital to decision making about the deployment of vaccines in acute humanitarian emergencies.

Commitment to human rights and the rule to rescue place on onus on wealthy countries to ensure that life saving vaccines are made available to the poorer countries during crises.

Justice and ethics obligate those who are better off to assist those who worse off and to allocate resources accordingly.

National health authorities are morally obligated to do all that they reasonably can to implement evidence based guidelines to avert preventable harm.

The allocation of a limited supply of vaccine calls for a fine balance between utility and equality and fairness.Accountability demands that decision-making may explicit,documented and open to public review.

In emergencies the informed consent process may reasonably modified to avoid delaying protection for vulnerable communities.

In situations that threaten the health and well-being of others,authorities may be required to mandate vaccination and intervene on behalf of minors against parental wishes .

Finally emergency head care workers should be trained in ethics to improve their decision making skills during acute humanitarian emergencies.