Everyday Ethics: Do I Discontinue Services for Unvaccinated Clients?

Question: I’m a private-practice, ASHA-certified speech-language pathologist who is three months pregnant. I have been treating a child in her home, but I want to discontinue services to the child because no one in the family has been vaccinated for the measles. Can I do so or would it be considered client abandonment? More than 1,150 measles cases occurred in more than 30 states in the U.S. in 2019, and most of those cases involved unvaccinated people, according to the U.S. Centers for Disease Control and Prevention (CDC). Measles is highly contagious and there is no cure. Measles in pregnant women may have serious consequences, including low-birth weight and miscarriage, reports the American College of Obstetricians and Gynecologists (ACOG). Your query triggers several ethical considerations. As always, the welfare of your client is paramount. However, the ethical analysis in this situation doesn’t stop there. Could it be considered client abandonment? First and foremost, as a CCC-SLP you must abide by the ASHA Code of Ethics. Accordingly, you have an ethical obligation not to abandon a client; but this obligation isn’t absolute. ASHA’s Issues in Ethics statement on client abandonment states, “no clinician is ever ethically required to work . . . in physical danger in order to offer client care.” The likelihood of you being exposed to measles while pregnant and providing services to an unvaccinated child in her home appears to pose such a...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Audiology Health Care Private Practice Slider Speech-Language Pathology Early Intervention Professional Development Source Type: blogs

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Rubella, sometimes known as German measles, is an infectious disease caused by the rubella virus, generally involving a mild febrile disease accompanied by rash and lymphadenopathy (Menser et al., 1978; Lambert et al., 2015). While rubella is mostly self-limiting and is asymptomatic for 25% –50% of infections, pregnant women infected in the first trimester can suffer a variety of complications, including miscarriage, stillbirth, and congenital rubella syndrome (CRS) (Panagiotopoulos et al., 1999; Lambert et al., 2015).
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Source Type: research
Authors: Ragusa R, Platania A, Cuccia M, Zappalà G, Giorgianni G, D'Agati P, Bellia MA, Marranzano M Abstract Measles is a highly contagious airborne disease. Unvaccinated pregnant women are not only at risk of infection but also at risk of severe pregnancy complications. As measles causes a dysregulation of the entire immune system, we describe immunological variations and how immune response mechanisms can lead to adverse pregnancy outcomes. We evaluated data during the measles outbreak reported in the province of Catania, Italy, from May 2017 to June 2018. We controlled hospital discharge records for pati...
Source: Journal of Pregnancy - Category: OBGYN Tags: J Pregnancy Source Type: research
This report summarizes progress toward rubella elimination and CRS prevention in WPR during 2000-2019. Coverage with a first dose of rubella-containing vaccine (RCV1) increased from 11% in 2000 to 96% in 2019. During 1970-2019, approximately 84 million persons were vaccinated through 62 supplementary immunization activities (SIAs) conducted in 27 countries. Reported rubella incidence increased from 35.5 to 71.3 cases per million population among reporting countries during 2000-2008, decreased to 2.1 in 2017, and then increased to 18.4 in 2019 as a result of outbreaks in China and Japan. Strong sustainable immunization prog...
Source: MMWR Morb Mortal Wkl... - Category: Epidemiology Authors: Tags: MMWR Morb Mortal Wkly Rep Source Type: research
New evidence published in the Cochrane Library today finds MMR, MMRV and MMR+V vaccines are effective and that they are not associated with increased risk of autism. Measles, mumps, rubella and varicella (also known as chickenpox) are infectious diseases caused by viruses. They are most common in children and young adults, and can lead to potentially fatal illnesses, disabilities and death. Measles remains one of the leading causes of childhood death around the globe. Rubella is also dangerous for pregnant women, as it can cause miscarriage or harm to unborn babies. The MMR (measles, mumps, rubella) is a combined...
Source: Cochrane News and Events - Category: Information Technology Authors: Source Type: news
Right now, many people are hoping for a vaccine to protect against the new coronavirus. While that’s still on the horizon, new research suggests that families who do vaccinate their children may not be following the recommended schedule. Vaccines are given on a schedule for a reason: to protect children from vaccine-preventable disease. Experts designed the schedule so that children get protection when they need it — and the doses are timed so the vaccine itself can have the best effect. When parents don’t follow the schedule, their children may not be protected. And yet, many parents do not follow the sc...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Adolescent health Children's Health Parenting Vaccines Source Type: blogs
The rise of vaccine-preventable illnesses, such as measles and hepatitis, in the United States and around the globe has been alarming in recent years. For women — especially those hoping to become pregnant, as well as women who are pregnant or have recently had a baby — vaccines can be a worrisome topic. There are many misconceptions about vaccine safety in and around pregnancy that can lead to confusion and unnecessary fear of a lifesaving medical tool. As a practicing ob/gyn, I often discuss vaccines with my patients and help them sort out fears versus facts. Which vaccines should you consider before concepti...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Parenting Pregnancy Vaccines Women's Health Source Type: blogs
‚ÄčI have been seeing a lot of second disease and fifth disease—it's that time of year. School is back in session, and winter is just around the corner.The rash-numbering system for these diseases is now a historical footnote, but fifth disease is still commonly used by physicians to refer to erythema infectiosum, a parvovirus. I suspect that this system was created as a memory device for similar names and the obscure Latin terms used for these diseases. Erythema infectiosum is also easy to confuse with the many other erythema rashes such as erythema migrans, erythema marginatum, erythema toxicum, and erythema multif...
Source: M2E Too! Mellick's Multimedia EduBlog - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
This report on the progress toward rubella and CRS control and elimination updates the 2017 report (3), summarizing global progress toward the control and elimination of rubella and CRS from 2000 (the initiation of accelerated measles control activities) and 2012 (the initiation of accelerated rubella control activities) to 2018 (the most recent data) using WHO immunization and surveillance data. Among WHO Member States,* the number with RCV in their immunization schedules has increased from 99 (52% of 191) in 2000 to 168 (87% of 194) in 2018†; 69% of the world's infants were vaccinated against rubella in 2018. Rube...
Source: MMWR Morb Mortal Wkl... - Category: Epidemiology Authors: Tags: MMWR Morb Mortal Wkly Rep Source Type: research
As a medical student, the place I dreaded most was the ward at the children’s hospital where they kept the chronic ventilator patients. Unlike the other floors, where there was shouting and laughter and tears, and all the commotion and turbulence of youth, here it was dark and lifeless and eerie, with no sound except the hum of the ventilators, and the rattle of air being forced through plastic tubes. It was a place of failure and defeat, the desolate aftermath of some vast and tragic battle. An unexpected aftermath of measles My patient was a teenager who had been in a coma for years. His limbs had stubbornly twiste...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Children's Health Infectious diseases Men's Health Vaccines Women's Health Source Type: blogs
Since it is not a brief answer, rather than respond to Mr. Bachtell's question in the comments, I'll do a front page post on it.CDC provides information about complications of measles here. This applies to the United States and other wealthy countries. Measles is much more dangerous in poor countries where many children are malnourished or debilitated from chronic infections, but that's a bit off topic.The actual death rate from measles in developed countries is about 1-2 per 1,000. However, 1 in 20 children will get pneumonia as a complication, which may require expensive treatment including mechanical ventilation. An add...
Source: Stayin' Alive - Category: American Health Source Type: blogs
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