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

Related Links:

‚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
Abstract Rubella is generally a mild and self-limited disease in children. During pregnancy, rubella can have potentially devastating effects on the developing fetus. Postnatal rubella is transmitted primarily by inhalation of virus-laden airborne droplets or direct contact with infected nasopharyngeal secretions. In susceptible pregnant women, the virus may cross the placenta and spread through the vascular system of the developing fetus. Postnatally acquired rubella typically begins with fever and lymphadenopathy, followed by an erythematous, maculopapular rash. The rash classically begins on the face, spreads c...
Source: Hong Kong Med J - Category: General Medicine Authors: Tags: Hong Kong Med J Source Type: research
Conclusions Apart West Nile virus (78), thousands of congenital microcephaly cases, fetal brain tissue damage and neurological syndromes have been associated with ZIKV infection. Unfortunately, the epidemics of this mosquito born, and a relative stable virus is on a rise. Although congenital microcephaly is a rare disorder however, due to lack of standardized diagnostic test facilities, the incidence in the geographically widespread ZIKV epidemic regions is higher. Animals studies showed that ZIKV is a neurotropic virus. It directly targets the developing embryonic brain cells by inducing apoptosis, cell-cycle arrest, and...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
ntesh S, Manasa S, Nehra U, Munjal SK, Nag VL, Naik S, Raj N, Ram J, Ratho RK, Raut CG, Rohit MK, Sabarinathan R, Shah S, Singh P, Singh MP, Tiwari A, Vaid N Abstract Rubella infection during pregnancy can result in miscarriage, fetal death, stillbirth, or a constellation of congenital malformations known as congenital rubella syndrome (CRS). The 11 countries in the World Health Organization (WHO) South-East Asia Region are committed to the elimination of measles and control of rubella and CRS by 2020. Until 2016, when the Government of India's Ministry of Health and Family Welfare and the Indian Council of Medica...
Source: MMWR Morb Mortal Wkl... - Category: Epidemiology Authors: Tags: MMWR Morb Mortal Wkly Rep Source Type: research
This report summarizes progress toward rubella and CRS control in SEAR during 2000-2016. Estimated coverage with a first RCV dose (RCV1) increased from 3% of the birth cohort in 2000 to 15% in 2016 because of RCV introduction in six countries. RCV1 coverage is expected to increase rapidly with the phased introduction of RCV in India and Indonesia beginning in 2017; these countries are home to 83% of the SEAR birth cohort. During 2000-2016, approximately 83 million persons were vaccinated through 13 supplemental immunization activities (SIAs) conducted in eight countries. During 2010-2016, reported rubella incidence decreas...
Source: MMWR Morb Mortal Wkl... - Category: Epidemiology Authors: Tags: MMWR Morb Mortal Wkly Rep Source Type: research
LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog aka Tropical Travel Trouble 007 When you think tropical medicine, malaria has to be near the top. It can be fairly complex and fortunately treatment has become a lot simpler. This post is designed to walk you through the basic principals with links to more in depth teaching if your niche is travel medicine, laboratory diagnostics or management of severe or cerebral malaria. If you stubbled on this post while drinking a cup of tea or sitting on the throne and want a fe...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Clinical Cases Tropical Medicine malaria Plasmodium plasmodium falciparum plasmodium knowles plasmodium malariae plasmodium ovale plasmodium vivax Source Type: blogs
Author Affiliations open 1Infectious Diseases Division, icddr,b (International Centre for Diarrhoeal Disease Research, Bangladesh), Dhaka, Bangladesh 2Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden 3Maternal and Child Health Division, icddr,b, Dhaka, Bangladesh 4Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan PDF Version (995 KB) Abstract About This Article Supplemental Material Background: Early-life arsenic exposure has been associated with reduced cell-mediated immunity, but little is known about its effects o...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
More News: Audiology | Centers for Disease Control and Prevention (CDC) | Child Development | Children | Dentistry | Education | Health and Safety | Health Management | Infectious Diseases | International Medicine & Public Health | Legislation | Measles | Measles Vaccine | Medical Ethics | Miscarriage | OBGYN | Occupational Health | Pathology | Pediatrics | Pregnancy | Professional Development | Speech Therapy | Speech-Language Pathology | Vaccines | Websites | Women