Imagine That Your State Legislature Is Considering A Law
Imagine That Your State Legislature Is Considering A Law That Would Re
Imagine that your state legislature is considering a law that would require parental consent for newborn screening. Parental consent is currently not required, although newborn testing is not conducted over parental objection. (Currently only a few states actually require consent.) The health department has been asked to take a position on the pending legislation. Using the readings for the week, the South University online library, and the Internet, write a 3–5-page paper. Cover the following: What position should the health department take? Use the following six questions to help craft your response (Bernheim, Nieburg, & Bonnie, 2005).
Ethics Guide for Public Health Decision Making What are the public health risks and harms of concern in this particular context? What are the public health goals? Who are the stakeholders and what are their moral claims? Is this source or scope of legal authority in question? Are precedent cases or the historical context relevant?
Do professional codes of ethics provide guidance? Submit your response in a Microsoft Word document On a separate page, cite all sources using the APA format. Bernheim, R. G., Nieburg, P., & Bonnie, R. J. (2005). Ethics and the practice of public health. In R A. Goodman (Ed.), Law in public health practice (2nd ed.). Oxford, NY: Oxford University Press.
Paper For Above instruction
The decision of whether the health department should support or oppose a legislative proposal requiring parental consent for newborn screening involves complex ethical, legal, and public health considerations. To inform this position, it is essential to analyze the public health risks and harms, identify the goals, consider stakeholder claims, assess legal authority, and reflect on relevant professional ethical codes.
Public Health Risks and Harms
Newborn screening is a critical public health intervention that allows for early detection of certain congenital conditions, such as phenylketonuria (PKU) and congenital hypothyroidism, which, if untreated, can lead to severe disabilities or death (Kemper, 2010). The removal of parental consent requirements may help ensure high participation rates, thus maximizing the screening's benefits. Conversely, requiring explicit parental consent could lead to increased refusal rates, potentially delaying diagnoses and interventions, resulting in adverse health outcomes. Additionally, there are concerns about the psychological impact on parents, including anxiety or guilt if abnormal results are identified (Wilkins & Friedland, 2013). The core issue revolves around the balance between respecting parental rights and safeguarding public health interests. The harms include missed opportunities for early intervention if consent leads to reduced screening coverage and possible erosion of trust in public health programs if parents feel their rights are marginalized.
Public Health Goals
The primary goal of newborn screening programs is to prevent morbidity and mortality from treatable conditions through early detection and timely intervention. Ensuring high participation rates is essential to attain maximum health benefits across the population, especially among vulnerable groups. Protecting individual rights while achieving population health objectives creates an ethical tension—maximizing public health benefits without infringing unnecessarily on personal autonomy. Transparency, informed consent, and ensuring parental understanding are also vital goals that could be compromised if the law mandates consent without adequate informational support (Guthrie & Green, 2017).
Stakeholders and Their Moral Claims
Stakeholders encompass parents, healthcare providers, public health officials, policymakers, and the children involved. Parents have moral claims rooted in autonomy and the right to make health decisions for their children. Healthcare providers have a duty to promote best practices and uphold ethical standards. Public health officials aim to optimize population health outcomes, often emphasizing beneficence and justice. Children, as vulnerable recipients of early interventions, have claims for protection and beneficence. The state's role in safeguarding public health may justify certain limitations on individual autonomy but must do so within ethical boundaries that respect fundamental rights (Beauchamp & Childress, 2013).
Legal Authority and Historical Context
The legal authority for mandatory newborn screening derives from statutes and public health laws recognizing states' power to protect children's health. Historically, states have mandated screening programs based on the societal benefit of preventing disability (Kass et al., 2004). Precedent cases, such as Jacobson v. Massachusetts (1905), underscore the state's authority to enforce health measures for the greater good. Nonetheless, legal debates persist about the extent of parental rights versus state interests, especially concerning consent. Some states have explicitly incorporated consent procedures, reflecting historical trends favoring autonomy, while others prioritize public health imperatives (Jones & Silverman, 2014).
Guidance from Professional Ethical Codes
Professional codes, such as those from the American Public Health Association (APHA) and the American Academy of Pediatrics (AAP), emphasize principles of beneficence, nonmaleficence, justice, and respect for persons. The APHA advocates for policies that protect children’s health while respecting family integrity and autonomy, promoting informed choice whenever possible (APHA, 2017). The AAP underscores the importance of informed consent and parental involvement, advocating for education and voluntary participation when practicable (American Academy of Pediatrics, 2012). These guidelines suggest that while parental consent is ethically valuable, public health programs must balance this with the need to ensure effective screening results. Therefore, the health department should consider policies that promote informed consent processes that are respectful, informative, and accessible but also understand that certain public health measures may justify some limitations on autonomy to achieve broader health benefits.
Conclusion and Recommended Position
Given the public health benefits of newborn screening and the ethical obligation to protect vulnerable populations, the health department should oppose the legislative proposal requiring parental consent as a strict prerequisite for screening. Instead, the department should advocate for policies that prioritize informed parental participation, providing comprehensive information about the importance, benefits, and potential risks of newborn screening. This approach aligns with ethical principles of beneficence, respect for autonomy, and justice, and respects legal precedents that recognize the state's authority to protect child health. When parental rights are balanced with public health needs, it is possible to ensure high participation rates without compromising individual rights unnecessarily. Ultimately, supporting a system that respects informed consent, transparency, and parental engagement best serves the ethical and public health goals integral to newborn screening programs.
References
- American Academy of Pediatrics. (2012). Policy statement: Ethical issues in genetic testing and screening of children. Pediatrics, 129(5), 1054-1060.
- American Public Health Association. (2017). Principles of Public Health Policy. APHA.
- Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics (7th ed.). Oxford University Press.
- Guthrie, R., & Green, R. (2017). Informed consent and autonomy in newborn screening. Journal of Public Health Policy, 38(4), 563-577.
- Jacobson v. Massachusetts, 197 U.S. 11 (1905).
- Kaiser, J. (2016). Ethical considerations in newborn screening. Science, 354(6319), 1354–1355.
- Kass, N. E., Faden, R., & Goodman, S. N. (2004). The evolving role of ethics in public health decision-making. The Hastings Center Report, 34(4), 35–41.
- Kemper, A. R. (2010). The role of newborn screening in public health. Pediatrics, 125(Supplement 2), S39–S45.
- Jones, R., & Silverman, J. (2014). Parental rights and state authority: The case of newborn screening. Journal of Law, Medicine & Ethics, 42(3), 334–345.
- Wilkins, E., & Friedland, J. (2013). Psychological aspects of newborn screening. Journal of Pediatric Health Care, 27(4), 300–306.