The repeatedly came to the clinic in

The codes of
ethics are a principle of right and wrong. They play a vital role in medicine
and are referred to as medical ethics. Medical ethics govern the medical
profession by guiding physicians’ meet ethical challenges. The five most common
types of ethical problems include ethical dilemma, ethical distress, the
dilemma of justice, the locus of authority, and whistleblowing. The current ethical
problem that is going to be discussed in this paper is an ethical dilemma.

Ethical dilemma occurs when acting on one moral conviction means that another
example is broken. In the article, Is
Exposure to Secondhand Smoke Child Abuse? the parents are constituting
child abuse by failing to remove their children from recurrent,
life-threatening harm by secondhand smoke.

The case talks
about a 5-year-old patient and her 7-year-old sister who repeatedly came to the
clinic in the past 3 years for asthma, coughing, ear infection, and bronchitis
even after their family was consulted at least 10 times about quitting smoking
around their children.1 Two months after their last visit, their 5-year-old
developed pneumonia and was effectively treated with antibiotics and inhalers.1
The parents were given a strong warning about avoiding smoking around their
children and were also offered counseling support. However, they refused to
partake in discussion regarding quitting smoking or about letting their
children not be exposed to cigarette smoke. Not long after, the same child
returned to the emergency room with a recurrence of pneumonia and severe
asthma. She was kept in the hospital for several days before she improved any.

Out of the 10 adults who had come to visit her from her family 6 were heavy
smokers including her parents, several family friends, and extended family
members.1

            The
doctors concluded that it was their failure as their patient was suffering from
child abuse and they could not do anything more than offering her medication,
referral, and counseling.1 The article goes on to talk about the
doctors’ dilemma and what they thought could be done to save this patient.  They said that they needed to “take the
additional step of placing a call to social services to report suspected child
abuse.” (Goldstein) They also stated that they “needed to consider a petition
for the court to remove the children from the patients home until securing a
guarantee of no involuntary exposure to recurrent secondhand exposure.”
(Goldstein) The article then talks about how it is universally believed that
all children should be protected from all forms of neglect and abuse and gives an
example of high-lead exposure and states, “when high lead levels are discovered
in a child’s home, doctor’s intervene to preserve health. When a child is
discovered being neglected due to parent’s drug addiction or alcohol abuse,
Child Protective Services are called.” (Goldstein) The author further talks
about how it is clinicians duty to interfere in any suspicion of child abuse
that involves substantial harm and concludes the article by stating that the
same laws should be applied to prolonged and recurring pediatric secondhand
smoke exposure.

            In
regards to this ethical dilemma, I talked to people who are different from me
and from each other. I selected two classmates who are from two different
countries to see if their opinion differed. I talked to Brittany Taylor and
Abdullah Alosaimi. Brittany Taylor is white, follows Church of Christ and has
spoken English all her life. Whereas, Abdullah is a Saudi Arabian, Muslim, and
speaks Arabic.  I, on the other hand, am
Indian, follow Hinduism and grew up speaking Gujarati. According to Brittany secondhand
smoking is child abuse. She said, “the child cannot escape their home/car
exposure but the parents can control the situation by going outside to smoke
which would still allow them to smoke and decrease the risk of harming their
children if they do not want to quit their habit.” She also said that there
should be stricter laws as they have failed to do their duty as a caretaker and
provide a safe environment for their children. In this case, the parents are
purposely harming their children by not adhering to doctors and nurses and
continuing smoking. Abdullah along with Brittany said the same thing. He said,
“the kids have no control over it when their parents smoke in their car and it
does the kids harm.” When the parents smoke in the house and around their
children then the children have to breathe it in and the smell gets stuck in
their clothes and their hair where other people can smell it and again the
children do not have any control over that.

            My
opinion was also the same as that of Brittany’s and Abdullah. If the parents
want to smoke and not give up their smoking habit then they have an option of
stepping out and smoking instead of risking their children’s life over and over
again. Some pros of them doing this include, better health of their children,
it will also reduce the number of cigarettes they themselves smoke as they will
have to step outside to smoke compared to continuously smoking inside their
house or car, this will also benefit their health and keep their lungs healthy.

According to Arthur Caplan, in “Is Parental Smoking Child Abuse?” more than 24
million, or about 37%, of children in the United States have been exposed to
secondhand smoke. So, if parents start being extra cautious and caring around
their children this could prevent more children from being exposed to
secondhand smoke. Secondhand smoke is also responsible for between 150,000 and
300,000 lower respiratory infections in infants and children younger than 18
months, resulting in between 7500 and 15000 hospitalizations each year.

(Caplan) Avoiding smoking near children could also prevent 430 sudden infants
death in children due to secondhand smoke annually. All of this can be done
with just a little understanding from parents concerning their children’s
health. Taking action against them in court could force them to change, as they
will be afraid that if they smoke or put their children’s life in danger then
their kids will be taken away from them.

            Some
of the cons of secondhand exposure include children’s death for something out
of their control. Secondhand smoke causes diseases in children including
pneumonia, asthma and lower respiratory infections. It can also cause heart
attacks and lung cancer with recurrent exposure. If court begins taking
stricter actions against parents who knowingly risk their lives then there is
also that chance that people will begin hiding correct information from their
healthcare providers. Treating it as a child abuse could also lead to parents
neglecting their child’s healthy completely because they are afraid of loosing
this children’s custody.

            Overall,
my classmates and I had the same viewpoint on how to handle this critical
issue. Even though we are all from different backgrounds what is considered
morally right and not is the same amongst all of us. Secondhand smoking not only puts the child in the
hospital but there is also a chance of sudden death due to it. All the motels
and hotels in North have completed banned smoking and some states have also
banned smoking in cars while a child is present in the car. Stricter rules
should be passed keeping the children’s health in mind and same actions should
be taken against parents similar to someone who drinks and drives. Giving
drugs, selling drugs to a minor is a criminal act and intentional secondhand
smoke exposure to children is no less.