Safeguarding Children

NURS478
Ethical Aspects of Nursing Practice
Abby Beckley, Tasha Germuska, Jules Hansen, Deja Taggart, & Amanda Truong
INTRODUCTION OF SAFEGUARDING CHILDREN
★ Safeguarding is the protection of health, wellbeing and human rights. Effective
safeguarding enables vulnerable populations (particularly children) to live free from fear
of abuse, harm, or neglect.

★ In Ethically Sound’s podcast, Safeguarding Children, there is discussion about the

safety of children in regards to prevention and research

★ How can we best protect children in the event of a bioterror attack?

★ Should we conduct clinical trials of the anthrax vaccine with children in case of an
attack or should we wait and see if an attack ever happens before testing the vaccine on
children?

(Chambers, 2021; Viers, 2017)

 SAFEGUARDING CHILDREN
What are the pros and cons of pre-event
testing?

Pros Cons
★ Knowledge gained can be useful ★ No direct benefit for a participant
in the event of an attack ★ Testing on healthy children with
★ Can help further research no prior exposure to anthrax or
★ Potential to save lives other potential diseases
★ We may never have such an
attack
(Viers, 2017)
SAFEGUARDING CHILDREN: ETHICAL PRINCIPLES
★ Informed consent is an ethical issue involved in safeguarding children. Informed
consent represents a patient's autonomy and requires that the patient (or legal
representative) is given all of the information about a medical intervention that would
allow them to weigh the risks and benefits.
○ Autonomy is the principle that allows patients to make medical decisions for
themselves. In the case of children, medical decisions are left to parents or legal
guardians.
○ This applies to children regarding the testing of vaccinations. How can informed
consent be given if risks are not yet established in this age range?
★ Nonmaleficence is the duty of medical professionals to do no harm to their patients.

(Murray, 2022)
WHERE ARE WE WITH THIS BIOETHICAL DILEMMA TODAY?
★ Save the Children is currently the largest humanitarian aid organization for children
○ Any agency or partner engaged by Save the Children must not have any forms of
child abuse, maltreatment or poor safegaurding practice.
○ The policies apply to any person working in the capacity for Save the Children
during or outside of working hours.
★ Children can be the intended target of biological or chemical attacks.
○ Pediatric health care providers should be knowledgeable of possible
agents and optimal medical management.
○ Health care providers should understand pediatric decontamination
strategies.

(Save the Children, 2019; American Academy of Pediatrics, 2020)

 HOW DOES THIS IMPACT NURSES?
★ Nurses may be negatively affected by the safeguarding of children as the lack of trust
from a parent or guardian regarding all health care decisions/concerns might be
heavily impacted.
★ Without proper testing of vaccinations or direct prospect of benefit on the pediatric
population, parents will be unwilling to offer their own child up to clinical testing of a
vaccine.
★ In order to prepare for a bioterrorist attack, nurses are required to:
○ Stay up-to-date on continuing education programs regarding bioterrorism such
as conducting regular simulations of situations that might occur
○ Remain educated on the topic of disease and prevention control.
○ The Nursing Emergency Preparedness Education Coalition requires that nurses
must be knowledgeable in 4 vital areas: assessment, critical thinking,
communication, and technical skills.

(Tom-James, 2020)
WHAT HAS BEEN LEARNED FOR FUTURE USE?
★ Nurses need to maximize opportunities to speak with families to discuss vaccinations
and provide up to date research on the safety and efficacy vaccines.
★ Ensure follow up conversations with families and provide any updates that may have
been presented through research.
★ Vaccines created for new or novel diseases or pathogens and given to children in an
emergency situation should have rigorous post-event research protection.
★ Pre-event research with children should only be used when the potential harm is no
more than minimal. De-escalation in ages should be used to slowly test safety and
efficacy in children (18 years old → 16 years old → 14 years old → etc).

(Green, 2021; Viers, 2017)

CONCLUSION
★ Safety of children regarding prevention & research: Is there any direct
benefit to the child?
★ Nonmaleficence - not causing additional harm to patient
★ Nursing impact - lack of trust, potential for more adverse effects if
bioterror attack occurs.
★ Research should be done on efficacy and safety of vaccines

(Chambers, 2021; Green, 2021; Murray, 2022; Viers, 2017)

Thanks!
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 REFERENCES
American Academy of Pediatrics. (2020). Chemical-biological terrorism and its impact on children. Pediatrics.
https://publications.aap.org/pediatrics/article/145/2/e20193750/68271/Chemical-Biological-Terrorism-and-Its-Impact-on?
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Chambers, D., Cantrell, A., & Booth, A. (2021). Recognition of risk and prevention in safeguarding of children and
young people: A mapping review and component analysis of service development interventions aimed at health and social
care professionals. BMC health services research, 21(1), 1241. https://doi.org/10.1186/s12913-021-07257-8
Green, J. (2021). The impact of the anti-vaccination movement and vaccine hesitancy on the health of the
child. Pediatric Nursing, 47(5).
Murray, E. (2022). Nursing leadership and management: For patient safety and quality care (2nd ed.). FA Davis
Company.
Save the Children. (2019). Save the children’s child safeguarding policy.
https://www.savethechildren.net/sites/www.savethechildren.net/files/SCI_HR_POL_Child%20Safeguarding%20External%2
0Policy_EN.docx.pdf
Tom-James, L. (2020). Bioterrorism: Exploring factors for improving nurse preparedness, policies, and
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https://www.researchgate.net/profile/Leone-Okey/post/Can_you_link_me_to_examples_of_phd_theses
_based_only_on_systematic_literature_review/attachment/5e8fe65c4f9a520001ded39d/AS%3A87861
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Viers, H. W. (Host). (2017, January 15). Safeguarding children. [Audio podcast episode]. In Ethically Sound.
Presidential Commission for the Study of Bioethical Issues. https://bioethicsarchive.georgetown.edu/pcsbi/node/5893.html