Developinga Health Advocacy Campaign: Ethical Considerations

Cigarette smoking has been associated with adverse healthconsequences that affect both the smokers and the non-smokers. Infact, such a scenario has raised the need to initiate a healthadvocacy program that will sensitize the community on the adversehealth consequences. However, the successful implementation of thehealth advocacy campaign relies on factors such as the ethicalframework. The ethical framework is quite useful in this scenariosince it defines the nature of the policies that will be initiated bythe health practitioners engaging in the advocacy campaign. In thiscase, the ethics and the lobbying laws are elements that they shouldrespect to ensure that the campaign ends up being a success as well.This paper will dig deeper into the ethical consideration needed tomake the health advocacy campaign a success as well. First, it willlook at the ANA Code of Ethics and illustrate how it applies to theparticular campaign. It will also look at the various ethicaldilemmas that will arise from the health advocacy program. Some ofthe ethical dilemmas will include the individual interests and thegroup interests that will arise after the audience seems to disagreewith the policies suggested. The autonomy and the informationcommunication is another issue since the ethics will need only acertain extent of facts and policies that are not discriminative innature. Apart from that, the paper will also evaluate whether theclinical practitioners should use the paternalism or the empowermentapproach in sensitizing the audience. The paper will also reveal anumber of lobbying laws that the health practitioners should use inensuring that the health advocacy program is on the right path. Theeffective ethical framework will also be effective in ensuring thatthe organizers plan and implement the suggested policies depending onthe ethics. All in all, the implementation of the cigaretteanti-smoking health advocacy campaign needs the presence of anefficient ethical framework that will guide the health practitionersin solving the various ethical dilemmas.

In the process of implementing the health advocacy campaign, there isthe need to comply with the ANA Code of Ethics, especially theseventh, eighth and ninth provisions. In this case, the seventhprovision asserts on the roles, settings and all the activitiesrelying on scholarly inquiry as well as the nursing professionalstandards (American Nurses Association, 2012). Hence, the cigarettesmoking advocacy campaign will need the health practitioners tocomply with each of the professional standards. In fact, complyingwith each of the scholarly inquiry will be a bold step in ensuringthat all the aspects in the campaign are covered appropriately. Theeighth provision under the ANA Code of Ethics insists on the nurseworking together with the other health professionals as well as thepublic (American Nurses Association, 2012). Evidently, the teamworkwill assert on the need to protect the human rights, minimize thehealth disparities and enhancing the health diplomacy. Lastly, ninthprovision should ensure that the profession will also abide by thenursing values and maintain the principle of social justice in thehealth field (American Nurses Association, 2012). Apart from that,the respectful advocacy activities are effective in ensuring that theteam coordinates towards providing the policies that will ensure thatthe smokers and the non-smokers find the help they need. In somecases, the health professionals might resort to the false claims oreven abusive comments that will undermine the credibility of the samehealth advocacy program. The scenario has led to the healthprofessionals maintaining the required values and ensuring that allthe ethical dilemmas will not be a concern to the audience or eventhe organizers. In fact, if the health professionals comply with allthose measures, the advocacy campaign will not face any ethicaldilemmas.

The non-smoking health advocacy program might experience variousethical issues that are more likely to undermine the success of thesame campaign. For instance, the smokers might feel like the campaignis undermining their individual autonomy. However, the smokers willexpect the health practitioners to respect their freedom yet, theywill fail to understand that they are interfering with the freedomand rights of the non-smokers as well. Even, research has proved thatthe second-hand smoking is also dangerous just like the first-handsmoking (Milstead, 2013). In essence, the first-hand smoking looks atthe smoker while the second-hand smokers are the non-smokers that arearound the smokers. Instead, they often inhale the smoke placing themat a higher risk of suffering some respiratory infections. Thescenario will give rise to the dilemma where the health professionalshave to choose between the individual and the group interests.Evidently, the smokers will assert how they have the right to engagein anything they love without the campaign interfering with theirautonomy (Crippen &amp Barnato, 2011). The scenario will leave thecampaigners in a dilemma, and they will be wondering if to proceedwith the mission that will protect the group interests or to stop thecampaign since it is interfering with the cigarette smokers’autonomy.

The autonomy and the communication are some of the important aspectsthat the health practitioners have to comply with. In this case, theNorth American society has often prioritized the respect for autonomyas well as the private life that the civilians need to enjoy. Assuch, the health practitioners have to make sure that the goalspromoting the public health should be persuasive and not coercive.Evidently, the coercive goals will be seen as a violation of theindividual rights of the targeted audience that also comprises of thecigarette smokers. Evidently, the ethical dilemma arises from theneed to create goals that are persuasive, but, they should not becoercive at the same time (Pavlish et al., 2011). The coercivemeasures are unethical and will most likely violate the code ofethics that is supposed to guide them. From the entire scenario, theresponsibility of the professional also comes into question as well.The audience has the “right to know” the harm and the risk thatthey are exposed to as they engage in the cigarette smoking. Thefailure to engage in such health advocacy campaign might seem a bitstrange and unethical since the audience has the right to understandsuch messages. Apart from that, the “duty to inform” is alsoanother issue that arises from the need to engage in the healthpromotion (Matthews, 2012). All in all,the conflict of the two values will lead to the ethical dilemma sincethe health practitioners will have the difficulties in implementingthe campaign. Even if the professionals have the “right to inform”the audience, they should not create harmful anxiety among theaudience. They should create messages that clearly present thereality, and nothing should be exaggerated. The conflict is achallenge and might undermine the credibility of the health advocacyprogram showing the need to be cautious as well.

Paternalism and empowerment also provide the ethical dilemmas thatthe health advocacy might also face. In this case, paternalism refersto the way that the health professionals will focus on the coercivemethods that will prohibit various behaviors such as the need tosmoke indoors. They might also decide to make the health promotionprograms more aggressive instead. However, the paternalisticapproaches might seem a bit inappropriate to a part of the targetaudience since they might feel like they are being forced to adoptsuch policies (Hebert et al., 2011). Thehard paternalism is the common approach that will implement thecoercive intervention measures and the one that violates the ethicalprinciples as well. For instance, it might interfere with the privacyof the smokers, and it might violate the respect for autonomy. Softpaternalism is the one that will instead suggest measures that areless aggressive, but, they will focus on improving the situation theyare going through (Hebert et al., 2011).However, the ethical dilemma arises from the conflict of paternalismand empowerment. In this case, empowerment focuses on the healthprofessionals respecting the autonomy of the audience and urging themto make some responsible decision in terms of avoiding their smokingbehaviors. After, being empowered the individuals will be more likelyto listen to the various details that the campaign is offering interms of improving their health. Even if the empowerment is seen asan approach that will offer the effective way of respecting thesmokers’ autonomy, it often seems ineffective and impractical sincethe approach will face a number of obstacles along the way (Hebertet al., 2011). At times, they might be empowering, but, stillless effective showing that the ethical justification might not bringthe results needed. Based on the issues of paternalism andempowerment, the clinical officers might be forced to adoptempowerment that might even fail. Instead, they might choosepaternalism that will provide the results, yet, it will not considerthe autonomy of the cigarette smokers. The ethical dilemma ofchoosing the two sides makes the campaign a bit confusing.

The description of the differences on the health risks associatedwith the cigarette smoking is another aspect that might cause theethical dilemmas as well. For instance, the health practitionersmight find it difficult in understanding the extent they should go inexplaining the health risks. Often, a certain extent of informationmight be viewed as being a violation of the individual’s rightsinstead. They are not supposed to release information that might seema bit intimidating, but, they should focus on informing the audienceand persuading them into following the required course of actions(Paquin, 2011). Based on theillustration, it is frustrating to the health practitioners that haveto provide the information to the audience. In fact, the scenarioreveals an ethical dilemma since the health practitioners areconfused with the quantity and quality of information that they aresupposed to release to the audience. They might release lessinformation believing that they are complying with the ethicalguidelines yet, they are making the campaign less efficient. Theethical dilemmas will undermine the health advocacy plan if thehealth practitioners fail to consider all the aspects needed to makeit successful instead.

The social labeling and the stigmatization often create anotherethical dilemma as the organizers have to deal with such issuesbefore implementing a perfect plan instead. In this case, thecommunity will have various people such as the immigrants that areless likely to benefit from the policy incentives. For instance, theAffordable Care Act is one example that illustrates how theimmigrants cannot benefit from the plan showing the stigmatizationyet the organizers are willing to help them. Apart from theimmigrants, the smokers might experience social labeling,stigmatization, and discrimination since the other group will viewthem as the cause of the harm (MacDonald etal., 2012). To make it worse, if they persist with thesmoking, they will most certainly create a problem in theimplementation of the program. The rest of the community might feellike this group is more of a burden since they keep increasing theexpenses and the medical costs as well. The aspect shows how thevulnerable group will keep suffering even with the presence of therequired help. The health professionals will be unable to help thevulnerable group by urging both groups to combine their effort. Inthe process, they will even face an ethical dilemma where they willnot understand the perfect approach they should undertake in theentire scenario.

The limits of the principles of justice and the beneficence areanother aspect that might create an ethical dilemma where theclinical practitioners are expected to undertake the requiredmeasures. In this case, it is more difficult to balance between thebenefits and the harm that the audience might be exposed to. Even ifthe campaign aims at providing the maximum benefits to the populationin terms of the efficient policies, it does not mean that thebenefits will be extensive. In some cases, certain individuals oreven the subgroups might be exposed to negative consequences thatwill end up being an obstacle to the progress of the campaign. Infact, the utilitarian approach asserts on the maximization ofbenefits, which is an aspect that the organizers of the healthadvocacy campaign have also embraced (Tomajan,2012). It shows the need for the clinical experts implementingpolicies that are favorable to a larger part of the audience as well.The fact that the health benefits suggested should have the leastnegative impact is a dilemma that the officers have to solve instead.Such issues also arise from the uncertainty of the policies they havesuggested. Along the way, more obstacles might arise that will thenundermine the progress and the success of the campaign instead. Theymight overcome such issues if they implement the measures based onthe ANA Code of Ethics that is supposed to guide them in the planningand the implementation of the entire program.

The various lobbying laws will often apply to the health advocacycampaign that the health professionals are undertaking. In this case,the anti-smoking campaign will be much relevant in identifying someof the important lobbying laws that might arise from the same. First,the government will consider their interest in protecting the publichealth and the safety of the community. In particular, the governmenthas the right to ensure that the community is free from any disease(Tomajan, 2012). They will support thecampaign because it protects the community from the harm associatedwith cigarette smoking instead. The liberty interest of theindividuals is also an important issue that should be consideredbefore the campaign begins. Some individuals value their liberty inthe society and they will oppose any activity that will interferewith their autonomy. Hence, the campaign will have to consider thatbefore implementing the entire campaign. Apart from that, the groupand the individual interests are another aspect of the law thatshould be considered before the campaign proceeds. For instance, theindividuals might feel like the campaign is interfering with theirpersonal autonomy and space too. However, the government might favorthe group interests especially if the consequences will more likelyaffect the entire community (Tomajan, 2012).In this case, the scenario will lead to the campaign ignoring the fewindividuals complaining and focusing on the appropriate measures thatwill ensure the community does not suffer from the adverseconsequences. Evidently, the compliance with such guidelines isreally crucial in ensuring that the health campaign avoids any lawsuits that will interfere with the progress of the advocacy campaign.In fact, the legal considerations are another way of ensuring thatthe campaign follows all the professional guidelines needed inensuring that the campaign is on the right path.

In this case, the health advocacy program needs to comply with anethical framework that will reveal all the important aspects needed.It will be considered as ethically acceptable if only it complieswith the ethical theories like utilitarianism, virtue theory, Kantiandeontology as well as liberalism. The theories guide one in ensuringthat the kind of goals and objective adopted by the campaign alignswith the theoretical framework illustrated above. In fact, thetheories often assert on the “common morality” that are alsoimportant in ensuring that the audience gets the respect they deserve(Spence, 2011). Besides that, theuniversal values that insist on the Human Rights also imply anotherimportant aspect that should be honored in the campaign. Evidently, aprogram that complies with all these elements might justify theethical considerations needed to make the campaign seem moresuccessful instead. The ethical framework needs to looks into theautonomy, beneficence, justice as well as the non-maleficence thatare the aspects that will ensure the health advocacy campaign is onthe right path (McCarthy &amp Gastmans, 2015).The elements are efficient in monitoring every activity and goalsthat the health practitioners will initiate towards raisingawareness.

All in all, the audience has the autonomy to implement the awarenessor simply ignore the progress of the campaign. It also needs tofacilitate the justice and fairness in terms of the practicesimplemented to reduce the impact of the cigarette smoking. Thebeneficence looks at the way that the health professionals willbenefit the community that might undergo experience adverseconsequences if they are not offered the required help. In this case,the health campaign is a better way of handling the case and ensuringthat the targeted audience does not suffer from the consequences thatmight arise from the entire scenario (Robichaux,2012). Lastly, the non-maleficence is also crucial since itprevents the campaign from causing any harm on the target audience.The absence of the harm will ensure that the audience captures allthe practices and policy changes that will ensure the campaign are onthe right path instead.

In this case, the ethical analysis will often need a three-stepprocess that will identify the specific important aspects that needto be implemented appropriately. The first step includes the healthpractitioners identifying the theoretical principles and undertakinga proper analysis of the entire case. For instance, the nature,context as well as the facts related to the cigarette smoking and theconsequences are the major points needed. The approach will need thearrangement of all the details and elements that will set thefoundation for the campaign as well. It will also reveal thecontribution that the theories will make in the ethical analysis andhelp the campaign in revealing all the information needed (Tomlinet al., 2014). The second step needs the theoreticalprinciples being weighed based on the case that is the adverseconsequences of cigarette smoking and how to prevent that as well. Lastly, looking at all the principles and assessing the healthadvocacy campaign is also an important aspect needed.

In conclusion, the anti-smoking health advocacy campaign will need anethical framework that will guide the health professionals insensitizing the audience and avoiding any of the ethical dilemmas. Inthis case, the interaction between the audience and the campaignorganizers will evoke a number of issues that will cause the ethicaldilemmas. However, the ANA Code of Ethics is one of the aspects thatwill more likely guide the participants into reaching the goals andpolicies needed. The multiple ethical dilemmas are more likely toundermine the progress of the campaign if some of the elements arenot evaluated right on time. In particular, the scenario has seen theindividual rights and the group interests conflicting and leaving theorganizers facing a dilemma. Apart from that, the autonomy and theinformation communication might create some confusion. For instance,they might need to understand the quantity and the quality ofinformation they must release to make the program more presentableand efficient as well. The paternalism and empowerment are the twoapproaches that the organizers might pick while delivering themessage to the targeted audience. The paternalism might come out asbeing aggressive and using some coercive measures that might beunethical. However, the empowering often grants the audience theautonomy they require, but, it ends up being ineffective as comparedto the aggressive paternalism. To overcome all the challenges theymight encounter, there is the need to comply with the lobbying lawsthat consider the right to know that makes the audience receive theinformation. The nurses’ right to inform also makes themresponsible in sensitizing the audience while the government has theright to protect the audience from any harm. Besides that, theethical framework also guides the organizers in creating the mostefficient campaign plan that will be effective in spreading themessage among the audience as well. The consideration of the ethicalframework and the lobbying laws suggested will most likely increasethe chances of the campaign being successful and the audienceunderstanding the policies that will guide them to full recoveryinstead.


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