In the nursing profession, decision making is backed by the American Nursing Association Code of Ethics. It was developed to foster nursing responsibility and ensure consistency in the quality of care and nursing competency. The ANA code of ethics is essential as every day; nurses are faced by choices in their professional duties, some of which are not clear or are not ideal. Thus, ethical codes help to make decisions through a standard framework that recognize non-maleficence, autonomy, justice, and beneficence of a nursing situation (Haddad & Geiger, 2019). As such, Sandy should consider the nursing profession ethical codes and decide not to administer the vaccine to Patty. Besides, she ought to consider the risks and need for autonomy in client care.

According to the ANA, patients have a moral and legal right to determine what shall happen to self (American Nurses Association, 2015). Haddad & Geiger (2019) finds that patients have the right to make healthcare decisions depending on their values and beliefs. The ANA recognizes this as autonomy, which might cause a dilemma in the nursing profession. For instance, Patty has the right to determine what should be done to her body. Nevertheless, this code is contradicted by other laws such as accompanying parent to receive the Gardasil vaccine. Besides, Sarah should maintain the privacy of Patty, as she insists her parents shall not know about her plans. That is to respect Patty’s rights to privacy and confidentiality. However, this puts Sarah at risk to violate nursing ethical codes and the hospital medication information sheet about Gardasil.


The beneficence of the Gardasil vaccine cannot be overstated, but so does the need to comply with ethical codes. About 80% of sexually active people contract HPV, and the Centers for Disease Control clusters people aged between 14 and 25 as at the highest risk of infection (McQuillan et al., 2017). Therefore, Patty is at a critical stage where she needs the Gardasil vaccine should she become sexually active. Besides, the vaccine has barely any significant side effects. However, involving the parent as per the medical vaccination sheet is critical in this case, as the family understands the strengths and weaknesses of Patty to influence her health and health care (Clay & Parsh, 2016). Therefore, should the nurse agree to administer the vaccine, Patty would be at minimal risk of contracting HPV.

Nevertheless, nurses should bear primary responsibility for nursing care practices when attending to patients. This is in line with the principle of non-maleficence. Among the roles of nurses in this capacity is to evaluate interventions and provide healthcare education to both patients and family members. They must adhere and comply with all laws and rules governing nursing practice and their healthcare facilities (American Nurses Association, 2015). For instance, the nursing practice acts, standards of care, the ANA codes of ethics, organization bi-laws, among others. Therefore, Sarah must maintain her authority, accountability, and responsibility regarding offering the vaccine. That way, she does is not warranted to administer Gardasil vaccine to Patty, but educate her of the ramifications of the vaccine, and the need to involve her parents. Nevertheless, this puts Patty at risk of contracting HPV in case she becomes sexually active and fails to promote a healthy parent-child connection.


American Nurses Association. (2015). Code of ethics with interpretative statements. Silver Spring, MD: Author. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html

Clay, A., & Parsh, B. (2016). Patient- and Family-Centered Care: It is Not Just for Pediatrics Anymore. AMA Journal Of Ethics, 18(1), 40-44. https://doi.org/10.1001/journalofethics.2016.18.1.medu3-1601

Haddad, L., & Geiger, R. (2019). Nursing Ethical Considerations (1st ed.). StatPearls Publishing.

McQuillan, G., Kruszon-Moran, D., Markowitz, L., Unger, E., & Paulose-Ram, R. (2017). Products – Data Briefs – Number 280 – April 2017. Cdc.gov. Retrieved 22 September 2020, from https://www.cdc.gov/nchs/products/databriefs/db280.htm.