The ethical principles involved in the article reviewed are beneficence (bring about positive good) fidelity (trustworthy), and veracity (honesty) The nurse involved is caught between the core principles of nursing, by following the patients wish of not informing her parents by the diagnoses of a sexually transmitted disease. The implications of betraying the core principles of nursing could cause internal conflict with her value principles, and not to mention the trust of the patient. Other implications could be how the parents view the patient. Strict religious convictions of the parents could cause more harm to the young teen by shunning the child, and not letting the child return home would keep the child from receiving the treatment needed, and possibly create a homeless situation for the teen. Making the school aware of the girls’ situation would also be breach of confidentially, and may even cause legal complications for the health care facility. The situation with the sex parties is not related to school activities, unless sex parties were occurring on campus. Due to the fact that the nurse informed the school the young teen attempts suicide, and again may have legal complications for the nurse and the health care facility. All of these implications can be seen in the article reviewed.
Ethical Theories and Ethical Principals
When it comes to veracity and fidelity the profession of nursing is considered to be at the top of the list. (“Honesty/Ethics in Professions,” 2013) The Nightingale Pledge calls nurses to have and use these value principles on a daily basis in nursing and also in every day life. According to the Code of Ethics for Nurses provision 3 3.2… the nurse has the duty to maintain confidentiality of all information. Maintaining these principles also promotes Nonmaleficence (do no harm). According Jean Watson’s carative factors (Lachman, 2012) “developing and sustaining a helping-trusting, authentic caring relationship” is at the very core of nursing. Building this relationship with the patient the nurse must be self aware of any judgmental feelings he/she may have regarding the patient situation.(Lachman, 2012) The nurse needs to decide what is the best way to care for the young teen. If confidentially is broken further treatment by the patient may not be sought after. Respecting the patient also means respecting confidentially. We must gain the patients fidelity and maintain the trust for continuing communication to occur. However in the article reviewed after the nurse discovers the young teens diagnoses she is torn between the trusting relationship she has been developing and the principle of beneficence by informing her parents of the diagnoses of cervical cancer. She also has the information regarding her sexual activates. Again this violates the confidentially needed to maintain the trusting relationship or beneficence. If the trust is not broken the young teen will not seek treatment and further harm will be done.
Alternatives to this situation would lead to probable breach of several core nursing values, fidelity and veracity. It would also breach Nonmaleficence. However the young teen is a minor and the diagnoses of cervical cancer is a diagnosis that needs treatment requiring parent’s consent. The alternative of keeping the young teens confidence, would result in the patient not receiving the care she needs. Which would be a breach of Nonmaleficence. It would also be a breach fidelity and veracity between the physician and the nurse. The alternative to not informing the school of the sex parties would have a much better outcome, the suicide attempt most likely would not have occurred, and the health care facility would not be looking at probable legal proceedings. Maybe changing the language and leaving out the young teens name would have been a much better alternative.
Ethics Committee Approaches
A breach of confidentially should never be taken lightly. The disclosure of he information to the school and the resulting attempted suicide may be of bigger concern to the health care facility, rather than the breach of confidentially between the nurse and the young teen since she is a minor, and the breach of confidentially will bring about the care the young teen needs. The committee could raise the question about the physicians’ judgment and his decision to notify the school.
Honesty/Ethics in Professions. (2013). Retrieved from http://www.gallup.com/poll/1654/honesty-ethics-professions.aspx Lachman, V. D. (2012). Applying the Ethics of Nursing to Your Nursing Practice. MEDSURG NURSING, 21(2), 112-117. Retrieved from www.ana.org Nathanson, P. G. (2011, July, 6). Betraying Trust or Providing Good Care? When is it okay to break confidentially? American Journal of Bioethics. Purtilo, R. B., & Doherty, R. F. (2011). Ethical Dimensions in the Health Professions (5th ed.). St. Louis, MO: Saunders. American Nurses Association (ANA). (2001). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author.