What is ethics?The most common way of defining “ethics”: they are norms for conduct that distinguish between or acceptable or unacceptable behavior. (http://www.apa.org/ethics/)Most people learn ethical norms at home, in school, in church, or in other social settings.
Human rights: The basic rights and freedoms, to which all humans are entitled, often held to include the right to life and liberty, freedom of thought and expression, and equality before the law.
I would like to talk to you about privacy and confidentiality. Privacy: the quality or condition of being secluded from the presence or view of others. (http://www.answers.com/topic ) Confidentiality: Containing information whose unauthorized disclosure could be injurious to either or both parties.
Not all the ethical issues have clear answers; some hinge on researcher’s judgment and scruples.
Need for respect.
Privacy and confidentiality should be fairly self explanatory. We need to be sensible as medical practitioners and respect the need for the protection of personal privacy in data, and need to facilitate access to data for research purposes. Respect: The state of being regarded with honor or esteem. Respect has great importance in everyday life, as children we are taught (one hopes) to respect our parents, other people’s feelings and rights.
Dramatic events of World War II.
Respect for patients as individuals prior to, during and after the research is one of the key issues of dramatic and horrifying events of World War II and the Nuremberg military tribunals highlight the degrading and inhuman consequences of research without respect for the individual.
History: When dignity was taken away from people.
History has played a large factor in the way people are treated and respected in present day. One particular incident is the Nuremberg military tribunals which played a major part in how human research is viewed concerning peoples rights. This code was formed in 1947 and still plays a big roll in research today. (Genocide. First relating to the Holocaust. It was not listed as a crime in the Nuremberg court’s charter, but after pressure from Raphael Lempkin the scholar who had actually coined the term “genocide” prosecutors included it in indictments against some of the major Nazis on trial, and their closing remarks. http://iwpr.net/pdf/reporting_justice_p1_w.pdf ).
This was one scenario that took away, the rights and dignity of human beings. Another example of history that has disrespected human kind, was UNIT 731, this was biological warfare research on humans by the Japanese army. It is events like these that have shaped how ethics have come about in today’s society.
Making decisions that wouldn’t be damaging.
How’s people’s respect and dignity protected today? What if during the course of research, an investigator notices that a person seems to have a learning disability or some other treatable condition? The decision to share this information with guardians or other services that could help shouldn’t be made lightly, since sharing information of uncertain validity may create damaging misconceptions about that person. On the other hand researchers need to know and inform participants of their legal responsibility to report abuse or neglect or any other illegal activity of which they become aware (Papalia, Olds, Feldman; Human Development p.56).
Privacy questions are also raised when employers expand the depth of their searches, sometimes including psychological, polygraph and even medical record checks. The privacy of medical records is of growing concern. Our medical history contains extremely sensitive information, and access to it should therefore be limited. However insurance providers, researchers, have an interest in obtaining and using our information.
Example from national nine news.
There was a story on the news about how private our personal details can be? (http:/aca.ninemsn.com.au/article, Fri 07/07/06). Victorian MP Anna Bourke says there are numerous ways in which our personal information is traded. “There are cases of doctors giving out patient information to drug companies, private schools selling off old student lists, it goes on and on. Even Centerlink has been caught out passing on personal information. You don’t realize how often you give away your details”, she says. We all value our individual personal privacy, trouble is many other people put a price on it to making your personal affairs their business, information that you think is confidential now been bought and sold without your knowledge and without your consent.
In one case, being investigated by the Privacy Commission, data was outsourced to and Indian Phone Company called Bricks and Click. Somehow that information ended up on the black market- the names, addresses, driver’s license numbers and even Medicare numbers of 1000 Australians. The challenge is to create policy or legislation that can balance the legitimate needs of health care and insurance providers with individual rights to privacy.
The idea of privacy is ancient.
The idea that medical records should be kept private is ancient, going back to Hippocratic Oath. The oath stated, “whatever, in connection with my professional practice or not in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret”.
http://www.srcd.org/ethicalstandards.htmlThis idea has become one of the keystones of medical ethics; doctors should not reveal confidential information about their patients.
However, there are certain times when it appropriate to share medical information. In today’s medical world, it is common for a person to have multiple doctors, and to seek treatment from specialists. If medical records are not readily available to doctors, than the patient’s care ultimately suffers, as information about past treatments and conditions could be unavailable.
Some questions remain though, how much information should an insurer be privy to? Should they be allowed to check and individual’s genetic record? Should they know if an individual has ever taken an HIV/AIDS test? How really available should our medical information be, and what steps should be taken to protect it? These important questions are currently unanswered.
Questions:Why are there so many ethical disputes and issues in our society?How would you feel if your privacy was invaded and information spread around to people who we didn’t want to have that info?References:Australian Institute of Health and Welfare (2002). Australia’s health 2002. Canberra: AIHW.
Barnsteiner, J., & Prevost, S. (2002). How to implement evidence based practice. Reflections in Nursing Leadership, 28 (2), 18-21.
Draper G, Turrell G, & Oldenburg B (2004). Health inequalities in Australia: Mortality. Health Inequalities Monitoring Series No 1. Canberra: Queensland University of Technology and the Australian Institute of Health and Welfare.
Hamric, A. B., Spross, J.A., Hanson, C.M., (2005) Advanced Practice Nursing. An Interactive Approach (3d ed.). Elsevier Saunders.
Lynch, J. W. & Kaplan, G. (2000). Socioeconomic position. In Berkman, L.F. & Kawachi, I (Eds) Social epidemiology, (pp13-35) New York: Oxford University Press.
Papalia, D.E., Wenkos Olds, S., Feldman, R., (2004) Human Development (9th ed.). Boston: McGraw Hill.
Polit, D. F., Beck, C.T., & Hungler, B.P. (2001) Essentials of Nursing
Research (5th ed.). Philadelphia: Lippincott Williams & Wilkins.
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