Patient confidentiality is essential in developing a trusting relationship between a healthcare worker and the patient. Confidentiality means that the patients personal and medical information that is given to a health care provider will not be disclosed to others unless the patient has given permission for the information to be released (“Confidentiality,” 2014). There are situations where a breach of confidentiality may occur and is acceptable. These situations include information when an individual has been diagnosed with a specific disease, such as Tuberculosis or an injury, such as a gunshot wound.
Other situations may be when there is evidence that the patient may cause harm to himself or others. The nursing profession is one that promises to abide by the laws of patient confidentiality. Protecting the patients’ rights is guaranteed by both common law-which is the decisions of the courts, and statute law-which is passed by Parliament (O’Dowd, 2014). This commitment to the patient helps preserve high quality care for that patient, as disclosing important information between the patient and nurse, is essential for the patient to receive the appropriate medical care.
Patients put their trust into the nurse, as they expect the nurse to respect their privacy, when that trust is broken, the relationship between the nurse and patient declines. Losing the trust is one of the ethical implications that may occur when a breach of confidentiality occurs. Other ethical implications that can occur are disciplinary action by the employer, disciplinary proceedings under the health professionals regulatory statute, and a fine may be imposed (“Patient Confidentiality,” n.
d. ). Pamela G.
Nathanson wrote an article in reference to an episode of NBC’s ER which reveals an ER nurse who faces an ethical dilemma in regards to patient confidentiality. The ER nurse has made a promise to two fourteen year old girls that she will not disclose any medical information to their parents. The girls trust the nurse that she will keep her promise; therefore, they disclose their personal concerns. One of the girls test positive for a serious medical condition, at this point, the ER nurse has reached an ethical dilemma.
She needs to make an ethical decision as to whether or not she should disclose the information to the young girls’ parents. In this situation, the ER nurse has made the appropriate decision to have a breach of confidentiality and inform the young girls’ parents of their daughters’ medical condition. In understanding ethical theories and/or ethical principles, this has assisted the ER nurse in making the correct decision. Ethical theories and principles guide individuals in making decisions.
When using ethical theories to determine an appropriate decision, the theory must be directed towards a common set of goals, which are ethical principles (Rainbow, 2002). The ER nurses’ goal is to ensure that the young girl receives the appropriate medical treatment for her condition. Ethical principles that can relate to this situation are beneficence, which is to do what is good and least harm, which is to do the least harm to an individual.
In looking at ethical theories, using Deontology and Utilitarianism is useful in that Deontology relates to the nurses obligations and duties to disclose the information and Utilitarianism relates to being able to foresee the consequences of actions if the information is not disclosed. A utilitarian looks at what is the greatest benefit for that individual (Rainbow, 2002). When an individual is confronted with an ethical dilemma, using an ethical-decision making model is useful.
This type of model assists in breaking down all the facts and individuals’ involved in the dilemma and helps to develop possible alternatives to address the dilemma. It guides ones’ decision making from an objective, cognitive perspective, rather than an emotional perspective (“GCU,” 2014). In the article discussed, the ER nurse can incorporate an ethical-decision making model to make the most appropriate decision. First is to address who is involved and what the actual dilemma entails and identify the ethical dilemma.
Next, she can look at the situation at hand and determine how her own personal values see this issue and determine what alternatives can be used to help resolve the dilemma. Once the alternative actions are decided upon, the ER nurse can look at each one and decide if they conflict with her own personal values. If so, she may need to get another health care provider involved to eliminate any biases. In the article, the nurse is advised by the physician that the girls’ parents need to be informed; therefore, guiding her into making the appropriate decision.
The next step is to prioritize the acceptable alternatives from most acceptable to least acceptable. The alternatives in the articles dilemma can be 1). The young girl informing her parents herself. The implication with this alternative is that most likely she will not inform her parents. 2). The nurse informing the parents of their daughters medical condition. The implication here is that the patient will not feel she can trust the nurse; however, by choosing this alternative, the decision is in the best interest of the child and 3).
Not disclosing information at all. The implications here is that the minor child will not receive the appropriate care needed which will cause further harm. The significance in using this model is to ensure that the appropriate ethical decision is made. Ethics committees are available as well to assist and guide when ethical dilemmas occur. In regards to the article, an ethical committee can discuss the alternatives and make recommendations, still keeping in line with the patients’ rights.
These committees focus on issues of morality, patient autonomy, legislation, and states’ interest. They have a significant influence on decision making and the power to influence a judge or jury (“GCU,” 2014). Ethical dilemmas will always be in a health care professionals’ daily work. Using ethical theories and principles will guide health care professionals in making the most appropriate ethical decision. Following these theories and principles will ensure that the patient is receiving the best quality care that they deserve. References