Ethical Theories and Principles in Health
In healthcare, the cardinal principle for having confidentiality is gaining the family members’ and patients’ trust. Breaking this confidentiality at any given time or disclosing private matters is referred to as a breach of confidentiality. It is worth noting that patients are entitled to a right to privacy in regard to health care matters and this has to remain a secret among the team of professionals. Breaching confidentiality is legally, ethically, and morally unacceptable (Davis & Aroskar, 1991).
This paper discusses a breach of confidentiality based on “Bioethics on NBC’s ER: Betraying Trust or Providing Good Care? When Is It Ok to Break Confidentiality?” article. In the article, nurse Carol Hathaway is faced with an ethical dilemma. Two teenagers were unprepared to begin their treatment but nurse Hathaway promised them that confidentiality would be maintained at all costs. A 14 year old Andrea is diagnosed with cervical cancer and HPV (humanpapillomavirus). The nurse is aware that the cancer can be treated and its survival results are critical and, thereby, she is faced with a dilemma if to inform the parents about the diagnosis (Davis & Aroskar, 1991). The nurse struggles with the situation but is advised by the ER physician that the parents and school authorities have to be informed as the girl admits to participating in sex parties and engaging with multiple sex partners. Thereby, the school ought to be warned of the risks. Regardless of the fact that maintaining confidentiality is regarded as a cornerstone in patient-nurse relationships, there are cases where protecting the greater good is considered a priority.
Ethical implications following a breach of confidentiality
After a breach of confidentiality is violated, there can be several implications. First, breaching confidentiality is an indication that there is no respect for patient autonomy. Second, violating the confidentiality is a kind of betrayal (Braveman & Bass-Haugen, 2009). In addition, patients are entitled a right to confidentiality and this is frequently demonstrated in particular statute and common law areas. If according to a patient a nurse has breached confidentiality wrongly, they may pursue their grievance through criminal proceedings, civil proceedings where patients are paid for compensation, or disciplinary proceedings. A nurse may face court charges if found guilty of breaking the confidentiality law.
However, in the light of this discussion, my take is that the nurse should inform the parents and school authorities. This will ensure that the parents are aware of what their daughter is suffering from and will, thereby, seek the best healthcare and counseling services. This will not be the case if they are not informed of their daughter’s predicament (Thompson & Thompson, 1985). Furthermore, the school authorities should be aware of the case so as to be able to contain the situation and come up with strategies for preventing such cases and assisting the affected.
Ethical principles and theories that substantiate my position
There are a number of basic ethical principles that patients expect from health-related services. Some of these fundamental values include justice, fidelity, veracity, respect for autonomy, beneficence, confidentiality, and altruism. In addition to these notions being implied, they are mandated through the federal law, professional organizations, and standards of care. The nurses’ ANA Code stresses that respect for the innate worth and dignity of individuality of persons and human existence is an exceptionally vital ethical principle (Braveman & Bass-Haugen, 2009). In 1996, the Health Information Portability and Accountability Act passed with an intention of protecting clients’ health-related information’s privacy. In the light of this discussion, although the significance of confidentiality is central and well-established in the health care industry, this case preludes this healthcare tenet.
My stand is substantiated by consequentialism ethics in that if the nurse reveals the information to the parents and school authorities, she will have maximized the greatest good for the majority (Purtillo, 2005). The second theory is virtue ethics where if the nurse has a good character, she will do the correct thing so as to uphold honesty and truth-telling. Finally, principlism is also applicable in that the professionals, school authorities, patient, and parent will be able to assess the situation and find a rationale and balance for decision-making.
A reasonable alternative that applies an ethical decision making framework
In the article discussion, the nurse promised to maintain confidentiality before identifying what Andrea was suffering from. In this case, the nurse can reason with the patient regarding the seriousness of the conditions she is suffering from and their impacts considering her tender age. The nurse should emphasize that letting the parents to know will be important so as to ensure that she receives the best care. The key aim for this will be to seek the patient’s consent towards revealing the confidential information (Beauchamp & Childress, 2009).
How an ethics committee might use a collaborative approach and ethical principles or theories to approach the dilemma
The committee should first gather the relevant information so as to find out who and what they are dealing with, and if the client has been experiencing an abusive situation. Then all the possible options should be explored and a decision made depending on the gathered information. This will ensure that the patient’s situation is given a keen consideration before any decisions are made.
Beauchamp, T. L., & Childress, J. F. (2009). Principles of biomedical ethics (6th ed.). New York: Oxford University Press.
Braveman, B., & Bass-Haugen, J. D. (2009). Social justice and health disparities: An evolving discourse in occupational therapy research and intervention. American Journal of Occupational Therapy, 63, 7–12.
Davis, A., & Aroskar, M. (1991). Ethical dilemmas and nursing practice (3rd ed.). Norwalk, Conn.: Appleton & Lange.
Purtillo, R. (2005). Ethical dimensions in the health professions (4th ed.). Philadelphia: Elsevier/Saunders.
Thompson, J. & Thompson, H. (1985). Bioethical decision making for nurses. East Norwalk, Conn.: Appleton-Century-Crofts.