When is it OK to break confidentiality?
Grand Canyon University: NRS 437V
March 28, 2013
When is it OK to break confidentiality?
A teenager presents to an emergency department (ED) and is promised no information will be divulged regarding her treatment. This teenager is subsequently diagnosed with cervical cancer and human papillomavirus (HPV) (Nathanson, 2000). The nurse that promised confidentiality now faces an ethical dilemma: if she keeps her promise to the girl, she may not get the proper follow up care and support to treat her illness, and if she breaks her promise, she has violated the ethical principles of fidelity, and autonomy (Nathanson, 2000). This paper will discuss the ethical implications of …show more content…
Gathering relevant information, asking questions, paying attention to the details in step 1 gives the nurse insight as to why the girl might not want her cancer and HPV diagnoses revealed. Step 2 identifies that this is clearly an ethical dilemma. The girl needs follow up care that only her parents will be able to provide since their consent is needed because she is a minor. Step 3 examines the situation through the use of ethics theory, in this case teleology, and brings the focus back on what is most important, what is best for the girl. Step 4 discusses possible alternatives. Diligent thought about possible alternatives is important in order to choose the best one (Purtilo & Doherty, 2011). In collaborating with other health care workers the nurse has a broader view of what options are possible. One possible alternative to not telling the parents is to allow the girl to leave, and think about it, give her information to review, and elicit a promise to return to discuss with the nurse any questions or concerns. This would allow the girl to be more autonomous but would not treat her underlying cancer if she does not speak with her parents, or if she fails to return to the ED. A second alternative would be to involve social services to help with counseling, to be a support and a presence in addition to the
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