When is it OK to break confidentiality?
Eva Tovstiga
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
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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
The main ethical issues that presented in the case scenario is maintaining privacy and confidentiality. “Privacy is limited access to a person, the person’s body, conversations, bodily functions or objects immediately associated with the person” (CNO, 2009, p. 7). Nurses recognize the importance
In this argument a 21 year old Hispanic male named Carlos is in the process of being released from the hospital and in need of a at home nurse. Since Carlos did not have the best insurance they would not pay for a at home nurse because Carlos sister is a nurse. The only problem that Carlos has with this situation is that he is HIV positive and does not want his family to find out. Carlos contracted HIV from sexual intercourse with males and Carlos does not want his family to know because it would be a disgrace to the family. In order for Carlos’s sister not to find out, Carlos asked his doctor not to inform his sister about the HIV. The argument is whether Carlos’s doctor be morally justified to breach the patient confidentiality on the grounds that he has a “duty to warn”?
Ethical implications arise when a situation deals with principles of morality and resolution is neither right nor wrong. Because of the stress and emotion ethical dilemmas present us with; steps have been recognized to help work through determination. Although each and every situation is unique, a framework for problem resolution along with laws for ethical situations has taken effect.
I feel it is a person’s choice and it is different than suicide. It has to be well thought out and talked about with a team of people involved including physicians, psychologists, and family. I also think it is based more on
Nurses are always the front line care giver of patients. A review of literature of nursing ethics about informed consent has been performed. It strongly demonstrates the importance of informed consent and that nurses are the key players for the advocacy role to protect the patient’s right.
Ethical dilemmas occur when there is a disagreement about a situation and all parties involved question how they should behave based on their individual ethical morals. (Newman & Pollnitz, 2005). The dilemma that I will be addressing in this essay involves Michael, recently employed male educator working in the nursery, and parents of a baby enrolled at the centre. The parents have raised concerns about male educators changing their child’s nappy as they have cultural practices that do not allow this practice to take place. This situation is classed as an ethical dilemma as there is a dispute between cultural beliefs and legal requirements within the workplace. There are four parties involved (parents, child, educator and director), all
Michael H., a 68-year-old man, was admitted for exploratory surgery of his abdomen. He is frail, and his attending physician describes him as “emotionally labile.” Marcy R. is a social worker at BFL General Hospital, who is assigned to the unit that Michael H has been admitted. After Michael’s surgery, Marcy R. was approached by Michael H.’s daughter, Ellen B. in which Ellen has told Marcy that her father’s physician had just informed her that the lab report from the exploratory surgery shows that her father has terminal cancer. Ellen said that she and the family are in shock and they have decided that they not want the hospital staff to tell her father about the terminal nature of his cancer once he recovers from anesthesia. In this essay, I will discuss the ethical dilemma of “to tell Michael or not to tell him he has terminal cancer. He has the right to confidentiality by not withholding information from him when he has been diagnosed with terminal cancer, informed consent, and self-determination.
Concepts of reasonable limits refers to limiting one’s actions or in reference to nursing, limiting what one can say or do in terms of a patient’s care (Jonstone & Fry, 2002). When discussing reasonable limits, a nurse has to take into consideration at what point is enough, enough. For example, in the case study regarding Mrs. Z, reasonable limit would prevent the nurse from pushing the patient further into pursuing treatment and disclosing her medical prognosis to her family. Mrs. Z is a lucid individual, so the nurse and doctor caring for her would have to limit their interference in disclosing information to her husband due to reasonable limits. In nursing, there are times when breaking a patient’s confidentiality becomes an ethical issue. If the nurse was thinking in terms of Utilitarianism, breaching confidentiality would be the only reasonable thing to do. For example, if a patient who is HIV positive is knowingly having unprotected sex in order to infect other people, it would only be right to break the confidentiality of their diagnosis to prevent further harm to other individuals in the future. Sometimes, in order to protect the greatest amount of people, confidentiality has to be broken. Another example where a healthcare individual can break confidentiality is if a minor is being harmed and the minor does not want to disclose to anyone their situation. For
Nurses are subject to a plethora of legal, ethical, and professional duties which can be very challenging on a day to day basis. Some of these duties include respecting a patient 's confidentiality and autonomy, and to recognize the duty of care that is owed to all patients. As nurses our duties are always professional; however there are legal implications if these duties are breached. We also must consider when it is okay as nurses to breach these duties and therefore ethical issues arise. As nurses one of our main priorities is to advocate for our patients, without our own personal feelings on the matter taking over.
Nurses are faced with ethical dilemmas every day. There are a lot of different beliefs surrounding ethics and the code of ethics. Ethics and ethical issues have always existed, that is why they have put in place the code of ethics. The American Nursing Association (ANA) Code of Ethics isa guideline to help nurses determine which course of action to pursue. Every minute many ethical decisions are made, some may not comply with guidelines and others the patient’s will never understand. In this case study the nurse is put in an uncomfortable position and has two find a way to comply with the family, the patient, and the doctor’s orders.How can she report to the doctor the information the daughter has told her? How she approached
With the utilization of the Act-utilitarianism mindset, an alternative plan of action to focus on the circumstances surrounding Andrea and the community at large can be established using Uustals ethical decision making model. The nine steps identified by Uustal can allow the nursing process to be applied in an effort to guide the nurse in practicing proper judgment. The quandary involves community, personal and patient dilemmas. While many nurses strive for adhesion to values of patient autonomy and keeping ones word, the very nature of health care can raise cause for nurses to contradict and deviate from their own ethical stand points, all in an effort to do the right thing. Due to Andrea’s development of cervical cancer, nurse Hathaway was right in disclosing the minor’s disease to her parents. Adolescents usually are covered by their family’s insurance, but they may not have coverage for unaccompanied care, and they may
An ethical dilemma is an incident that causes us to question how we should react based on our beliefs. A decision needs to be made between right and wrong. I have experienced many ethical dilemmas in my lifetime, so I know that there is no such thing as an ethical dilemma that only affects one person. I also know that some ethical dilemmas are easier to resolve than others are. The easy ones are the ones in which we can make decisions on the spot. For example, if a cashier gives me too much change, I can immediately make a decision to either return the money or keep it. Based on Kant’s, categorical imperative there are two criteria for determining moral right and wrong. First, there is universalizability, which states, “the person’s
What are the relevant facts of the case? What facts are not known? Can I learn more about the situation? Do I know enough to make a decision?
The word “ethics” comes from Greek ethikas meaning character. Today, we use ethics to describe the normative standard of behavior. The history of philosophical ethics has been broken up into five rational methods: Virtue, Traditional, Modern, and Post-Modern Ethics. Within these periods, the philosophy of ethics changed along with the changes being made within society.
Everyday we are tested as individuals to make the right choice. How we view ourselves as individuals and how others view us are directly correlated to our moral decision-making. But morals are somewhat misleading. What might be a wrong decision for one person might be a solution to another. So how do we define morals? Do we follow Gods’ moral rules because to do so would increase out likelihood of obtaining salvation in the afterlife? Or is it simpler than that. Is God going to deny our entrance into heaven because we have run a stop sign here and there? No. I believe our moral values are much simpler than that. I believe that our moral decision-making comes from our upbringing of what is right or wrong. Our parents and