Principles of Confidentiality, Ethical Theories, and a Presented Case Study on the Z Family and the Practitioner's Ethical Decisions

The topic of ethics is prevalent in health care and addresses a broad range of topics in nursing. In almost every interaction with a patient there could be a situation that may bring up the question of ethics. Fortunately, there is the realization that placing the nurse in the care of a patient, may put the medical personnel in an environment where the ethics are questioned. There are whole departments dedicated to advising nurses in these situations. There are also ethic committees to help guide you when you find yourself in a situation that may question your practice or circumstances.

Confidentiality can relate to any form of communication that is capable of sharing applicable information about a patient (SRNA, 2011, p. 26). A registered nurse in Saskatchewan is responsible to advocate for any professional, legal or ethical commitments within the health care community (SRNA, 2011, p. 26). As mentioned in the introduction, the registered nurse from Utah, Alex Wubbels, perfected the act of confidentiality and privacy based on the SRNA’s guidelines. Within Appendix C of the SRNA’s expectations regarding privacy and confidentiality, one of main points is, “Only staff directly involved in a specific client’s care have legitimate access to the records.” (SRNA, 2011, p. 26). Alex Wubbels demonstrated the proper ethical and legal actions when faced with the complicating situation that was at hand. Regardless of being threatened by another legal source, Wubbles performed complete confidentiality and consent of the patient. As privacy and confidentiality is a large component of nursing, Wubbels handled this situation

The topics that will be discussed in this paper will be the ethical decisions that have to be made by Dr. F and the RN in regards to disclosing information to Dr. J. Also, according to the NANDA nursing diagnosis for ethical consideration, Dr. F and the RN also have to consider if Mrs. Z has some knowledge deficits in regards to her prognosis and if due to her culture, she feels powerlessness towards her diagnosis. Ethical theories are important to justifying and relating situations in nursing. In this paper, there will be discussions relating ethical theories to nursing, as well as, ethical decision making models that will relate to the delivery of healthcare.

The subject I intend to reflect upon is confidentiality within a professional healthcare setting. Confidentiality formed a part of our professional issues lectures and it piqued my interest due to how differently it is interpreted within healthcare as opposed to education, which is my background. In an educational setting I was taught repeatedly that I could never ensure confidentiality between myself and a child. Comparing that to what I have now learnt in healthcare, this seemed to me almost the opposite way of working as I was used to and so I wish to reflect upon this.

When it comes to confidentiality there are rules that one has to follow in order to abide by the person’s rights. Using caution when talking to others about the client who want to obtain information that they are not at liberty to have. An example of this would be someone claiming to be a patient’s friend wanting a room number in the hospital to go visit them. Confidentiality is a very delicate situation in the practicing field of professionals.

Effective nursing, in order to properly serve patients as well as the greater community, must necessarily be based on a strong, unshakeable foundation of ethical practice, which can be expressed through various theoretical nursing models. This paper will examine the theoretical basis for author’s own ethical nursing practice, and relate the theoretical discussion to the specific Phenomenon of Interest that was previously identified in earlier papers.

Health care professionals are subject to a multitude of professional, legal, and ethical responsibilities which call for personal judgment to be utilized in such a manner as to protect clients as well as public wellness and interests. Overall considerations in handling such duties may be considered to be respect of a client’s autonomy, confidence, and recognition of obligations owed to all clients. While the aforementioned acts fall within the professional realm, there are also legal implications that guide care. Therefore, it can be said that ethical considerations occur in observation of legal responsibilities. Confidential information is perceived as private facts which are disclosed with the

`Ethics' is defined as ."..the basis on which people...decide that certain actions are right or wrong and whether one ought to do something or has a right to something"(Rumbold, 1986). In relating `ethics' to nursing care, "Nursing decisions affect people... nurses have the power to good or harm to their patients" (Bandman et al, 2002). In this essay, the author will also identify the most important ethical principles and concepts of Evan's case, will outline the different stages of one's approach to ethical decision-making by utilising the "DECIDE Model for Ethical Decision-Making" founded by Thompson et al (2000) and will make a decision on the best course of action to take as a nurse in this

Ethical issues in nursing will always be an ongoing learning process. Nurses are taught in nursing school what should be done and how. Scenarios are given on tests with one right answer. However, there are situations that nurses may encounter that may have multiple answers and it is hard to choose one. “Ethical directives are not always clearly evident and people sometimes disagree about what is right and wrong” (Butts & Rich, 2016). When an ethical decision is made by a nurse, there must be a logical justification and not just emotions.

Ethics is an essential aspect of health care practice and those working in the nursing profession are often subject to frequent ethical dilemmas. It is essential for all nurses to be aware of the importance of ethics in health care and to practice within the ethico-legal parameters that govern the profession. However, while this is relatively easy in theory, ethics is not a black and white subject and often one’s culture, upbringing, attitudes and beliefs can influence what one views as ethical and this can therefore influence practice. This report will discuss the importance of ethics in nursing practice. The definition of ethics will firstly be presented followed

Laabs (2008) stated that nurses require applied ethics to give moral direction while practicing. A moral community is a safe “place where community members are encouraged to bring ethical concerns to light and deal with these in a manner that promotes shared understanding and mutual respect”(Hardingham, 2004). In this paper I will tell you a story of an ethical conflict that I have encountered about breach of confidentiality, I will then go on to discuss how this experience has help to teach me about my own morals and how I can utilize this knowledge to inform nursing practice and encourage others to perform ethically as members of a moral community.

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.

There are several ethical implications to consider in regards to a breach of confidentiality, especially when considering cases within the healthcare industry. Nathanson's article, "Bioethics on NBC's ER: Betraying trust or providing good care? When is it OK to break confidentiality" explores some of the more salient ramifications. One of the fundamental components of this article is a case study in which a teenager, Andrea, has developed a form of cancer related to sexual activity and a medical professional, Nurse Hathaway, has learned of her condition. Professional entities such as the Nursing and Midwifery Council have strict codes about what information these practitioners can and cannot give out regarding their patients. This case study, then, alludes to the central issue at play in such an instance of a breach of confidentiality. If the nurse's true obligation is to the welfare of her patients, is it in the best interest of a patient for nurses to reveal their confidentiality to individuals and organizations that can ultimately help them, or should the nurse maintain her confidentiality agreement even if doing so will ultimately reduce the patient's chance for assistance with a medical condition?

The issue of HIV status and reporting procedures raises several legal questions that relate to patient confidentiality and privacy concerns. Code of ethics and integrity are an element of the nursing underpinning; thoughtfulness, compassionate and advocacy are some fundamental qualities every nurse conjures daily as a vocation and individual clinical practice. Amongst other profession, it is imperative that nurses function with moral standards, a proficient parameter of the law (American Nurses Association, 2010a). It is important to remember that legal protection of patient confidentiality depends on whether or not health concerns for the general public supersede the interest of preserving the patient and provider privilege. The balancing of these two fundamental interests is a grave challenge when it comes to privacy concerns with HIV status.

Being a nurse in today’s society is fun and challenging. Not only are we to care for our patients, but by law, we are to protect the patients by respecting their privacy and keeping information confidential. Privacy entails the patients’ right to control their information, and to pick what may or may not be disclosed to others with consent. Although privacy and confidentiality are sometimes interchanged, confidentially is different. With confidentiality, we are bound by ethics not to reveal any information of our patients unless we are sharing it with another organization that is necessary. For example, if a patient has to have a surgery, then the primary doctor will have to share some pertinent information to the surgeon (Burkhardt & Nathaniel,