As a health care provider, one must realize that there may be situations where ethics may be involved. In health care, a provider will come in contact with details of a person’s intimate part of their life. Sometimes these intimate details may become a privacy issue where families, spouses and life partners are not allowed to have access. The Health Insurance Portability And Accountability Act of 1996 protects these details, also called Protected Health Information. When a patient becomes incapacitated, extremely ill or placed on continuous sedation due to mechanical ventilation, usually a proxy is appointed to make decisions if the patient does not have a health care surrogate in place. At times a patient may not want their condition disclosed to a third party despite their prognosis and an ethical dilemma is introduced.
Using the Ethical reasoning cooperative tool (Davis, Nogueras, & Goodman, 2007) to help state the facts, issues, options, duties, decision and assessment the following is an example of an ethical dilemma.
Disclosing HIV Status
A 42 year-old female was admitted to the Critical Care Unit with pneumonia and hypoxemia. The patient spent several days in the unit on Bi-level Positive Airway Pressure, alternating with a nonrebreather mask. Her husband spends every moment he can at her bedside, rubbing her feet and trying to make her comfortable. A local college nursing school instructor sees this patient as a good learning opportunity for one of her nursing students. The nursing student works closely alongside the primary nurse and notices that the Infectious Disease doctor orders a HIV test. Once the patient’s husband leaves her room the primary nurse and the student nurse asks the patient for her consent to test for HIV. The patient states, “No matter what happens, do not tell my husband that I was tested or if the test is positive.” The patient signed the consent and her blood was tested for HIV.... [continues]
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