Running Head: ETHICAL FRAMEWORKS IN PRACTICE
Ethical Frameworks in Practice
Grand Canyon University: NRS 437V
October 14, 2011
Ethical Frameworks in Practice 2 Introduction
The article by Pamela Nathanson, Bioethics on NBC’s ER: Betraying Trust or Providing Good Care? When is it OK to Break Confidentiality, presents a dilemma that some nurses may experience in their careers. In the episode, Carol Hathaway assures two young patients who are reluctant to enter into care that no matter what they tell her, she will not divulge any information to the patient's parents or to anyone else. Unfortunately, when it turns out that one patient has a severe medical problem, Hathaway faces the dilemma of breaking her promise of confidentiality in order to ensure proper medical care and support for her young patient. This dilemma raises issues about the nature of confidentiality in health care, and the possible reasons why confidentiality may be broken. (2000). I have never experienced the dilemma of breaking confidentiality before but in the case mentioned above I believe the right thing to do would be to tell the parents and get the patient the care needed to ensure good health. Ethical Implications of Confidentiality
According to The American Heritage Stedman’s Dictionary confidentiality is defined as the ethical principle or legal right that a physician or other health professional will hold secret all information relating to a patient, unless the patient gives consent permitting disclosure. (n.d.). There are many reasons why it is important to maintain confidentiality. If a patient is not assured that their information is treated confidentially they may not be forthcoming, honest and open with their healthcare providers which could delay care or put off receiving care. “Breaches of confidentiality are disrespectful of individual privacy and autonomy rights. Fidelity of the physician patient relationship requires respect for confidentiality. When patients enter into a relationship with a medical professional, an implied promise of confidentiality is made. The Ethical Frameworks in Practice 3 patient’s expectations of privacy and earn patient’s trust,” (Nathonson, 2000). The federal Health Insurance Portability and Accountability Act (HIPAA) clearly states that a breach of this sacred trust by any member of the health care community is subject to serious repercussions, including civil and criminal penalties. There are instances, though, when sharing information is appropriate and in the best interest of patient care. In the United States there are laws that state a physician has an obligation to report certain infectious diseases to public health authorities, in order to protect the health of the community. (Nathonson, 2000). Ethical Theories
In the article presented the patient is a fourteen year old girl, Andrea, who has had a promiscuous past and shows up in the emergency room to be tested for a sexually transmitted disease (STD). It comes out that her and her friends have been having sex parties with multiple partners. She is promised that her history will not be mentioned to her parents. The STD test shows she has HPV and the results of the ensuing Pap smear results show she has cervical cancer. What is Nurse Hathaway to do? According to the Code of Ethics for Nurses, the rights, well being and safety of the individual patient should be the primary factors in arriving at any professional judgment concerning the disposition of confidential information received from or about the patient.”Duties of confidentiality, however are not absolute and may need to be modified in order to protect the patient, other innocent parties and in circumstances of mandatory disclosure...