Ethics 83% Grade

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Protecting the confidentiality of a patient with an infectious disease can be complex. On one hand health care professionals are expected to follow the Nursing and Midwifery Council’s (NMC) Code of Conduct 2010 guidelines which stress the importance of protecting patient confidentiality: “you must respect people’s right to confidentiality” (2010, p.3) and making every effort to promote patients as individuals who should be treated with dignity and respect (2010, p.3). Health care professionals may find themselves in turmoil over whether their necessity to protect others from cross-infection overrides the duty of care to their patient by keeping their information confidential; particularly in this case (see Appendix A) where the patient, Sam, has a head injury, knowingly has the Human Immunodeficiency Virus (HIV) and has told his nurse not to disclose this information with others over his fear of future career prospects. This essay will discuss in general the moral and professional issues raised by this scenario. There are no definitive answers to this scenario as everyone’s opinion of what is right and what is wrong differs. This essay explores the legal legislation that may guard his nurse if they feel that his confidentiality needed to be breached and also what legislation is in place to protect the general public from Sam. It will also try to explain what actions are in place to protect Sam; professional guidelines and laws available that protect confidentiality rights and procedures available to staff to prevent cross-infection. The four ethical principles of autonomy, non-maleficence, beneficence and justice are also used in relation to Sam; discussing what each principal means and how it relates to this scenario. Medical information about a person is particularly sensitive and Sam must feel certain that it will be protected, and not used or shared in inappropriate ways. Concerns about confidentiality can be even more serious for Sam who has a stigmatised condition. Sam wants to feel confident that his nurse will protect his personal information as instructed. However, in certain circumstances there may be times when confidentiality must be breached. In health profession ethics, there is a general implied promise of confidentiality. Two major exceptions involve cases in which keeping confidence would pose either a threat of harm to the patient or if it would pose a threat of harm to others. The Nursing and Midwifery Council’s ‘The Code’ (2010, p.3) states that: “You must disclose information if you believe someone may be at risk of harm, in line with the law of the country in which you are practising.” Staff routinely handle confidential patient information; they should have an insight and the discipline necessary to maintain patient confidentiality in the appropriate circumstances. They receive information on a need to know basis. Generally, the need to know should be presumed to be based on the interests of Sam and not the staff. The NMC clauses stress the importance of collaborating with patients and rule that: “You must listen to the people in your care and respond to their concerns and preferences.” (2010, p.3) On the other hand there may be times when information is essential to share between multi-disciplinary teams to ensure good quality treatment. Sam may have to understand and accept that there must be some personal information shared between healthcare staff; especially with increasingly complex care pathways. The main question that needs to be asked is whether there is a risk to others if Sam’s nurse did not disclose the fact that he had HIV. In order to come to a conclusion, Sam’s nurse must first decide whether Sam is a real danger to other patients and nurses. A large quantity of people from the UK have been prosecuted for knowingly transmitting the HIV infection to their sexual partners. Unlike these cases, Sam is not purposely trying to infect anyone with HIV. When making any kind of decision, Sam’s...
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