Ethical Dilemmas In Nursing

Ethical Dilemma Derrick SUNY Empire State College

Patient confidentiality has become an integral aspect of healthcare ethical standards since the HIPPA law came into being. (Erikson 2005). According to the American Nurses Association (ANA) code of ethics “the nurse has a duty to maintain confidentiality of all patient information” (Nursingworld, 2005). When a patient’s confidentiality is violated, his/ her wellbeing is negatively impacted. Patient confidentiality encompasses protecting any information the patient reveals to medical staff, and not divulging or sharing it to others. If trust is betrayed, the patient would be uncomfortable and reluctant to share their private and personal information.
According to the American Nurses Association, the ethical principles that underlie confidentiality are autonomy ( agreement to respect another 's right to self-determine a course of action; support of independent decision making), beneficence ( compassion; taking positive action to help others; desire to do good; core principle of our patient advocacy) and nonmaleficence (avoidance of harm or hurt ).These principles ensure that nurses act in a way that benefits the patient, causing no harm, respecting the patient’s personal information and promoting patient’s right to
Dilemmas around confidentiality arise when the principle of confidentiality is in possible conflict with other ethical principles such as avoiding harm to the patient or others. The scenario below underscores this point: A day after he was admitted to the hospital, Fiifi was informed that he is HIV positive. The medical team advised him to contact his sexual partner and inform her of his status. For the past 15 months, Fiifi has been in a relationship with Derby and they are expecting a baby in 6 weeks’ time. Before this relationship Fiifi admits having a series of sexual partners. 5 days later, it became clear that he has not told Derby of his HIV status. Being aware of the baby, soon to be born, the medical team tells Fiifi that steps should be taken to assess whether Derby is HIV positive and whether the baby is at risk or not so that necessary treatment could be initiated. At this point, Fiifi was reluctant to tell Derby and even threatens to sue the hospital if she is told without his consent. What should the team do? This is a typical case of ethical dilemma; should the team inform Derby or what? A critical analysis reveals that the principle of autonomy requires that personal information should not be disclosed without consent. However, in some cases the autonomy of another person may also be at play as it is in this case Derby, the