Module 3 Applying Ethical Frameworks in Practice Lijimol Biju Grand Canyon University NRS-437V Ethical Decision Making in Health Care 01/08/2012 Applying Ethical Frameworks in Practice In the health care, the main idea of having confidentiality is for to gain the patients and family members trust. At any time this confidentiality is broken or the private matters are disclosed it is called a breach of confidentiality. Patients have the right for privacy related to their health care matters and it has to confidential among the health care team.
Breaching confidentiality is morally, ethically and legally wrong.In this paper the writer explains about the professional position regarding patient confidentiality using the assigned article, "Bioethics on NBC's ER: Betraying Trust or Providing Good Care? When Is It Ok to Break Confidentiality? " (Nathanson, 2000). In this article the writer explains about an ethical dilemma arose for the nurse Carol Hathaway. Two teenagers were not ready to get started their treatment and nurse Hathaway promise to them that the matter will be confidential and confidentiality will not be breached for whatever the reasons may be.Andrea, who is 14 years old, has a positive diagnosis for a human papillomavirus-(HPV) and a cervical cancer.
By having the knowledge that the cervical cancers can be treated and the survival results are high, nurse Hathaway is in a dilemma about informing the teenagers’ parents of her diagnosis. The nurse is struggling with the situation and talks to an ER physician who told her that the matter has to be brought to Andrea’s parents and also to the school authorities because the girl admits taking part of sex parties and having multiple sex partners and the school should be warned of the risk.Ethical Implications of a Breach of Confidentiality In olden day’s breach of confidentiality involved preventing harm to others, such as carriers of contagious diseases who wished to keep the condition a secret. The importance of confidentiality is recognized in both law and professional practice, in certain cases, the most caring response requires breaching the patient's confidence.
Nursing confidentiality cannot be breached.A patient’s trust is sacred and breaching that information is a violation of the trust between the relationship of the nurse and the patient (Burkhardt & Nathaniel, 2008). The implications of breach of confidentiality are a lack of trust between the patient and the healthcare provider and the patient may not disclose vital information regarding their condition thereby may not receive adequate care (Nathanson, 2000). Breach of confidentiality has significant effects like lack of trust between nurse and patient. Lack of respect, non compliance from the patient will also may occur.Theories and principles One of the major responsibilities of nursing profession is to advocate for the patients safety and care, in this situation based on the Utilitarian theory the situation has to be brought to Andrea’s parents for better treatment and care.
To analyze an issue using the utilitarian approach, first identify the course of action Second, ask who will be affected by each action and what benefits or harms will be derived from each. And third, choose the action that will produce the greatest benefits and the least harm.The ethical action is the one that provides the greatest good for the greatest number. By this approach in the given dilemma, the matter has to be brought to Andrea’s parent’s attention. By using the ethical decision making model of Uustal 1993 the dilemma has to be resolved such as (Step 1) Identify the problem, that whether the dilemma can be brought to the parents attention or not.
(Step 2) Considering Nurse Hathaway’s situation, it is hard to break the confidentiality related to the teenagers, but the same way the teenager needs the treatment. Step 3) In this situation the alternatives are to bring the issue to the ethical committee, give counseling for the teen and then make the teen to bring the issue to the parent’s attention if not the nurse has to bring it to their attention. (Step4) Examine and categorize the alternatives. Identify those that are consistent and inconsistent with personal values like give counseling and bring the issue to the parents after getting ethical committee’s advices. Step 5) Predict all possible outcomes for those acceptable alternatives like give enough time and counseling for the teenager.
Explain and teach her the importance of the treatment. (Step 6) Prioritize acceptable alternatives like advice from the ethical committee, counseling for the teenager and bring issue to the parent’s attention by the teenager if not by the nurse. (Step 7) Need to develop plan of action by utilizing all the alternatives. (Step 8) Implement the plan. (Step 9) Evaluate the action taken.The ethically accepted decision has to support the teenager in her difficult situation and need to protect her life and future.
The only alternative in this case as mentioned the study is to give the teenager counseling after very well educating about her diagnosis, its ` prognosis, the treatment plans and so on and make her inform the parents of the diagnosis. If the patient disagrees to inform the parents, Nurse Hathaway should inform the parents about the diagnosis in order to save her life and to provide her with the proper treatment.In an ethical committee there are doctors, nurses, social workers and chaplains and also members from the community who are ready to help in difficult dilemmas. The main responsibility of the ethical committee is to advocate for the patient.
By reviewing the policies and procedures and provide advisory consultations when ethical dilemmas arise in the hospitals. In this particular situation that Nurse Hathaway is facing, the committee may provide a safe, supportive and confidential forum, think through the problem sort through options and consider deferent point of views.They will then give recommendations and advice and then it will be the patient’s choice to decide on further treatment. In this case Andrea may need to tell the issues to the parents if not Nurse Hathaway has to bring this to their treatment in order to protect Andrea’s life and the future. In conclusion, Health care professionals often face with dilemmas. Difficulties on the subject of the exemption to the obligation of confidentiality come under the imprecise description of public distress and awareness.
Which increases ethical dilemmas as to who a nurse is obliged to protect? Nursing duties include prevention of disease, the facilitating of disorders, and the defense, encouragement, and re-establishment of welfare in the care of persons, families, and the public (American Nurses Association). In the given dilemma the nurse has the responsibility of protecting the teenager’s confidentiality, but the same way in order to protect her life from possible danger the issue has to be brought to the attention of parents and the school. Reference Purtilo, Doherty. Ethical Dimensions in the Health Professions, 5th Edition.
W. B. Saunders Company, 112010. p.
208). (Nathanson, 2000). BIOETHICS ON NBC'S ERBetraying Trust or Providing Good Care? When is it okay to break confidentiality? Retrieved from, http://www. bioethics. net/articles.
php? viewCat=7&articleId=133 (Burkhardt & Nathaniel, 2008). Ethics and issues in contemporary nursing, Retrived from, http://nej. sagepub. com/content/16/5/670.
extract (American Nurses Association). http://nursingworld. org/codeofethics.
