Bioethics in Nursing

 

 

 

 

 

 

 

Bioethics in Nursing

In the healthcare profession, it is extremely important for nurses to practice confidentiality so as to gain the patients’ and family members’ trust. A breach of contract occurs when nurses disclose the patients’ private issues. Patients are supposed to enjoy a right to privacy as far as their health care matters are concerned and the health care professionals should keep this information a secret amongst themselves. Morally, ethically, and legally, nurses are prohibited from breaches of confidentiality.

This paper discusses breach of confidentiality and the relevant bioethics. It is based on an article, “Bioethics on NBC’s ER: Betraying Trust or Providing Good Care? When Is It Ok to Break Confidentiality?” the article discusses a case where nurse Carol Hathaway was faced by an ethical dilemma. There were two teenagers that were not ready to start their treatment but the nurse assured them that confidentiality would be a key component during their treatment. Andrea, a fourteen year old girl, was diagnosed with humanpapillomavirus and cervical cancer. According to the nurse, it is possible to treat the cervical cancer but the survival results are detrimental. Therefore, the nurse finds herself in a dilemma if or if not to inform Andrea’s parents about this diagnosis. The ER physician advises the nurse that it is vital to inform the school management and parents as Andrea does not deny that she participated in sex parties as well as involving with multiple sex partners. Hence, the school should be warned of these risks.

Ethical implications following a breach of contract

The cardinal point that underlies this discussion is that regardless of the fact that there is a need to maintain confidentiality in all patient-nurse interactions, some situations warrant protection of the greater good as a crucial priority. In this case, the nurse is supposed to share this information with the school management and parents (Yang et al., 2010). The parents will, therefore, be aware of what their daughter is suffering from. This is the foundation towards appropriate counseling and healthcare services. If the parents are not informed, Andrea’s medical conditions may progress to a critical point or there may be complications. On the same note, there is a need to inform the school management so as to ensure that proper prevention measures are laid, there are no more victims, and the affected are assisted accordingly (Yang et al., 2010).

However, a nurse is subject to several ethical implications following the breach of confidentiality. Breaching confidentiality indicates the autonomy of the patient is not being respected. The act is also a form of betrayal. Certain common laws and statute areas indicate that patients should enjoy a right to confidentiality. Not only are there ethical implications, there are legal implications as well. Following a breach of confidentiality, a nurse may be required to pursue her grievance via civil proceedings in which the patients benefits by being compensated, disciplinary, or criminal proceedings. In addition, a nurse may face court charges (Johnstone, 2011).

Ethical principles or theories to substantiate my position

There are several basic ethical principles that should be practiced during provision of medical care services, and in fact, patients expect them when seeking medical care. These cardinal principles are veracity, fidelity, respect for autonomy, justice, altruism, beneficence, and confidentiality. Regardless of the fact that these motions are implied, they are also mandated via the standards of care, professional organizations, and federal law. According to the nurses’ ANA Code, there is a need to esteem the innate worth as well as the people’s dignity of individuality and human existence (Beauchamp & Childress, 2009). This is an extremely important ethical principle. The Health Information Portability and Accountability Act was passed in 1996 to promote the protection of privacy of health-related information belonging to clients. In the case under discussion, regardless of the fact that the worth of confidentiality is well- established and principal in the healthcare profession, the situation preludes this tenet (Braveman & Bass-Haugen, 2009).

Consequentialism ethics substantiates my stand; if the nurse passes the information about Andrea’s conditions to the school management and parents, she will maximize the majority’s greatest good. Virtue ethics is another theory that is applicable whereby if the nurse’s character is good, she will do what is correct in order to uphold trustworthiness and honesty (Braveman & Bass-Haugen, 2009).  Principlism also applies since the school management, practitioners, parents, and patient will be able to reach a balance and rationale for making appropriate decisions after accessing the information.

A reasonable alternative for addressing the dilemma and the importance of using this framework

The nurse had promised to adhere to confidentiality before finding out what the patient was actually suffering from. Since the patient’s conditions are critical considering also the tender age, it would be worth to reason the impending results with her. The nurse should stress that informing the parents is important as it will promote good medical attention. In a nut shell, the nurse should seek consent from the patient before passing the information to those concerned (Beauchamp & Childress, 2009).

How an ethics committee may address this dilemma

            An ethics committee should gather all important details and facts first and find out whether the patient was going through an abusive situation. Based on these details and facts, the best options should be sought and a proper decision made. The patient’s situation should be considered keenly before making any decisions (Beauchamp & Childress, 2009).

 

References

Beauchamp, T. L., & Childress, J. F. (2009). Principles of biomedical ethics (6th ed.). New York: Oxford University Press.

Braveman, B., & Bass-Haugen, J. D. (2009). Social justice and health disparities: An evolving discourse in occupational therapy research and intervention. American Journal of Occupational Therapy, 63, 7–12.

Johnstone, M. J. (2011). Bioethics: a nursing perspective. Elsevier Health Sciences.

Yang, W. P., Chen, C. H., Chao, C. S. C., & Lai, W. S. (2010). Bioethics education for practicing nurses in Taiwan: Confucian-western clash. Nursing Ethics, 17(4), 511-521.

 

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