Healthcare Issue invoking patient confidentiality
Healthcare ethics involves the application of the core principles of bioethics to inform healthcare decisions. These principles include beneficence, nonmaleficence, autonomy, and justice among many others. Healthcare professionals understand that ethics is an inseparable part of care delivery because they serve to minimize harm and respect the values of the patient (Varkey, 2021). Confidentiality is among the ethical principles that govern privacy and respect for the patient’s wishes. Confidentiality means that the healthcare provider should not share the personal details of the patient without their permission (Olejarczyk &Young, 2021). I believe it is not ethically permissible to violate patient confidentiality unless it is absolutely necessary. However, applying the principle of confidentiality during patient care can be challenging because it conflicts with other ethical principles including autonomy and nonmaleficence.
Patient confidentiality is an ethical and legal issue subject to detailed regulation in the United States. Maintaining confidentiality during care delivery is a legal requirement that ensures the promotion of trust during patient care (Varkey, 2021). Maintaining confidentiality ensures the promotion of other ethical principles like autonomy that allows patients to dictate who has access to their state of health. Additionally, confidentiality during care delivery can ensure the creation of trustworthy relationships and sharing of important information by patients to promote their health.
Ethical Principles, Values, Theories
Dilemmas around confidentiality occur when the application of confidentiality is in possible conflict with other ethical principles or healthcare values. While information should only be shared when the patient provides permission, there are exceptions to this subject. For example, sharing of necessary medical information from the primary physician to other healthcare teams is allowed without permission from the patient (Olejarczyk &Young, 2021). However, physicians are prohibited from discussing information with families, social gatherings, or social media (Noroozi et al., 2018). Another aspect that can lead to confidentiality breaches involves instances like sexually transmitted diseases, epidemics, and criminal incidences like gunshot wounds that can be a source of harm to others. These exceptions provide a cover for healthcare professionals to routinely disclose their practices regarding confidentiality during care delivery.
The ethical principle of nonmaleficence is observed to conflict with the practice of confidentiality during patient care. Under this principle, the healthcare provider is required not to intentionally create harm or injury to the patient, either through acts of omission or commission (Olejarczyk &Young, 2021). Healthcare professionals are required to provide standard care that minimizes the risk of harm to the patient and others. Practically, healthcare professionals are supposed to weigh the benefits of the decision against consequences. As explained before, physicians can disclose patient information to partners and family members when conditions like STIs and HIV are involved. Patients might feel harmed by such actions but maintaining confidentiality will eventually harm others.
Another ethical principle that often conflicts with other principles of bioethics is autonomy. Autonomy is the rule of the self that is free from control and interference from others. Apart from exceptions like patients who lack the capacity to act autonomously as in the case of children and infants, patients have full control over their medical decisions (Olejarczyk &Young, 2021). In clinical patient care, autonomy affects confidentiality when patients decide to omit important health information from their partners or families. For example, a patient’s decision to keep their HIV status private or deny taking medication may be overlooked if the decision poses danger to others. Health information can be shared even when the patient makes decisions against these actions for the protection of other people. In healthcare research, confidentiality and autonomy may conflict if the patient’s decision to withhold medical records would result to harm outside treatment contexts (Noroozi et al., 2018). Additionally, patients have a duty to make their records available for a wide range of research and this may be in conflict with confidentiality.
Recommendation and Implications
Confidentiality is one of the core healthcare duties for nurses and other professionals. It is not ethically permissible to violate a patient’s confidentiality because of its implications for patient care and the practice of healthcare providers (Olejarczyk &Young, 2021). Confidentiality promotes trust between the patient and the physician allowing sharing of information and improvement of outcomes. Creating a trusting environment encourages patients to seek care more often and improves honesty during the course of treatment (Varkey, 2021). Although exceptions are available to conditions like infectious diseases and STIs, I believe confidentiality should prevail and options weighed before making healthcare decisions.
Maintenance of confidentiality and its breach during care delivery can have consequences to patients and providers. Well-maintained confidentiality can improve healthcare delivery and achieve quality care outcomes (Olejarczyk &Young, 2021). Maintaining confidentiality creates a trustworthy relationship that promotes sharing and access to healthcare services. Breaching confidentiality by disclosing the patient’s protected health information can lead to legal action against the healthcare provider and the organization (Varkey, 2021). Health Insurance Portability and Accountability Act (HIPAA) provides a guide on privacy, access, and disclosure of protected patient health information that should be followed to the latter. Individuals can file complaints about privacy practices and if found guilty providers can lose their practice license, pay fines, or go to jail.
Ethics is an inherent and inseparable part of healthcare delivery by nurses and other healthcare professionals. Practicing ethically means adhering to ethical principles like confidentiality that govern patient care. Healthcare providers have a duty to keep the patient’s personal medical information confidential consistent with the patient’s preferences. Confidentiality promotes trust in healthcare and can improve patient outcomes through improved information sharing and willingness to seek care.
Noroozi, M., Zahedi, L., Bathaei, F. S., & Salari, P. (2018). Challenges of Confidentiality in Clinical Settings: Compilation of an Ethical Guideline. Iranian Journal of Public Health, 47(6), 875–883.
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28.
Olejarczyk, J. P., & Young, M. (2021). Patient rights and ethics. 2021. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
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