Confidentiality in medicine is one of the main principles the medical workers should follow. There are a great many reasons for either following or breaking the promise of confidentiality, everything depends on the situation. Some cases are regulated by the country’s law, the others must just be related to the nurse’s conscience. Analyzing the case of Andrea who was diagnosed with human papillomavirus, it is very easy to consider a number of issues that should be remembered by the nurses. Deciding whether to break the promise of confidentiality or not, medical workers should check the ethical side of the problem, highlight the public interests and consult personal convictions.
Considering the professional position regarding patient confidentiality, it is important to mention that from the ethical point of view I am convinced that by giving a promise, nurses should never break it despite the cases stipulated by law. Taking the notice of the Andrea case study, it should be mentioned that there were some ethical reasons in favor of breaking the promise of confidentiality. The problem was beyond control because of the girl’s multiple sex partners and the problem became not private but public. Moreover, the nurse was also convinced that the break of the promise could guarantee the girl “proper medical care and support” (Nathanson, 2000, par. 1). The case was not stipulated by law, so, there is was no necessity to dwell upon the problem in public. The modern world is full of information about the hazards that may be caused by failing to practice safe sexual relations.
It also should be remembered that the nurse who broke the promise of confidentiality should be responsible for those actions. There is no guarantee that the girl would not try to commit suicide or conduct any other activities when she gets to know that her secret is made public. Moreover, another result of breaking the promise of confidentiality could be the loss of trust in medicine in general (Nathanson, 2000). I am also absolutely convinced that before breaking a promise of confidentiality the nurse should check two points. Firsts, it should be analyzed whether the problem is urgent and may expose others to a life-threatening emergency. Second, a nurse should think about whether she would be able to endure the blow or not. Furthermore, returning to the case under consideration, it is crucial to notice that the being betrayed once, the girl will never turn for medical help again. Considering the girl’s way of life and attitude to sexual relations, it is impossible to reject that Andrea will have health problems related to the sexually transmitted disease. If to betray her now, she would never turn for help again.
On the other hand, there are some arguments that can justify the nurse who decided to make the problem public and tell her parents the truth. First, the problem was not private anymore, it was public and multiple numbers of sex partners of the girl could cause the epidemics of sexually transmitted disease. The nurse cared for the patient and to tell the truth, to parents was the action that could improve the girl’s treatment and lead to positive results faster and with fewer costs. The medical promise of confidentiality is one of the reasons for people to turn to nurses with private cases. The absence of confidentiality in medical practice could be a barrier between nurses and patients (Nathanson, 2000).
There are always alternatives for any situation. Relating to the case study devoted to Andrea and the detection of papillomavirus, several alternative decisions may be offered. The nurse who gave the promise of confidentiality could just remain silent hoping for the girl’s responsibility and thorough treatment. Instead of making the problem public, the nurse could just tell Andrea’s parents. In this case, the nurse may be sure that leaving the medical center, the girl will receive the necessary treatment. The nurse must convince Andrea to do it personally. Otherwise, the nurse will have to intrude.
The case study under discussion examines the variant to make the problem public. It is inadmissible in my opinion as the problems on the conscious level that are sure to appear after implementing the decision in life may be unpredictable. Adolescents’ mind is too vulnerable and in case of its hurt, the consequences may be irreversible. It is significant to consider and try to predict the consequences of any actions and decisions that may follow. The ethics committee should consider each case separately as it is impossible to treat all the cases alike. There are situations when the promise should be broken, but this is conducted exclusively in a good cause.
In conclusion, giving a promise of confidentiality to the patients, nurses are to keep the word. Still, there are a number of cases when nurses should break the promise and make the problem public. If there is no legislative background for making the problem public, the nurse should think twice and discuss the problem from different angles with colleagues before making a decision.
Reference List
Nathanson, P. G. (2000). BIOETHICS ON NBC’S ER: Betraying Trust or Providing Good Care? When is it okay to break confidentiality? Bioethics.net. Web.