The question of confidentiality in nursing is considered to be one of the most controversial and open-to-discussion points. In our case, a nurse, Hathaway, promised to maintain patient’s confidentiality to gain necessary trust and clarifications; however, with some period, patient’s problem is regarded as a disease the outcomes of which may threaten other people’s lives, this is why the promise has to be broken. The point is that a patient is a 14-year-old girl, Andrea, and her disease is sexual (Nathanson, 2000). Our task is to define the conditions under which a breach of confidentiality is possible, consider the principles of autonomy and justice to substantiate the chosen position to break a promise, and prove that there is an alternative to a dilemma that may be justified by an ethics committee and helps a patient.
“Confidentiality is one of the most important ethical precepts in psychiatric/mental health nursing because the therapeutic nurse-patient relationship is grounded in trust” (Butts & Rich, 2005, p. 162).
On the one hand, there are certain rules and requirements to be met by different people. People are responsible for their own words and decisions, this is why they have to evaluate a situation properly and think over the outcomes.
On the other hand, there are also several cases when a breach of confidentiality is possible, and to be sure that a nurse does right, it is necessary to evaluate a situation and define whether there are some other ways out with less harm to a patient and third parties. Paola et al (2009) admit that the principle of confidentiality is far from being absolute, and it is possible to find enough powerful reasons to disclose information with a purpose to protect third parties (sexual partners or parents).
However, patients are still able to sue for a breach of confidentiality (Buppert, 2007).
There are two main principles in nursing: autonomy is all about the patient’s ability to make independent decisions concerning his/her healthy future and justice implies an idea of being fair to other people and promoting appropriate consequences. In the case under consideration, several unclear points should be mentioned. First, a nurse did not have the right to develop confident relations with a 14-years-old patient because children under such age have to be protected by parents. Second, under the working Act, a nurse does not have the right to breach information about a patient. This is why a huge dilemma appears and needs to be solved. Should a nurse break her promise to protect other people and help them get necessary treatment in time? Is it necessary to inform parents about their daughter’s condition? Which are the most appropriate ways out?
The answers to the above-mentioned questions may vary considerably, but still, it is possible to find a good alternative. Due to special professional help, a young patient may comprehend independently that her parents have to be aware of this information. In case a nurse proves that a patient needs to share these facts with her parents, there is no breach of confidentiality from the side of a nurse.
If a person is against informing her parents about her disease, a nurse may take all conditions under which breaking confidentiality into account and inform parents explaining her actions as an obligatory step to save a third party, parents. In case their daughter dies, parents choose suicide because of many reasons. To prevent the case of suicide, it is possible to break confidentiality. The point is that a nurse has to evaluate each side of the problem, define her role in this situation, and be sure to cope with any possible outcomes after a breach of confidentiality.
This is why one of the successful examples of how the representatives of the ethics committee can use an ethical principle of justice and make the right decision. Though confidentiality is regarded to be a duty, a committee may find several clear and effective reasons to break this confidentiality to protect the third party. Doctors and nurses have the same aim: they take steps to save human life. If one human life is in danger because of medical negligence, the reputation of this person is under question. The question “to disclose or not to disclose information” should not be compared to another question “to save a life or to kill a person”.
Even more, a nurse has already treated a child under the age of 14, she has already broken several rules when did not inform her parents. This is why she had to change the situation and make an attempt to help a child and involve her parents in the process of treatment because the question of the life of death is under consideration.
Nursing ethics does not appreciate people’s mistakes; this is why it is necessary to evaluate a situation from numerous perspectives at once. In this case, a nurse has to break confidentiality and inform the patient’s parents to take all precautions, provide a person with necessary in-time treatment, and save human lives.
Reference List
Buppert, C. (2007). Nurse Practitioner: Business Practice and Legal Guide. Sudbury: Jones & Bartlett Learning.
Butts, J. B. & Rich, K. (2005). Nursing Ethics: Across the Curriculum and into Practice. Sudbury: Jones & Bartlett Learning.
Nathanson, P. G. (2000). Betraying Trust or Providing Good Care? When It Is Okay to Break Confidentiality? Bioethics. Web.
Paola, F.A., Walker, R., & Nixon, L.L. (2009). Medical Ethics and Humanities. Sudbury: Jones & Bartlett Learning.