Through the advancement of science and technology, healthcare providers run functions efficiently – from treatment to information management. Ethical decisions are required during which the healthcare professionals need to be honest and trustworthy. Given that the world keeps on changing in terms of unique work ethics, new technologies, different healthcare settings, and diverse patient needs, there is the need to have codes of conduct practiced to maintain a good relationship. This essay examines the ethical decisions and the application of the ETHICAL model in handling an ethical dilemma case, while avoiding privacy violations and their consequences.
As a designated privacy officer, I feel that the privacy of Paul’s parents has been violated. The case manager should have waited to discuss the other matters with the parents. I think this is careless of the case manager, and he should apologize to the client and the family for mishandling such critical information. The problem is a violation of privacy because of the careless handling of critical information. If the case manager was careful enough, he should have noted that the PDA has the ability to send data to the family, including Paul’s sister. He did not practice informatics ethics, which led to the spread of information to uninterested parties. Two ethical principles would guide me in this case: autonomy and non-maleficence. According to (McGonigle & Mastrian, 2017), in the guiding principles by Beauchamp and Childress (1994), autonomy is the person’s freedom to manage intrusion from others and from individual hindrances that can alter meaningful decisions. On the other hand, non-maleficence, requires any professional to carry out their duties without imposing harm or any risks (Zareshahi, Mirzaei, & Nasiriani, 2022). The act of negligence under this principle requires carelessly imposing risks unintentionally, to do the right thing.
The alternatives for solving the dilemma in the case study include: (1) The case manager could have just sent the email to bring Paul in for assessment, as instructed by the physician; (2) The case manager could have shared the extra information with the family during the assessment instead of sharing it through the PDA; (3) the case manager could have encrypted the extra message to avoid it from being accessed by Paul’s sister. However, there are consequences for each alternative generated. Firstly, the parents might fail to access the home computer when they return from work, meaning they will not have the information. Secondly, the parents might get furious and confront Paul in the hospital, hindering his treatment and recovery. Lastly, Paul’s sister might access the password later and share the encrypted data with the other parties. As a designated privacy officer, my opinion would be to encrypt the data. Because we are in a technological era, such data would be stored safely under a folder that guests cannot access when using the home computer. Atique et al. (2020), maintains that it is significant to protect the privacy and confidentiality of clients’ rights. Paul did not know that his case manager had shared some information with his parents concerning his health. The information confidentiality would have been maintained by hiding it to a location that only the parents would access.
My choice of data encryption takes into consideration all the persons involved. Paul cannot access the information even through the PDA. Her sister or any other guest will not be given the password to the encrypted folder. The consequences can only be there if the parents carelessly expose the password. As a designated privacy officer, I would take responsibility if a worst-case scenario happens. I understand that violation of privacy happens in such scenarios, and instead of shifting the blame, the best approach would be to accept the liability and be ethical next time. My plan of action is to apologize to Paul’s parents for their rights violation and be moral in the next job. Also, I plan to use my problem-solving and critical thinking skills to educate the family on the importance of privacy. I expect to reach an understanding with the parents on the various ways of handling and storing digital information. The types of monitoring procedures that I would develop are evaluation, internal investigations, and monitoring. For evaluation, I will need to identify and understand the current policies and ensure the confidentiality consents follow the current practices. Regarding the internal investigations, I intend to carry out in-house audits to ensure all electronic information is safe from breach, and privacy policies are strictly followed. In sanctions for violations of privacy, I will include full responsibility for the actions, which includes suspension or termination of employment depending on the seriousness of the offense.
My responses to the two scenarios:
- Scenario 1: Tracking each point of access to the patient’s database, including who entered the data
- My answer: I think it is appropriate to determine who was handling the patient for accountability reasons. I would encourage the attending nurses to maintain the privacy of the database to avoid access by other parties.
- Scenario 2: Nurses in your hospital have an access code that only gives them access to the Unit’s patients. A visitor accidentally comes to the wrong unit looking for a patient and asks the nurse to find out what unit the patient is on.
- My answer: to avoid violation of patients’ rights, I would instruct the nurses to refer such visitors to the right places. Under no circumstances should the access code be shown to any visitor. They can use the list of names to identify if the patient belongs to that unit. Nurses who breach the rights should face the consequences.
In conclusion, privacy and confidentiality are salient aspects, not only in nursing informatics, but in many fields. When faced with ethical dilemmas, it is important to use critical skills to create a great ethical decision. Information should not be shared without the client’s consent to avoid the consequences of violating their rights.
References
McGonigle, D., & Mastrian, K. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Jones & Bartlett Learning, LLC, an Ascend Learning Company.
Atique, S., Bautista, J. R., Block, L. J., Lee, J. J., Lozada-Perezmitre, E., Nibber, R., & Topaz, M. (2020). A nursing informatics response to COVID-19: Perspectives from five regions of the world. Journal of Advanced Nursing, 76(10), 2462-2468.
Zareshahi, M., Mirzaei, S., & Nasiriani, K. (2022). Nursing informatics competencies in critical care unit. Health Informatics Journal, 28(1), 14604582221083843.