Applying ethical frameworks guide professionals in their everyday practice. The ethical issues that arise in a particular profession are often numerous, making ethics a practical and not theoretical concept (Moulton & King, 2010). In several cases, applied ethics defines the moral behind actions, even as differences between good and bad acts challenge communities every day.
Nonetheless, incorporating diverse views has created universal codes of conduct that reduce any glaring disparities. Breaching confidentiality is, however, an ethical issue in nursing that still draws debates on whether it is worth to betray trust, but provide good care.
Confidentiality is central to creating trust between nurses and patients, thereby, making it the foundation for all medical care settings. Nurses are obliged to protect the ethical and legal aspects of patient rights to gain their trust (Moulton & King, 2010). This professional boundary should resonate across all settings, because any nurse is bound to come across information that any client may want to keep confidential. Trust is a key issue in getting patients to divulge sensitive information such as medical or personal history. Thus, both legal and ethical reasons exist for keeping information confidential.
There are ethical theories and principles that support breaking confidentiality to provide good care. For instance, the non-maleficence principle supports that in practice one has to balance risk and costs. Although breaching confidentiality carries risks such as loss of clients, reputation, and revenue, Nurse Hathaway faces the dilemma of treating the minor without consent from the parents. This principle supports breaking confidentiality even though it carries both lawful and moral obligations (Silen, Svantesson & Ahlstrom, 2008).
Next, the deontological theory also supports breaking confidentiality, since it argues for adhering to independent moral rules. Nurse Hathaway has a duty to inform the parents of the minor about her condition, if she fails to do so herself. Therefore, the nurse has a moral obligation to report to the minor’s parents, since she cannot initiate treatment without their consent (Nathanson, 2000).
The framework for ethical decision making that best address the dilemma that Nurse Hathaway faces is the utilitarian approach, since it balances between good and bad. The utilitarian approach requires evaluation of ethical concerns by arguing for the benefits or harms that we derive from each action. The framework then chooses the action that bears the greatest harm and least harm.
If a client expects you to hold some information confidential and you end up divulging to a third party, one could ruin their relationship (Silen, Svantesson & Ahlstrom, 2008). Breaching confidentiality breaks trust and respect levels between nurses and patients. However, providing care for the patient weights more as it is the priority of nursing care (Nathanson, 2000).
How the ethics committee addresses the ethical dilemma that Nurse Hathaway faces using the utilitarian approach best explains how Nurse Hathaway should proceed. Nurse Hathaway believes that informing the school administration could lead to further diagnosis on cancer teens who are possibly involved in queer sexual activities (Nathanson, 2000).
However, the General Media Council will hold Nurse Hathaway responsible if she involves school authorities. The rules of this ethics committee hold that nurses can only break confidentiality, if certain information benefits a patient. While one may argue that the actions of the students constitute a public health issue, the committee will hold firm that Nurse Hathaway can only let the school in on the seriousness of the acts that students engage in, but not inform of the source.
In my professional opinion, it is okay to break confidentiality to enable nurses provide good care. However, it is important for a nurse to explain the confidentiality policy before starting any work with a patient.
If a client goes on to give out information that may force a nurse to break confidentiality, it is important to remind them of the confidentiality policy before letting them continue. In Nathanson’s article, the actions of Hathaway are right if she informs Andrea’s parents about the cervical cancer. Still, nurses should not disclose patient information unless laws and ethics require disclosure of this information to the right parties.
References
Moulton, B., & King, J. (2010). Aligning Ethics With Medical Decision-Making: The Quest for Informed Patient Choice. Journal of Law, Medicine & Ethics. Web.
Nathanson, P. (2000). Bioethics on NBC’s ER: Betraying Trust or Providing Good Care? When Is It Okay to Break Confidentiality. American Journal of Bioethics. Web.
Silen, M., Svantesson, M. & Ahlstrom, G. (2008). Nurses’ Conceptions of Decision Making Concerning Life-Sustaining Treatment. Nursing Ethic, 15(2), 160-173.