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Applying Ethical Framework in Practice - Essay Example

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Professional Position Regarding Patients’ Confidentiality Institution Applying Ethical Framework in Practice Introduction Any healthcare system requires that the patients’ confidentiality regarding health status be maintained and should only be known to the doctors and the patient…
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Professional Position Regarding Patients’ Confidentiality Applying Ethical Framework in Practice Introduction Any healthcare system requires that the patients’ confidentiality regarding health status be maintained and should only be known to the doctors and the patient. However, this principle may not hold in some cases, and the confidentiality requirement may have to be broken. Several ethical principle and theories have been postulated to guide medical officers and nurses in handling dilemmas such as those relating to the breaking of confidentiality. Ethical Implications of a Breach of Confidentiality In medical practice, four main principles apply; beneficence, least harm, respect for autonomy and justice (Rainbow, 2002). The principle of beneficence demands that the healthcare provider does what offers most good. Least harm demands that the medical officer does the least harm in the event that they are faced with situations in which alternative actions present harm or no benefit to the patient. The principle that relates to respect of autonomy demands that patients should be allowed to make decisions that affect their lives. This principle is based on the assumption that people best understand their lifestyles and are therefore the only ones who fully appreciate how decisions affect their personal lives (Rainbow, 2002). Lastly, the principle of justice states that actions prescribed by ethical theories should be fair to the parties involved. In view of Hathaway’s case, the principle of beneficence calls for good actions in cases of dilemma. By maintaining confidentiality of the patients, the health expert acts for the good of the patients. By maintaining confidentiality, Andrea would not have attempted suicide. However, Hathaway would have acted without considering the good of the public and the legal requirement for parental consent. In this respect she would be exposed to litigation for treating the patient without parental consent. Yet again, by breaking the patient’s wish for confidentiality in handling their cases, Andrea gets to act against the principle of Autonomy. In this respect, Hathaway’s choice would have discourage the patients from further opening up to treatment and cause them to lose respect for her. Professional Position Regarding Patient Confidentiality Nurse Hathaway’s choice to break confidentiality (Nathanson, 2000) was the best choice given the situation at hand. By respecting the patient’s autonomy and maintaining their confidentiality, the Nurse would have done greater harm to the society than to the patients. More students would have continued to participate in the sex parties leading to more infections and possibly a health crisis. By breaking confidentiality, the nurse acted in respect of the principles of least harm and beneficence and preserved more people from harm. Furthermore, it would be fair to preserve the lives of more people in the society by breaking the confidentiality of two patients. Reasonable Alternative to Address the Dilemma The dilemma faced by Hathaway may be solved by considering the application of the utilitarian theory. The theory demand that the predicted consequences of an action be considered before action is taken. Breaking patient confidentiality will result in loss of respect of the patience, and their stigmatization as noted in the attempted suicide. On the other hand such an action will result in the proper treatment of the patients with the involvement of the society and parents with less risk of facing litigations for breach of consent laws. However, keeping confidentiality will result in less stigmatization of the patients, but potentially greater harm to the school children. Yet again, the nurse would be subject to probing considering the breach of consent laws. Considering the utilitarian theory, breaking confidentiality would be a reasonable alternative to solving the dilemma considering the lives of the bigger society against two individuals whose diseases are also exhaustively diagnosed and treated. How an Ethics Committee Might Approach the Dilemma When an ethical committee has to solve the dilemma, it has to first get the relevant facts related to the cases (Graber, Beasley & Eaddy, 1985). Based on the facts, the committee will begin to appeal to ethical values. The ethical committee will consider the various ethics theories and principles related to the solving of dilemmas. The principles in this case include autonomy, beneficence, justice and least harm. On the other hand, the ethics theories that the committee will consider include deontology, utilitarianism, rights, casuist and virtue (Rainbow 2002). Based on the utilitarian theory, the committee will analyze the consequences of each decision and establish which offers most good and least harm without infringing on the autonomy and rights of the patient. In making the decision, the committee will also seek to establish the obligations and duties of the nurse as a healthcare provider. In this respect, the nurse has a duty to offer medical care to the patients while at the same time seeking ways to protect the larger society from health threats. The committee may also refer to previous cases similar to the one at hand in making a decision. The decision made may be guided by the premises and decisions made in the past case(s). The nurse’s character may be questioned in the process of decision making based on the virtue theory. Conclusion Nurses face a lot of ethical dilemmas in the course of offering their vital services. There are a number of principles and theories that may be applied in solving such dilemmas. The consideration of the various theories and principles makes decision making easier during professional practice. In the case under review, the nurse’s decision to break patient confidentiality may have gone against their some rights and autonomy. However, considering the situation in light of beneficence, utilitarianism, more good, least harm and deontology, the nurse’s choice to breach confidentiality was the best decision. References Graber, G. C. Beasley, A. D., Eaddy JA, (1985). Ethical Analysis of Clinical Medicine: A Guide to Self-Evaluation: Professional Codes and ethical theories. Urban and Schwarzenberg. Nathanson, PG, (2000). Bioethics on NBC's ER: Betraying Trust or Providing Good Care? When Is It Ok to Break Confidentiality? http://www.bioethics.net/articles.php?viewCat=7&articleId=133 Rainbow C. (2002). Descriptions of Ethical Theories and Principles. Retrieved 20 January, 2012 http://www.bio.davidson.edu/people/kabernd/indep/carainbow/Theories.htm Read More
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