Confidentiality - Ethical and Law in Nursing Practice - Essay Example

?Confidentiality: Ethical and Law in Nursing Practice Confidentiality: Ethical and Law in Nursing Practice Introduction Nursing as health practice has become a vital practice especially in regards to vital life concerning issues. Nurses are expected to make such profound decisions in their everyday lives; therefore, they must consider laws and ethical standards towards reaching to their decisions since their decisions concerns the lives of other persons. Therefore, making appropriate decisions will require nurses to understand the interface between laws, ethics, and nursing as a practice. Additionally, they must consider that laws are ever dynamic; thus, they should constantly update themselves on new laws that are targeting the maintenance of ethical issues within the nursing practice lest they find themselves on the wrong side of the law in relation to their decisions. On the same note of laws, ethical issues, and nursing practice and decision making, this essay aims at comparing three articles within which these issues are addressed especially how legal and ethical factors usually affect clinical nursing practices and the consideration that nurses must consider in making decision within their practice. Article 1: Confidentiality, Secrecy, and Privacy in Ethics Consultation Gerald Neitzke (2007) conducted a research on Confidentiality, secrecy, and privacy in ethics consultation. According to Neitzke, confidentiality is likely to pose problems especially to counselors and he noted that these challenges are can be in two different ways including the uncertainty on the actual extent of the optimum practice and the problem in implementing the ethical practice within a nursing practice. Nonetheless, Neitzke noted in his article that the British association for the counseling had once published some codes of ethics to help counselors to resolve the dilemma. Additionally, Neitzke acknowledged that these counselors are sometimes challenged with the law as they undertake their duties (Neitzke, 2007). It should be noted that law and ethical values can only be breached in this situation if the client or patient feels that their confidentially have been interfered with without their consent. Therefore, Neitzke noted that if such dilemmas have to be minimized or eradicated, it is then vital for the medical practitioners in this case the counselors to seek permission to breach the confidentiality of their patients. Neitzke discussed three ways through which breaking of confidentiality is permissible and they include the counselor seeking the consent of the patient or client to break their confidentiality. Additionally, the counselor can break the confidentiality of the patient if such information regarded confidential are already in the public domain. Finally, a nurse which in this case if a counselor, may be at liberty to break person confidentiality if the public interest in the protection of such information outweighs personal interest in the disclosure or use of such information. It should be noted that if counselors are obliged legally to break personal confidentiality, they will be protected the law for such break (Neitzke, 2007). In the cotemporary world, keeping confidential information about client is usually vital for counselor especially for maintaining perfect relationship with clients and or maintaining their practice. Therefore, these professionals must only breach the confidentiality law in situations demanded by law; otherwise, they will lose trust from their clients; thus, interfering with their business and practice. In some cases, they may be taken to court to answer to their unethical and unprofessional behaviors. Hence, despite the fact that the law may give the nurse or the counselor in Neitzke’s case the right or protection to provide some private information about their clients, they must only do so without exterior motives or in a manner to harm their clients (Neitzke, 2007). Regardless, of the window that confidentiality in nursing and counseling practice can be breached on legal demands, some persons sampled for opinion on the same issue by Neitzke, maintained that confidentiality is an absolute principle that can never be breached. They also noted that there is a significant difference in the meaning of ethical and the nursing practice; therefore, the two should never be integrated. Article 2: Quality Improvement in Primary Care Tapp, L., Elwyn, G., Edwards, A., Holm, S., and Eriksson, T. (2009) addressed the concerns of the Quality improvement in primary care and related the same with the Ethical issues explored. Tapp et al. (2009) were concerned mainly on the quality improvement processes on medical processes provided to families. They note that the quality improvement in family medicine was becoming a complex issue and the same affected the functionality of organizations in that the complexity of the quality improvement processes in the family medicine hindered the daily work processes. These researchers noted from their literature review that a series of ethical issues were pegged on quality improvement. The areas that were addressed by this research included the ethical issues of patients’ data, issue of the ethical approval dilemma, prioritizing (quality Improvement) QI projects, and impacts of QI. Regardless of the dilemma presented in each case, the researcher provided solution per case. According to Tapp and his colleagues, prioritizing of issues is quite vital in nursing practice since it is the only means to ensure that most of the obligated or planned duties are conducted without neglecting some groups of patients (Tapp et al. 2009). Moreover, the nurses should be flexible and transparent on different levels of executing their duties and these character traits usually ensure harmful consequences are avoided especially in terms of bureaucratization, general practitioners (GP) burnout, and increased workload. Development of these circumstances is usually noted to be harmful on the patient doctor relationship. Finally, they noted the concern of addressing the system approval especially for the national QI projects and programs that utilize highly sophisticated methodologies. This article provided data from nearly 17 different nations; nonetheless, the data presented indicated that there are needs to encourage ethical issues in providing primary care to patients. According to Tapp et al. bioethical principles are the main factors guiding the GPs. Some of these principles include the beneficence principle, non-maleficence, and respect for autonomy of patients, and justice that ensures patients receive treatment in ethical and fair way (Tapp et al. 2009). Tapp et al. contributions on the nursing ethical and legal issues reflect immensely on the contemporary society (Tapp et al. 2009). It is worth noting that breaching of ethical issues usually affect patient in different ways including the trust confidence between patient and the nurse or the entire health institution. The same has been represented in this work as the involved patients stating they are reluctant to seek medical assistance in medical institutions or from patient that have been noted leak patient confidential information to the public. Nonetheless, in analyzing the stipulated research aspects, these researchers noted that despite prioritizing duties, what matters the most is the way such duties are performed in relation to the ethical principles or known by the patient. In other words, regardless the order medical services are provided to the patient, the patient expect medical services to be provided in the best way and as stipulated or provided by the laws regulating nursing practices. Moreover, it should be noted that prioritizing medical issues to certain patients may also lead to breach of law; thus, nurses need to be fully aware of their ethical concerns with laws governing such issues without compromising the right of the patients under their care. Laws have changed and fully fledged in governing the right of human beings at all points in life. Notably, the contemporary laws have penetrated into medical institutions to govern and protect the right of patients. Therefore, Tapp and his colleagues’ contributions are effective in the contemporary medical society; thus, the concerns addressed by this research report should be embraced by all medical professionals and institutions (Tapp et al. 2009). Article 3: the Legal and Ethical Aspects of Confidentiality on Handling Patients Suffering from HIV/AIDS Christian Safken and Andreas Frewer (2007) conducted a on the duty to warn and clinical ethics. Their research was related to the Legal and ethical aspects of confidentiality on handling patients suffering from HIV/AIDS. Safken and Frewer were really concerned with confidentiality in handing these patients. According to them, confidentiality is a principle that is corollary to medical treatment and must never be compromised. In their analysis, they noted that confidentiality is rooted into two vital principles that includes physician – patient relationship. In these cases, they noted that it is the patient who relies fully on the confidentiality of a physician. In other words, a patient can never reveal physician’s private information or data since they never have the same, but physicians have patients’ data. Additionally, it is vital that physician to keep patients’ private details that is essential for public confidence. Nonetheless, the duo noted that there are special or difficult circumstances that physician can contemplate to reveal patient’s confidential information or breach the confidentiality principle. According to Safken and Frewer, such situation may only arise when the patient’s confidentiality puts the life or physical integrity at risk. They note that these situations only arise in special legal and ethical concerns. For instance, the major medical concerns that can lift medical confidentiality include situations when a patient is suffering from vulnerable diseases including mental illness and HIV/AIDS as well as venereal diseases including Hepatitis B (Safken and Frewer, 2007). Safken and Frewer also concentrated their research on the responsibility of others in engaging on certain medical unethical behaviors. Safken and Frewer are concerned on other inflicting body injury to other such as infecting someone with HIV/AIDS virus due to negligence. As noted from their research, this is a grievous ethical issue that has its penalties in the courts of law as stipulated in many countries (Safken and Frewer, 2007). In the entire globe, nobody is permitted by law to infect anyone with any kind of disease or disease causing organism. In such situations legal actions are usually allowed to take cause since such actions are regarded as criminal offense. Medical institutions that are been on spotlight that such actions have been committed usually suffer immense public humiliation and medical services in such institutions are often affected greatly. Confidentiality is a vital aspect in medical institutions especially among the medical practitioners. Keeping medical information and data of patients confidential is quite vital since publicizing such information may be injurious to the patient and his or her families and or friends. Nonetheless, medical practitioners must be fully informed that the privacy of the medical information is currently government by laws and breach such laws may lead to vital consequences. Additionally, providing such data to unconcerned parties constitutes to unethical behavior within medical profession; thus, can lead to lose of job among other consequences. However, if a medical practitioner feels that certain patient information or data needs to be made public for the public interest, the concerned medical practitioner must follow due process as stipulated by law towards making such information public. Otherwise, such actions may cause them great deal. In other words, physicians must at all time maintain cordial relationship with the patient by building confident with patients through keeping their records with a high degree of confidentiality as required by ethical and legal principles. Reference Neitzke, G. (2007). Confidentiality, secrecy, and privacy in ethics consultation. HEC Forum, 19(4), 293-302. Retrieved July 10, 2013, from doi:http://dx.doi.org/10.1007/s10730-007-9049-y Tapp, L., Elwyn, G., Edwards, A., Holm, S., & Eriksson, T. (2009). Quality improvement in primary care: Ethical issues explored.International Journal of Health Care Quality Assurance, 22(1), 8-29. Retrieved July 10, 2013, from doi:http://dx.doi.org/10.1108/09526860910927925 Safken, C., & Frewer, A. (2007). The duty to warn and clinical ethics: Legal and ethical aspects of confidentiality and HIV/AIDS.HEC Forum, 19(4), 313-26. Retrieved July 10, 2013, from doi:http://dx.doi.org/10.1007/s10730-007-9051-4 Read More