Patient confidentiality and ethics in nursing
In their line of duty, perioperative nurses are bound to the duty of patient confidentiality and ethics. However, in executing their responsibilities, perioperative nurses find themselves in dilemma situations with regards to ethical issues and patient confidentiality concerns accompanying the sharing of patient’s health information (Ulrich et al., 2010). According to the Nursing and Midwifery Board of Australia (2010), ensuring confidentiality of the health information of a patient is at the core of nurses establishing and maintaining trusting relationships with patients, patient’s families, and other health professionals.
With no assurance regarding the confidentiality of their health information, patients could be hesitant to provide sensitive yet important information regarding their health status/condition that can help in provision of high quality care (Price, 2015). However, perioperative nurses are faced with dilemma in situations where they consider appropriate to share a patient’s confidential health information to his or her family member(s) or caregiver for purposes of ensuring the patient continue to receive quality and safe health care.
The ethical implication of this action is the violation of ethics duty by the nurse as well as the potential loss of trust in the nurse and other health professionals in the institution by the patient or family should it be discovered that such confidential information was shared.
Additionally, in situations where the health condition of the patient deteriorates, health professionals find themselves in a dilemma state with regards to protecting the patient’s privacy whilst addressing the carers’ concerns about the patient’s condition (Price, 2015). For instance, patients that have undergone brain surgery are often mentally and physically unstable because of the nature of the surgery and as such are not in a position to interact with family as well as make important decisions concerning their health information, which could be confidential.
At the same time, the patient’s family members might request to know about the health condition of the patient, being unaware and unfamiliar of the hospital procedure and policies and health care code of ethics regarding the application of confidentiality in their context (Ulrich et al., 2010). In this situation, disclosing the patient’s confidential health information to the family members can be a complex task.
Thus, the nurse must obtain the patient’s permission about the information that can be shared, to who and under what circumstances to minimise possible misunderstanding with family member(s) as well as evade possible legal implications accompanying such (Olson & Stokes, 2016).
According to the Nursing and Midwifery Board of Australia (2010), patients have an inherent right to autonomy, which allows for their informed consent or the withheld of this consent. The law of informed consent holds that patients have the right to withhold personal information unless it is required by law to provide such information; or make decisions concerning their own treatment (Taylor, 2014).
Thus, perioperative nurses have ethical and legal obligation to respect and protect patient’s right to autonomy by allowing the patients to make their own treatment decisions or not to provide certain personal information deemed confidential. However, nurses may find themselves in a dilemma in situations where protecting and respecting patient’s right to autonomy could result in harm to the patient (Olson & Stokes, 2016).
For instance, in situations such as multiple series of surgery or uneventful incidents, letting the patient make his/ her own treatment decisions or withhold important information to health care practitioners could result in self-harm or harm others altogether.
In such scenarios, the nurse or health professional might be compelled to violate the duty of confidentiality through such means as disclosing important information concerning the patient to the family or deciding on the suitable heath care for the patient through the help of family and other health professionals without patient’s consent. This could result in an ethical break that can have legal implications on the nurse or health professional involved (Simek, 2016).
Nursing and Midwifery Board of Australia (2010). Nursing and national competency standards for Registered nurse. Retrieved from: http://www.nursingmidwiferyboard.gov.au
Olson, L., L., & Stokes, F. (2016). The ANA Code of Ethics for Nurses with Interpretive Statements: Resource for Nursing Regulation. Journal of Nursing Regulation, 7(2), 9-20
Price, B. (2015). Respecting patient confidentiality. Nursing Standard, 29(22), 50-57.
Simek, J. (2014). Specifics of nursing ethics. Kontakt, 18(2), 64-68
Taylor, H. (2014) Promoting a patient’s right to autonomy: implications for primary healthcare practitioners. Part 1. Primary Health Care, 24(2), 36-41
Ulrich, C., M., Taylor, C., Soeken, K., O’Donnell, P., Farrar, A., Danis, M. & Grady, C. (2010). Everyday Ethics: Ethical Issues and Stress in Nursing Practice. Journal of Advanced Nursing, 66(11). doi: 10.1111/j.1365-2648.2010.05425.x
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