Current Ethical Issues In Nursing

Patient Privacy And Confidentiality

Core values or ethical issues for nurses include preventing illness, promoting health, alleviating suffering, protecting patient privacy and confidentiality, and improving access to care. Many interventions across the globe aim to improve access to health care for the poor (Cherry & Jacob, 2016). Nurses play a crucial role in promoting health and social participation, and the fact is many feel the anguish and pain of patients unable to access health services. In the provision of health care, nurses have an opportunity to protect and defend patient rights, promote compassionate care, and enhance the autonomy and dignity of a patient or client (Lin, Watson & Tsai, 2013).

As a nurse, I believe that we are at times required to choose from some least wrong or good alternatives and to assess and defend the actions taken or choices made. Furthermore, we are faced with ethical issues each day in the healthcare setting, and dealing with these issues may be difficult (Burkhardt & Nathaniel, 2013). Dealing with an ethical issue requires value clarification, critical thinking, self-awareness, empowerment, and ethical decision-making. Nurses are expected to maintain confidentiality and patient privacy. Confidentiality as an ethical principle requires nondisclosure of secret or private information with which a nurse is entrusted with (McGowan, 2012). Privacy is the right of nurses to keep information about their patients from being disclosed (Burkhardt & Nathaniel, 2013). So, a patient should be the one to decide when, who, and where to share health information. Confidentiality is how a nurse treats secret or private information once it has been disclosed. So, nurses are entrusted with private information. This paper is an analysis of patient privacy and confidentiality ethical issues in nursing care.

Violating the privacy and confidentiality of a patient can have ethical and legal consequences for professionals and healthcare providers. The Health Insurance Portability and Accountability Act protects the medical information of a patient. Every patient has a right to privacy, and such rights involve the confidentiality of information that is related to the patient and his or her bodily privacy. Patient privacy and confidentiality should be required in all instruments. Privacy and confidentiality are crucial for establishing and maintaining a respectful and effective clinical relationship (Lin, Watson & Tsai, 2013). The right to privacy constitutes a social merit because it encourages discussion of health-related problems in an explicit style between a nurse and his or her patients. Privacy requires nurses to safeguard confidential information about what their patients provide or what they obtain from their interactions with patients.

Maintaining privacy is critical because it provides a secure environment for a patient where he or she receives medical care and provides complete as well as accurate information, which strengthens confidence in healthcare and emphasizes the need for respect for patient autonomy. Today, patient rights are debated both at the international and national level. Patient rights have been added to the legislation that is related to health (McGowan, 2012). Every patient has the right to confidentiality and privacy of personal information, and that includes information regarding their state of health and potential therapeutic or diagnostic procedures and the protection of their privacy during the performance of specialist visits, diagnostic exams, and medical treatment. All the information and data relative to a patient’s state of health and the treatments to which they are subjected ought to be considered private and, as such, should be adequately protected (Reinbeck & Fitzsimons, 2013). The personal privacy of a patient must be respected in the course of surgical/medical treatments, which should take place in the right environment and in the process of professionals who need to be there unless a patient explicitly gives consent or has made a request.

I believe that it is wise to keep the health information of a patient confidential and private because that would protect the patient from harm and contribute to public protection. Ethics are part of patient care, and the practices of nurses reflect how moral and ethical values are being valued to provide compassionate care. The concept of privacy and confidentiality ponders that a patient’s private data or information should always remain confidential or shared among nurses or medical staff for quality care. When it comes to nursing practice, confidentiality determines that data and information should be protected from divulging practitioners as it promotes the right of being self-determine on the part of a patient and helps build a trusted relationship between patient and nurse (Shahriari et al., 2012).

Privacy and confidentiality promote patient health and are, therefore, important to society. Patient privacy and confidentiality should be protected because they maintain to protect patients’ rights to be self-determinant and guarantee the existence of worthy relationships between healthcare providers and patients. Moreover, this issue helps in attaining patient confidence in nurses and other medical professionals and treatment plans, which is crucial as it promotes patient health. When a patient feels protected, stigmatization is precluded, and the nurse has the chance to perform effectively (Lin, Watson & Tsai, 2013).

As a nurse, my position is that protecting privacy and confidentiality is a formal responsibility of the nurses and a patient’s right. In a healthcare setting, I am of the opinion that it is the patient’s right to be autonomous regarding their medical and personal information and how much and what information should be shared with others, even their relatives of the family. Patients usually seek help from us with the expectation that their private or personal information will not be revealed without their consent. Besides this, we nurses are responsible for not revealing patient’s personal information. As a nurse, I should hold a patient’s personal information in confidence and use my judgment when sharing the information I gather. Trust is one thing that a patient should have a nurse or doctor. Ensuring that the patients trust me with their personal information and protecting privacy and confidentiality is less of a dilemma. Patient confidentiality should not be breached unless the move is for the benefit of the patient or people close to them (Reinbeck & Fitzsimons, 2013). For example, in a situation where the patient is suffering from infectious diseases or is HIV positive, a nurse should know about such a patient so that they can protect themselves from the contagious infection and, in the process, that would prevent other patients as well. However, from a professional point of view, I am of the opinion that patient privacy, as well as confidentiality in the above-describing position, is acceptable, but as nurses, we should be aware of to what extent information we should share.

I believe that, as a nurse, I should embrace confidentiality because it helps build a trusted relationship between healthcare professionals and patients. The relationship that exists grows private information about the professional situation of a patient, which is not shared among paramedical staff or other professionals (Burkhardt & Nathaniel, 2013). Patients’ expectations regarding confidentiality mean that information should not be given or discussed with another paramedical staff unless essential, patients’ personal information ought to be given with their consent, and patient matters ought not to be discussed in open wards or nurses’ desks.

It means that nurses should be honest and should take the expectations of a patient privately and confidentially (Shahriari et al., 2012). Taking information privately and confidentially protects ethics and helps achieve patient confidence in a trusted relationship. The practice of protecting confidentiality and privacy generates clear and open communication between nurses and patients, which helps in the formulation of a mutual care plan and intervention for the patient (Dossey et al., 2012). However, in protecting privacy for the sake of maintaining trust, nurses may not share critical patient information with other nurses, which may hinder paramedical staff from working as a team in providing holistic care, and that may affect patient health (Reinbeck & Fitzsimons, 2013). In my opinion, holistic care should only be given when nurses demonstrate their values with regard to patient privacy. Privacy and confidentiality are a patient’s basic rights and serve to further a frank, trustful, and open relationship between nurses and patients, thus improving patient care (Dossey et al., 2012).

Responsibility is another value that underpins my support for protecting privacy and confidentiality. The truth is that privacy precludes stigmatization and labelling of patients. By maintaining privacy and confidentiality, a patient can be protected from stereotyping and discriminatory behaviours of the people who are around them. Many patients experience economic devastation, discrimination or stigma in the case of confidentiality breaches (Reinbeck & Fitzsimons, 2013). So, nurses play an important role when it comes to protecting the private information of their patients from disclosure and breaching. I believe in human dignity, human relationships, privacy, and autonomy in decision-making. These values help me anticipate language differences when I am in a culturally diverse society and need to communicate with my patients (Shahriari et al., 2012).

In the case of language differences, a nurse should pay attention when seeking the assistance of an interpreter. In such a case, a patient’s consent must be obtained before enlisting the help of an interpreter, and a breach of confidentiality could result if a nurse opts to use an informal interpreter without proper consent. Protecting patient privacy and confidentiality has always been and still is a cornerstone of nursing (Dossey et al., 2012). It is imperative when it comes to preserving the dignity of a patient, and as a nurse, I believe that we are obliged to comply because we owe our patients a duty of confidence, and that is a sure way to maintain an efficacious nurse-patient relationship.

According to Shahriari et al.- 2012, there is a need to incorporate ethical principles as far as privacy and confidentiality are concerned. When dealing with confidentiality issues, four ethical practices come into play: beneficence, respect for autonomy, justice, and non-maleficence. These ethical principles are supported by ethical rules like confidentiality, honesty, and professionalism. Respect for autonomy means that as a nurse, I should comply with the decision that a competent and informed patient makes. Any information I gather from them, or they disclose to me should remain between no third party, and answers should be involved. Respect for autonomy is highly recommended in nursing care because it determines the patient-nurse relationship that exists and the quality of care that a nurse can deliver (Cherry & Jacob, 2016).

It has many prima facie consequences as it requires a nurse to obtain informed consent before they get to carry out the treatment of the patient. The decision about privacy and confidentiality, especially where disclosure is supposed to be justified with regard to reducing risk to a third party, ought to be strongly influenced by consideration of the nurses’ values and public policy. Maintaining confidentiality is an ideal way to enhance autonomy because the patients are given control over their personal information. In fact, it is a form of property right where information solely belongs to the patient, who has the right to control its use as arising from an agreement so that a nurse may be obliged to honour the undertaking to maintain confidentiality (Shahriari et al., 2012). The principle holds that patients should have full control over their health and lives, and that includes control over their personal information with unjustified interference from others, including nurses.

Beneficence as an ethical principle refers to the balancing of the benefits of treatment against risks and costs before the nurse puts into action the ideal treatment plan that will benefit the patient. On the grounds of beneficence, the idea that the actions of a nurse should only promote good is addressed. When a nurse promotes good, then they are taught to do what the patient deserves and what is best for them. As a nurse, one should see patients as a whole, and one should think about the long-term outcomes of the treatment plan or decision that they make for the patient. The principle of beneficence is centred on promoting good for the patient but has difficulties in defining or determining what good means to patients (Huston, 2013). Some patients may take well to mean that their life can be taken, while to others, it would mean promoting the patient to undergo a difficult or challenging procedure to better their life by prolonging it. Before a nurse acts with beneficence in mind, they ought to consider the needs and wants of the patient and what is best for their life. Nurses should take care that in their haste to care for their patients, they don’t insert what they perceive to be good for what a patient would perceive to be most good. What is good for the patient should be kept confidential and should not be disclosed to a third party without the patient’s consent. The principle of beneficence is likely to be confused with the ethical principle of nonmaleficence (Huston, 2013).

According to the principle of no maleficence, a patient should not harm the patient. The principle of nonmaleficence acts as an obligation for a nurse to protect his or her patients from harm by preventing or removing bad situations and promoting or encouraging the good (McGowan, 2012). In this case, promoting good situations would mean that nurses should respect the decisions of the patient and not disclose anything they get from them without their authorization or permission. Nonmaleficence prevents nurses from carrying out any action that will result in cause harm to the patient, and that entails protecting privacy and confidentiality.

This principle requires an intention to avoid injury or harm that may arise from acts of omission or commission. It can be considered negligence when a nurse imposes unreasonable or careless risk of harm upon a patient. Harm can occur when confidential or private information is made known to individuals, and a patient would never have disclosed the information (Huston, 2013). This principle should always remind a nurse that the main concern when carrying out a task is never to harm the patient. The principles help build confidence and trust on the part of the patient, and they will believe that their problems are safe with a nurse (Cherry & Jacob, 2016). As a nurse, I think we must look to reduce as well as eliminate any actions that will make the patient lose confidence or trust in us. The ethical principle of justice refers to the idea that the moral duty to distribute risk, cost, and benefits should be done in a fair manner.

The bottom line is that privacy and confidentiality are key factors in the foundation of nursing. A nurse should assess the situation of a patient in a unique way and exercise confidentiality at all times for the benefit of the patient. Protecting privacy and confidentiality has a remarkable significance from nurses’ and patients’ perspectives. Privacy and confidentiality should always be considered the right of a patient, and the nurse and other paramedic staff are responsible for protecting their patient’s personal and medical information. There is a need to incorporate ethical principles as far as privacy and confidentiality are concerned. Patient autonomy, justice, nonmaleficence, and beneficence are unpinning rights of privacy and confidentiality. Nurses should always protect a patient’s private information and embrace the value of confidentiality because that way, they can build trusted relationships with the patients. Healthcare providers, especially nurses, should be aware of to what extent they should share information which does not inhibit patients’ respect and dignity and cause a reason of discrimination and stigma.

References

Burkhardt, M. A., & Nathaniel, A. (2013). Ethics and issues in contemporary nursing. Nelson Education.

Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Elsevier Health Sciences.

Dossey, B. M., Certificate, C. D. I. N. C., Keegan, L., & Co-Director International Nurse Coach Association. (2012). Holistic nursing. Jones & Bartlett Publishers.

Huston, C. J. (2013). Professional issues in nursing: Challenges and opportunities. Lippincott Williams & Wilkins.

Lin, Y. P., Watson, R., & Tsai, Y. F. (2013). Dignity in care in the clinical setting: A narrative review. Nursing Ethics, 20(2), 168-177.

McGowan, C. (2012). Patients’ confidentiality. Critical care nurse, 32(5), 61-64.

Reinbeck, D. M., & Fitzsimons, V. (2013). Improving the patient experience through bedside shift report. Nursing management, 44(2), 16-17.

Shahriari, M., Mohammadi, E., Abbaszadeh, A., Bahrami, M., & Fooladi, M. M. (2012). Perceived ethical values by Iranian nurses. Nursing ethics, 19(1), 30-44.