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 as well as enhancing the autonomy and the dignity of a patient or client (Lin, Watson & Tsai, 2013). As nurses, I believe that were 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 that comes forth 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 on when who, and where to share health information. Confidentiality is how a nurse treat 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 issue 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. Privacy and confidentiality of a patient should be required in all instruments. Privacy and confidentiality are crucial for establishing and maintaining a respectful and an effective clinical relationship (Lin, Watson & Tsai, 2013). 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 a nurse to safeguard confidential information about what their patients provide or what they obtain from their interaction with patients.
Maintaining privacy is critical because it provides a secure environment for a patient where he or she receives medical care and provide complete as well as accurate information, and 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 date relative to a patient’s state of health, and to treatments to which they are subjected, ought to be considered private, and as such, should be adequately protected (Reinbeck & Fitzsimons, 2013). 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 because that contributes 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 therefore important to the society. Patient privacy and confidentiality should be protected because they maintain to protect patient’s rights to be self-determinant and guarantees the existence of worthy relationships between health care providers and patients. Moreover, this issue helps in attaining patience confidence over nurses and other medical professionals and treatment plan 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 patient’s right for them to be autonomous for their medical and personal information that how much and what information should be shared with other, even to their relatives of the family. Patients usually seek help from us with the expectations that their private or personal information would not be revealed without their consent. Beside this, we nurses are responsible not to reveal patient’s personal information. As a nurse, I should hold in confidence a patient’s personal information and use my judgment in sharing the information I gather. Trust is one thing that a patient should have a nurse or doctor.
Through ensuring that the patients trust me with their personal information, protecting privacy and confidentiality is less of a dilemma. Patient confidentiality should not be breached not unless in an extreme situation if the move will be in the beneficence 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 on above describing position, is acceptable, but as nurses, we should be aware 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 grow the private information about the situation of a patient professionally is not shared among paramedical staff or other professionals (Burkhardt & Nathaniel, 2013). Patients expectations to me regarding confidentiality means that information should not be given or discussed to another paramedical staff unless essential, give of patients personal information ought to be given with their consent, and patient matters ought not to be discussed in open wards or nurses’ desk.
It means that nurses should be honest and should take the expectations of a patient privately and confidentially (Shahriari et al., 2012). Taken information privately and confidentially protects ethics and helps achieve patient confidence for a trusted relationship. The practice of protecting confidentiality and privacy generates a clear and open communication between a nurses and patient which helps in the formulation of the mutual care plan and intervention for the patient (Dossey et al., 2012). However, protecting privacy for the sake maintaining trust nurses may not share critical patient information with other nurses who may hinder paramedical staff to work 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 regards 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, privacy precludes stigmatization and labeling of patients. By maintaining privacy and confidentiality, a patient can be protected from stereotyping and discrimination behaviors 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 patient from disclosing and breaching. I believe in human dignity, human relationship, privacy, and autonomy in decision-making. These values help me anticipate language differences when I am in a cultural-diverse society and need to communicate with my patients (Shahriari et al., 2012).
In the case of the language difference, 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 as a cornerstone of nursing (Dossey et al., 2012). It is imperative when it comes to preserving the dignity of a patient, and as I 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 the need to incorporate ethical principles as far as privacy and confidentiality are concerned. When dealing with confidentiality issues, four ethical practices that come to play include beneficence, respect for autonomy, justice and non-maleficence. These ethical principles are supported by ethical rules like confidentiality, honesty, and professional. 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 us should be involved. Respect for autonomy is highly recommended in nursing care because that determines the patient-nurse relationship that exists and it determines 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 regards 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 honor 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 other, including nurses.
Beneficence as an ethical principle refers to the balancing of the benefits of treatment against risks and costs before the nurse will put 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 are addressed. When a nurse promotes good, then they are thought of doing what the patient deserves, what is best for them. As a nurse, one should see patients as a whole, and one should think regarding the long-term outcomes of the treatment plan or decision that they make for the patient. The principle of beneficence is centered on promoting good for the patient but has its difficulties which lie 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 of 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. A nurse should take care that in their haste of care of their patient, that they don’t insert what they perceive to be good for what a patient would perceive to be most good. What good for the patient should be kept confidential and should not disclose 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 the promoting or encourage the good (McGowan, 2012). In this case, promoting good situations would mean that nurses should respect the decisions of the patient and not to disclose anything they get from them without their authorization or permission. Nonmaleficence proscribes nurses from carrying out any action 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 a careless risk of harm upon a patient. Harm can occur when confidential or private information is made known to individuals 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 eliminating 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 fairly manner.
Bottom line, privacy, and confidentiality ethical issue was a key factor as far as the foundation of nursing is concerned. A nurse should at all time assess the situation of a patient in a unique way and exercise confidentiality at all time for the benefit of the patient. Protecting privacy and confidentiality has a remarkable significance in nurses and patients perspective. Privacy and confidentiality should always be considered the right of a patient and the nurse and other paramedic staffs are responsible for protecting their patient’s personal and medical information. There is the need to incorporate ethical principles as far as privacy and confidentiality are concerned. Patient’s 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 relationship with the patients. Healthcare providers, especially nurses should be aware that to what extent they should share information which does not inhibit patient’s respect, 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.
