Importance of Confidentiality and Ethics in Healthcare (2023)

Paper Type: Free EssaySubject: Nursing
Wordcount: 1382 wordsPublished: 29th Jan 2018

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  • Sara Lan

Case Three

Confidentiality protection is an essential component of a patient-physician relationship. Only in a setting of trust can patients feel comfortable sharing personal feelings and sensitive information regarding their health with their health care providers. Having access to confidential health services is especially important when the patients are adolescents. This is particularly because the medical care needs of adolescents can often conflict with the opinions and values of their family members. Therefore, adolescents are less likely to seek medical treatment if they fear that the information they share with their medical care providers might be disclosed to their families. On the other hand, this fear may also cause adolescents to withhold certain information from medical professionals which can create problems in providing accurate diagnoses. Thus, medical care providers should do everything they can to respect adolescent patients’ confidentiality unless the patients are at significant risk of harming themselves or others.

Confidentiality is linked in to several bioethical principles, including the principle of respect for patient autonomy, the principle of beneficence, and the principle of nonmaleficence.

Within bioethics, the principle of respect for patient autonomy is usually associated with allowing informed and competent patients to make their own choices regarding their medical treatments (15). Meanwhile, confidentiality is respecting a patient’s right to control the information relating to his or her own health. While these concepts generally refer to adult patients, adolescents of Bill’s age are presumed competent to make medical choices for themselves. Unless the law requires otherwise, a competent minor can consent to medical care without involving the patient’s parents. In this particular case, Bill has good reasons for his reluctance to disclose the information that he has shared with the medical team to his parents. Bill mentions that his parents have explicitly expressed their views against same sex marriages and negative opinions about gays and lesbians. Therefore, in respecting Bill’s confidentiality and keeping information about Bill’s sexual orientation a secret, the medical team is acting beneficently. At the same time, disclosing the information to Bill’s parents presents the potential for harm. For instance, Bill may face rejection from his parents as a result and this may cause his depression to worsen. Thus, maintaining confidentiality can also be seen as acting in the principle of nonmaleficence.

(Video) Medical Ethics 3 - Confidentiality & Privacy

Concerns with regards to Bill’s competency may arise due to his past suicide attempt. In cases involving minors who do not have the capacity to make their own health care decisions, parents are generally the default surrogate-decision makers (94). Consequently, some people may argue that Bill’s medical decisions should be determined by his parents. Furthermore, by invoking the best interest standard, they might add that knowing all relevant information is necessary in determining what treatments are most beneficial for Bill. This can be justified if Bill is deemed incapable of making his own medical decisions then his parents may need to know about the causes of his depression in order to decide what specific types of medical treatments he needs. However, based on the sliding scale model of competency, I argue that Bill does in fact have the competency required to make his own health care choices. According to the sliding scale of competency, medical treatments that are highly beneficial with relatively small risks require a low level of competency to provide informed consent (90). Bill’s treatment plan fits into this category quite well. Furthermore, due to the highly therapeutic nature of these types of treatments, a presumption of competency holds when a patient agrees to treatment because the patient is making a rational choice (90). Although Bill’s competence may be questioned again when medical treatments involving higher risks are involved, he is still capable of making his own decisions about the treatment plan that is offered to him at the moment.

While it is important to respect a patient’s autonomy and confidentiality, the medical team should still encourage conversation between adolescents and their parents. When an illness strikes a member in the family, it not only affects the patient, but also the patient’s family as a whole. For that reason, in “Bioethics for Clinicians: Involving Children in Medical Decisions”, the writers proposed a family-centred approach which takes into consideration the burdens and the benefits for all family members, as well as their responsibilities toward each other (93). Since family members can provide much-needed support during the patient’s illness, medical care providers should always encourage communication between a minor and his or her parents. If Bill agrees to it, the medical team can speak to his parents about his treatment plan in more general terms. For instance, adolescence can generally be a difficult time for many people. Being the transition stage between childhood and adulthood, there are unique challenges and struggles that exist in this stage of life such as developing a personal identity. Therefore, it is not uncommon for adolescents to seek therapy and counselling for one reason or another. For the same reasons, schools also have counsellors to guide and help adolescents deal with these issues in life. By framing Bill’s treatment plan in this way, the medical team is able to provide a way for Bill to communicate and obtain support from his parents while he undergoes treatments without disclosing Bill’s secret.

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(Video) Capital Health Ethics Support Privacy and Confidentiality

It may be objected that withholding information from Bill’s parents is the same as lying. This objection is understandable since certain information does in fact have to be withheld when discussing Bill’s treatment plan with his parents as a means to protect Bill’s confidentiality. Nevertheless, the motivations behind lying and moral acts of withholding information are fundamentally different. For this reason, I argue that lying and moral acts of omission should not be viewed as equal. In “When Self-Determination Runs Amok”, author Daniel Callahan also speaks of the moral differences associated with “stopping life-sustaining treatments” with informed consent and “active forms of killing, such as a lethal injection” (345). Clearly, lying and active forms of killing are motivated by maleficence. Other the other hand, stopping life-sustaining treatments with informed consent and moral acts of withholding information are based on medical professional duties. Ultimately, should the medical team lie to protect Bill’s confidentiality? The answer is no. Under no circumstances should the medical care providers lie. After all, no one would be willing place their health and well-being in the hands of medical professionals who are capable of dishonesty. Meanwhile, moral acts of omission are justifiable when disclosing full informationwill very likely cause predictable harm. Generally, people find the latter to be acceptable.

If Bill’s depression does not improve with treatment and he is at significant risk of harming himself again, confidentiality may be justifiably breached. The medical should convey their intention to breach confidentiality to Bill before notifying his parents of his risk of harm to himself. However, it should be noted that it is not appropriate for the medical team to disclose information about Bill’s orientation if he does not wish for that information to be disclosed. It may take years before Bill feels comfortable sharing this information with his parents. Ultimately it is up to Bill to decide when he is ready. For the time being, the medical team’s role is to encourage a healthy support network between Bill and his family as well as to ensure that Bill has a confidential environment for his health care needs.

Works Cited

Gedge, Elisabeth (Boetzkes), and Wilfrid J. Waluchow. Eds. Readings in Health Care Ethics. 2nd ed. Peterborough: Broadview, 2012. Print.

(Video) Importance of confidentiality lecture No 4 Nursing Ethics

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FAQs

What is ethics of confidentiality in healthcare? ›

Confidentiality in the medical setting refers to “the principle of keeping secure and secret from others, information given by or about an individual in the course of a professional relationship,”1 and it is the right of every patient, even after death.

What is the importance of confidentiality in the relationship between the nurse and the client? ›

The American Nurses Association (ANA) believes that protection of privacy and confidentiality is essential to maintaining the trusting relationship between health care providers and patients and integral to professional practice (ANA, 2015a).

Why is privacy and confidentiality important in healthcare professions? ›

Ensuring privacy can promote more effective communication between physician and patient, which is essential for quality of care, enhanced autonomy, and preventing economic harm, embarrassment, and discrimination (Gostin, 2001; NBAC, 1999; Pritts, 2002).

How is confidentiality related to ethics? ›

The Code of Ethics identifies the confidentiality of information pertaining to clients, patients, students, and research subjects as a matter of ethical obligation, not just as a matter of legal or workplace requirements.

What is the main purpose of confidentiality? ›

The purpose of a confidentiality agreement, which is also referred to as a nondisclosure agreement or NDA, is to protect information exchanged between two or more parties. Anyone who signs a confidentiality agreement is promising to keep the relevant information secret.

Why is confidentiality an ethical issue? ›

Applying The Four Pillars of Ethics to Confidentiality

Breaking confidentiality without a patient's consent breaks their autonomy. It also undermines trust and may cause patients to be reluctant to seek help from healthcare professionals in the future, even if they desperately need medical attention.

How do you maintain confidentiality in healthcare? ›

Record and use only the information necessary. Access only the information you need. Keep information and records physically and electronically secure and confidential (for example leave your desk tidy, take care not to be overheard when discussing cases and never discuss cases in public places.

Why is confidentiality important in healthcare nursing? ›

The integrity of the health system relies on the protection of privacy and confidentiality because: Patient autonomy requires that individuals be free to choose, except in certain limited circumstances, who accesses information about their health.

How do you maintain privacy and confidentiality in healthcare? ›

5 important ways to maintain patient confidentiality
  1. Create thorough policies and confidentiality agreements. ...
  2. Provide regular training. ...
  3. Make sure all information is stored on secure systems. ...
  4. No mobile phones. ...
  5. Think about printing.
Sep 24, 2019

Why is it important to maintain confidentiality in the workplace? ›

Failure to properly secure and protect confidential business information can lead to the loss of business/clients. In the wrong hands, confidential information can be misused to commit illegal activity (e.g., fraud or discrimination), which can in turn result in costly lawsuits for the employer.

Why is it important to maintain client information as confidential? ›

For example, you could restrict all the accounts and financial data of your business to the specific people who work with this information directly. This avoids other workers from accidentally (or intentionally) stumbling across this sensitive information, which may invite bias, discrimination and criticism.

Is confidentiality is very important? ›

Confidentiality, or not disclosing certain information, is important in a wide range of jobs. Confidentiality matters for legal and reputational reasons, and it also matters because your future employment may depend on it.

What are the golden rules of confidentiality? ›

accurate, timely and secure: Ensure that the information you share is necessary for the purpose for which you are sharing it, is shared only with those people who need to have it, is accurate and up-to-date, is shared in a timely fashion, and is shared securely.

What are the four principles of confidentiality? ›

Confidentiality's value is not intrinsic but rather instrumental. That is to say, the value of confidentiality is derivative from the other values it advances. We can distin- guish four such values: autonomy, privacy, promise-keeping and utility (or welfare).

What are the 7 principles of confidentiality? ›

What is Caldicott?
  • Justify the purpose(s) of using confidential information.
  • Only use it when absolutely necessary.
  • Use the minimum that is required.
  • Access should be on a strict need-to-know basis.
  • Everyone must understand his or her responsibilities.
  • Understand and comply with the law.

What are the five rules of confidentiality? ›

Dos of confidentiality
  • Ask for consent to share information.
  • Consider safeguarding when sharing information.
  • Be aware of the information you have and whether it is confidential.
  • Keep records whenever you share confidential information.
  • Be up to date on the laws and rules surrounding confidentiality.
Sep 9, 2020

How do you promote confidentiality in the workplace? ›

There are various ways you can keep your business confidential information safe.
  1. Label confidential information. ...
  2. Train staff to know what is confidential and what is not. ...
  3. Put in place rules and procedures. ...
  4. Update your employee handbook. ...
  5. Sign a non-disclosure agreement. ...
  6. Regulate online conduct.

How do you protect patients rights and protect confidentiality requirements? ›

5 Ways To Protect Your Patients' Rights
  1. Never discuss the patient's case with anyone without the patient's permission (including family and friends during off-duty hours)
  2. Never leave hard copies of forms or records where unauthorized persons may access them.

What is confidentiality in a healthcare setting? ›

Confidential information about service users or patients should be treated confidentially and respectfully. Members of a care team should share confidential information when it is needed for the safe and effective care of an individual. Information that is shared for the benefit of the community should be anonymised.

What are the 5 confidentiality rules? ›

Dos of confidentiality
  • Ask for consent to share information.
  • Consider safeguarding when sharing information.
  • Be aware of the information you have and whether it is confidential.
  • Keep records whenever you share confidential information.
  • Be up to date on the laws and rules surrounding confidentiality.
Sep 9, 2020

Is confidentiality a medical ethics? ›

Respecting patients confidentiality and privacy are considered as the patients' rights. From deontological aspect, confidentiality is a duty and based on virtue ethics which Islam insists on; maintaining data privacy and confidentiality is the key virtue for trust building in physician-patient relationship.

What is your understanding of confidentiality in healthcare? ›

Confidential information about service users or patients should be treated confidentially and respectfully. Members of a care team should share confidential information when it is needed for the safe and effective care of an individual. Information that is shared for the benefit of the community should be anonymised.

Videos

1. What is Healthcare Confidentiality?
(Plain Law)
2. Ethical Integrated Healthcare: Case Study on Confidentiality and Shared Information
(Matthew Martin)
3. Ethics matters in health
(World Health Organization (WHO))
4. Ethics in Nursing and Healthcare Research, Part 1: Ethical Concepts and Principles
(Jennifer Jackson PhD RN)
5. Basic Principles in Medical Ethics - CRASH! Medical Review Series
(Paul Bolin, M.D.)
6. English for Nurses: Explaining about patient confidentiality
(Virginia Allum)
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