Patient confidentiality means keeping information that is personal to them and their situation away from any third party member. This issue can be a very controversial issue at times. Doctors are required to do all they can to protect, but sometimes protecting people will require them to break a patients confidentiality. For example, someone who has been identified with the HIV virus may choose not to let others know about their status, putting others at risk. In this situation, the healthcare professional is placed in an ethical complication (Wong-Wylie 35). If the professional chooses to keep the patients status private, others may be in harm’s way. If he notifies the third party members, however, the patient may lose trust in the doctor and terminate their connection; it is really a stick issue (Wong-Wylie 37).
The American Psychological Association (APA) talks about this topic in their ethical standards 5.05. It says professionals should keep the patients information private unless doing otherwise is ?mandated by law or where permitted by law for valid purpose such as . . . to protect the patient or client or others from harm (APA, 1992, p. 1606) (Wong-Wylie 37). APA rules from 1991 concerning this also state that professionals in these situations arent to be forced to warn others, but if they make the decision to do so, they will be defended from action against them (Wong-Wylie 37). The Canadian Counseling Association (CCA) has three exceptions to disclosure they use: the first is when it is needed to keep the patient and others safe, when legal regulations demand it, and when it is needed to keep minors safe (Sumarah et al 16).
Breaking a patients trust can harm their sense of hope, which is crucial to personal satisfaction and recovery. It may even cause the patient to avoid getting any more help with their issue at all (Wong-Wylie 38). This is a definite negative to breaking promises of confidentiality. If the issue is one that can be avoided by sensible people, then maybe an alternative action, such as counseling them about being responsible and the risks they may carry with them (Wong-Wylie 39). When dealing with younger patients, trust may be more valuable because they tend to rely and depend on it more than adults do and tearing that trust may cause greater internal pain for the younger patients (Blunt 3).
A study performed in the late twentieth century showed that patients through their information should be kept private but understood when revealing some of it in a professional way would benefit public health and safety (Blunt 6). Another situation that can be examined is if a minor has revealed to a counselor or such that they are abusing drugs. The minor will expect to have this kept secret, yet shouldnt the counselor notify the someone such as the parents? Breaking the minors trust will cause harm to the patient but possibly keep them from harming themselves or others in the future (Blunt 6).
The two sides of this argument are that doctors should be able to break patient confidentiality if needed and that doctors should not be able to break their confidentiality under any set of conditions. The pro-revealing side would see keeping that keeping a patients confidentiality when it couldve been sacrificed to save others as a bad choice while the other side would see that as the necessary action. Lets present the case referenced earlier concerning a patient with HIV/AIDS. If a patient who has this disease decides not to disclose the fact that they have this disease to others and puts them in danger, should the healthcare professional interfere and let people in possible danger know (Wong-Wylie 35).
Application of consequence-based ethics (act utilitarianism) to my ethical dilemma
Premise 1: Doctors must do whats best for their patients.
Premise 2: Doctors must do what’s best for the public health.
Premise 2.1: Keeping the fact that the patient has HIV confidential poses substantial risks to public health.
Premise 3: Patients have a right to know that their information is private.
Premise 3.1; Revealing the patients information breaks the patients trust.
Premise 4: Doctors should prevent the spread of pathogens and viruses if possible.
Premise 4.1: Revealing the patients status may prevent HIV/AIDS from spreading further.
Conclusion: Therefore, the doctor should break the patients confidentiality because it will possibly save people from contracting HIV/AIDS. It will also prevent the further expansion of HIV. The patients trust may be broken, but more people are helped with this route and the disease is quelled. But even afterwards, the patient may realise that it was for the greater good, so it may lessen the pain.
Application of duty-based ethics to my ethical dilemma
Premise 1: Doctors have a duty to protect people
Premise 2: Doctors have a duty to keep a patients confidentiality.
Premise 3: Doctors have a duty to prevent the spread of disease.
Conclusion: Therefore, the doctor should break the patients confidentiality and disclose the information because doing so will protect more people and fulfill more of the duties than the opposite option will. His duties require him to choose to disclose the information.
Application of virtue ethics to my ethical dilemma
Premise 1: Choosing to break the patients confidentiality will allow the doctor to be redeemed personally.
Premise 2: Knowing that he is preventing the spread of HIV/AIDS by breaking the patients confidentiality is good for his moral character.
Premise 3: Knowing that he lost the trust of his patient by breaking the patients confidentiality is bad for his moral character.
Conclusion: Therefore, the doctor should break the patients confidentiality because he will get more out of it morally than keeping the information private.
Application of rights to the ethical dilemma
Premise 1: The patient has a right to privacy.
Premise 2: The public has a right to be able to avoid contracting HIV/AIDS.
Premise 3: The public has a right to not have to worry about an increasing yet preventable disease.
Premise 4: Right to life.
Conclusion: Therefore, the doctor should break the patients confidentiality because it protects the most rights. It only breaks the patients right to confidentiality. Keeping the information private may even threaten some peoples right to life by allowing them to contract this slow yet deadly disease.
Application of medical principles to the ethical dilemma
Premise 1: Breaking a patients confidentiality violates his autonomy.
Premise 2: Breaking the patients confidentiality is a beneficent act for the public.
Premise 2.1: Breaking the patients confidentiality is not a beneficent act for the patient.
Premise 3: Breaking the patients confidentiality is the least harmful choice.
Premise 4: Breaking the patients confidentiality is a just act because it provides the most good for the most people.
Conclusion: Therefore, the doctor should break the patients confidentiality because it promotes the most medical principles positively.
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