In medical practice, patients are entitled to confidentiality. It means that their personal information, got in the professional interaction with health personnel is kept in secret. It is maintained within various ethical frameworks and it is also provided for one of the earliest frameworks, the Hippocratic Oath. “What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself holding such things shameful to be spoken of” (UIC, 2012). It is supposed to protect a patient from social judgment/prejudice and rumors. Similarly, according to the Declaration of the Geneva Oath, medical graduates affirm that they will respect in confidence all the secrets revealed by a patient even after the demise of a patient. The American Medical Association requires physicians to uphold confidentiality of patients’ information and not to reveal it without the patient’s consent on grounds of a mandatory law provision.
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A breach of patients’ confidentiality might impact negatively on the way patients are treated and it is a serious public health concern. Confidentiality serves to protect patients in very vulnerable states. Such individuals might be reluctant to seek treatment for fear of discrimination (UIC, 2012). This is well exemplified in those patients who require tests to check the presence or absence of sexually transmitted diseases (STDs). The test results and information about one’s subsequent treatment program should not be disclosed to third parties. This is crucial in areas where patients with STDs especially HIV/AIDS face discrimination. Psychiatrists and psychologists should not disclose the information of patients whose psychological problems and various cognitive disorders are known for them. Through the enforcement of confidentiality, patients feel encouraged to be completely candid about any disorder, injury or any underlying problem. Such information may be withheld if there is a notable tendency of health personnel to broadcast information, concerning the illness and the treatment of patients. This will lead to the compromise of medical management and will damage psychiatric relationships, so that it will be hard to stop the spreading of infectious diseases such as STDs.
There are accepted ethical principles that govern the doctor-patient relationship (Law Teacher, 2012). First, health personnel should respect autonomy. Privacy forms are an essential component of this relationship and health personnel should respect the decision made by an informed. All information shared and revealed during the patient-doctor interaction should be held in utmost confidence. The principle of beneficence requires health personnel to balance treatment benefits with costs and risks. In addition, physicians should not hide any information from their clients and they need to truly give them all the information concerning their health status. Patients are entitled to receive the most appropriate therapeutic intervention for their health conditions. Third, the principle of non-maleficence proscribes all medical professionals against actions that will bring harm to their patients. This might easily result from a breach of patients’ confidentiality. The patient may face stigmatization, following the disclosure of particular medical conditions (HIV /STD status or mental/cognition conditions).
In the case of Nurse Hathaway, two girls are tested for STDs. One girl, Andrea tests positive for Human papillomavirus (HPV). The girls further disclose their participation in sex orgies that are very popular in school, where they encounter multiple sexual partners. Nurse Hathaway faces an ethical dilemma as she has assured the girls of the utmost confidentiality of the information disclosed. Yet, she needs to inform the parents as it is their duty to monitor any treatment regimen, administered on Andrea. They also need to be informed of any risky behavior that predisposes their children to harm and in this case it’s the girls’ erratic sexual behavior. Nurse Hathaway also feels the need to contact the school in a bid to inform the management of the ongoing risky sexual behavior by students (Nathanson, 2000).
Youndsters do not enjoy the same confidentiality rights as adults. That is the reason why parents are always informed and engaged in matters pertaining to the treatment of the first. However, the law provides the confidentiality rights for the maturing adolescents who are allowed to experience abortions, psychiatric treatment and contraceptives without parental consent or notification. Children, aged 12 and above, can receive the treatment for sexually transmitted diseases, alcohol addiction and drug abuse without parental consent or notification. In the case of Andrea, Nurse Hathaway should take the prerogative and to immediately enroll the girl in a treatment program for cervical cancer. There are programs that offer free screening and treatment for cervical cancer. Andrea should be encouraged to inform her guardians, but in the event she declines, Nurse Hathaway cannot disclose the information without Andrea’s consent. It is no secret that teenagers are often engaged in dangerous premarital sex. This greatly predisposes them to STDs and it is the duty of any health practitioners to offer somebody a treatment except for guidance and counseling. Fewer teens will avail themselves of treatment if they feel that the details of their general health being will be disclosed to parents and school officials. Before the test, Andrea requested confidentiality and commenced to take the teat after Nurse Hathaway assured her of privacy. Nurse Hathaway should display her respect of autonomy by adhering to her client’s wishes. Moreover, she should exercise beneficence and non-maleficence (Law Teacher, 2012) by making Andrea enroll a free treatment program. This will ensure that Andrea receives counseling and treatment for cervical cancer. Nurse Hathaway should contact the school and inform the school officials of the ongoing risky sexual behavior by students. However, the girls’ anonymity should be maintained as the disclosure of their identity is tantamount to a breach of confidentiality. The sexual behavior is a public health concern and there is need for stakeholders such as teachers and parents to be informed. Both can join efforts in an attempt to solve the problem, if not to disclose the identity of the affected student.
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