When is it ok to break confidentiality?
Using "Bioethics on NBC's ER: Betraying Trust or Providing Good Care? When Is It Ok to Break Confidentiality?," write a paper of 750-1,000 words in which you describe your professional position regarding patient confidentiality. 1. Explain the ethical implications of a breach of confidentiality. 2. Provide ethical theories and/or ethical principles (from among those introduced in your readings) to substantiate your position. 3. Identify a reasonable alternative to address the dilemma presented in the article using a framework of ethical decision making presented in lecture or in your readings. Explain the significance of applying this framework. 4. Explain how an ethics committee might approach the dilemma using ethical theories, principles, and a collaborative approach to ethical decision making. Prepare this assignment according to the APA 6th edition guidelines. An abstract is not required. Please include an introduction and conclusion. Do not use the I or me. Instead use either, "this nurse " or "one". Use these sites for review and references 1. Bioethics on NBC\'s ER: Betraying Trust or Providing Good Care? When Is It Okay to Break Confidentiality? Read \"Bioethics on NBC\'s ER: Betraying Trust or Providing Good Care? When Is It Okay to Break Confidentiality?\" by Nathanson, located on the American Journal of Bioethics website. http://web(dot)archive(dot)org/web/20110706061843/http://www(dot)bioethics(dot)net/articles.php?viewCat=7&articleId=133 2. American Journal of Bioethics Explore the American Journal of Bioethics website. http://www(dot)bioethics(dot)net 3. Presidential Commission for the Study of Bioethical Issues Explore the Presidential Commission for the Study of Bioethical Issues website. http://www(dot)bioethics(dot)gov 3.1. Principles • Autonomy: Would we be exploiting others, treating them paternalistically, or otherwise affecting them without their free and informed consent? Have promises been made? • Non-maleficence: Will this harm patients, caregivers, or members of the general public? • Beneficence: Is this an occasion to do good to others? Remember that we can do good by preventing or removing harms. • Justice: Are we treating others fairly? Do we have fair procedures? Are we producing just outcomes? Are we respecting morally significant rights and entitlements? • Fidelity: Are we being faithful to institutional and professional roles? Are we living up to the trust relationships that we have with others. Thinking Ethically: A Framework for Moral Decision Making The Utilitarian Approach To analyze an issue using the utilitarian approach, we first identify the various courses of action available to us. Second, we ask who will be affected by each action and what benefits or harms will be derived from each. And third, we choose the action that will produce the greatest benefits and the least harm. The ethical action is the one that provides the greatest good for the greatest number. The Rights Approach Of course, many different, but related, rights exist besides this basic one. These other rights (an incomplete list below) can be thought of as different aspects of the basic right to be treated as we choose. • The right to the truth: We have a right to be told the truth and to be informed about matters that significantly affect our choices. • The right of privacy: We have the right to do, believe, and say whatever we choose in our personal lives so long as we do not violate the rights of others. • The right not to be injured: We have the right not to be harmed or injured unless we freely and knowingly do something to deserve punishment or we freely and knowingly choose to risk such injuries. • The right to what is agreed: We have a right to what has been promised by those with whom we have freely entered into a contract or agreement. In deciding whether an action is moral or immoral using this second approach, then, we must ask, Does the action respect the moral rights of everyone? Actions are wrong to the extent that they violate the rights of individuals; the more serious the violation, the more wrongful the action. The Fairness or Justice Approach The fairness or justice approach to ethics has its roots in the teachings of the ancient Greek philosopher Aristotle, who said that "equals should be treated equally and unequals unequally." The basic moral question in this approach is: How fair is an action? Does it treat everyone in the same way, or does it show favoritism and discrimination? Favoritism gives benefits to some people without a justifiable reason for singling them out; discrimination imposes burdens on people who are no different from those on whom burdens are not imposed. Both favoritism and discrimination are unjust and wrong. The Common-Good Approach This approach to ethics assumes a society comprising individuals whose own good is inextricably linked to the good of the community. Community members are bound by the pursuit of common values and goals. The common good is a notion that originated more than 2,000 years ago in the writings of Plato, Aristotle, and Cicero. More recently, contemporary ethicist John Rawls defined the common good as "certain general conditions that are...equally to everyone's advantage." In this approach, we focus on ensuring that the social policies, social systems, institutions, and environments on which we depend are beneficial to all. Examples of goods common to all include affordable health care, effective public safety, peace among nations, a just legal system, and an unpolluted environment. Appeals to the common good urge us to view ourselves as members of the same community, reflecting on broad questions concerning the kind of society we want to become and how we are to achieve that society. While respecting and valuing the freedom of individuals to pursue their own goals, the common-good approach challenges us also to recognize and further those goals we share in common. The Virtue Approach The virtue approach to ethics assumes that there are certain ideals toward which we should strive, which provide for the full development of our humanity. These ideals are discovered through thoughtful reflection on what kind of people we have the potential to become. Virtues are attitudes or character traits that enable us to be and to act in ways that develop our highest potential. They enable us to pursue the ideals we have adopted. Honesty, courage, compassion, generosity, fidelity, integrity, fairness, self-control, and prudence are all examples of virtues. Virtues are like habits; that is, once acquired, they become characteristic of a person. Moreover, a person who has developed virtues will be naturally disposed to act in ways consistent with moral principles. The virtuous person is the ethical person. In dealing with an ethical problem using the virtue approach, we might ask, What kind of person should I be? What will promote the development of character within myself and my community?
When is it okay to breach confidentiality?
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Explain the ethical implications of a breach of confidentiality
One of the negative implications of breaking confidentiality is the fact that patients lose their trust in physicians. The loss of trust is detrimental to medical practice because patients are unwilling to provide all the necessary information because of fear that it might reach undesired parties. It is important that patients provide truthful information while seeking medical assistance to enable medical practitioners explore effective medical regimens failure to which patients continue to suffer from different conditions. Patients may at times fail to seek medical help altogether when their privacy is exposed (Nathason, 2000).
Breaking the implied confidentiality agreement between the patient and the doctor is tantamount to disrespecting the patient’s privacy. Medical practitioners are bound by the Hippocratic Oath to uphold their patient’s privacy and the patients expect them to do so. Breaking the promise of confidentiality is a violation of privacy which has negative implications that in exposing patients to undue shame or loss of certain privileges depending on the parties involved (Nathason, 2000).
There are some positive implications arising from breaking the promise of confidentiality. The law sometimes requires medical practitioners to break the promise of confidentiality when the perceived health problem poses great public health danger. Breaching the agreement to shield a larger group of people from the imminent danger of an infectious disease is a credible ground (Nathason, 2000). When physicians detect a condition that poses risk to the community they are under obligation to breach confidentiality to shield the community against possible threat to their health and overall wellbeing.
My position is that physicians require exercising courage in their profession to save as many lives as possible. Comprehensive care includes both preventative and curative care and physicians ought to give equal attention to both forms of care. Breaching confidence with the intention to save the lives of more than just one patient is justified.
Provide ethical theories and/or ethical principles (from among those introduced in your readings) to substantiate your position
This position to uphold the health of majority is in conformity with the principle of non-maleficence. The decision to breach the promise on privacy for the greater public health good considers the degree of harm that holding information would have on the general public. It is important for physicians and medical practitioners at large to have a comprehensive outlook when dealing with patients with conditions that put the patient and their associates in harm’s way and to recommend precautionary measures. This position also considers the justice principle as it applies to safeguarding the public’s right to health. Medical practitioners are obligated to safeguard the health of the public through preventative measures in the spirit of justice. This principle would guide them in making decisions to breach confidence as a fair way of safeguarding the public to known risk.
The position would als...