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Health Care Ethical Dilemma Analysis

Health Care Ethical Dilemma Analysis

Health Care Ethical Dilemma Analysis

Health Care Ethical Dilemma Analysis

Introduction

One of the fundamental obligations of healthcare professionals is confidentiality. Healthcare professionals should keep a patient’s confidential health information private until the patient approves sharing the information. Healthcare providers frequently receive personal information from patients. Trust in the doctor-patient relationship would suffer if confidentiality is breached. Patients would be less likely to provide private information, which might have an adverse effect on their treatment. The patient is more inclined to ask for assistance and to be as open and honest as possible during a medical visit when a trustworthy environment is established and patient privacy is respected. This paper explores confidentiality as an ethical dilemma in healthcare, the role of interprofessional collaboration in addressing the issue, ethical decisions to make in this dilemma, and how professionalism, integrity, and self-confidence can help resolve the dilemma.

The Ethical Dilemma

Patients share information with health professions to aid their healthcare process and inform diagnosis and treatment regimens. Patients expect healthcare professionals to maintain this information private and confidential and only share it with authorized individuals to third parties like family members after obtaining patient consent (Noroozi et al., 2018). However, some situations might limit confidentiality, creating an ethical dilemma where the principle of confidentiality conflicts with other principles like beneficence and nonmaleficence. An example is when an ex-husband comes to the clinic and inquires for information about his sick ex-wife, who they are co-parenting. The patient’s ex-wife is unconscious in the ICU and cannot provide consent. The ex-husband demands to know about the patient, pointing to his rights to the information because he still loves her, she was his ex-wife, the mother to his children, and they are co-parenting. The healthcare profession has to decide whether to share the information or not because the patient did not provide information about immediate family or person to share information with before undergoing the emergency treatment.

The ethical principles at risk in this dilemma

The principle of confidentiality forbids the healthcare provider from sharing patient information with third parties without the patient’s consent, and it urges providers and healthcare systems to implement security measures to guarantee that only authorized individuals have access (Noroozi et al., 2018). All team members have been permitted to access confidential information regarding the patients they are responsible for and are responsible for keeping that information safe from those who do not have access to provide patients with the appropriate treatment they need. The confidentiality of electronic medical records may face difficulties. Institutions are required by the Health Information Portability and Accountability Act (HIPAA) to establish protocols for computer access and security and policies to preserve the privacy of patient electronic data.

Confidentiality can be threatened when a family member inquires about the patient or wants to access patient records or information. The conditions for establishing an exception to confidentiality may not be met, even though there may be situations where the doctor feels compelled to provide information, for example, in response to a curious spouse or a family member. In general, it is not ethically acceptable to disclose information to family members without the patient’s express consent (Tegegne et al., 2022). The patient (and perhaps local public health officers) is still responsible for informing the spouse, not the doctor unless there is a specific potential of harm associated with the diagnosis or illness.

Additionally, unintended disclosures can also happen in several other ways. For instance, in a hurry, healthcare professionals can be tempted to talk about a patient on the escalator or another public area, yet ensuring patient privacy may not be viable in these situations. Similarly, additional copies of teaching conference handouts that include patient-identifiable information should be disposed of after the meeting to maintain patient privacy (Tegegne et al., 2022). Also, any identifiable patient information that is withdrawn from the security of the healthcare facility should be encrypted. Leaks of this nature constitute a violation of the patient’s confidentiality rights.

How the Christian worldview could be used to apply ethical patient-centered principles, values, and culture to this situation

Christian ethics, which aspires to love God and neighbor across every moral and ethical situation, is governed by God’s revelation in Scripture rather than other schools of thought. Loving God with all of one’s heart, mind, soul, and strength is the ultimate ethical obligation a person may have in Christianity. The obligation to love one’s neighbor as oneself is the second highest ethical obligation (Rheeder, 2018). In order for Christians to fulfil these moral commitments, they must submit to the principles of God’s Word and the Law of Christ. The ultimate aim of anything spoken, done, thought, and felt is to glorify God. Being a blessing to others and being a more virtuous person are two more overarching ethical objectives in Christianity (Rheeder, 2018).

The Bible cherishes secrets and forbids gossip, and God holds high the secrecy in intimate relationships with His people. The ability to have secrets and the decision to reveal them with close contacts is the foundation for confidentiality (Rheeder, 2018). People must stay silent or stick to speaking in an edifying manner in order to protect these secrets. The Old and New Testaments advocate maintaining secrets, edifying others through discourse, and disapproving of gossip (Rheeder, 2018). People should promise and commit to maintaining patient information’s confidentiality because these scriptural instructions are behavioral standards for Christian healthcare professionals, which is fundamental in addressing ethical dilemmas associated with confidentiality.

The importance of interprofessional collaboration when resolving an ethical dilemma

Interprofessional teams that actively collaborate to find, assess, and address ethical difficulties or issues to raise the standard of healthcare are how ethical challenges in the field of medicine are typically addressed. Because it enables the inclusion of all pertinent professional voices in talks about ethical principles in patient care, interprofessional collaboration is perfect for examining ethical issues (Kurtz & Starbird, 2020). Understanding the views and preferences of patients, their families, and the many professional players, such as clergymen, nurses, doctors, and therapists, is necessary to recognize ethical issues and respond to them. Engendering the opinions of all individuals engaged in making decisions, not only the client and families but also all other core professional partners, is fundamental to resolving patient confidentiality dilemmas since perspectives are widened, and solutions are myriad.

The ethical decision I would make in this dilemma

Health professionals have a moral and legal obligation to safeguard patient data from unauthorized exposure. The case established of the ex-husband demanding information about his ex-wife on the basis of loving her, being the mother to his children, and they are co-parenting is challenging because, as a healthcare professional, I would be pressed to inform someone close to the patient regarding the patient situation and treatment progress. However, the patient had not indicated someone close to share information with, and she is not awake to prove if the person presenting at the clinic is the ex-husband or if the information he is sharing is true. Therefore, I would maintain the confidentiality of the patient’s information until she is awakened after undergoing an emergency procedure that prompted her to be put in a comma for three days to fasten recovery.

How professionalism, integrity, and self-confidence all have a role in achieving a resolution in this ethical dilemma

Professionalism is among the most essential features of moral judgment and reasoning and a crucial skill for medical staff members to have alongside other technical and scientific abilities. Making healthcare decisions for patients entails being aware of ethical considerations (Kamali et al., 2019). Integrity says that rather than preaching an ideal and then acting in a way that is inconsistent with it, people should conduct themselves by ethical principles. A person’s subjective assessment of their ethical decision-making skills includes their capacity to recognize the competing values at stake, understand the expectations of their role, consider their skill and knowledge level, and assess their capacity to do the right thing in the given circumstance (Kamali et al., 2019). Therefore, professionalism, integrity, and self-confidence enhance an individual ability to make ethical decisions. For instance, in this case, I understand I have a professional duty to ensure patient confidentiality, and I need to work with integrity to uphold the principle of confidentiality and have the self-confidence to address the situation and inform the presenting ex-husband that the information cannot be shared until the patient wakes up to confirm his claims.

Conclusion

Ethical dilemmas present in many clinical situations where two or more ethical principles or personal, cultural, and religious beliefs and perspectives conflict with ethical principles and guidelines at the workplace. Confidentiality is a patient right and a professional obligation to secure patients’ information from unauthorized access. A confidentiality ethical dilemma can arise when a family member inquires about the patient’s information, but the patient has not provided consent or is not in the capacity, at the moment, to provide consent, like in the example above. In such a case, I would uphold the patient’s interest and professional and ethical duty to ensure the patient’s information’s confidentiality.

References

Kamali, F., Yousefy, A., & Yamani, N. (2019). Explaining professionalism in moral reasoning: a qualitative study. Advances in Medical Education and Practice, 447-456.

Kurtz, M. J., & Starbird, L. E. (2020). Interprofessional clinical ethics education: the promise of cross-disciplinary problem-based learning. AMA J Ethics. 2016; 18 (9): 917-924. doi: 10.1001/journalofethics. 2016.18. 9. nlit1-1609. https://journalofethics.ama-assn.org/article/interprofessional-training-not-optional-good-medical-education/2016-09

Noroozi, M., Zahedi, L., Bathaei, F. S., & Salari, P. (2018). Challenges of confidentiality in clinical settings: compilation of an ethical guideline. Iranian Journal of Public Health47(6), 875.

Rheeder, A. L. (2018). Respect for privacy and confidentiality as a global bioethical principle: Own reasons from a Protestant perspective. In die Skriflig52(3), 1-11.

Tegegne, M. D., Melaku, M. S., Shimie, A. W., Hunegnaw, D. D., Legese, M. G., Ejigu, T. A., … & Chanie, A. F. (2022). Health professionals’ knowledge and attitude towards patient confidentiality and associated factors in a resource-limited setting: a cross-sectional study. BMC Medical Ethics23(1), 26.

 
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