HLSC220: Healthcare Ethics Assessment Answers

Introduction

In society, maintaining the privacy of sensitive information is emphasised by the ethical principle of confidentiality. It mandates that people and organisations protect sensitive information in a responsible manner from unauthorised access, disclosure, or utilisation (Pietilä et al., 2020). This idea is crucial in various fields, including business, law, healthcare, and interpersonal interactions. Maintaining secrecy promotes confidence, upholds privacy, and guarantees the integrity of sensitive data. It frequently finds expression in governmental policies, business rules, and moral guidelines (Taherdoost, 2023). For example, in healthcare, it's essential for patient-doctor trust, and in business, it protects trade secrets. In order to protect individual rights and the authenticity of business partnerships, confidentiality is a fundamental social value (Pietilä et al., 2020).

Relation between confidentiality and healthcare

Healthcare confidentiality is a fundamental ethical idea that is based on the core values of medical ethics. This point of view is highly supported by compelling evidence demonstrating its crucial role in safeguarding individual rights, preserving patient trust, and assuring the delivery of high-quality healthcare (Ventura et al., 2021). Research repeatedly shows that patients are more ready to divulge sensitive information necessary for their diagnosis and treatment when they have confidence in their healthcare providers to protect their medical information (Keshta & Odeh, 2021). A study by Allison et al. (2022) indicated that patients were more open to discussing delicate subjects like substance addiction or sexual behaviour when they felt their healthcare practitioners respected their privacy. Furthermore, respecting patient privacy rights requires maintaining secrecy (George & Bhila, 2019).

Role of confidentiality in healthcare

In the first place, confidentiality promotes confidence between patients and medical professionals, establishing a setting where patients feel at ease disclosing their most private medical problems (Esmaeilzadeh, 2019). According to a study by Frik et al. (2019), people who feel confident that their medical data will be kept private are more likely to provide sensitive information, improving the accuracy of diagnoses and the quality of medical care. It also supports the idea of patient autonomy. Respecting a patient's right to manage their personal health information is consistent with moral guidelines like the American Medical Association's (AMA) Code of Medical Ethics and the World Medical Association's (WMA) Declaration of Geneva (AMA, 2023; World Medical Association, 2023). Patients should be able to make educated choices about the treatment they receive without worrying about unauthorised disclosure (Keshta & Odeh, 2021).

Confidentiality also protects against prejudice and stigma. If a person is concerned that their medical data will be disclosed without their permission, they may decide against receiving treatment for conditions that carry a social stigma (Mayer et al., 2020). According to a 2020 study by Yuvaraj et al., stigma and prejudice are major obstacles to HIV testing and care, underlining the significance of anonymity in enticing people to seek medical attention. The obligation of healthcare practitioners to safeguard patient anonymity is further reinforced by legislative frameworks like the Health Insurance Portability and Accountability Act (HIPAA) (Center for Disease Control [CDC], 2022). The serious legal repercussions that might arise from breaking these regulations highlight the importance of confidentiality in healthcare from a moral and legal perspective.

Ethical disagreements

Divergent ethical perspectives, such as absolutism, relativism, and pluralism, are frequently the cause of ethical debates in healthcare addressing secrecy. Absolutists support steadfast adherence to confidentiality, upholding its rigorous maintenance even in the face of potential harm (Sopher, 2019). A study by Reece-Nguyen et al. (2023) shows that healthcare workers who lean toward absolutism are typically less reluctant to divulge patient information, even when doing so would help others avoid injury. Relativists, on the other hand, support a case-by-case strategy, recognising the significance of context in ethical decision-making and weighing potential benefits and drawbacks before determining whether to violate confidentiality (Baghramian, 2019).

The conflict was examined in a 2020 study by Forsyth et al., showing the complex moral decisions that must be made when dealing with mentally ill people who pose a risk to themselves or others. Divergent ethical opinions on healthcare confidentiality are also profoundly shaped by cultural and legal differences (Steinmann et al., 2020). An analysis by Omer et al. (2021) indicated that cultural norms and regulatory constraints can have an impact on healthcare personnel's attitudes regarding secrecy. When stakeholders have divergent priorities—some emphasise secrecy and trust, while others emphasise preventing harm or advancing justice—ethical disputes may result.

Confidentiality and Code of Conduct

The Nursing and Midwifery Board of Australia's (NMBA) Code of Ethics for Nurses and Code of Conduct for Nurses are strongly related to the fundamental ethical principle of confidentiality. In accordance with the Code of Ethics, Standard 4 highlights the significance of offering care that respects and preserves the privacy and dignity of each individual. As it entails protecting patients' private information, preserving their privacy, and creating faith in the nurse-patient relationship, maintaining confidentiality is a clear manifestation of this ideal (NMBA, 2018). The importance of secrecy in nursing practice is specifically discussed in Standard 7 of the Code of Conduct. It mandates that nurses must uphold the confidentiality and privacy of patient medical records. Sensitive information is entrusted to nurses, and revealing it to unauthorised people is a violation of this standard and goes against both legal and ethical requirements (NMBA, 2018). Furthermore, anonymity supports the NMBA's primary goal of delivering high-standard, secure treatment. According to Standard 1 of the Code of Ethics, patients are more willing to divulge critical information when they feel confident it will be kept private. This empowers nurses to provide quality care and make educated clinical judgments (NMBA, 2018).

Conclusion

In conclusion, maintaining confidentiality is a crucial ethical concept in both the healthcare industry and society at large, as it fosters confidence, patient autonomy, and privacy rights. The intricacy of reconciling confidentiality with potential harm or public safety considerations is reflected in ethical arguments, which include viewpoints like absolutism, relativism, and pluralism. Assuring dignity for patients, trust, and high-quality treatment, confidentiality in nursing is not just a moral requirement but also a legal requirement. It is a practical requirement that is essential for making accurate diagnoses and advancing patient well-being. Preserving this fragile equilibrium between openness and protecting private information is essential for moral healthcare and considerate patient-provider relationships as society changes.

References

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American Medical Association. (2023). About. https://code-medical-ethics.ama-assn.org/

Baghramian, M. (2019, June). I—The virtues of relativism. In Aristotelian Society Supplementary Volume (Vol. 93, No. 1, pp. 247-269). Oxford University Press. https://doi.org/10.1093/arisup/akz013

Center for Disease Control. (2022). Health Insurance Portability and Accountability Act of 1996 (HIPAA). https://www.cdc.gov/phlp/publications/topic/hipaa.html

Esmaeilzadeh, P. (2019). The impacts of the perceived transparency of privacy policies and trust in providers for building trust in health information exchange: Empirical study. JMIR medical informatics , 7 (4), e14050. https://doi.org/10.2196/14050

Forsyth, D. (2020). Making moral judgments: Psychological perspectives on morality, ethics, and decision-making (p. 210). Taylor & Francis. https://library.oapen.org/handle/20.500.12657/57765

Frik, A., Nurgalieva, L., Bernd, J., Lee, J., Schaub, F., & Egelman, S. (2019). Privacy and security threat models and mitigation strategies of older adults. In Fifteenth symposium on usable privacy and security (SOUPS 2019) (pp. 21-40). https://www.usenix.org/conference/soups2019/presentation/frik

George, J., & Bhila, T. (2019). Security, confidentiality and privacy in health of healthcare data. Intern J Trend Sci Res Dev , 4 , 373-7. https://d1wqtxts1xzle7.cloudfront.net

Keshta, I., & Odeh, A. (2021). Security and privacy of electronic health records: Concerns and challenges. Egyptian Informatics Journal , 22 (2), 177-183. https://doi.org/10.1016/j.eij.2020.07.003

Mayer, L., Rüsch, N., Frey, L. M., Nadorff, M. R., Drapeau, C. W., Sheehan, L., & Oexle, N. (2020). Anticipated suicide stigma, secrecy, and suicidality among suicide attempt survivors. Suicide and Life‐Threatening Behavior , 50 (3), 706-713.  https://doi.org/10.1111/sltb.12617

Omer, S., Zakar, R., Zakar, M. Z., & Fischer, F. (2021). The influence of social and cultural practices on maternal mortality: A qualitative study from South Punjab, Pakistan. Reproductive Health , 18 (1), 1-12. https://doi.org/10.1186/s12978-021-01151-6

Pietilä, A. M., Nurmi, S. M., Halkoaho, A., & Kyngäs, H. (2020). Qualitative research: Ethical considerations. The application of content analysis in nursing science research , 49-69. https://doi.org/10.1007/978-3-030-30199-6_6

Reece-Nguyen, T. L., Tollinche, L., Van Rooyen, C., & Roque, R. A. (2023). Current challenges faced by transgender and gender-diverse patients and providers in anesthesiology. International Anesthesiology Clinics , 61 (1), 26-33. https://doi.org/10.1097/AIA.0000000000000384

Sopher, G. M. (2019). The ethics of smart pills in South Africa (Doctoral dissertation). https://wiredspace.wits.ac.za/server/api/core/bitstreams

Steinmann, G., Van De Bovenkamp, H., De Bont, A., & Delnoij, D. (2020). Redefining value: A discourse analysis on value-based health care. BMC Health Services Research, 20 (1), 1-13. https://doi.org/10.1186/s12913-020-05614-7

Taherdoost, H. (2023). Legal, Regulatory, and Ethical Considerations in E-Business. In E-Business Essentials: Building a Successful Online Enterprise (pp. 379-402). Cham: Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-39626-7_15

Ventura, C. A. A., Austin, W., Carrara, B. S., & de Brito, E. S. (2021). Nursing care in mental health: Human rights and ethical issues. Nursing Ethics , 28 (4), 463-480. https://doi.org/10.1177/0969733020952102

World Medical Association. (2023). WMA Declaration of Geneva https://www.wma.net/policies-post/wma-declaration-of-geneva

Yuvaraj, A., Mahendra, V. S., Chakrapani, V., Yunihastuti, E., Santella, A. J., Ranauta, A., & Doughty, J. (2020). HIV and stigma in the healthcare setting. Oral Diseases , 26 , 103-111.  https://doi.org/10.1111/odi.13585

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