Bioethics on NBC's ER

Confidentiality builds trust between health care providers and patients. There are cases when patient confidentiality is breached as defined by the law. Breaching patient confidentiality is a sign that the health care professionals do not respect the autonomy of patients. Violation of confidentiality contributes to the patients feel betrayed by the medical practitioners. Patients sensing confidentiality violation can subject the health care professionals to criminal proceedings, civil proceedings or pursue the disciplinary proceeding within the health care facility. Medical practitioners who are found guilty of breaching confidentially according to the law are subjected to the disciplinary actions by the relevant authorities.

Ethical Implications of a breach of confidentiality

There are various cases when breach of confidentiality is considered right, in this context; it is ethical to breach confidentiality. In the medical practice, there are cases when medical practitioners may breach confidentially unintentionally (Glenn, 2012). Such unintentional disclosure of patient information may occur in canteens, lifts, wards, departments, patient notes and through electronic gadgets like emailing through a computer. Confidentiality is the right of patients; some instances force the medical practitioners to breach the confidentiality; when issues circle on the interest of patients and public interest. In this context, breaching of confidentially is necessary (Saunders, 2006).

Ethical breach of confidentiality happens if the patient offers a consent; sharing of critical clinical information with other medical practitioners with the intention of improving the management of the patients, and if the patient has agreed to share the information with the family members. Medical practitioners must report communicable diseases such as tuberculosis, sexually transmitted diseases and meningitis among others (Saunders, 2006).

It is also ethical for the medical practitioners to breach confidentiality if the patient intends to harm other people, and confidentiality is also breached if the patient intends to harm him or herself. Breach of confidentiality also happens if the medical case involves traffic violations. Disclosure also happens in data protection in the health care facility and confidentiality also takes place if the patient faces complex drug reaction. Disclosure of information may happen if requested by government agencies such as tax departments among others (Glenn, 2012).

Ethical Principles

Ethical principles are fundamental in moral actions and decision making. Ethical principles are prominent to the medical practitioners in making moral judgments in the professional practice. Ethics and moral are intertwined, in the sense that moral describes the standards of behavior while ethics is defined by the study of morals. Health care practitioners value ethical principles as the patients are concerned with the morality of health and medicine (Glenn, 2012). Ethical dilemmas are common with multiculturalism and various situations. Ethical principles are attached to respect for beneficence, autonomy, justice and non-maleficence. Ethical rules are connected to confidentiality, honesty and professionalism as part of the ethical principles (Saunders, 2006).

Medical practitioners face ethical dilemmas in the line of duty; there are cases when providing good care conflicts with betraying the trust through breaking confidentiality. Medical practitioners are faced with legal responsibilities and ethical responsibilities which influence the decision making processes. Taking a critical look at respect for autonomy of the patients, the medical practitioners must respect the decisions made by competent and informed patients.

Framework of Ethical Decision Making

In addressing the Dilemma

Medical practitioners understand that breaching confidentially is ethically, morally and legally wrong unless defined by law otherwise. Carol Hathaway came across two teenagers who were not ready to be treated if confidentially was to be breached. Nurse Hathaway convinced the teenagers that confidentiality will be maintained, no matter the situation (Nathanson, 2000). Andrea, 14 years had cervical cancer and human papillomavirus (HPV). Diagnosis of Andrea and her friend are presenting a dilemma of involving the school administration and parents in the medical intervention. The students had sex parties and the students had multiple sex partners.

It is ethical to inform the school on the risk of sex parties involving multiple sexual partners. HPV is considered to be a public issue in health matters. Andrea is a minor and parents must be involved since parental consent is a prerequisite in treating cervical cancer. It is wise to counsel Andrea on the importance of informing the school and the parents (Nathanson, 2000). Hathaway should inform the school but hold the identity of Andrea; this is critical in breaking the sexual parties to curb the spread of the disease. Hathaway identified the ethical issue, gathered the facts, evaluated possible actions, made decisions, tested the decisions and acted on the decisions made.

Ethics Committee

Members of ethics committee will use ethical principles and theories in making collaborative decisions. The medical practitioners are expected to show respect, honesty and loyalty in avoiding any chances of annoying the patients. Medical practitioners must respect patient confidentiality in improving the physician-patient relationship (Nathanson, 2000). The committee will borrow from Utilitarianism ethical theory, Deontology theory, Casuist ethical theory, Rights ethical theory and Virtual ethical theory. The theories are influential in decision making processes.

Breach of confidentiality destroys the patient-physician relationships, and it is protected by law. A reasonable alternative of resolving dilemmas is requesting consent from the patients, which is part of an ethical decision making framework. The framework is critical in building trust in physician-patient relationships, which improves on the patient outcomes.