Overview-
Public health ethics rests upon a set of general moral considerations (GMC’s) that have been widely discussed in literature, and utilized in the practice of public health decision-making. Your text identifies nine GMC’s; however, goes into detail about the first five- producing benefits; avoiding, preventing, and removing harms; utility; distributive justice/procedural justice; and respect of autonomous choices and actions.
Instructions-
For this assignment, you are to explore the ethical issue/dilemma you chose from Supportive Submission 1, then complete the following:
1. Discuss how each of the five GMC’s listed above may or may not apply.
2. Identify any current and/or future political, legal or economic challenges as they relate to the ethics of public health practice and/or health care delivery.
3. Hypothesize potential solutions to the ethical challenges through utilization of appropriate GMC’s.
This assignment is expected to be 3 pages at minimum.
Reference: Bernheim, Childress, Melnick, & Bonnie. (2013). Essentials of public health ethics. Burlington, MA: Jones & Bartlett Learning.
ISBN-13: 978-0763780463, ISBN-10: 0763780464 and the attached essay.
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When should “Breaching of confidentiality” be allowed
Julie Thenethaysong
California Baptist University
HSC210: Ethics in Health Care
Dr. Dominick L. Sturz
11/06/2022
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When should “Breaching of confidentiality” be allowed?
Breaching confidentiality implies knowingly breaking the rules of retaining a client’s
private information and sharing it with a particular third party with or without their consent.
While there are areas of conflict regarding the circumstances necessitating a breach of
confidentiality, most professionals agree that an exception arises when there are concerns
regarding public health or third-party safety (Noroozi et al., 2018). This general perspective
places third-party and public health safety as priority aspects to consider above a single client
when information regarding the client endangers either. For example, revealing information
about a patient who confesses plans to bomb a hospital or perform another action that would
threaten an identified third party or the public health system would be understandable and
acceptable. However, opponents to the breach of confidentiality do not see any circumstances
where confidentiality breaches are necessary because any violation is a betrayal of patient trust.
They support the client’s resort to available grievance alternatives, including pursuing criminal
proceedings and seeking patient compensation through civil suits and disciplinary measures by
the relevant healthcare committee (Ministry of Ethics, n.d.). Therefore, it is essential to
determine circumstances that justify confidentiality breaches in the healthcare industry and why
it is crucial to understand this issue.
Given its significance, confidentiality can cause healthcare professionals to second-guess
themselves as they continue to face situations where they may need to breach confidentiality
(Bernheim et al., 2013). Noroozi et al. (2018) provide four situations where confidentiality
violations are acceptable. First is when the professional receives an authorized request from legal
sources such as law enforcement, the judiciary, criminal systems, or tax inspectors. Another
circumstance where confidential violations are acceptable is when the healthcare professional
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observes that the patient’s best interests necessitate such disclosure. The third circumstance is
when sharing private information helps promote societal welfare. Fourthly, the necessity of
breaching confidentiality becomes apparent when it would ensure a third party’s safety.
Additionally, healthcare professionals can breach confidentiality when encountering
patients with notifiable diseases such as meningitis, Ebola, Tuberculosis, and others (Ministry of
Ethics, n.d.). Another situation that may necessitate breaching confidentiality is when the
healthcare professional deems it necessary to inform family members of a patient’s medical
situation because it might injure the patient’s health. For instance, when the patient has been
diagnosed with a terminal disease. It is also permissible to share information with other staff
members as part of an interdisciplinary collaboration effort to assist in patient management
(Ministry of Ethics, n.d.). However, in cases where the patient denies the healthcare professional
consent to discuss confidential information with peers, they may need to convince the patient to
grant consent to enable assessment, disease management, and treatment procedures. While
healthcare professionals may breach confidentiality under these circumstances, they must
carefully adhere to all federal, state, and healthcare industry regulations and guidelines.
Ethical and legal considerations associated with a breach of confidentiality connect to the
necessity of upholding confidentiality rules to protect patients. One of healthcare professionals’
most vital ethical responsibilities is to protect and maintain their client’s confidentiality.
Confidentiality is critical to healthcare because it assures clients that their information is
safeguarded from unsanctioned disclosure, use, access, loss, or modification. Confidentiality
aligns with privacy because treating information intimately empowers the healthcare professional
to prevent unnecessary third-party interference or intrusion. Healthcare professionals should
safeguard client information to build a trusting relationship that defines the interactions between
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both parties. When patients or clients sense that they cannot trust their healthcare professional
with their private information, they may be tempted to withhold essential information that may
enable assessment and treatment procedures. Opponents of breaching confidentiality for any
reason find that breaches of confidentiality are common ways of disrespecting or negating the
patient’s importance as a healthcare organization’s client and as a human. Common breaches in
the healthcare environment happen during discussions in lifts and canteens between healthcare
professionals, inwards, and in accidents & emergency departments where healthcare
professionals discuss patient information near patient families (Ministry of Ethics, n.d.).
Additionally, nurses and physicians may unwillingly send patient information to the wrong
recipients or leave notes in plain view of other third parties, including patients or fellow staff
members. Therefore, healthcare professionals must understand their responsibility to patients and
safeguard their confidentiality at all costs.
In conclusion, the breach of confidentiality is essential to discuss now because recent
cases have shown that some healthcare professionals are unaware of when it is appropriate to
breach confidentiality. For instance, a case titled Lena v Iowa Board of Nursing discusses the
case of a nurse who accessed patient census lists over 11 times while out of work, leading to
disciplinary measures and a 24 hours suspension to enable her to recite the Health Insurance
Portability and Accountability Act (HIPPA) module (Brent, 2019). Such a case highlights the
problem that healthcare professionals face in adhering to confidentiality laws and determining
when they can breach them. Therefore, it is essential to understand the circumstances allowing
the breach of confidentiality.
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References
Bernheim, R. G., Childress, J. F., Melnick, A., & Bonnie, R. J. (2013). Introduction: A
Framework for Public Health Ethics. In Essentials of public health ethics. Jones &
Bartlett Publishers.
Brent, N. J. (2019, December 4). RN breaches patient confidentiality policy to check work
schedule. Nurse.com Blog. https://www.nurse.com/blog/rn-breaches-patientconfidentiality-policy-check-work-schedule/
Ministry of Ethics. (n.d.). Consequences of breaching confidentiality – Ministry of ethics .co.uk.
Ministry of Ethics .co.uk – An online resource for learning Medical Ethics and
Law. https://ministryofethics.co.uk/index.php?p=6&q=7
Noroozi, M., Zahedi, L., Bathael, E. S., & Salari, P. (2018). Challenges of Confidentiality in
Clinical Settings: Compilation of an Ethical Guideline. Iranian Journal of Public
Health, 47(6), 875–883. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077627/