Answer The Questions At The End Of Each Case 289995
In Each Case Answer The Questions At The End Of The Case And Give Res
In each case, answer the questions at the end of the case and give researched references to support your assertions; also, explain what would be the ethical course of action and the legal requirements for action in the case.
Case One: Mary Stokes and Confidentiality in Family Medical History
Mary Stokes requires a kidney transplant, and her family members have been tested for compatibility. Her father, who is the only compatible donor, explicitly requests that his medical information remain confidential, fearing undue pressure from his family if they learn of his compatibility. The father states he does not want anyone, especially his wife, to know about his compatibility. He specifically tells the doctor to keep this information private.
The questions raised are:
- Is the father a patient and protected by confidentiality?
- Even if he is not considered a formal patient, does his explicit request constitute confidentiality protection?
- What can the physician say or do to protect the secret while respecting ethical and legal standards?
Case Two: Dr. Curious and Hospital Records
Dr. Curious habitually examines hospital records of friends without authorization. Despite efforts by nurses to prevent him, he retaliates by belittling them publicly, creating a hostile work environment. The nursing administration has been notified but opts to do nothing, citing a desire to avoid conflict.
The questions raised are:
- What are the nurses’ ethical obligations after their initial efforts to stop Dr. Curious?
- Is “not wanting to rock the boat” a sufficient reason for the administration to neglect further action?
Paper For Above instruction
Introduction
Confidentiality and professional ethics play a vital role in healthcare, ensuring trust between patients and providers and safeguarding sensitive information. The two cases presented highlight the complex interplay between ethical obligations, legal requirements, and institutional policies. Case One explores the boundaries of confidentiality concerning familial genetic information, while Case Two examines ethical responsibilities in institutional settings when misconduct is observed but ignored. This paper analyzes each case from ethical and legal perspectives, supported by scholarly references, and discusses appropriate courses of action.
Case One Analysis: Confidentiality and Family Medical Information
The first case involves Mary Stokes’s father, who explicitly requests confidentiality regarding his compatibility and potential kidney donation. Legally, patient confidentiality is protected under laws such as the Health Insurance Portability and Accountability Act (HIPAA) in the United States, which mandates that healthcare providers safeguard protected health information (PHI) (U.S. Department of Health & Human Services, 2020). Generally, the individual tested for compatibility is considered the patient, and their confidentiality is protected unless they give explicit consent to share information.
However, the father's status is nuanced. If he is not formally a patient (e.g., he has not been seen for medical care), the legal basis for confidentiality might be less explicit. Still, his explicit wishes can be considered a form of privacy right, and ethical standards in medicine emphasize respecting patient autonomy, including confidentiality (Beauchamp & Childress, 2013). Moreover, the physician has an obligation to honor the father's explicit request to keep his compatibility private unless there are overriding legal or ethical obligations to disclose, such as imminently saving a life or preventing harm.
In terms of what the doctor can do to protect confidentiality, they must ensure that the information is only shared on a need-to-know basis. This includes securing records and discussing sensitive information privately and only within the healthcare team when necessary. The physician cannot confirm or deny the father's compatibility to others if the father has explicitly requested privacy. If pressed by Mary or others, the physician should reinforce the father's privacy rights and legal obligations to withhold information unless legally compelled to disclose.
From an ethical standpoint, this case underscores respect for autonomy and confidentiality (Beauchamp & Childress, 2013). Legally, it aligns with HIPAA’s mandates and state laws on privacy. The physician's role is to balance confidentiality with the potential benefit of informing the patient about options, advocating for the father's wishes, and protecting his privacy.
Case Two Analysis: Ethical Obligations and Institutional Responsibility
The second case involves Dr. Curious’s inappropriate behavior in reviewing hospital records without authorization, and the resistance of the nursing administration to intervene. Nurses, as key participants in patient care, hold ethical obligations grounded in the principles of non-maleficence, beneficence, fidelity, and justice (Garrett et al., 2013). They are responsible for maintaining confidentiality and reporting unethical conduct or violations of policy.
Initially, nurses attempted to address Dr. Curious’s misconduct by stopping him, fulfilling their duty to protect patients’ confidentiality and uphold professional standards (ANA, 2015). When the administration fails to act, the nurses face an ethical dilemma. According to the American Nurses Association’s Code of Ethics, nurses are obligated to advocate for patients and protect their rights, which includes reporting unethical or illegal behavior (ANA, 2015). They should escalate the issue to higher authorities, such as hospital ethics committees or regulatory bodies, if internal reporting does not prompt action.
The administration’s refusal to act, citing a desire to “not rock the boat,” neglects their ethical and legal duty to ensure a safe and respectful environment. Indifference to observed misconduct can violate institutional policies and regulations, potentially leading to legal liability. Ethically, the avoidance of conflict undermines organizational integrity and may compromise patient safety and confidentiality.
The ethical course of action involves implementing zero-tolerance policies for misconduct, ensuring staff training on ethical standards, and establishing clear reporting mechanisms. Legally, hospitals are responsible for maintaining confidentiality and protecting staff from harassment and misconduct under employment law and healthcare regulations (Levine, 2021). Ignoring Dr. Curious’s behavior may expose the institution to legal risk and damage staff morale and patient trust.
Discussion and Ethical Recommendations
In both cases, the core values of confidentiality, respect for autonomy, and the duty to act ethically are central. For the first case, respecting the father's confidentiality aligns with both legal and ethical standards, preventing familial pressure and ensuring trust in healthcare providers. The physician should reinforce the confidentiality policy and refuse to disclose information without explicit consent.
In the second case, nurses have an ethical obligation to advocate for ethical standards and patient safety. They must continue to report misconduct through formal channels and seek external oversight if necessary. The administration’s passive stance is incongruent with their legal and ethical responsibilities, and active steps should be taken to address Dr. Curious’s behavior and prevent future violations.
Legal and Ethical Frameworks
The legal landscape, governed by laws such as HIPAA and institutional policies, mandates strict confidentiality and safeguards against misconduct. Ethically, principles of autonomy, beneficence, non-maleficence, and justice guide healthcare professionals’ actions (Beauchamp & Childress, 2013). Professionals must balance respect for individual privacy with the obligation to protect others from harm.
Conclusion
Both cases exemplify the importance of ethical integrity and legal compliance in healthcare. Respecting confidentiality, advocating for ethical conduct, and addressing misconduct are vital to maintaining trust and ensuring quality care. Healthcare providers and organizational leaders must act proactively to uphold these standards, fostering a culture of transparency and accountability.
References
American Nurses Association. (2015). Code of Ethics for Nurses with Interpretive Statements. ANA.
Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics (7th ed.). Oxford University Press.
Levine, R. J. (2021). Ethics and Regulation of Clinical Research. Yale University Press.
U.S. Department of Health & Human Services. (2020). Summary of the HIPAA Privacy Rule. HHS.gov.
Garrett, K., et al. (2013). Health Care Ethics (6th ed.). Jones & Bartlett Learning.