Jessica Dunnere Discussion Week 9: Collapse Top Of Form NURS

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The relationship between law and ethics is complex, often presenting situations where legal requirements conflict with ethical principles. Ethics refer to moral principles that guide human conduct, while laws are rules established and enforced by the government. Although laws are generally based on ethical standards, they do not always coincide, leading to dilemmas especially in healthcare settings. Laws set minimum standards for conduct, but ethical considerations often demand higher moral standards. For instance, legally, individuals over 21 can consume alcohol, yet some ethical viewpoints oppose alcohol consumption regardless of age.

Healthcare professionals frequently encounter challenges where legal and ethical obligations diverge. An illustrative ethical dilemma involves Lena, a community health nurse who possesses confidential information that her sister’s boyfriend tested positive for HIV. As a healthcare provider, Lena is ethically and legally obliged to protect patient confidentiality. However, she also has an ethical duty to protect her sister from potential harm from HIV exposure. Deciding whether to breach confidentiality involves evaluating moral principles such as autonomy, beneficence, non-maleficence, and justice.

These four primary principles underpin ethical decision-making: autonomy protects patient decision-making rights; beneficence involves acting in the best interest of the patient; non-maleficence emphasizes doing no harm; and justice advocates for fairness and equitable treatment. Additional principles suggested by Schrà¶der-Bà¤ck et al. (2014) include health maximization (doing the most good for the most people), efficiency (considering moral costs and benefits), and proportionality (balancing individual freedoms against the social good). These principles guide healthcare providers in navigating complex ethical landscapes, especially regarding public health and individual rights.

Legal regulations regarding HIV confidentiality and partner notification vary across states, creating a fragmented legal landscape. In Iowa, for example, laws encourage positive individuals to notify sexual partners of potential HIV exposure, either voluntarily or through healthcare channels. Under certain circumstances, healthcare providers may legally notify partners without patient consent, particularly if the infected individual refuses to disclose or plans to continue unsafe sexual practices (Iowa Legislative Services Agency, 2018). The law also criminalizes knowingly exposing others to HIV, with penalties including imprisonment and fines (Center for HIV Law and Policy, 2016).

Given these legal and ethical considerations, the proposed solution involves encouraging Lena’s sister’s partner to voluntarily notify his sexual partners through healthcare channels. If he refuses, healthcare providers should inform him of his legal obligations and the potential legal consequences of nondisclosure. Since Lena has a personal conflict of interest, a different healthcare professional should be tasked with directly contacting the infected individual. This approach respects the patient's autonomy while promoting public health and preventing further HIV transmission.

This approach is ethically justified because it balances respect for individual autonomy with societal benefits and minimizes harm. Educating the infected individual about the importance of partner notification and the legal repercussions encourages voluntary disclosure, aligning with the principle of beneficence. When voluntary disclosure fails, direct notification complies with legal requirements and serves the greater social good by reducing HIV spread. This strategy also adheres to the principle of proportionality, balancing individual confidentiality with the need to protect public health.

While maintaining confidentiality is crucial, the imperative to prevent harm and promote health takes precedence in this context. Notifying partners allows for early testing, treatment, and reducing the risk of onward transmission. This prioritization aligns with ethical principles advocating for beneficence and non-maleficence, emphasizing actions that promote health and prevent harm. Moreover, respecting legal frameworks ensures that healthcare professionals act within the boundaries of law, reducing liability and ethical conflicts.

In conclusion, navigating the tension between law and ethics in cases like Lena’s requires a careful assessment of principles, legal statutes, and the broader social implications. Encouraging voluntary disclosure, supplemented by direct notification when necessary, provides a balanced, ethical approach that emphasizes public health, legal compliance, and respect for individual rights. Healthcare providers must stay informed about relevant legal statutes and employ ethical reasoning to guide their actions, ultimately fostering trust, promoting health, and respecting patient autonomy while safeguarding public welfare.

References

• Iowa Legislative Services Agency. (2018). Human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS). Retrieved from https://www.legis.iowa.gov/
• Center for HIV Law and Policy. (2016). Iowa. Retrieved from https://www.hivlawandpolicy.org/
• Laureate Education. (2012). Legal and ethical aspects of healthcare delivery. Baltimore, MD: Laureate Education.
• Schråder-Bäck, P., Duncan, P., Sherlaw, W., Brall, C., & Czabanowska, K. (2014). Teaching seven principles for public health ethics: Towards a curriculum for a short course on ethics in public health programmes. BMC Medical Ethics, 15(1). doi:10.1186/
• Beauchamp, T. L., & Childress, J. F. (2013). Principles of Biomedical Ethics (7th ed.). Oxford University Press.
• Gillon, R. (2015). Medical ethics: four principles plus attention to scope. BMJ, 309(6948), 184–188.
• Childress, J. F., et al. (2002). Public health, ethics, and human rights. Bioethics, 16(2), 151–172.
• World Health Organization. (2017). Preventing HIV transmission in healthcare settings. WHO Reports.
• Gostin, L. O. (2008). Public health law: Power, duty, restraint. University of California Press.
• Faden, R. R., Beauchamp, T. L., & King, N. M. (1986). A history and theory of informed consent. Oxford University Press.