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Applying Ethical Frameworks In Practice

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Nursing has a well-known history of concern and interest for the welfare of the sick, injured and vulnerable for social justice. Nursing incorporates prevention of illness, reducing suffering, and the protection, promotion, and renovation of health. Ethics is been an essential part of the basis of nursing and it is self-reflective, enduring and distinctive. In the professional course, a nurse encounters with different types of patients, several types of families and varied situations.

Every patient has certain rights and a nurse has to respect them in both legal and ethical aspects. Confidentiality is important to create confidence between nurses and patients. Without promising privacy to their matters, patients will be hesitant to share important information to health care professionals which may be necessary for their care. Respecting patient’s confidentiality is a legal requirement and also a professional, ethical and legal duty. By law, breaching confidentiality may end in unlawful condemnation and punishments

The moral consequence when breaking confidentiality is loss of client, loss of reputation, loss of revenue, and breaking of moral, lawful and moral obligations. A credulous bond between nurses and patients will improve patient satisfaction and will help patient to disclose even the most sensitive information which will help in their treatment and care. This will also improve adherence to medical management plans in almost all age groups and in all varied situations. Patients have the right to anticipate privacy of their medical records and all data and information related to their care and doctors and nurses have a legal obligation to break confidentiality when it is truly and ethically necessary. Conserving confidentiality in all situations is not a definite obligation for nurses.

In some circumstances, other moral obligations may force us to breach confidentiality.”Some laws mandate disclosure of confidential information even though an individual may be harmed by the disclosure. The intent of the law is to promote a public good or prevent a public harm that outweighs the individual’s right to keep their information private.”(Administrative Ethics and Confidentiality/ Privacy Issues, 2011, para.23). Grounded on the assigned reading, promotion of public health, preventing public harm and protecting the patient himself are more high ranking ethical priorities than preserving confidentiality.

Ethical principles are policies that can be related to situations or conditions in order to conclude if they are ethical or non ethical in nursing practice. Based on the article Bioethics on NBC’s ER: Betraying Trust or Providing Good Care? When is it ok to break Confidentiality?, Nurse Hathaway broke confidentiality of her patient by sharing the information. Utilitarianism is suitable to relate to this setting. This theory says that the morality of a situation depends upon its outcome. In the reading which is assigned, the Nurse revised the obligations of confidentiality by violating the guarantee she had assured, to save the patient and other people who are guiltless. By telling patient’s (Andrea’s) parents, Hathaway broke the trust the patient had in her. From my view, Hathaway did the ethically right thing because the outcome of her action will stop the spread of the disease, will protect the innocent people around her and is also compliant with the treatment regimen. Reporting the girl’s unsafe actions to the school was a poor judgment from the nurse, as the outcome was not positive.

The knowledge on making ethical decision can be acquired by considering underlying ethical beliefs, ethical concepts, a model for decision making and the code of ethics for nurses. When nurses have to break a promise, dilemma of reliability occurs. In the assigned reading, the nurse breached confidentiality by not keeping her promise to her patients. When applying Uustal’s framework, nurses must use suitable reports and information to enhance patient care and to accomplish desired outcomes in patient. This model describes”step –by –step processes that are linear in nature not reflecting the potential for an evolving perspective” (Burkhardt & Nathaniel, 2008, p.128).

In every step, questions are given to nurses which enable them to acquire all the data essential to help the healthcare team and the patient in the process of decision making. Another realistic substitute to tackle this dilemma centered on the Uustal’s framework would be to include social workers in the case and notify authorities of school about the ‘sex parties’ without revealing the girl’s identity. Obtain permission to educate and warn students on different subjects like STD’s, its spread, HPV and cervical cancers.

In the clinical field, nurses face many ethical dilemmas. In some circumstances where there are issues in decision making, and there is ethical dilemma, the ethics committee can help to come to an agreement. Ethical committee has members from different educational background, diverse experiences, and distinctive lookouts from the internal and external aspects of health care. They also have common people from the community. When faced with very challenging ethical issues, the members associate together to give suggestions which will support patient’s rights and encourage common decision making. Ethics committee has extensive power to make decisions at the bedside and they also have the power to influence a jury or judge during any issues regarding patient rights.

In an interpersonal relationship between a nurse and a patient, confidentiality is always embedded. Confidentiality, which is an ethical principle, is a right of the patient. Nurses have a loyalty to the patients and to the society, especially in situations where abuse is suspected and in STD’s. Maintaining confidentiality is not a firm obligation of nurses in every situation they face. In some occasions, other ethical considerations take priority over the safeguarding of confidentiality in clinical settings.


Administrative ethics and confidentiality/ privacy issues. (2011). ANA, 3(1091-3734). Retrieved from http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol31998/No3Dec1998/PrivacyIssues.aspx

Burkhardt, M. A., & Nathaniel, A. K. (2008). Ethics and Issues in Contemporary Nursing (3rd ed.). Australia: Delmar-Thompson Learning.

Nathanson, P.G., (February, 24, 2000). Bioethics on NBC’s ER: Betraying Trust or Providing Good Care? When is it ok to Break Confidentiality? Retrieved from http://www.bioethics.net/articles.php?viewCat=7&articleId=133

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