Breach of Patients Confidential Information, Essay Example

Introduction

In patient care, nurses must conform to a number of legal and ethical obligations in their professional practice, including the need to maintain a patient’s confidentiality and privacy. In Australia, the legal and ethical obligations apply in the areas of state regulation, hospital policies, as well as the federal law (Pitts, 2008). The objective of these obligations is to protect the confidentiality, privacy and general well-being of the patient (Erickson & Millar, 2005). Nurses are usually privy to patient’s confidential information while undertaking their nursing practice. They may, therefore, face an ethical dilemma regarding whether to disclose the patient’s health information. This essay explores the standards regarding handling patient’s privacy rights and confidential information in nursing care.

Central ethical and legal issue

As indicated by the evidence in the case study, the central issue is whether the Registered Nurse (RN) breached her legal and ethical obligations by accessing the male patient’s medical files and informing the patient’s girlfriend. The nurse is a friend to the patient’s girlfriend and wanted to inform her that his boyfriend was being treated of a sexually transmitted disease.

Legal obligations

The Health Records Act 2001 also requires that the personal information of a patient requesting a test be kept private. In addition to the Health Records Act 2001, the Privacy Act 1988 provides the patients with privacy rights, whether they are treated in private or public hospitals (Fitzroy Legal Service, 2015).

Based on the evidence the case provides, it is clear that the nurse has breached the Privacy Act 1988, which provides patients with privacy rights. The privacy rule is intended to protect patient’s health information, including their past, present or future health conditions (Erickson & Millar, 2005).

According to the Privacy Act 1988, a healthcare professional has an obligation to protect a patient’s confidential information unless the law requires that she disclose the information (Erickson & Millar, 2005). In the case study, since the Registered Nurse was not obligated by the law to supply the information on the patient’s status to his girlfriend, it could be argued that she breached the Privacy Rule (Erickson & Millar, 2005). The other exception is that a nurse may disclose the information when the patient permits it or when the information is needed to provide treatment to the patient. This is to allow information flow needed for the treatment of the patient while making sure that the wellbeing of the patient is upheld (McGowan, 2012).  In which case, the patient’s consent should be sought before his confidential information is disclosed or when the situation provides the patient with an opportunity to decline or agree (Carey, 2012). On the other hand, when a patient is in an emergency, the nurses may disclose the confidential information if it is to the patient’s own best interest.

However, in the case study, none of these exceptions applies. For instance, the patient was not in an emergency. Additionally, the patient’s consent was not sought to make the disclosure to his girlfriend, and lastly, the information was not disclosed in the best interests of the patient, especially since the RN was not even involved in his treatment. In Erickson and Millar’s (2005) view, the privacy section of the Privacy Act 1988 and the Health Records Act 2001 limit those with access to the health information of the patient, as well as how they should use it. The information may only be used for treatment of the patient, acquiring payment for the patient’s care as well as for medical purposes, including the need to improve the quality of care. Additionally, the healthcare providers are obligated to notify the patient in writing regarding how their health information will be used, such as by creating systems that allow patients to monitor disclosure, and allowing patients to review and change amend their personal health information.

Ethical obligations

Code of Ethics for Nurses in Australia specifies the Code of Professional Conduct for Nurses in Australia. It specifies the minimum standards for nursing practice that any nurse should uphold in the nursing profession. The Code requires that a nurse had both legal and moral obligation to protect any confidential information they learn regarding the patient. The code of ethics for Nurses in Australia is the standard by which nurse’s ethical conduct is directed and assessed. The relevant ethical duties for the present case scenario include protecting the private health information. Under the Code, the nurses are obligated to promote and maintain patient’s rights by protecting their privacy. The Code also demands that the patient’s confidentiality be maintained (Australian Nursing and Midwifery Council, 2008).

The nurses have to protect the right to privacy. However, in the case study, the RN breached her ethical obligation by failing to protect the patient’s private information. The RN’s decision to inform the patient’s girlfriend that the patient was being treated for a STD, just because they are friends, did not justify unwarranted intrusion into the privacy of the male patient. The Code of Professional Conduct for Nurses in Australia requires that the nurse should advocate for an environment that offers adequate physical privacy, as well as practices that protect the patient’s confidential information.

When it comes to confidentiality, the Code states that nurses are obligated to uphold the confidentiality of patient information. This is since the health of the patient may be put at risk and the elemental trust between the health care providers and the patient damaged by uncalled for access to the information or by the inapt disclosure of the patient’s information (ANMC, 2011). The Code posits that the safety and general wellbeing of the patient should be given priority as the primary factors that assist in arriving at any professional judgement regarding disclosure of the patient’s confidential information, whether electronic, written or oral. However, the case study provides evidence suggesting that the RN was not involved in the treatment of the patient. Therefore, the nurse did not consider the safety and general wellbeing of the male patient as the primary factors that assisted her to arrive at a professional judgement regarding disclosure of the patient’s confidential information to his girlfriend.

On the other hand, the standard of nursing practice demands that relevant information only be shared among those members of the healthcare team taking part in the patient’s treatment. Additionally, only the information relevant to the treatment of the patient should be disclosed, and strictly directed to those taking part in the treatment of the patient (Dudley, 2004). In the case study, the RN was not a member of the team taking part in the patient’s treatment (ANMC, 2011). Therefore, her decision to access the patient’s medical files to extract the information with the view of informing the patient’s girlfriend regarding the confidential information was unethical. Hence, the RN’s actions showed that she failed to uphold, advocate and protect the male patient’s privacy rights and the doctrine of confidentiality or even protect the patient privacy and confidentiality within the restrictions of the law.

Conclusion

From the discussion, the central issue is whether the Registered Nurse (RN) breached her legal and ethical obligations by accessing the male patient’s medical files and informing the patient’s girlfriend. Therefore, since the Registered Nurse was not obligated by the law to supply the information on the patient’s status to his girlfriend, it could be argued that she breached the Privacy Act 1988 and Health Records Act 2001. The Privacy Act 1988 expects the healthcare professional to protect a patient’s confidential information unless the law states otherwise. RN also breached her ethical obligation accessing the patient’s information without permission and disclosing the information to the patient’s girlfriend. The code of ethics for Nurses in Australia is the standard by which nurse’s ethical conduct is directed and assessed. It specifies the Code of Professional Conduct for Nurses in Australia. Under the Code, the nurses are obligated to promote and maintain patient’s rights by protecting their privacy. The nurses have to protect the right to privacy. However, in the case study, the RN breached her ethical obligation by failing to protect the patient’s private information. It is, therefore, important to note that, in Australia, the legal and ethical obligations apply in the areas of state regulation, hospital policies, as well as the federal law.

References

Australian Nursing and Midwifery Council (2008). Code Of Professional Conduct For Nurses In Australia. Retrieved: <Retrieved: <http://www.nursingmidwiferyboard.gov.au/documents/default.aspx?record=WD10%2F1353&dbid=AP&chksum=Ac7KxRPDt289C5Bx%2Ff4q3Q%3D%3D>

Carey, C. (2012). Protecting Patient Privacy: Strategies for Regulating Electronic Health Records Exchange. New York: New York Civil Liberties Union

Dudley, G. (2004). Electronic Records, Patient Confidentiality, and the Impact of HIPAA. Patient Safety. Retrieved: <http://psqh.com/octdec04/dudley.html>

Erickson, J. & Millar, S. (2005). Caring for Patients While Respecting Their Privacy: Renewing Our Commitment. Online Journal of Issues in Nursing 10(2)

Fitzroy Legal Service (2015).Privacy and Confidentiality. Retrieved: <http://www.lawhandbook.org.au/handbook/ch19s01s04.php>

McGowan, C. (2012). Patients’ Confidentiality. Critical Care Nurse 32(5), 61-64

Pitts, J. (2008). The Importance and Value of Protecting the Privacy of Health Information: The Roles of the HIPAA Privacy Rule and the Common Rule in Health Research. Retrieved: <http://www.iom.edu/~/media/Files/Activity%20Files/Research/HIPAAandResearch/PrittsPrivacyFinalDraftweb.ashx>