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Confidentiality Agreement, Essay Example

Pages: 1

Words: 710

Essay

The need to keep certain information confidential is an integral component of many different types of organizations and relationships. In the business world, for example, it is often necessary for employees of a particular company to keep product information confidential; Apple Computers Inc. is a well-known example of a company that insists on confidentiality among its employees. The need for confidentiality is also seen in the relationship between religious leaders and their followers. Nowhere, however, is the need for confidentiality more fundamental than as manifested in the doctor/patient relationship. From the start, as medical students, physicians must maintain the strictest confidence with each of their patients. This need for confidentiality can be stressful, and there are situations wherein health care professionals may feel obligated to overlook confidentiality agreements where a particular patient is concerned. The following is a first-person account of a hypothetical scenario in which a medical student is faced with a dilemma regarding confidentiality.

As medical student, I am bound by the same confidentiality rules and agreements that apply to doctors, nurses, and other health care professionals. Were I to knowingly violate a confidentiality agreement, or otherwise breach the confidentiality of a particular patient, I would be subject to expulsion from my studies and even possible legal action, both in civil and criminal court. Despite these constraints, there are circumstances where I could feel compelled to ignore such rules and agreements; one such case happened recently as I was conversing with a 22-year old patient who was about to be discharged.

I was meeting with a patient who was soon to be discharged from the hospital. The patient had been treated for some injuries sustained in a fall, including several broken bones. I was simply responsible for following up with the patient and writing up some notes as an assignment. My conversation with the patient started off normally enough; I asked him how he was feeling physically, if he was still in a lot of pain and other questions relevant to his injuries and the treatment of those injuries. The patient indicated that he was not feeling a great amount of pain, and was in fact surprisingly comfortable.

As I prepared to leave, however, the patient asked if he could confide in me, and if I would swear to keep secret what he was about to tell me. I indicated that yes, of course I would keep his information confidential. The patient then told me that his fall had not been an accident; his injuries had actually been sustained in a botched suicide attempt. What’s more, the patient told me, he planned to make another suicide attempt as soon as he was discharged.

It was clear that I had a very serious ethical and moral dilemma to deal with. I was obligated to maintain strict confidentiality with patients; this was bound by rules such as those found in HIPAA, as well as in the confidentiality agreement I had signed when I began my studies. Further, I had sworn a personal oath directly to the patient that I would not tell anyone of his secret. In this situation I had to determine whether my Hippocratic oath was stronger than my HIPAA obligations, and whether it was appropriate for me to risk the possible consequences that could occur if I did violate the confidentiality agreement.

I first considered the fact that I was not actually in a doctor/patient relationship with the patient; I was, at most, assisting the patient’s physician. I also considered the fact that even though I was not the patient’s physician, I still had an obligation to see that the patient did not come to harm. Finally, I thought, I had an obligation simply as a fellow human being to intervene. After weighing these factors, I also considered the fact that I would not actually be making the patient’s information “public;” I would simply be sharing the information with the patient’s physician; she was the one who could then decide what to do with the information.

In the end I believe I did the right thing. The matter is still open for review, however, so I do not yet know if there will be any consequences for me in terms of my education or exposure to possible litigation or other legal action.

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