Ethical Issue In The Case Of Sharni
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Introduction
This paper will discuss the case of Sharni, who is a newly graduated nurse. Sharni is working on the C5 surgical ward, where se sees Carla, who is from her mother’s group. Sharni become curious to know about Carla, even when Carla I not under her care. She accesses the Carla’s medical document without the permission of the registered nurse, who is responsible for the care of Carla. Carla has been admitted to the ward post-surgery of rupture ectopic pregnancy. After this incident Sharni posts a condolence message on the Facebook wall of Carla. Therefore, this incident has resulted in creating many legal, ethical and professional issues, as Sharni has crossed her professional boundaries, did not fulfilled the ethical and professional duties and also crossed legal boundaries expected from registered nurses. Therefore, this paper will discuss the legal issue, ethical issue and professional that occurred in given case scenario.
Legal Issue
According to the code of professional Conduct for Nurses in Australia, nurses have the legal and ethical duty to protect the privacy of the patient. According to the conduct statement 5 “Nurses treat personal information obtained in a professional capacity as private and confidential” (Code of Professional Conduct for Nurses in Australia, 2008, p. 3). Privacy and confidentiality are the terms that are used interchangeably in nursing practices. According to the legal requirement nurses have to ensure the privacy of the patient’s information, as they have the legal obligation of protecting patient information in order to protect patient’s respect and dignity (Privacy policy, 2014).
The Common wealth Privacy Act of Australia is applied for protecting or regulating the use, collection, holding and disclosure of a private and sensitive information of a person. he Privacy Act 1988 (Cth) regulates the use of personal and private information of the individuals all over Australia (Privacy policy, 2014). The health care practitioners in Australia are under the core obligation of protecting and regulating the use of personal information of a patient. The health care professional in Australia are also required to protect the private and personal information of the patient under the Health Practitioner Regulation National Law Regulation. The nurses and other health professionals have the duty of confidentiality towards the patient and breach of such duty can lead to legal consequences for the health professionals (Health Practitioner Regulation National Law Regulation, 2016). According to Health Records and Information Privacy Act 2002 No 71 (2018) also informs about the fair and responsible handling of the health information and also require the health care professionals to use such information in a way that it does not affect the privacy of an individual.
The patient confidentiality policy also informs that health professional have the common law duty of confidentiality that they owe towards the patients. The statutory duty of confidentiality is also considered under the Health Service Act (2016) (Patient Confidentiality Policy, 2016). According to the duty of confidentiality defined under the common law as well as under the statutory law, the health professional are required to maintain the confidentiality and privacy of patient information that is directly or indirectly acquired. In the given case scenario, Sharni acquired the patient information indirectly, but this does not relieve her free from the duty of privacy of patient information. The duty of confidentiality and privacy extends to every person, who come in contact with the information (Patient Confidentiality Policy, 2016).
Consent of the patient is equally important while using the patient’s personal health information. Seeking patient consent is the very significant principle that is also at the core of the healthcare practice in Australia. The consent of the patient is very important in all aspects of accessing or using information, as well as also for the providing medication or treatment. All the private health care providers have the obligation under the Privacy Act to obtain the consent of the patient or their representative before accessing their health information or health records. The healthcare providers can collect the patient information only if the patient has provided the consent or it is reasonably necessary in order to carry out some diagnosis or treatment (Australian Government, 2018). However, in the given case scenario Sharni did not obtained the patient consent before accessing her health records. Sharni breached the duty of privacy and confidentiality and also duty of obtaining the informed consent under the common law and statutory law as well. However, in the case the legal duties towards privacy and consent of the patient were breached, as neither the health information was accessed with obtaining permission nor the consent of the patient was taken before accessing he health records.
Ethical Issues
According to the study of Hao & Gao, (2017) the nurses must always ensure that they maintain the privacy and confidentiality of patient information. However, some times the nurses can use social media and post patient information that can result in breach of patient’s privacy and can also result in creating ethical issues. The study conducted by Tuckett, & Turner (2016) also identified that new registered nurses are often unware of the code of conducts, ethical principles of practice and social media policy due to which they use social media ineffectively that also affects their practice and can create ethical and legal issues. Being unaware of the ethical principles and standards of practice can result in creating ethical issues, as the nurses fail to take the appropriate actions in order to benefit the patient.
The ICN Code of Ethics for Nurses (2012) informs that respect towards the human rights must be inherent in nursing. The patients have the right to dignity and to be treated with respect. Breaching confidentiality and privacy of the patient can be considered as the lack of respect towards rights and dignity of the patient. The code also informs that nurse should hold the patient information with confidence and use their professional judgement in sharing patient information. The ICN Code of Ethics for Nurses (2012) also informs that information obtained by the nurse during the professional contact and disclosure of such information can lead to ethical issue, as it violates the right to privacy, can also cause inconvenience and embarrassment for the patient or could result in mental or emotional harm to patient or family.
The ethical issue in nursing practice can also be viewed from the perspective of bioethics. Bioethics are mainly focused on the moral issues that result in creating ethical dilemmas in nursing practice (Butts, & Rich, 2015). The first ethical principle that has been violated in the given case is the principle of autonomy. Autonomy of the patient is associated with their self-rule and obtaining informed consent. The informed consent of the patient was not obtained which resulted in the breach of patient’s autonomy and also rejected the patient’s right to self-determination. Sharni violated the ethical principle of autonomy by posting a condolence message on the patient’s Facebook wall and creating a public embarrassment for the patient.
The second ethical principle is the principle of beneficence, which states that nurses must take the actions that are for the benefit of the patients. However, taking the action against the self determination and autonomy of the patient is also considered as the violation of the ethical principle of beneficence (Butts, & Rich, 2015). Another ethical principle is non-maleficence that states that health professional must not do any harm towards patient. This also means that nurses must not take actions that can directly or indirectly harm patient. Also, the principle of justice has been violated in the given case because this principle states about using the moral reasoning before taking any actions. However, Sharni failed to comply with all the ethical principles and violation of ethical principles resulted in creating the ethical issues.
Professional Issue
The given case scenario also presents many professional issues, as the registered nurse have breached many aspects of professional conduct and did not considered the provisions under the social media policy. The NMBA code of conduct for the registered nurses inform that nurse have the responsibility of protecting the privacy of the patient. They are legally and ethically responsible to protect the patient’s privacy. Also, the code of conduct hat health information should be gathered or accessed only for the professional use (Code of Conduct for Nurses, 2018). The privacy of the information is maintained by respecting the right of the people and not releasing the obtained information till the time it is legally justifiable in the public or patient’s interest (Code of Conduct for Nurses, 2018).
Consenting to sharing the personal health records or information is the right of the patients. Patients can refuse to share their health information if they find that sharing information is not for the medical purpose (Whiddett et al, 2016). Therefore, the patient has the complete right towards privacy and confidentiality of their personal health records. Also, according to the confidentiality and privacy provision given under the Code of conduct for nurses (2018) states that nurses are required to “respect the confidentiality and privacy of people by seeking informed consent before disclosing information, including formally documenting such consent where possible” (p. 9). However, in the given case scenario nurses did not acted in he best interest of the patient and used the private information of the patient to be exposed on social media.
NMBA Social media policy and the Standard for practice also informs that nurses must abide with these professional codes to ensure that social media is being used safely and the nurse use of social media is in accordance to the obligation ethically and legally protecting the privacy and confidentiality of patient. Social Media Policy (2014) informs that healthcare professionals should be aware of all the professional codes of conduct, National Law and privacy act as well as the Advertising guidelines and use social media in accordance to them in order to display the professional behaviour. Therefore, the nurse and all other healthcare professionals are expected to comply with these professional obligations.
The confidentiality and privacy obligation has been clearly stated in the NMBA code of conduct as well as in the social media policy. However, in the given case scenario the nurse failed to comply with these obligation that resulted in creating the professional issues. The breach of duty of confidentiality and privacy can result in hurting patient mentally and emotionally. According to the study of Ward, (2017) professionalism and trust are very significant in nursing practice. Professionalism is important for providing safe and effective care to the patient, and trust of the patients enhances their confidence in care and service that is being provided. Violating the confidentiality and privacy obligation and misuse of the social media also breaks the trust of the patients in professionals and service.
Posting the unauthorized information about the patient on the social media site like Facebook is prohibited for the healthcare professionals, as it is considered as the breach of confidentiality and privacy obligation. According to the National competency standards for the registered nurse, the nurses are required to comply with the legislations ad common law requirements during their nursing practice. All the actions taken by the nurses should be aware of the legal and professional obligations and also legal implications of their actions. The nurses are required to comply with the professional responsibilities and must also be accountable for their actions and practice (National competency standards for the registered nurse, 2012).
Conclusion
This paper discussed the case study that involves nurse Sharni and patient Carla. Paper discussed the various legal, ethical and professional issues that arise due to the breach of the patient’s rights to confidentiality and privacy of information. According to the findings of the paper, it can be concluded that nursing practice is significantly based on many legal, ethical and professional principle and nurses are required to comply with such principles in order to work effectively. It is important to follow the legal, ethical and professional duties in all aspects of nursing practice in order to protect patient from harm and to promote patient’s well-being.
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