Ethical Decision Making in Health Care

Privacy of your medical records in health care is the means used in guarding facts that clients state when seeking treatment/medication(s) when they are or they feel unwell. Data obtained in the seeking of well care usually will not be divulged unless the client gives permission for its release. There are rulings in effect and rights that clients have supporting the given of privacy of health files. Ethically and legally it has long been agreed upon that privacy in medically related associations of the physician/nurse/client, should be respected and viewed as privileged.

This assumption has been around as long as the Hippocratic Oath: “What I may see or hear in the course of the treatment or even outside of the treatment… I will keep to myself “And even today the Declaration of Geneva Oath (last updated in 1982), declares: “I will respect the secrets which are confided in me, even after the patient has died. ” The American Medical Association (AMA) declares, “The physician must not speak of confided conversation(s) or of acquired facts without the expressed permission of the patient, unless necessitated by law. ” This came about for protection of clients from gossipers and community thoughts.

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The reasons for discretion have not changed. Most of the moral concepts give importance to a person’s right of deciding matters affecting them over their life-span and in the medical data that is contained in their files regardless of findings, so we are obligated to secure and safeguard their history as pertains to health check-ups with release of health matters solely on the clients permission, by doing this we are acknowledging them as human beings of value. With that being said, it is not a totally iron clad rule, for there have been justified reasons to breach/break confidence(s), whether mandated by law or it was the right thing to do.

I believe and honor patient’s right to privacy and will keep their confidence of what is told to me within the nurse – client relationship, but, if it is a reportable subject then has to be honest and say I will report this to management, social services, and or proper authorities according to policies in place. For areas of un-certainty I would use the locus of authority framework of ethical decision making to ensure doing the right thing for the patient/client, myself and continued good standing of licensure.

When we break patient privacy there are feelings of mistrust and possible loss of respect that will have to be dealt with because breaching/breaking patient secrecy fosters mistrust of the health care professional. And clients become hesitant to reveal complete facts to medical doctors/nurses, or sometimes they won’t seek needed care, because the client (s) has to be able to rely on the discretional type of matter looked at when being examined.

Breaks in privacy are discourteous of the person’s privacy and autonomy with loss of respect and lack of trust occurring which hampers the building of a relationship between the nurse – client… Trustworthiness of doctor-client association needs deference for discretion within the association of health care personnel, the unspoken assurance of privacy is noted, as strive to gain and honor the confidence entrusted to us.

Ethical theories and principles: Normative theories and approaches deal with methods to ascertain right and wrong actions and morally praise or blame worthy attitudes and behavior. Meta-ethics deals with the why of the reasons we give for our positions. Knowledge of meta-ethics helps us gain insight into our own and others’ basis for moral judgments. Story or case-driven approaches and virtue theories, emphasize the importance of the kind of person we should strive to be. Moral distress- when a situation is blocking the agent from doing what is right.

This occurs when the moral agent knows what the morally appropriate course of action is but meets up against external barriers, internal resistance, or a high level of uncertainty. Ethical dilemmas are two or more morally correct courses of action, but, cannot follow both; only one may be chosen to bring about an outcome consistent with the professional goal of a caring response. Locus of authority problems – who should have the authority to make important ethical decisions. Deals with determining the appropriate moral agent to handle the circumstance.

Conflicts may be resolved with an analysis of who has the most expertise, the traditional practices regarding who makes what decisions, an appeal to policies, and respect for experience. We are striving to achieve an outcome consistent with a caring response. Ethical principles we use while working to obtain a caring response solution: Nonmaleficence to cause no harm, Beneficence to bring about good, Fidelity commitment, Autonomy independence, Veracity be truthful, Justice be fair, Paternalism decide for another.

The six-step process in frame work of ethical decision making: Step 1 Gather relevant and factual information – to define the problem Steps 2 identify the type of ethical problem – moral or ethical Step 3 the ethics approach to analyze and get to actual problem Step 4 explore the practical alternatives a decision of what is to be done and best approach to use, look at all options Step 5 complete the action by using one’s own conclusions about what ought to be done

Step 6 evaluate the process and outcome answer questions was it the right decision, In ethical decision making using the framework aids in a thoughtful reflection on facts garnered so a logical and workable judgment can/may be reached in circumstances that are calling for the health professional to be an agent and draw on ethical theories that focus on principles, duties and rights, or consequences as these are the tools of action.

We can use ethical theories and principles, and collaborative approaches in decision making to guide us in developing a caring response and by aiding in becoming clear thinkers and deciding on a course of action. Upon looking at different options we use the best action to benefit and protect the client who is receiving care from us.

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