Abstract
Ethical issues at the hospitals that prohibit nurses, doctors or any medical practitioner to disclose a patient’s personal data and information has created several dilemma cases especially if there is an exposed person who might be affected in some way if the information is withheld. This is mostly more difficult when the patient fails to willingly inform the other people especially family members or spouses and the medical practitioner is left with a choice of whether to disclose the information or just keep quite. Such scenarios where the ethical duty to disclose privacy data for the patient and the duty to care for the involved parties is in case of a genetic or hereditary diseases and cases of sexually transmitted diseases such as the Human Immune-deficiency Virus.
This paper therefore, tries to address an ethical issue of a patient, Mrs. Joan Smith with ovarian/breast cancer that is genetically defined and the disease is likely to affect the patient’s sister but she did not wish her medical issues to be discussed to any family person. This brings out an ethical contradiction since the sister is also a patient in the same hospital and by informing her, there is likelihood that she can be prevented from the disease since she has a probability of one to two in inheriting the disease.
As a nurse, it is both illegal and unethical to disclose the private information of the patient. This is because, confidentiality at the hospital is required as the patient needs complete trust with the nurse so as to open up to him/her knowing that all her health issues are confidentially kept in a safe and secure place.
According to the ELSI (Ethical, Legal and Social Issue) group which is a branch of Human Genome Organization (HUGO), has argued in the past that most patients prefer their medical information be kept private for the fear of discrimination from the society, losing their medical insurance covers and avoid discrimination at home and workplaces.
However in the case of Mrs. Joan Smith, the information is a d way of letting the patient’s sister to find out whether she already has the infection and in this way she can start an early treatment. This is mostly since she is already a patient in the hospital and hence she can easily access medical assistance. The patient does not wish this medical situation be disclosed to her sister because they are not in good terms. The sister shares similar genetic make-up as the patient and hence, she is likely to suffer from the same genetic disease.
In this case, the nurse has a responsibility of informing the sister even though it is legally unethical to disclose the information without Mrs. Smith’s consent. This is as a result of several reasons that are likely to result if this crucial information is withheld.
First, the patient’s sister is already exposed to a risk of having the genetic cancer and even though she is a patient in the hospital, she cannot be screened without first getting an explanation as to why the cancer check-up is necessary (Burke, 2006). The only explanation she can get is by being informed of her sister’s situation.
Secondly, Mrs. Smith’s personal problems with the sister have prevented her from disclosing the information to her sister on her own. This is mostly recommended that the patient inform the third party especially if they are directly likely to suffer from the situation. However she should be encouraged to do this on her own by educating her on the risks that her sister is exposed into and the importance of informing the family as early as possible (Offit, 1998). If she refuse to willingly tell the sister that she has cancer which is genetically defined, then the nurse has to practice a ‘duty to warn’ and inform the sister on the risk she is exposed into so that she can take early precautions (Harris, 2005). This is even easier since the sister is assessable to the nurse and the technology can help the exposed party prevent or cure the disease as early as possible.
Finally, the nurse should weigh the potential harm that is likely to occur if the information is disclosed. In this case, disclosing the information will affect the trust that Mrs. Smith has on the nurse and also cause emotional harm to the patient. On the other hand, withholding the information exposes the patient’s sister to the risk of developing a critical ovarian cancer which can be prevented or treated successfully if it is in early stages.
Conclusion
Despite the legal issues surrounding medical practitioners in the United States encouraging them to observe ethical issues on patient’s confidentiality, the nurse in this case has a right to violate these ethical requirements and share the information with the sister. This will enable the sister undergo medical screening for any chance of the infections and as such she can take early medical precautions.
References
Harris, M. et al (2005). Controversies and ethical issues in cancer-genetics clinics. Lancet Oncol. vol. 6 (5).
Burke, W. (2006). Genetics as a tool to improve cancer outcomes: ethics and policy. Nat Rev Cancer. Vol. 6 (6).
Offit, K. (1998). Clinical Cancer Genetics: Risk Counseling and Management. New York, NY: John Wiley and Sons.
