Intimate Partner Violence (IPV) is a sensitive topic in the society. This is because although it is one of the most common situations, it is also one of the least discussed or reported to authorities (Burkhardt & Nathaniel, 2007). This phenomenon is based on the negative perceptions of those who undergo IPV under the judgmental eye of society, associating this unfortunate situation to their physical or moral standing (Burkhardt & Nathaniel, 2007). Even though IPV rates have drastically reduced in the present society, these demeaning perceptions have still maintained their presence among those affected by IPV, for both genders.
Nurses are identified as the health professionals who spend most time with patients in healthcare settings. Therefore, they are well-versed with the patient, his/her needs, concerns, and thus act as patient advocates. As a result of the nature of their work, nurses are bound by a Code of Ethics as provided by American Nurses Association to provide guidance and reference while in the course of duty.
Identify an ethical theory and principles important to the case
Nursing ethics focuses on what is considered right and wrong in a typical patient-nurse relationship. In this case, three main concepts are involved, the patient, the nurse, and health (Cranmer & Nhemachena, 2013). Consideration of these options influence one’s decision and the ethical aspects considered in each aspect. The case study presented is an ideal situation that reflects virtue ethics. According to Yeo, Moorhouse, Kahn, and Rodney (2010), virtue ethics is based on the concept of virtue. Virtues dictate the nature of human interaction as well as communication, which precede acting purely on reason. Yeo et al. (2010), indicate that virtue ethics takes into consideration an individual’s character and disposition as opposed to the main focus on rules, duties, or one’s principles as supported by other ethical theories such as deontology. Therefore, virtue ethics in nursing is pegged on the concept that nurses act as moral agents and fulfill their functions as professionals.
Discuss your ethically bound role as a nurse caring for the client in this situation supporting your response with the ANA Code of Ethics.
The case presented provides a moral dilemma to the nurse assigned to the case. This is because she/he is expected to undertake his/her duty based on the ethical principles of autonomy and beneficence. The autonomy principle requires the nurse to respect the patient’s wishes and not impose his/her wish that contradicts the patient’s. Since the woman in question still intends to go back to her husband even after experiencing IPV, the nurse is required to respect her wish (Burkhardt & Nathaniel, 2007). According to the ANA Code of Ethics (n.d), nurses are required to advocate for the safety and rights of his/her patients and are required to act in the best interest of the patient as in the case of the beneficence principle. Therefore, since IPV threatens the patient’s life and also goes against virtues, the nurse would best bring the matter before the relevant authorities. Therefore, this situation presents an ethical dilemma for the nurse.
Analyze how the issue may influence health care decisions both ethically and legally.
Ethically speaking, nurses are required to maintain confidentiality in all dealings with the patients. Since the patient-nurse relationship is founded on trust, breaching of confidentiality would destroy this foundation. According to ANA (n.d), nurses are required to refrain from inappropriate disclosure of sensitive information provided by patients. Therefore, in the case presented, the nurse would be bound to refrain from informing the patient’s spouse of her HIV status. This is because the patient indicated she would disclose to him this information at her time of her own choosing. Therefore, going against the patient’s wishes would be paramount to breaching confidentiality, which goes against the Code of Ethics.
On the other hand, legally speaking, it is also the role of the nurse to disclose information that can be potentially harmful to innocent parties. According to ANA (n.d), the concept of confidentiality is not absolute and its application varies in various instances. Therefore, the duties of nurses in regards to confidentiality may be modified in instances where public health may be compromised, hence requiring mandatory disclosure (Yeo, Moorhouse, Kahn, and Rodney, 2010). In regards to the case study, the nurse would be exempted from breaching confidentiality on legal grounds, as disclosure of the patient’s HIV status to her partner is pertinent in protecting innocent lives. This is based on the assumption that the patient’s husband is HIV negative and her lack of disclosure of her status would amount to endangering his life. Furthermore, if this disclosure is not made, this situation becomes a public health issue, as the disease can be transmitted sexually by infected persons. Therefore, the nurse’s decision to inform the patient’s husband would not harm her in any way, legally speaking, as her decision would be protected by the above provision.
Compare and contrast your initial response with your response after analyzing the scenario
My initial response prior to reading the case study would have been to allow the patient inform her husband at her own time. This approach would have ensured compliance with the autonomy principle (Cranmer & Nhemachena, 2013). However, after reading the case study, the prior decision would have been difficult to make. In this case, being a victim of IPV and later finding out she is HIV positive has created hurtful feelings for the patient as she may feel betrayed, going by her account. Therefore, this situation may create vengeful feelings towards her husband for infecting her, subjecting her to IPV and causing distress and suffering to her children. In this case, she may decide to retaliate by not informing her husband. In this case, as opposed to the response proposed above, I would adopt a legal standing and choose to notify her husband of the patient’s HIV status. This is because the situation is a public health issue.
References
American Nurses Association (n.d). Code of ethics for nurses with interpretive statements. Retrieved from https://courseweb.pitt.edu/bbcswebdav/institution/Pitt%20Online/Nursing/NUR%202008/Module%2001/Readings/ANA_ethics.pdf
Burkhardt, M. A., & Nathaniel, A. K. (2007). Ethics and Issues in Contemporary Nursing (3rd ed.). Clifton Park, NY: Delmar Cengage Learning
Cranmer, P., & Nhemachena, J. (2013). Preparing for nursing ethical practice. New York: Elsevier Publishers.
Yeo, M., Moorhouse, A., Kahn, P., & Rodney, P. (2010). Concepts and cases in nursing ethics. New York: Broadview Press.
