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Privacy and confidentiality ( health care ethics)

Privacy and Confidentiality One of the ethical rules that healthcare practitioners should keep in mind is maintaining the patient’s privacy and confidentiality. The healthcare system and the patient have long had the relationship of trust and confidence. The patient places trust in his or her medical practitioners and relies on that practitioner to respect that trust. The medical profession have traditionally pledged themselves to uphold such an ethic. The Hippocratic Oath, for example, provided: “ Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret” (as translated by Francis Adams).
Why is it appropriate that the healthcare practitioners to keep mum over the medical conditions of patients? It just makes practical sense that medical professionals should uphold the confidentiality of their clients. This is because in the clinical setting patients are expected to fully disclose their habits, their ailments, their strengths, and their weaknesses. Beyond this, they are frequently required to undress and allow physicians access to their bodies for examination, treatments, and surgery. Thus, the patient is vulnerable, needy, and prone to feelings of shame. Patients endure these experiences because they want to be treated for what ails them and because they trust their physicians to keep their secrets. If this trust were eroded, it might follow that patients would become unable to seek medical attention or they will be hesitant to disclose some information that is vital for their treatment.
Most often, dilemmas arise when medical practitioners should or should not disclose patient information. For, example, confidentiality is regarded as crucial by those involved in the care of mentally ill or emotionally disturbed patients. A stigma has traditionally surrounded those with mental disorders. This is why the preservation of confidentiality is necessary to ensure that patients are prepared to come forward for treatment and that they continue with treatment. Patients require that assurance. They do not want the risk of becoming the butt of cruel jokes and being socially ostracized.
Another example, in family research, is that when both the husband and wife may report on sensitive topics such as his and her own and the partner’s extramarital relationships, marital aggression, or alcohol use. Margolin et al. (2005) revealed that the “ standard safeguard for discomfort in revealing sensitive information is that participants can choose not to answer any question without prejudicial consequences, is of limited applicability with cross-informant data”. Another dilemma is that a “ child might disclose a parents physical child abuse or substance abuse without understanding possible consequences”.
This is why, in respect to healthcare ethics, the principle that confidentiality should characterize this relationship with the patient dictates the norm that only under the most extraordinary and exceptional conditions may a physician disclose privileged information. An extraordinary, exceptional case would be that involving a psychiatrist who becomes aware that his or her patient is plotting to murder someone. In such a case confidentiality may be breached as the psychiatrist’s duty to protect an innocent person from harm supersedes her duty to respect his or her patient’s confidence. Law enforcement personnel must be informed in order to prevent a murder.
Recently, another threat to patient privacy and confidentiality arose when patient records are being entered onto computers. At the present time, hospital administrators, legislators, providers of managed care, and patient advocacy groups are considering ways of how to safeguard computer files which contain the most private and personal information possible, individual’s medical data.
Thus, confidentiality is a complex matter requiring decency and discretion in all cases, and, in some hard cases, difficult judgment calls. The decisions we make about patient privacy and confidentiality determine whether or not we become people of integrity. In addition, the ethical standards which our society encourages influence our communal identity, for good or for bad. Therefore, it goes without saying that the importance we place on understanding and implementing ethics in the medical profession will have profound and far-reaching impacts.
Reference
Margolin, G., Chien, D., Duman, S. E., Fauchier, A., Gordis, E. B., Oliver, P. H., Ramos, M., & Vickerman, K. (2005) Ethical Issues in Couple and Family Research. Journal of Family Psychology, 19, 157-167.

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