Confidentiality and Truthfulness – Healthcare Case Study

Case One

Mary Stokes is in need of a kidney transplant, and her parents and siblings have been tested for compatibility. Her father is afraid of operations and knows that kidney trouble runs in the family. Before the test, Mary’s father tells the doctor that he does not want anyone, especially his wife, to know that he is compatible. He explains that if the family knows they will pressure him into being a donor. The father turns out to be the only one who is compatible. Mary asks the doctor, “Are you sure no one in my family is compatible?”

Is the father a patient and protected by confidentiality? Even if he is not a patient, is his explicit request, which was not refused, a protection of his confidentiality? If the matter is confidential, what can the physician say or do to protect the secret?

Sample Answer

The medical professions have a duty that come out of the association between doctors and patients. According to Moskop (2016), the principle remains that confidentiality of a patient must be safeguarded at all cost. This is because some information is sensitive and the person may want to protect their family from harm resulting from such news. However, a breach of this can result to professional misconduct that can result to a legal case. This paper analyses the case of Mary Stokes and seek to analyze if her father is protected through confidentiality, whether his explicit request a protection of confidentiality, and the action the physician can take to conceal the secret.

The father in this case is a patient as he will have to be operated to remove the kidney. However, he is afraid of the surgery and his mental condition is not set to donate his kidney. Donor selection criteria states that before someone accept to donate any part of the body, they must be physically and emotionally prepared. Mary’s father is physically suitable and the organs are compatible but he has fears and reservation making him unable to offer his kidney. The doctor has an option of either keeping this data confidential or to be truthful to Mary. There is no provision that is either legal or ethical barring the doctor from disclosing such information.

Consent is refers to an agreement to an act that is based on familiarity of actions and likely consequences(Longenecker, 2013). For explicit consent, the patient must either express it orally or in writing. Unless the disclosure of such information is in the public interest and intended to protect people from risks of serious harm like communicable ailments or harm to the patient and the third party, the doctor should uphold the confidentiality as requested by Mary’s father. The explicit request to maintain confidentiality that the doctor did not object should be maintained.

There are a number of things that the physician can do to protect the secret. The physician can disclose data that is anonymous without breach of data protection regulation or confidentiality. Also, the physician can remove the personal details of the patient’s such as age, address, name and any other information that can result to his personality identified. The data should be processed in a secure environment that has capacity and is proper for processing the information.



Case Two

Dr. Curious has a habit of wandering around the hospital and looking at the records of friends who are in the hospital. The nurses have tried to stop him, but he has retaliated by making their lives miserable and belittling them in public at every opportunity. The nursing administration has been notified but has done nothing, as it wants to avoid rocking the boat.

What are the nurses’ ethical obligations after they have done everything mentioned in the text? See Chapter 2 (Garrett). Is “not wanting to rock the boat” a sufficient excuse for the administration to do nothing further?

Sample Answer

This case study talks about truthfulness and involves a doctor who has a habit of checking the records of his friends who have visited the hospital. Dr. Curious has belittled those nurses that have been trying to stop him from this uncouth and unethical behavior. This analysis seek to examine the nurses ethical obligations after the attempt to stop him are futile. Further, it will examine if not wanting to rock the boat or causing trouble a sufficient excuse for the management not to put extra efforts to eliminate the vice.

The nurse should ensure that they limit access to records and patient’s information. This would minimize the risk of other health practitioners and Dr. Curious to breach the confidentiality policies. They should have a safe place to keep the records where they are not easily accessible. Additionally, they should report the matter to the administration for action every time such an incident occurs(Moskop, 2016).

The management should discipline Dr. Curious for practicing unethical behavior in the workplace. The management can check on the policy of the hospital on regards to confidentiality to ensure that the data is consistent with the laws. If Dr. Curios have been given warnings on this unethical behavior and he has repeated it, he should be summoned to the disciplinary committee through a written notice. The administrations should then listen to his plea before making a choice that would ensure such a behavior is not tolerated. It is the responsibility of the management to ensure that they educate the health employees on confidentiality and to ensure that they are aware of their responsibility to safeguard and keep the patient’s data in secrecy.

Rocking the rock is not satisfactory excuse for the management to take actions. They should take the necessary disciplinary action even if it means to dismiss or expel him from job. It is the responsibility of the health facility to ensure that the information about patient’s visiting is confidential.According to Longenecker(2013), the legal requirement for this process is to ensure that any process is well documented, fair, and within the confine of the law.

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