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Ethical Dilemmas in Healthcare and Education: A Comparative Analysis
Ethics Case 5
Matt S. is the nurse manager of the Coronary Care Unit. He is logged on to his computer workstation to review and update patient records when one of his patients experiences a cardiac arrhythmia. At the sound of the alarm, Matt leaves his workstation and proceeds to the patient's room to initiate treatment. Joe is in the hallway cleaning and replacing ceiling lights. When Joe sees the vacant workstation, he sits at the terminal and searches for information about his neighbor, a patient on another unit. Joe's neighbor has been quite mysterious about his medical condition, and Joe is very curious about what is wrong with his neighbor. Joe learns the truth about his neighbor's health condition and shares this information with another neighbor.
Jill P. is a School Nurse in a suburban school district. Because of a crisis during her regular work hours, she is unprepared for a scoliosis screening and education program the following day. She decides to go into her office after hours to catch up. Her daughter Susan is working on a homework assignment. She asks Jill if she can use the computer in the office because it has more sophisticated programs and a better printer than their home computer. Jill agrees to let her daughter use the computer. While Jill is setting up for the screening, Susan accesses the student database and learns that four of her classmates were recently treated for sexually transmitted diseases. Susan shares this information in the lunchroom the following day. The news spreads rapidly through the school, and one of the affected students learns that her "problem" is now common knowledge. She informs her parents, who go to the school superintendent, demanding to know how this could have happened.
Consider the following:
How are the two cases alike? How are they different? What ethical principles apply to each case? To what extent is the employing institution accountable for a breach of confidentiality? Should disciplinary action be taken? Why or why not?
Ethical Dilemmas in Healthcare and Education: A Comparative Analysis
In the given scenarios involving Matt S., a nurse manager in a Coronary Care Unit, and Jill P., a School Nurse in a suburban school district, ethical dilemmas arise due to breaches of confidentiality that impact individuals' privacy and well-being. While both cases involve unauthorized access to sensitive information and subsequent dissemination, they differ in the context and implications of the breaches. Exploring the ethical principles at play and the accountability of the employing institutions sheds light on the complexities of maintaining confidentiality and upholding professional standards in healthcare and education settings.
Similarities and Differences
Both scenarios involve individuals gaining unauthorized access to confidential information and subsequently sharing it without consent. In both cases, the actions of Matt and Susan lead to the disclosure of sensitive medical information, causing harm to the individuals involved. However, the contexts in which these breaches occur differ significantly. Matt's breach occurs in a healthcare setting, where patient information is protected by strict privacy laws such as HIPAA. On the other hand, Jill's breach takes place in an educational setting, where student records are subject to FERPA regulations.
Ethical Principles
Several ethical principles are relevant to these cases, including confidentiality, privacy, autonomy, beneficence, and non-maleficence. Healthcare professionals like Matt have a duty to protect patient confidentiality to maintain trust and ensure quality care. Similarly, school nurses like Jill are entrusted with safeguarding student information to create a safe and supportive learning environment. Breaching confidentiality violates these principles and undermines the trust essential to effective healthcare delivery and education.
Accountability of Employing Institutions
The employing institutions, whether a healthcare facility or a school district, bear responsibility for ensuring compliance with privacy regulations and upholding ethical standards. They are accountable for providing training on confidentiality policies, implementing secure systems for managing sensitive information, and enforcing consequences for breaches. In both cases, the institutions should investigate the breaches, address any systemic vulnerabilities, and take corrective action to prevent future incidents.
Disciplinary Action
Disciplinary action should be considered in both scenarios to hold the individuals accountable for their actions and deter similar breaches in the future. Matt's unauthorized access to patient records compromises patient care and violates professional ethics, warranting disciplinary measures such as reprimand, additional training, or suspension. Similarly, Susan's unauthorized access to student records and subsequent disclosure result in harm to her classmates and raise concerns about her judgment and professionalism as a school nurse's daughter.
In conclusion, ethical dilemmas involving breaches of confidentiality in healthcare and education settings highlight the critical importance of upholding privacy principles and maintaining trust with patients and students. Employing institutions must prioritize confidentiality training, implement safeguards to protect sensitive information, and take appropriate disciplinary action when breaches occur. By upholding ethical standards and accountability, healthcare providers and educators can foster environments built on respect, integrity, and professionalism.