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Examination of the Ethical Dilemma
The accessibility of electronic health record data leads to an ethical dilemma related to the responsibility of medical staff to protect patients from possible violations of their confidentiality. Many patients are very concerned about the insecurity of the system. The main question is whether a secondary use of personal information is acceptable or not, and which protective measures have to be applied. The plan of action that will satisfy patients should include additional services which can guarantee their confidentiality. On the other hand, medical organizations do not have resources to maintain such services, and they assure patients that the current system is secure.
First, it is necessary to explain to patients the importance of the current system and demonstrate its security mechanisms. Second, the expenditure on additional services should be divided among all parties. The third alternative is to engage governmental agencies to facilitate this process. The best-case scenario is the improvement of the current system. The worst-case scenario is unnecessary costs and the overloading of the system. However, advantages of such solutions outweigh their drawbacks. In addition, the system could continue performing even in case of the worst consequences. Under such circumstances, no one will be significantly harmed, but the system could become a bit unstable. However, if these solutions work out, there will be no risk to anyone.
The utilitarian approach should be applied in this case as it allows determining potential benefits and harms of each course of action. This approach generates converging conclusions regarding what has to be done. There are several moral principles that can be brought into play to guide the implementation of the plan. These are honesty, trustworthiness, and loyalty.
Evaluation of Alternatives
The first alternative might be very effective and the least expensive. However, it implies certain ambiguity as patients could not comprehend the practical value of the existing system and trust its security mechanisms. Hence, it might lead to some debatable issues, for example, the reliability of the current system. The reasoning for the first alternative might be rated 3 (McGonigle & Mastrian, 2014). The second alternative requires much more additional resources, and it makes the existing system more complex. However, it does not imply any questionable issues. Therefore, it might be rated 4.
The third alternative is the least effective as it involves a third party. The confidentiality of patients is exposed to additional risks in this case. Therefore, it might be rated 1. These alternatives correspond to values of the key players as patients require safety and medical organizations – additional resources. Therefore, each alternative considers interests all of the key players. However, the second alternative is more likely to be the most successful. Also, these alternatives are supported by the main principles of my professional code of ethical conduct: integrity and concerns for others.
The Best Alternative
In my opinion, the best alternative is to establish additional services that will guarantee the patients’ confidentiality, but split expenses among all parties equally. This decision takes into account interests and concerns of all of the key players and minimizes potential risks for them. My opponents might argue the unfairness of such a decision as patients need to pay additionally for their confidentiality. However, I believe that it is worth it because in the most effective solution in the long run. Therefore, I would feel secure if my ethical decision-making process was sent out globally, and the closest people in my life will observe it.
The plan should be implemented in several stages. First, it is necessary to assess financially the design and maintenance of additional systems that ensure the confidentiality of patients. Second, representatives of medical organizations should negotiate these expenses with the key players. Third, the plan should be corrected according to the results of negotiations. The final stage is the implementation of the plan.
It is necessary to monitor the implementation of the plan at all stages. Also, outcomes should be prudently evaluated. Conclusions based on the evaluation should be used to revise the plan if necessary.
McGonigle, D., & Mastrian, K. (2014). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones & Bartlett Publishers.