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Competency- related scenario
In health care practice, there are a large number of young adults and older adolescents. During some instances, patients request that their information be kept confidential. This is particularly experienced when treating young adults. During one case, a practitioner encountered with a nineteen-year-old lady, who was suffering from depression. Moreover, the lady had a binge- drinking history, as well as escalated suicidal thoughts. The lady confided in the healthcare professional that she had not acted on, or told any member of the family about the suicidal thoughts. The lady believed that revealing this information would hurt the family members. The practitioner was extremely concerned about the lady. The mother brought the lady frequently for her appointments. The practitioner was aware that discussing the issue with the mother could be beneficial to the lady, and may help her address the underlying causes. Consequently, she would heal faster.
The practitioner was also aware that the underlying causes could be based on the family. The practitioner was, therefore, in a dilemma since the patient had warned him against informing the family. A practitioner’s friend told him that he could not reveal the patient’s issues to the family, as a result of privacy legislation. The practitioner became more confused and wondered if remaining silent was the correct thing. He asked how he could safeguard the patient’s safety. One morning, and amidst these deliberations, the practitioner received information that the patient had overdosed herself the previous night, and had been brought into an emergency. She had to be admitted to the Intensive Care Unit. This made the practitioner deeply traumatized as he blamed himself for failing to inform the family.
Steps for Embracing Ethical practices
To make ethical decisions, the practitioner should first identify the moral issue. He should consider whether the situation might harm those involved. The second step is acquiring facts. The practitioner should search for adequate events, which will ensure the most appropriate decision. While learning the facts, it is essential to involve individuals who are close to the patient. The third step consists of assessing and evaluating alternative actions. While doing this, the practitioner should consider the virtue, common good, justice, rights, and utilitarian approaches. In the fourth step, a decision is made and then tested. During this step, it is imperative to consider the opinions of the involved parties. Finally, there is action and reflection upon the outcome. The practitioner should, therefore, consider how to implement the decision while using keen attention and care. Another consideration is the impacts of the resolution, and the lessons learned from the encounter. Through these steps, the general principles of integrity, justice, responsibility, fidelity, nonmaleficence, beneficence, and respect for dignity and patient’s rights would be respected (Corey, Corey & Callanan, 2011).
Ethical, Legal, Professional, and Moral Problems
According to the HIA (Health Information Act), regarding the health sector’s privacy and access law, health information custodians, for instance, nurses and physicians, must safeguard patient information’s confidentiality. Moreover, the Act permits physicians the discretion of revealing the health information, when according to the custodian’s professional judgment, the revelation is appropriate, given the circumstances.
Under the HIA’s 58(2) section, custodians must assess the wishes expressed by the patient. This is an extremely significant factor in knowing the amount of health information to be revealed. In the scenario discussed, the patient requested that the mother should not be informed. Therefore, the patient’s expressed wish is the principal factor for the practitioner not to reveal the patient’s health information. It is, however, worth emphasizing that this is not the critical factor.
On the contrary, patient safety is a vital concern. According to the Act’s 35(1)(b), custodians have an obligation of disclosing a client’s health information to an individual who can offer continuing care and treatment to the patient. In this regard, the health care professional could have revealed the young lady’s information to the mother. The lady’s mother was in a position to care for her for as long as she required care and attention (Canter et a, 1994).
Irrespective of the fact that the patient was an adult, the mother often accompanied her to the appointments. This is an indication that the mother was deeply concerned about the daughter’s health. The practitioner needed to scrutinize the relationship between the patient and the mother. He should then decide whether it was appropriate to reveal the information to the mother.
Another section of the Act stipulates that the practitioner can disclose the patient’s information to the mother, depending on the situation’s urgency. According to HIA’s section 35(1)(m), the practitioner can reveal the information to anyone if they believe that under the current reasonable grounds, the revelation will reduce or avert an imminent danger to the patient’s safety and health (Fisher, 2009).
Possible Solutions or Opportunities for Resolution
It is worth emphasizing that the HIA does not restrict practitioners to a perfection standard, but rather, reasonableness. As argued above, the practitioner only required to consider the implications of his silence. First, the mother often accompanied the daughter for her treatments, which indicates that she was concerned about her health. Moreover, although the practitioner remained silent, the patient’s condition deteriorated after she overdosed herself.
There is adequate reason to believe that revealing the patient’s suicidal thoughts could deter the impending danger of the patient causing harm to herself. Therefore, it is recommendable for the practitioner to discuss the patient’s issues with the mother (Lowman, 2006). Consequently, the patient could be engaged in counseling sessions. In addition to other health acts, HIA offers physicians the authority to practice professional judgment, whenever a patient is in danger. After deciding to disclose the patient’s information to the mother, the practitioner needs to record the reasons for the disclosure. Moreover, he should keep track of every action he takes. The practitioner must reveal only the information, which will cater for the intended reason.
Having overdosed herself and consequently admitted to the Intensive Care Unit, the practitioner should realize the impending danger. Suppose the patient recovers but still has the desire to commit suicide, would she not attempt suicide again? In this case, the practitioner should act towards the welfare of the patient.
Implications for the Ethical Decision- making and Actions
In light of this discussion, there are several benefits associated with ethical decision making in health care. According to Lowman (2006), the key implication is quality health care and protecting the patient’s life. In every decision made by any health care practitioner, the life of the patient should be protected. Through making ethical decisions, the practitioner protects his reputation and the image of the health care institution.
Canter, M. B., Bennett, B. E., Jones, S. E., & Nagy, T. F. (1994). Ethics for psychologists: A commentary on the APA ethics code. Washington, DC: American Psychological Association.
Corey, G., Corey, M. S., & Callanan, P. (2011). Issues and ethics in the helping professions (8th ed.). Belmont, CA: Thomson Brooks/Cole.
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Fisher, C.B. (2009). Decoding the ethics code: A practical guide for psychologists. (2nd ed.). Thousand Oaks, CA: Sage Publications.
Lowman, R. L. (2006). The ethical practice of psychology in organizations. Washington, DC: American Psychological Association.