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Commonly asked questions on ethical and legal issues in research
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Ethical and Legal Considerations When conducting research there are a myriad of considerations when working amidst patients. Regardless of where research is carried out, shared ethical and legal trepidations for protecting and respecting our patient’s remains constant. It should be requisite to keep at the forefront maintaining a respect for each person, beneficence, and justice while participating in research. Another critical aspect of research is the confidentiality and anonymity, ensuring the dignity of each patient.
In research, there is protected health information (PHI) that could conceivably be exposed, causing one to question to the validity and impartiality of the research. If a consent or waiver form is not signed and research
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Confidentiality is important in research and is accomplished by storing all the data in a locked cabinet at the nurse’s station. The only people allowed access to the information are the 6 RN’s currently carrying out the study. To protect anonymity of the patient, I will assign a code number to each patient. I will keep a separate master list of each subject with only the code number identifying that person, also maintained and locked in the cabinet at the nurse’s station. Also, an additional list will be safeguarded in the Unit Managers office in a locked drawer with the specific code number they were assigned. The main research RN will hold the list of names of each patient matched to their specific codes and the other five RN’s will not be allowed to know the patients name and have access only to the code number, thusly protecting the anonymity of each patient. Consent forms will be kept in another drawer of the cabinet at the nurse’s station, and on each consent form we will place the code number in the right hand corner. All of these steps are necessary in order to protect our patient confidentiality and the validity of the research ensuring the data can disseminated beneficially for all parties
List 3 ways patient confidentiality is maintained in the reception/waiting area of a medical office.
In order to provide the best care, nurses must not break patients’ rights nor their trust. When a patient walks in a health facility, health care providers (HCP) must respect the patient health privacy.
Identifying patients correctly when providing Care: Nurses are supposed to have two resident Identifiers when trying to care for a patient for the first time and after that, one identifier is acceptable. Identifiers such as Room number or location are not acceptable. To ensure this is carried out correctly nurses must ask for two identifiers in situations such as specimen collection, when providing treatments or when collecting blood for clinical testing (containers must be labeled in front of the patient). The Purpose of this guideline is to ensure that the patients are been properly identified and that they are receiving the right treatments and medications (The Joint Commission, 2012).
During the process of research, professionals collect data or identifiable private information through intervention or interaction. While this is a vital part of the scientific and medical fields, every precaution must be taken by researchers to protect the participants' rights. Ethics, outlined by the Belmont report; requirements, described by the Department of Health and Human Services (DHHS); and regulations, laid out by the Food and Drug Administration (FDA) are verified by an Institutional Review Board (IRB). This procedure assures that all human rights are safeguarded during the entire research process.
Confidentiality is a major topic within care environments. When it comes to deciding what information is shared and who it is shared amongst can be difficult. Confidential information, is information that is ‘not to be told to anyone’ (The Open University, 2015, p. 58). Information that is sensitive or not publicly known is confidential, also if information is given by a person who is in a setting where confidentially is expected then that information should remain private and not shared with others. It can be very difficult for a staff member to find the balance between knowing what information is confidential and appropriate information that needs to be shared between the staff team.
When I was working as a Customer Service Representative in the Bank, one of my responsibilities was to supervise the tellers. I was friends with two of the tellers working there at the time. We used to go out together outside of work and had great time. At some point I started noticing that they are being too friendly with each other and acting inappropriate for a professional environment. I decided to confront them and they confessed to me that they were dating. That is when I realized that I was faced with an ethical dilemma.
Protecting Personal Health Information in Research: Understanding the HIPAA Privacy Rule, NIH Publication Number 03-5388. Retrieved November 12, 2011 from http://privacyruleandresearch.nih.gov/pr_02.asp
Advocating for diverse patients is important. In this paper I will be discuss a personal ethical dilemma in which I have encountered. I will give an objective interpretation of both my side as well as my patient’s side of the dilemma. Then I will describe the conflicting values and beliefs that I and the patient had. Then I will give the information I was lacking concerning the patient’s culture. Lastly, I will define culturally congruent care.
As health care providers, nurses strive to instill confidence in their patients and their loved ones. A nurse is respectful to their colleagues as well as their patients. Nurses promote patients’ independence, patients can be confident in the knowledge that a nurse will do what is best for them, respecting their privacy and dignity. This means that a nurse does not share the patient information for personal reasons nor does the nurse get involved in a patients personal relationship if it is not medically relevant (NCSBN, 2011).
Ethics refers to the values and customs of a community at a particular point in time. At present, the term ethics is guided by the moral principles that guide our everyday actions. These moral principles guide the researcher into deciding what is ‘right’ or ‘wrong’. The foundation of medical ethics is governed by two philosophical frameworks that are deontology, and utilitarianism. However ultimately the ethics committees need to balance the risks, and benefits for the participants and the community associated with the particular research proposal. This balance is quite important as the well being of participants is at risk.7
Patient confidentiality is one of the foundations to the medical practice. Patients arrive at hospitals seeking treatment believing that all personal information will remain between themselves and the medical staff. In order to assure patients privacy, confidentiality policies were established. However, a confidentiality policy may be broken only in the case the medical staff believes that the patient is a danger to themselves or to others in society. Thesis Statement: The ethics underlying patient confidentiality is periodically questioned in our society due to circumstances that abruptly occur leaving health professionals to decide between right and wrong.
Informed consent is a very serious decision a patient has to make when it comes to their health and consenting to procedures that are believed to cure or treat their current health status. It is important to address the effectiveness of the role a physician play in the informed consent process assuring that the patient has given truly informed consent and what safeguards can be put in place to assure the patient is exercising informed consent. Informed consent is based on the fact that the person consenting is a rational individual that is aware of the action to which he/she is consenting. Allen and McNamara (2011) notes that "On the standard understanding, the important elements of informed consent are the provision of information, the voluntariness of the choice and the competence of the chooser to make the choice— so the potential research participant should be provided with information relevant to the decision to participate, they should be able to choose freely about their participation and they should be competent to decide.
Individual privacy and confidentiality play a role in both research and clinical health care settings. In each instance, standards and expectations put in place by researchers and health care practitioners to follow to protect patients and research participants while interacting with them. The evolving health care system and convergence of research and treatment protocols to create learning health care systems (LHCS) are creating the need to look at patient confidentiality and privacy differently to protect them and their information.
Similarly, legislation and privacy worries are in effect all cross the globe and nurses have the beliefs which they will continue to keep confidential and private detail and information for their clients within the client doctor realm. However, clients use the medical services to understand that their personal and medical information are not in the wrong person’s hand because in nursing professional, nurses have the most interaction between the client and doctor, these are the preeminent vital to the nurses in nursing
The principles of documentation is clear, confidential, accurate, complete and concise, objective, organized and timely. Using documentation nurses are required to legally and ethically keep all information in the patient record confidential. There is the Health Insurance Portability and Accountability Act, known as HIPAA, which helps gives patients a greater control over their health care record (). Precise measurements and times must be used as much as possible. Accuracy can be enhanced through point of care documentation (Craven, 2017). The accuracy of documentation can be view from three perspectives veridical reflection of nursing, comprehensive while through detail of a patient journey and finally clarity in usage terms (Britain Summer of Nursing). The accuracy part is the really vital part in documentation within nursing because it shows the complete reflection of the stages of care that was provided by the health care professionals to an individual. Next, when an individual is documenting it needs to be complete and concise and organized. Having the report done as so allows for any health professional to find any information quick as possible without having to search throughout the entire chart for answers. When reporting it needs to be in a chronical flow order of the information about the patient care and procedures being done, within the chronological