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Ethics in confidentiality in healthcare
Ethics and patient autonomy
Ethical dilemmas in the medical field about confidentiality
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Recommended: Ethics in confidentiality in healthcare
Patient Deception: A Question of Ethics
A physician is often tasked with a very difficult task of informing their patient about their diagnosis. The medical professional may choose to completely disclose the diagnosis or withhold details that can “aggravate” the situation. It is argued that deception can help the patient by not bringing down their mental health or even that the whole truth cannot be revealed in medical cases. In most cases, the deception carried out by a medical professional is morally impermissible as it undermines and disrespects a patient's autonomy and goes against the doctor's responsibility of removing them from harm.
There is often debate of exactly what or how much information a physician should disclose. Physicians should disclose enough information to where a patient is informed and aware of any risks of treatment. Respecting autonomy should be the number one priority because it protects the patient’s right to know what is going on with their health and allows them to make personal decisions regarding their health. In 1958,
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In these cases, it is argued that it is morally permissible for a physician to deceive a patient. The medical professional violates the patient's autonomy so he can regain his health. According to Cullen and Klein, “It is easy to overestimate the extent to which lying to a patient will be useful in helping him regan his health” (160). There is lack of data for their claim that it is easy to overestimate the actual benefit of deception in the patient’s regaining of his or her health. Serious medical conditions require the patient’s full attention to and participation in a proper treatment regimen. Respect for the patient’s autonomy requires that the patient know the facts about their health state so they can be well prepared for their
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
Cullen and Klein understand that deception is wrong and disrespectful to the patient but criticize that some cases are more complicated and not so black and white. They argue that physicians should be able to withhold information that can significantly benefit the patient. The key part is that the benefit is greater than what the deception causes.
One of the most complex, ever-changing careers is the medical field. Physicians are not only faced with medical challenges, but also with ethical ones. In “Respect for Patients, Physicians, and the Truth”, by Susan Cullen and Margaret Klein, they discuss to great extent the complicated dilemmas physicians encounter during their practice. In their publication, Cullen and Klein discuss the pros and cons of disclosing the medical diagnosis (identifying the nature or cause of the disease), and the prognosis (the end result after treating the condition). But this subject is not easily regulated nor are there guidelines to follow. One example that clearly illustrates the ambiguity of the subject is when a patient is diagnosed with a serious, life-threatening
Patient autonomy was the predominant concern during the time of publication of both Ezekiel and Linda Emanuel, and Edmund D. Pellegrino and David C. Thomasma's texts. During that time, the paternalistic model, in which a doctor uses their skills to understand the disease and choose a best course of action for the patient to take, had been replaced by the informative model, one which centered around patient autonomy. The latter model featured a relationship where the control over medical decisions was solely given to the patient and the doctor was reduced to a technical expert. Pellegrino and Thomasma and the Emanuel’s found that the shift from one extreme, the paternalistic model, to the other, the informative model, did not adequately move towards an ideal model. The problem with the informative model, according to the Emanuel’s, is that the autonomy described is simple, which means the model “presupposes that p...
Memory is everything to the human society. We communicate and build relationships off of our memories through the stories we tell. We are natural story tellers and have been telling stories since the beginning of time. More than half of the human race lives their lives based off of stories told by others such as culture, religion, and our general history. Have you ever asked yourself how real are these stories? Not saying that they are false, but it has been recently revealed that memory is false. So if memories are false then that would mean the stories that are being told are false. You probably looking at me as if I’m crazy but if you pay attention you will understand by the end of this essay. “It has been proven
In “Should Doctors Tell the Truth?” Joseph Collins argues for paternalistic deception, declaring that it is permissible for physicians to deceive their patients when it is in their best interests. Collins considers his argument from a “pragmatic” standpoint, rather than a moral one, and uses his experience with the sick to justify paternalistic deception. Collins argues that in his years of practicing, he has encountered four types of patients who want to know the truth: those that want to know so they know how much time they have left, those who do not want to know and may suffer if told the truth, those who are incapable of hearing the truth, and those who do not have a serious diagnosis (605). Collins follows with the assertion that the more serious the condition is, the less likely the patient is to seek information about their health (606).
Truth in medicine is a big discussion among many medical professionals about how doctors handle the truth. Truth to a patient can be presented in many ways and different doctors have different ways of handling it. Many often believe that patient’s being fully aware of their health; such as a bad diagnosis, could lead to depression compared to not knowing the diagnosis. In today’s society doctor’s are expected to deliver patient’s the whole truth in order for patients to actively make their own health decisions. Shelly K. Schwartz discusses the truth in her essay, Is It Ever Ok to Lie to Patients?. Schwartz argument is that patients should be told the truth about their health and presented and addressed in a way most comfortable to the patient.
From deontological perspective, nurse must always tell the truth regardless of the outcome. Utilitarian would argue that withholding the truth or telling a lie is permissible if it may produce better outcome for a patient or prevent harm. According to Tuckett (2012), the principle of truth telling is often violated during provision of care to dementia patients and based on intention to eliminate distress, anxiety, or depression (beneficence and non-maleficence). It can be argued that withholding the truth or telling lie is deceptive to patient’s autonomy, however permissible if can be justified. Such as, “Providers have a responsibility to determine the resident’s level of insight over time to ensure decisions to deceive are genuinely in the resident’s best interest. In the context of lying to a resident with dementia, lying is conceptualized as therapeutic” (Tuckett, 2012,
From the utilitarian’s side, lying might be a good choice, since it brings more happiness to the patient. In fact, truthfulness can actually do harm. Patient’s health situation becomes worst when he knows that he have a serious disease. He will become depressed and might suffer from psychological disorders like anxiety which reduces the efficiency of healing. For example people suffering from Nosophobia , Hypochondriasis or Nosocomephobia: “which are an irrational fear of contracting a disease, a fear of hospitals or refers to excessive preoccupancy or worry about having a serious illness ” are most likely to be affected by truth of having a serious ill or undergoing a dangerous medical operation. That’s why some doctors use lying as way of curing; they don’t try only to heal the disease, but also they make sure that the patient is in his most relaxed state, in order not to harm him. Roger Higgs in his article “On telling patients the truth” argues that doctors have no exemption from telling the truth. I other words, when a doctor lies he needs to give justifications. For the maleficence argument, Higgs argues that the truth actually does not harm; but the way the doctor tells the truth a...
Informed consent is the basis for all legal and moral aspects of a patient’s autonomy. Implied consent is when you and your physician interact in which the consent is assumed, such as in a physical exam by your doctor. Written consent is a more extensive form in which it mostly applies when there is testing or experiments involved over a period of time. The long process is making sure the patient properly understands the risk and benefits that could possible happen during and after the treatment. As a physician, he must respect the patient’s autonomy. For a patient to be an autonomous agent, he must have legitimate moral values. The patient has all the rights to his medical health and conditions that arise. When considering informed consent, the patient must be aware and should be able to give a voluntary consent for the treatment and testing without being coerced, even if coercion is very little. Being coerced into giving consent is not voluntary because others people’s opinions account for part of his decision. Prisoners and the poor population are two areas where coercion is found the most when giving consent. Terminally ill patients also give consent in hope of recovering from their illness. Although the possibilities are slim of having a successful recovery, they proceed with the research with the expectation of having a positive outcome. As stated by Raab, “informed consent process flows naturally from the ‘partnership’ between physician and patient” (Raab). Despite the fact that informed consent is supposed to educate the patients, it is now more of an avoidance of liability for physicians (Raab). Although the physician provides adequate information to his patient, how can he ensure that his patient properly ...
One day while doing his job, a physician used a used swab that was possibly infected with HIV on another patient. When looked at by certain people, the doctor did the correct thing by telling his patient that he roused a swab on him/her. However, the chances of this patient getting HIV was substantially low, and he should have waited for the patient to develop symptoms, which would have been rare, before telling the truth. As stated by Michael Greenberg, “he might have done better by keeping his mouth shut.” If the doctor did lie, he could have lied to protect himself, the quality of life of the patient, and his ability to help others with their lives. If he had not told the patient that he used the swab on him/her, he/she would not have had to live in fear of getting HIV. Because of this decision of truth telling, the doctor lost his job, money, confidence, and also affected someone’s quality of life.
The most common areas of clinical practice where truth-telling and deception become an ethical dilemma are critical care, cancer and palliative care, mental health and general nursing practice (Tuckett, 2004). Other areas where it can raise potential ethical concerns are in placebo therapy, disclosure of human immunodeficiency virus and informed consent (Tuckett, 2004). Truth-telling is also an act of exchanging moral agents (patients, relatives, nurses) with their sets of values and norms, which in turn are derived from culture, personal and religious beliefs, and traditions (Dossa, 2010). For this reason, the issue of truth-telling is not only approached differently in the various clinical settings but also in different countries, cultures and religions (Kazdaglis et al., 2010). For example, in the United States of America (USA), England, Canada and Finland, the majority of patients are told of their diagnosis (Kazdaglis et al., 2010). Conversely, in Japan, family members play a major role in the decision of ...
The writer discusses a situation of the doctor failing to disclose the nature of important medical condition which can jeopardize several of the patient’s family members and puts the doctor at odds with them. The problem is also discussed by Sutrop (2011) who show how protecting the patient’s confidentiality and self- decision capacity has actually caused severe hindrances to the field of scientific development and research.
Patient confidentiality is one of the foundations of 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.
Consequently, it can be assumed that doctors might tend to avoid such a confession in order to maintain their image of being a “good doctor” (J.Shahidi). Not being a good doctor may eventually lead to doctor’s loss of business and as a result physicians may tend to hide the truth even if it opposes patient autonomy