Privacy: A Concept Analysis
Concept is an abstract awareness of an idea, process, action, phenomenon, or reality that is regarded or treated as if it had a concrete or material existence (Walker & Avant, 2005). Meleis (1991) acknowledged that concepts create a base on which actions and phenomenon can be better described.
When analyzing a concept, a method entitled concept analysis allows for the deciphering of what a concept is at its roots to determine the defining attributes or characteristics (Encyclopedia of Nursing Research, 2016). Walker & Avant (2005) defined concept analysis as a method to define vague concepts through the explanation and determination of their base elements to achieve a clearer understanding. The significance of the breaking down of a concept is best exemplified when attempting to establish a differentiation between various nursing concepts within the healthcare field (Carpineto & Romano, ).
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Privacy is a necessary element to providing professional and ethical care to a patient during times of his nursing care. Beech (2007) states that privacy is a fundamental component to not only the code of ethics and law but also to the duty of care to a patient. Therefore, this concept analysis intends to identify the main distinguishing factors of privacy within the nursing field while looking to other professions to complete this goal.
Privacy is defined as “the quality or state of being apart from company or observation – freedom from unauthorized intrusion” (Merriam-Webster, 2019). It is a concept synonymous with both confidentiality and secrecy; however, these three words have various purposes and meaning. Confidentiality pertains to the protection of an individual’s personal information and can be classified as an extended branch of privacy (Denisco & Barker, 2016). The term secrecy can have the implication of being the harshest of the three words as it can conjure the idea of possible shame if the information is disclosed (Pinch, 2000).
Privacy indicates that an individual has drawn a line at what is accessible in terms of his or her physical or mental integrity and information (Loh, 2018). Peate & Potterton (2009) continue to define privacy as a basic patient right that enables for healthcare information to be free from disclosure to unnecessary parties. This idea of privacy acting as an integral component of health and social care stems from its inclusion in the Hippocratic Oath of the 5th century B.C. and the Universal Declaration of Human Rights set forth by the United Nations in 1948 (United Nations, 2019).
In terms of the nursing field, privacy encompasses the keeping of a patient’s healthcare information, feelings, physicality, and actions in confidence without disclosure to unnecessary individuals – including: healthcare workers, friends, and family (Ozturk, Bahcecik, & Ozcelik, 2014). Nevertheless, each profession with a standing code of ethics holds its members to the risk of legal retaliation if this established circle of trust is broken – including the law, business, and nursing professions (Papadodima, Spiliopouluo, & Sakelliadis, 2008).
Privacy within the Nursing Profession
Within the context of the nursing profession, privacy stands as an ethical and legal obligation for healthcare workers. Per Provision 3 of the current Code of Ethics for Nurses, “the nurse promotes, advocates, for, and strives to protect the health, safety, and rights of the patient” (ANA, 2001). This protection of information to ensure privacy begins when the patient accepts care from a designated healthcare worker and ends upon the dismissal of that designated healthcare worker’s role from the treatment team (Erickson & Millar, 2005). This becomes evident when the privacy rule under the Health Insurance Portability and Accountability Act (HIPAA) entails that appropriate safeties are in place to protect the privacy of personal health information while also setting limits and conditions in which the use and disclosure of such information can be made without patient authorization (HHS, 2015). As a result, patient privacy is treated as an “inclusive model of confidentiality” since it is based in a team approach. Interpretation of this model states that either a stated or implied contract of privacy exists between the members of the treatment team that require ‘need to know’ information relevant to the patient’s condition. This “inclusive model of confidentiality” structure can be found within and in line with both statute and case law (Jenkins, 1999).
Privacy within the Law Profession
For centuries, privacy has been one of the most, if not the most, prominent responsibilities for law professionals. Within this field of work, privacy refers to the professional relationship between an attorney and his client (Simon, 2017). This professional relationship allows for client assurance to exist that any applicable or relevant facts shared with his solicitor will not be shared with the public or uninvolved parties (Solicitor’s Regulation Authority, 2017). The Rule 1.04 of the Solicitor’s Code of Conduct (2017) clearly defines the role of privacy – “the lawyer must act in the best interest of the client and not disclose the client’s information unless permitted by the client himself or by law”.
Privacy within Business
Defining Attributes of Privacy
Walker & Avant (2005) state that a concept’s attributes are the constantly emerging components when a literature review is conducted. These repeated qualities allow for a more comprehensive understanding of the concept itself.
Erickson & Millar (2005) contribute the following defining attributes to privacy:
- Information must exist to be disclosed
- At least two individuals must know the information – this includes the healthcare worker that receives the shared information and the client who gives the information
- Existence of a duty of care by the information receiver to hold the information in confidentiality – duty of care is rooted in a law, oath, assurance, or a promise
- The sharer of information must have trust, belief, or faith that the shared information will continue to be confidential
- Receiver must have an innate sense of decision on when it is appropriate and lawful to disclose the information
To keep from negating the concept of privacy, the existence of sensitive information must be in existence – thus making this the most essential attribute of privacy. This belief is supported by both McGowan (2012) and the American Nurses Association (2005) who state that practicing healthcare workers remain in constant access to patient information. This access to patient information exists in the professional relationship between the patient and their direct caregivers but can extend out to other healthcare members when necessary and appropriate (Pinch, 2000).
- American Nurses Association (2001, February). Code of Ethics for Nurses. Retrieved March 24, 2005, www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/EthicsStandards/CodeofEthics/AboutTheCode.aspx.
- Beech, M. (2007). Confidentiality in health care: Conflicting legal and ethical issues. Nursing Standard. 21(21). pp. 42-46.
- Bruneli, T. (2005). A concept analysis: The grieving process for nurses. Nursing Forum. 40(4). pp. 125-128.
- Carpineto, C., & Romano, G. (n.d.). Concept data analysis: Theory and Applications. West Sussex, England: John Wiley & Sons, Ltd.
- Encyclopedia of Nursing Research. (2016). Nursing research resource: Concept analysis. Retrieved from https://usuhs.libguides.com/c.php?g=176584&p=3957502.
- Erickson, J., & Millar, S. (2005). Caring for patients while respecting their privacy: Renewing our commitment. The Online Journal of Issues in Nursing, 10. Retrieved from http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume102005/No2May05/tpc27_116017.html
- Federal Trade Commission (FTC). (2017, December 18). Our history. Retrieved from https://www.ftc.gov/about-ftc/our-history.
- Loh, W. (2018). A practice-theoretical account of privacy. Ethics and Information Technology, 20, 233–247. doi: 10.1007/s10676-018-9469-1
- Merriam-Webster Dictionary. (2019). Privacy. Retrieved from https://www.merriam-webster.com/dictionary/privacy.
- Ozturk, H., Bahcecik, N., & Ozcelik, K. (2014). The development of the patient privacy scale in nursing. Nursing Ethics, 2(7), 812–828. doi: 1.01177/0969733013515489
- Papadodima, S., Spiliopouluo, C., and Sakelliadis, E. (2008). Medical confidentiality: legal and ethical aspects in Greece. Bioethics. 22(7). pp. 397-405.
- Peate, I. & Potterton, J. (2009). Hush! Let’s talk confidentiality. British Journal of Healthcare Assistants. 3(12). pp. 609-612.
- Pinch, W. J. (2000). Confidentiality: concept analysis and clinical application. Nursing Forum. 35(2).
- Simon, W. (2017). Attorney-Client confidentiality: A critical analysis. Georgetown Journal of Legal Ethics . Retrieved from https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2922744
- United Nations. (2019). Universal decleration of human rights - 1948. Retrieved from https://www.un.org/en/universal-declaration-human-rights/.
- U.S. Department of Health & Human Services (HHS). (2015, April 16). Privacy. Retrieved from https://www.hhs.gov/hipaa/for-professionals/privacy/index.html.
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