In health care setting, ethics are considered as a part of patient care. The practices of paramedical staff reflect how ethical and moral values are being valued to provide compassionate care. Currently the concept of confidentiality is highly debated in health care settings. It ponders that whether patient’s private information should keep confidential or shared among medical and paramedical staff for quality improvement and research or audit purposes. According to Lenard (2007) “Confidentiality in the health care setting means that an agreement exists to protect information shared between a patient and a provider, unless explicit permission is given to share that information.” Confidentiality determines that the patient information should be protected from divulging by health care professionals. It promotes patient right of being self-determine and builds trusted relationship between patient and health care professionals ultimately upholds patient health. Slowther (2010) viewed confidentiality as a trusted relationship between doctors and patient which promotes patient health and describes that” Without assurances about confidentiality, patients may be reluctant to seek medical attention or to give doctors the information they need in order to provide good care.”
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On contrary, Brann and Mattson (2004) as cited in (Paulsel, M.L., Richmond, V.P., McCroskey,J.C. and Cayanus,J.L. 2005). described a confidentiality breach as a situation in which health care providers do not keep patients’ private information confidential. Different views exist about breaching confidentiality. It is considered as sharing of patient information between health care members which is a collective and essential practice in the delivery of healthcare. Muhammad (2006) clears the notion of confidentiality in this context that “counselors recognize the need for communicating confidential patient information with other health care workers as parts of the client’s care.” Also, White (2006) describes that “Utilitarianism supports confidentiality if it promotes the best consequences, but obviously allows for breaches of confidentiality if the greater good is best served by disclosure.”
I argue that confidentiality should be maintained to protect patient’s right to be self-determinant that it promotes a worthy relationship between patients and health care providers. Moreover, it helps in attaining patient confidence over medical professionals and treatment plan which eventually promotes patient health. Further it precludes stigmatization and gives chance to an individual to perform effectively in daily living.
Confidentiality is patient’s right and a formal responsibility of health care professionals. In health care setting it is patient’s right to be autonomous for their personal and medical information that what and how much information should be shared to others. Patients usually seek help from medical professionals with the expectation that their private information would not be revealed. Beside this health care providers including (nurses and doctors) are responsible not to divulge patient’s personal information. The International council of nurses has adopted the international code of ethics which states that “The nurse holds in confidence personal information and uses judgment in sharing this information.
However, opponent says that in certain situations patient confidentiality can be breached in beneficence of patient and others. For instance, the paramedical staff should know about the patients who is with HIV positive or any other infectious disease which will protect themselves from such contagious infections and would definitely prevent other patients as well. Though, I believe that patients privacy and confidentiality on above describing situation is acceptable but health care providers should be aware that to what extent information should be share.
Secondly, Confidentiality builds a trusted relationship between patient and health care providers. This relationship grows in a professional way when patient’s private information is not shared among people or other paramedical staff. Matiti and Trotrey (2008) describes patient’s expectations in terms of confidentiality that;
(1) Information not to be discussed or given to another person unless essential.
(2) Giving of information should be with the patient’s consent.
(3) Patient matters not to be discussed at nurses’ desks, in open wards or corridor
Hence, it clearly indicates patient’s expectations regarding their personal information which should be taken as privately and confidentially. It not only protects ethics but also helps in achieving patient confidence for trusted relationship. Moreover, this practice generates an open and clear communication between patient and health care professionals which help them to formulate a mutual care plan and intervene for the patient.
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In contrast, it could be possible that for the sake of maintaining trust health care providers may not share patient information with other health care team members which may hinder paramedical staff to work as team to provide holistic care and ultimately it may affect patient health. But, I consider that holistic care can only be given when we health care providers demonstrate their values regarding patient privacy. According to Iman (2008) “Privacy and confidentiality are not only basic rights of the patients but also serve to further a trustful, frank and open relationship with the doctor, thus improving patient care”.
Lastly, Confidentiality precludes labeling and stigmatization of patients. By maintaining confidentiality patients can be protected from discrimination and stereotyping behaviors of people around them. Brann & Mattson (2004) states that “Many patients experience discrimination, economic devastation, or social stigma as a result of confidentiality breaches” so, in this perspective health care provider plays an important role in protecting patient’s private information from breaching and disclosing. According to Gable (2007) “Physicians and other providers must conduct partner notification in a confidential manner to avoid violations of their patient’s right to privacy and reduce possible stigma and discrimination.”
On the other hand, in certain circumstances sharing patient information can be helpful for the patient. For instance, by providing patient’s disease information such as HIV or cancer, those who have resources may help them to treat and support patient in such vulnerable condition. But I think that here patient’s respect, dignity and self-esteem may be violated. So, in my view point Confidentiality establishes a sense of safety, autonomy and self-respect for patients.
In the light of the above, I conclude that confidentiality has a remarkable significance in patient and staffs perspective. Confidentiality should be considered as patient right and paramedical staff is responsible to protect patient medical and personal information. Patient’s autonomy and beneficence are unpinning rights of confidentiality.it builds a trusted relationship between patient and health care provider Health care providers should be aware that to what extent information should be share which do not impede patient’s dignity, respect and cause a reason of stigma
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