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Concept of Ethics in Health Care
The relationships between representatives of various medical professions and patients form a complex social network through which individual, group, and state interests related to health issues are implemented. Different theorists interpret their attitude to the basic bioethical principles in different ways. Some see them as consequences of fundamental principles, while others insist on their theoretically independent status (McLean, 2016). However, despite the discrepancies in the interpretation of the status of ethical rules in health care, no one disputes their importance for discussing the moral problems of the doctor-patient relationship. This paper aims to discuss how ethical principles are related to the issue of patient confidentiality.
Patient confidentiality is designed to protect individuals from unauthorized intrusion. The information about the patient, which the doctor receives as a result of the examination, cannot be transferred to third parties without permission. Medical confidentiality rule is fixed in many ethical codes, and its subject is the diagnosis of the disease, health data, and prognosis. Non-medical information about the patient, which becomes known to the doctor, should also be confidential. The principle of confidentiality is a condition for protecting the patients social status (McLean, 2016). A diagnosis or other medical information can become a stigma for a person, which can significantly limit the possibilities of social self-affirmation. This especially concerns information about the presence of mental illness, HIV infection, malignant disease, genetic defect, venereal disease, and sexual disorder (McLean, 2016). Having become public, such information often causes the unconscious reaction, which is expressed in the social isolation of the patient. Violation of the confidentiality rule poses a direct threat to social status and self-esteem.
The confidentiality rule also protects the economic interests of patients. The information that a person is seriously ill can severely limit opportunities for promotion or employment. For example, disclosing the information that a psychiatrist or a lawyer is HIV-positive can reduce the number of customers (McLean, 2016). It will cause significant financial damage, although their carriage of the virus does not pose any serious threat to clients. The modern healthcare system empowers patients to choose their doctor and healthcare facility. Preference is always to someone who, in addition to high professional qualities, demonstrates compliance with high ethical standards, in which confidentiality plays a significant role. By effectively protecting confidentiality, healthcare providers ensure trust in patient relationships.
Despite the importance of adhering to the patient confidentiality rule to maintain an adequate standard of medical practice, there are situations in which its application is problematic. The legislation defines situations in which a medical worker has the right to share medical information with third parties. These can be the cases with immature minors, for example, or when patients are unable to independently express their will due to impaired consciousness (McLean, 2016). The law also restricts the confidentiality rule when there is a threat of the spread of infectious diseases, mass poisoning, or injury (McLean, 2016). The legislation also allows violation of confidentiality if the doctor has any reason to believe that the damage to the patients health was the result of illegal actions.
One of the most acute conflicts arises when medical information about a given patient concerns the vital interests of third parties, mainly relatives. A typical example is the situations that arise during the genetic testing of individuals. A diagnosis indicating the presence of a gene that predisposes to the development of serious pathology is essential for people who are genetically related or married to the patient. The patient is not always disposed to share such information with relatives, although they can save them from impending danger (McLean, 2016). The professional duty of a physician is to do everything possible to prevent a threat to other peoples health. At the same time, the confidentiality rule obliges a doctor to respect the interests of a particular patient and not to share information without their consent.
A similar conflict of values can occur in the practice of a psychotherapist or psychiatrist. For example, during a conversation, a client says that he wants to kill someone. On the one hand, the doctor should warn these people about the danger that threatens them. On the other hand, the psychiatrist risks to lose patients confidence and complicate the treatment process. In this case, all advantages and disadvantages should be analyzed. If the doctor has any reason to think that there is a real threat, people should be warned. The doctor should discuss the situation with the patient in detail and make the most ethical decision.
Patient confidentiality is important because it protects a fundamental value of privacy. For effective diagnosis and treatment, a doctor sometimes needs the most intimate information about the patients private life. The guarantee of unconditional observance of confidentiality by the physician allows the patient to be frank, without fear that their private life will be violated in any way. Only the confidence in the strict observance of confidentiality ensures frankness, without which the normal professional activity of medical workers is impossible. However, there are debatable situations in which medical confidentiality rules can be violated. In such cases, the doctor has to make the most ethical, responsible, and morally justified choice.
Reference
McLean, S. A. (Ed.). (2016). First do no harm: Law, ethics and healthcare. Routledge.
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