If professionals are left to act in whichever way they deem fit, there is bound to be a lot of mistakes and behavior disparity. Consequently, each profession has come up with guidelines which prescribe the correct code of conduct not only to ensure uniformity in actions, but also to avoid inappropriate behavior. Health professionals have their code of conduct that is defined in the code of ethics. Among the ethics that health professionals are supposed to uphold, the principle of confidentiality and autonomy are very crucial because they touch on the patient directly. In many instances, confidentiality and autonomy of the client are compromised and this makes the two very crucial to be addressed.
Health professionals will be required to make ethical decisions in their duties daily. Whenever a problem occurs, it would be prudent to refer to the ethical principles before making any decision. Confidentiality and autonomy are among the ethics principles that present challenges to many health workers. In many cases, health workers present forms which seek the consent of patients before treatment in commenced (Pera & Tonder, 2005). However, there are patients who are unable to read or write. In this regard, these patients do not really understand the exact issues enumerated in the consent forms. On the same note, it is quite difficult to get enough time to explain to some patients what needs to be done due to time factor. Consequently, patients are rushed through the discussions and the issue of capacity is not adequately assessed. It is therefore difficult to sometimes say with certainty that a patient gave an informed consent.
Ethical Challenges Facing the Two
There comes a point in time when a patient may be totally unable to make any decision due to his or her medical condition. As a result, other people are sought after to act as substitute decision makers. In situations like this, it is very difficult to maintain autonomy as well as confidentiality of the patient since substitute decision makers usually require to be informed of the exact state of affairs. The matter gets complicated when the patient has no express directions on how the situation should be handled (Pera & Tonder, 2005). There arises conflict of interests whenever issue like this arise because while the health care providers will want the patient’s affairs to be given priority, relatives may be unwilling act with the urgency it requires.
The principle of confidentiality is supreme. Health workers find themselves on the wrong side when determining which people should be given specific information. Patients have the right to determine who should be given information about their medical status. Nevertheless, there are instances when the patient’s condition may be very critical to the extent that patients may be unable to determine how their medical records should be handled. Similarly, the confidentiality principle has some exceptions which are sometimes ambiguous to implement. There are a lot of challenges in the application of the confidentiality principle.
Furthermore, it should be noted that in some cases, it is very difficult for the privacy of a patient’s information to be maintained within a health institution. The medical information of a patient is supposed to remain between the patient and the person giving the health services only (Morrison, 2010). However, there are instances where other health staff within the institution not directly involved with the client may want to snoop on the information. In addition, data entry staff may make mistakes and post patient’s private information where every staff can access it.
Securing patient’s information from outsiders is a problem. Given the current state of technology, people can hack into the institution’s system and access private medical information of patients. Moreover, determining how much information should be given to some authorized parties is not easy. Sometimes excess information may be released which may be used to the disadvantage of the patient.
Importance of the Two
It is the duty of every health care professional to read and understand the code of ethics. The principle of autonomy requires that each patient has the right to determine the kind of treatment they want to receive and the person who will provide the treatment. Nevertheless, the overall responsibility of making the patient aware of his or her current situation lies with the medical officer (Pera & Tonder, 2005). This includes explaining to the patient all the available methods in which his or her condition can be treated. As a result, health care officials have the duty of ensuring that all patients have enough information to allow them make informed decisions. It is important to note that the duty of ensuring that patients make informed decisions does not mean that health care professionals should make decisions on behalf of their clients. Furthermore, it does not mean that health care professionals can impose decisions on patients. However, health care professionals need understand that patients come to them because they need guidance so that they can make informed decision. As a result, health professional should ensure that they not only address any fears present but they also counsel them to eliminate any conditions that may interfere with the ability of the patient to make good decisions.
In ensuring that the principle of autonomy is upheld, health professionals will be required to observe confidentiality of the patient. The principle of confidentiality requires that health care official should not release the private medical information that patients give them to any unauthorized persons. During treatment, patients not only release medical information to health professionals, but also vital financial and insurance information (Morrison, 2010). This information is very crucial and should be maintained absolutely secret because it might have grave consequences to patients if revealed.
Technology and the Ethical Principles
Nowadays, technology has changed the way many things are done. Lab test requests and results are done online. More information is collected from patients and this is also stored online. Consequently, the number of people who can access this information has increased. As a result, the need of confidentiality has enhanced. There is need for enhanced efforts to ensure that confidentiality in every sense is attained. It should be noted that there are some instances where confidentiality can be dishonored. The first instance is when patient poses a risk to public heath for example, when the patient has contagious disease (Pera & Tonder, 2005). Secondly, when a health official has sufficient prove that a patient plans to harm another person. Lastly, in case the patient is a minor and evidence is tilted towards the case of child abuse.
Confidentiality is important to assure the patient that his or her interests are taken care of. Unless patients are sure that their information will be kept private, they will not reveal some of their information. The information held will sometimes be crucial for medication and its absence may lead to wrong prescriptions. Moreover, revealing patient’s information may sometimes lead to prejudice and stereotyping of patients. The negative social reception that patients may receive if their health conditions are known may lead to adverse effects like depression and even suicide.
Consequences of Not Adhering To the Two
If the principle of confidentiality and autonomy are not upheld, there are consequences involved. To begin with, going against the code of conduct attracts punishment from the relevant bodies to which the health professionals belong. The punishment may range from simple warnings to fines and even deregistration. In addition, the law requires confidentiality of medical information to be maintained. It is therefore illegal to violate the confidentiality requirement. The Data Protection Act 1998 regulates how data is used and processed (Pera & Tonder, 2005). The law stipulates that autonomy and confidentiality must be upheld. As a result, there are legal consequences if one breaches these principles. Besides setting a bad example of the profession, the culprits can be barred from practicing by having their certificates confiscated.
How to Avoid the Ethical Challenges
Nevertheless, health professionals have very many ways to avoid contravening the requirements. To begin with, all health professionals should ensure that they read and understand the code of ethics that is relevant to their practice. Ignorance of the code of ethics cannot be used as an excuse. Similarly, it will be quite beneficial for health professional to consult relevant authorities in case there is a decision they need to make and they doubt how to go about it (Morrison, 2010). This will minimize their chances of breaching any law or code of ethics. Furthermore, due to improvement in technology which has been witnessed in recent years, health sector needs to invoke the use of high class technology in the protection of patient information. Institutions need to put in place state-of-the-art security systems that can protect online information from hackers and other individuals who may be harboring ill motives.
In addition, all health care professionals should be trained on the need of confidentiality and autonomy. The training should include the security procedures in place as well as the kind of information that each individual can access. On the same note, since confidentiality is threatened even internally, rules should be put in place to regulate access to data section (Morrison, 2010). Staffs who are not directly concerned with patient information should be totally restricted from accessing the information. It may also require establishment of physical structures to protect client information.
As far as autonomy of patients is concerned, it would be crucial for health care practitioners to ensure that always express consent of the patient is sought before any treatment is commenced. In cases where language is a barrier, services of an interpreter should be involved. This will ensure that the patient will not claim later that he or she did not understand what was going on during treatment. In case the health care practitioners want to publish any material that may directly or indirectly use particular information of a patient, it is important to ensure that the patient is notified. Moreover, the practitioner should explain to the patient explicitly what information will be used and possible consequences if any before getting authority of the patient.
Even when information is required by authorized institutions, it would be prudent to consult and agree on the information that can be released. Additionally, if a patient is unable to give consent and a substitute authority is required, care should be taken to release only the very necessary information taking into consideration the prevailing circumstances. It is paramount to note here that health professionals should keep their distances as far as family matters are concerned. Patients have the last word as to who should be informed about their medical information. Not even the family members can be told about the condition without express consent from the patient.
Whenever possible, health professionals should seek permission from the patient before releasing any information. This includes ensuring that they talk to patients who are about to undergo surgery so that during their recovery, health care personnel may know exactly which information they can release and which one they will keep secret (Pera & Tonder, 2005). However, there is need to institute good policies in health institutions to deal with the ethical dilemmas that arise.
Confidentiality and autonomy cannot be addressed in isolation. A challenge in one of them directly brings the other one into focus. Moreover, it will be a lie to say that there will come a day that the ethical dilemmas resulting from the application of the principle of autonomy and confidentiality will ever cease. Health practitioners have the moral and ethical responsibility of ensuring not only that the patient is given the best service but also that family members are not kept in the dark unnecessarily. Nevertheless, care should be taken to ensure that due diligence is applied in any scenario.
Morrison, E. (2010). Ethics in Health Administration: A Practical Approach for Decision Makers. Sudbury: Jones & Bartlett Learning.
Pera, S. A. & Tonder, S. V. (2005). Ethics in Health Care. Landsdown3: Juta and Company Ltd.