Introduction In nursing, patient privacy information is crucial in the clinical setting. Only the involved medical personnel will be able to access the patient’s record. In Personal Data Protection Act (PDPA), it comprises various rules governing the collection, disclosure, and care of personal data. It recognizes both the rights of individuals to protect their personal information including rights of access and correction. (PDPC, 2018) . The explanation of dilemma means that a difficult situation whereby there seems to be like least satisfaction solution. An ethical dilemma arises when moral claims conflict, affecting the nurse have to make a decision with equally unsatisfying alternatives. (Davis & Aroskar, 1991) The aim of this write-up is to increase awareness among the nurses and also the medical personnel that we must protect patient privacy regardless of what situation.Step 1 The healthcare professional breach of duty is when Dr. John invaded Joyce’s confidentiality. The main reason for breach is due to Dr. John accessed the patient’s data without any permission and was not under his care. Besides, he suspected that his girlfriend, Betty is having an affair with Dr. Steve who is married to Joyce that is hospitalized in ward 32. Moreover, the nurses in the ward 32 also did not stop or question him since he is medical personnel. After all, John told Joyce that his husband, Steve was cheated on her. This incident has breached the following ethical component which is Justice, Respect, Autonomy, and Integrity in confidentiality. While the doctor acted in Veracity, he also breached Integrity in confidentiality because John misuses his authority to check Joyce’s personal information that was not under his care. Step 2 Why Dr. John misuse his authority to access the patient’s data that was not under his care?Why the nurses in ward 32 never stop or question Dr. John before he accessing Joyce’s data?Did Joyce know about his husband was cheated over her?Why Dr. John didn’t tell Joyce beforehand or ask for Joyce’s opinion? Step 3 Respect for AutonomyJoyce was not informed that her confidentiality would be accessed by Dr. John who was not involved in the care. This is failing to respect Joyce’s personal rights.BeneficenceDr. John told Joyce that her husband was cheated over her but John assume that I would not be upset after knowing these issues. FidelityDr. John as medical professional did not obey to Singapore Medical council Physician’s Pledge which is to “maintain due respect for human life” (SMC 2016) Paternalism Dr John was acted in a paternalism manner but he did not seek for Joyce’s permission before accessing her personal information, he assumed that I would not doubt about his competency. Justice The nurses in ward 32 did not display Justice. The nurses did not stop and question Dr. John before he accesses the patient’s information that was not under his care. Hence, Joyce did not receive the fairness treatment as other patients do as her privacy was invaded. VeracityDr. John told Joyce the truth that her husband, Dr. Steve was cheated over him with Betty. Non-maleficenceThe harm caused was John upset Joyce as he accesses her personal data unauthorized, however, beneficence is that he had told her the truth that her husband cheated on her. Integrity in ConfidentialityDr. John did not seek any permission to access Joyce’s personal information that was not under his care. Step 4 In Joyce’s view, as a patient, she wants to be respectful and expected that the professionals to act in a responsible manner. Dr. John’s moral position is to respect the client’s individual values, privacy and confidentiality. Under the SMC Physician’s Pledge “Respect the secrets which are confided in me; uphold the honor and noble traditions of the medical profession” (SMC 2016). This is applicable to my scenario as Dr. John breached and access Joyce’s personal data that was not under his care.International Patient Safety Guidelines Goals is not applicable in this scenario because the main issues is fall on the doctor and the patient. However, Goal 2: to improve effective communication is breached as the nurses did not stop and question Dr. John before he accesses Joyce’s personal data that not under his care. Standard of Practice for Nurses and Midwives SNB 2011 is applicable in this scenario because there were nurses involved. She has breached Standard 2 Responsibility and Accountability which is to protect patients by recognizing and reporting unsafe practices when the patient’s safety and well-being are potentially compromised.International Council of Nurse Code of Ethics for Nurses (2012) is applicable to my scenario because the nurses and doctors were involved a they did not protect the patient’s privacy. The nurses breached Code #1: Nurse and People, which is to provide care that respects human rights and is sensitive to the values, customers, and beliefs of people. Code of Ethics and Professional Conduct Singapore Nursing Board is applicable for both nurses and doctors, Value Statement 3: Safeguard People’s right to privacy and confidentiality was breached because nurses did not maintain the safeguard and confidentiality unless there is sound justification for disclosure to be made without the person’s consent. The nurses did not protect the patient’s data by stopping Dr. John to access Joyce’s data. Step 5 The moral position of the key individuals are, Joyce as a patient, she wishes her personal data to be protected, including her confidentiality. Dr. John, as the medical personnel, must adopt professionalism attitude such as evidence of honesty and integrity and accountability for themselves and colleagues. (The World Book of Family Medicine, 2015). As nurses, they should protect and respect the patient’s rights, to provide and maintain confidentiality and be accountable for their actions as they are guided by the Singapore Nursing Board. Step 6 The values conflicts are: Nurses failing to protect Joyce’s rights to confidentiality. Dr. John failed to act in a responsible manner by accessing Joyce’s data that was not under his care.Step 7 Nurses should make the decision to tell Joyce that her personal data was exposed by Dr. John. Besides, Nurses should also advise Dr. John that he should have apologized to Joyce that he had accessed her data for the sake of his own purpose. Step 8 Alternatives ConsequenceNo action As the doctor is unaware of how to handle the incident, Joyce might get upset due to his actions. Nurses can still continue with their daily work routine but the patient might get worried about their working attitude.Report to Singapore Medical Council Singapore Medical Council would investigate this breach of confidentiality. The nurses must be willing to accept that they would be questioned for reporting Dr. John to the Singapore Medical Council.confronting the doctor Dr. John and Nurses might have an argument. This would lead to a loss of the patient-doctor working relationship. The doctor might refuse to treat the nurses as his patient and advise them to seek medical advice from other doctors.Temporary AccommodationNurses can advise him to apologize to Joyce and let Dr. John, Betty, Joyce, and his husband to discuss their issues harmony in a room.Step 9I will choose to report Dr. John to the Singapore Medical Council. As the doctor had breached the patient’s rights and privacy. The doctor access Joyce’s data not under his care and without Joyce and the ward nurses’ permission. Even though I might be questioned about my responsibility but the doctor has harmed my patient’s rights hence I should place my client at my first priority.Step 10 I might be experiencing any unpleasant interrogations but it is important that as a nurse, I will be able to learn from the mistake and serve my patients with better performance. Moreover, by doing this, all the patients will be treated fairly and this is to help in the prevention of recurrence of exposure of confidentiality. The doctor will also be questioned by the Singapore Medical Council but it is good that he can know where to improve.Anticipated objectionsJoyce might object to my decision as she might be thankful that Dr. John who acted in a veracity manner to tell her the truth that her husband was cheating on her. Conclusion Joyce might object to my decision as she might be thankful that Dr. John who acted in a veracity manner to tell her the truth that her husband was cheating on her.
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