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Journal articles on the topic 'Patient confidentiality; Medical ethics'
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1
Niveau, Gerard, Sandra Burkhardt, and Sarah Chiesa. "Medical confidentiality and the competent patient." Journal of Medical Ethics 39, no. 11 (January 7, 2013): 686–89. http://dx.doi.org/10.1136/medethics-2012-100947.
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Waddington, Ivan, Andrea Scott-Bell, and Dominic Malcolm. "The social management of medical ethics in sport: confidentiality in English professional football." International Review for the Sociology of Sport 54, no. 6 (October 9, 2017): 649–65. http://dx.doi.org/10.1177/1012690217733678.
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This paper examines one of the major ethical challenges in the practice of sports medicine, confidentiality. Drawing on interview and questionnaire data with doctors and physiotherapists working in English professional football clubs, it explores the degree to which ethical compliance has improved since the publication of, and publicity surrounding, an earlier study of medical practice in professional football conducted by Waddington and Roderick. Thus, it provides an updated empirical examination of the management of medical ethics in sport. The data illustrate how the physical and social environmental constraints of sports medicine practice impinge upon the protection of athlete-patient confidentiality, how ethical codes and conflicting obligations converge to shape clinician behaviour in relation to lifestyle and injury issues, and the ethically problematic contractual constraints under which clinicians and athletes operate. It demonstrates that medical ethical practice continues to be very variable and draws on Freidson’s work on medical ‘work settings’ to argue that there is a need to augment existing confidentiality policies with more structurally oriented approaches to ensure both professional autonomy and medical ethical compliance in sport.
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Choong, Kartina Aisha, and Jeanne Pia Mifsud Bonnici. "Posthumous Medical Confidentiality." European Journal of Comparative Law and Governance 1, no. 2 (May 12, 2014): 106–19. http://dx.doi.org/10.1163/22134514-00102002.
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This paper reflects on the balancing of public interests that needs to be undertaken under English law when dealing with posthumous medical confidentiality. Until 2007, doctors were bound only by professional codes of ethics to maintain confidentiality after their patients’ death. In 2008, the High Court stated that it is arguable that confidentiality applies in the post-mortem context. This, it claimed, is in the public interest. The court then followed the ecthr in using the same basis – public interest – to accept that there may be exceptions to this duty. This paper considers different situations where multiple interests come together for and against the posthumous disclosure of medical information. This examination suggests that there is considerable uncertainty caused by using one notion of public interest to justify confidentiality, and another to make the case for disclosure. It calls for the legislator to intervene to help resolve the conundrum.
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Aacharya, Ramesh P., and Yagya L. Shakya. "Knowledge, attitude and practice of medical ethics among medical intern students in a Medical College in Kathmandu." Bangladesh Journal of Bioethics 6, no. 3 (May 6, 2016): 1–9. http://dx.doi.org/10.3329/bioethics.v6i3.27613.
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This baseline study was conducted to find out the knowledge, attitudes and practices of medical ethics among the undergraduate medical interns who did not have structured ethics curriculum in their course. A descriptive, cross-sectional study was carried out using a self-administered structured questionnaire among the medical undergraduate interns of Maharajgunj Medical Campus, the pioneer medical college of Nepal which enrols 60 students in a year. A total of 46 interns participated in the study. The most common source of knowledge on ethics was lectures/seminars (35.7%) followed by experience at work (24.5%), training (21.4%) and own reading (17.3%). The main contents of Hippocratic Oath were known to 98.8% while 60.9% knew the main contents of Nepal Medical Council (NMC) code of ethics. Great majority (91.3%) regard ethics as very important in medical profession. Doctors know the best irrespective of patients opinion was disagreed by only 39.1% indicating the paternalistic attitude. However, 78.3% were in favour of adhering to the patients wish. None of the participant agreed to abandon confidentiality. Only about one-fourth (26.1%) claim to encounter ethical dilemma every day while the highest number (43.5%) had once in a month. To deal with the situation of ethical dilemma, majority approached to immediate supervisor followed by head of the department and colleagues. Eighty-seven percent of participating interns were involved in research activities involving human subjects. Only one of the participants had encountered the ethical issue on end-of-life and it was do-not-resuscitate consent in a terminally ill patient. On implementation of the curriculum on medical ethics focus should be - principles of biomedical ethics, sensitive ethical dilemmas like end-of-life care and practical experiences with participation in deliberations of the ethics committee.
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Cosyns, P. "Medical ethics and the judicial coerced treatment of sexual abusers." European Psychiatry 13, S3 (1998): 121s—124s. http://dx.doi.org/10.1016/s0924-9338(98)80043-6.
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SummaryThe increasing demand for judicial coerced treatment of sexual abusers constitutes a new challenge for mental health professionals. The discussed controversial ethical issues are the influence of coercion on the treatment, the motivation of patient as well as therapist, confidentiality and hormonal treatment. Social control is not the primary concern of therapists and any treatment must be beneficial to the individual patient. The coerced treatment of sexual abusers requests an agreement between psychiatric and judicial authorities with respect for their respective professional ethics.
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Boulliat, Caroline, Gilles Melki, François Targe, and Bernard Massoubre. "Ethics and confidentiality of a patient in a medical biology laboratory." Annales de Biologie Clinique 78, no. 6 (December 2020): 665–70. http://dx.doi.org/10.1684/abc.2020.1597.
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Kamran, Maha, Sarah Arif, and Sameen Ejaz. "Professional Secrecy And Privileged Communication In Medical Practice." Pakistan Journal of Surgery and Medicine 1, no. 1 (February 1, 2020): 72–74. http://dx.doi.org/10.37978/pjsm.v1i1.99.
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A medical professional has the faith and confidence of society in him/her. It is his utmost duty and responsibility to uphold the ethical standards of confidentiality, set forth in the Hippocratic Oath, the Declaration of Geneva, the International Code of Medical Ethics and the World Health Organization. Communication between the physician and his patient is privileged. This information can only be divulged, in part, under special circumstances.
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Sykes, Leanne M., and Elmine Crafford. "Consent and confidentiality in children." South African Dental Journal 75, no. 8 (September 30, 2020): 462–64. http://dx.doi.org/10.17159/2519-0105/2020/v75no8a9.
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Confidentiality is central to the establishment and preservation of trust between a doctor and their patient, yet is one of the lesser-discussed principles of medical bio-ethics. A "duty of confidence arises when one person discloses information to another in circumstances where it is reasonable to expect that information to be held in confidence".1
Its moral basis is in that it should improve patient welfare, and as such, it is encompassed during all aspects of the treatment process, beginning with the initial consultation where patient autonomy and informed consent are first addressed.
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Maixner, Andrew H., and Karine Morin. "Confidentiality of Health Information Postmortem." Archives of Pathology & Laboratory Medicine 125, no. 9 (September 1, 2001): 1189–92. http://dx.doi.org/10.5858/2001-125-1189-cohip.
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Abstract Context.—Recent discussions of health care privacy have prompted new concerns over the control of private health information after a patient's death. The importance of confidentiality protections postmortem is compounded as genetic technologies and research capabilities advance and public interest in this information increases. Objective.—The Council on Ethical and Judicial Affairs of the American Medical Association developed this report to guide physicians in the management of patients' health information postmortem. Participants.—This report was developed by the 9 physician members of the Council on Ethical and Judicial Affairs with the assistance of staff from the Ethics Standards Group at the American Medical Association. Evidence.—Literature searches in the MEDLINE and BIOETHICSLINE databases using the search terms postmortem and health information qualified with confidentiality or privacy yielded a combined total of 129 references. Additional references were culled from policies of a number of health care organizations. Consensus Process.—The Council on Ethical and Judicial Affairs solicited suggestions from the federation of state medical and specialty societies before drafting this report. A copy of the report was sent to the College of American Pathologists for comment. It was then adopted by a majority vote of the House of Delegates of the American Medical Association. Conclusions.—The report emphasizes the importance of maintaining confidentiality for information held within a deceased patient's medical record. However, these protections are subject to certain exceptions. Confidentiality can be upheld when such information is used for educational or research purposes by removing individual identifiers. For disclosures in which the identity of the deceased patient is known, a number of considerations are provided to assess when disclosure would be ethically permissible.
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Büken, Erhan, Serap Sahinoğlu, and Nüket Örnek Büken. "Statutory Disclosure in Article 280 of the Turkish Penal Code." Nursing Ethics 13, no. 6 (November 2006): 573–80. http://dx.doi.org/10.1177/0969733006069693.
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A new Turkish Penal Code came into effect on 1 June 2005. Article 280 concerns health care workers’ failure to report a crime. This article removes the responsibility from health care workers to maintain confidentiality, but also removes patients’ right to confidentiality. It provides for up to one year of imprisonment for a health care worker who, while on duty, finds an indication that a crime might have been committed by a patient and who does not inform the responsible authorities about it. This forces the health care worker to divulge the patient’s confidential information. A patient who thinks he or she may be accused of a crime may therefore not seek medical help, which is the universal right of every person. The article is therefore contrary to medical ethics, oaths taken by physicians and nurses, and the understanding of patient confidentiality.
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McQueen, Matthew J. "Ethics and Laboratory Medicine." Clinical Chemistry 36, no. 8 (August 1, 1990): 1404–7. http://dx.doi.org/10.1093/clinchem/36.8.1404.
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Abstract Ethical issues have been given limited attention by professionals in laboratory medicine. Professional ethics is the moral bond that links a profession, the people it serves, and society. Understanding the complexities of individual and common good is essential for full professional participation in major issues in health care. Specific issues that challenge laboratory professionals in clinical research are allocation of health-care resources, testing conducted nearer the patient, confidentiality, screening tests, and molecular biology. A voice in ethical issues is an essential element of professional independence. The ethical attitudes we display influence the kind of people who choose to work in our profession. More open discussion about ethics is necessary in our professional literature.
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O'Donovan, Katherine, and Roy Gilbar. "The loved ones: families, intimates and patient autonomy." Legal Studies 23, no. 2 (June 2003): 332–58. http://dx.doi.org/10.1111/j.1748-121x.2003.tb00217.x.
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Patient autonomy is one of the central values in medical ethics. It is generally understood as recognition of patients' rights as free individuals answerable only to themselves. This emphasis on the individual leaves open the question of the position of the patients' ‘loved ones’, that is of families and significant others. The authors examine this question in three areas of law and medical ethics. Organ donation offers an example of preference given by medical ethics to family views, notwithstanding an expressed wish of the deceased to donate, and the legal position protecting such a request. Decisions concerning the treatment of incompetent patients illustrate consideration for the family in medical ethics, but hesitations in both law and ethics in accepting family views once expressed. And the tension between the interests of patients and family members over the access to genetic information usually results in respecting the patient's right to confidentiality. This individualistic perception of autonomy, as adopted by medical law, overlooks the patient's relationships with others and is too narrow to face the complexities of human lives.
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Yacoub, A. A., and N. A. Ajeel. "Teaching medical ethics in Basra: perspective of students and graduates." Eastern Mediterranean Health Journal 6, no. 4 (August 15, 2000): 687–92. http://dx.doi.org/10.26719/2000.6.4.687.
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The University of Basra Medical College introduced a course on medical ethics for undergraduate students in 1994. We explored the opinions of 54 graduates and 52 final-year medical students about the benefits they perceive they gained from the course and its relevance to their training or practice. About 31% of students and 34% of graduates thought the course was practically and theoretically useful. Over 80% of graduates and students thought the course was either very relevant or relevant to some extent to the practice of medicine. When asked to recall the important ethical issues taught in the course, 52% of graduates and 44% of students listed patient-doctor relationship. Confidentiality, physician liability and ethical issues concerning recent medical innovations were listed by few respondents. Only 6% of both graduates and students were able to list the four principles of medical ethics as described by Raanan. The self-learning component of the course should be developed to strengthen ethical reasoning and judgment in decision-making
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Choudhury, Minati, and Poonam Malhotra Kapoor. "Are We Clinicians Away from Ethics?" Journal of Cardiac Critical Care TSS 02, no. 02 (December 2018): 066–70. http://dx.doi.org/10.1055/s-0039-1685413.
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AbstractMedicine has always stood at the intersection between science and society. From antiquity to the present, everyone has faced health challenges that prompted the formation of groups of healers and the development of codes of ethics to govern the treatments that they offered. Medical codes of ethics blend the moral precepts, normative behavior, and social duties of the population in which they are used, and they change as new medical therapies and social issues arise. The written codes of ethics are based on modern terms for many of the issues raised in Charak Samhita. They also represent an effort to codify the essence of “the clinical encounter between physician and patient” and the role of society while emphasizing the importance of compassion, beneficence, nonmaleficence, respect for persons, and accountability. Medical ethics have been an integral part of Charak Samhita and its complete incorporation in present-day medical teaching and clinical practice will yield great results to this noble profession. Is it true that we clinicians are away from practice of ethics in medicine? Are we not following a structural approach to identify, analyze, and resolve ethical issue in clinical practice? We as clinicians should have some working knowledge about informed consent, confidentiality, patient's rights, and end-of-life care. At times, clinicians and patients disagree about the choices that may challenge their lives. It is then that ethical problem rises. While dealing with a patient, ethical problem can be avoided when the case is analyzed in four important areas: medical/surgical indications, preference by patient, quality of life with or without treatment, and other circumstantial features, for example socioeconomic, legal, or administrative aspects of the case.
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Pauls, Merril, Andrew McRae, Sam G. Campbell, and Paul Dungey. "Ethics in the trenches: Part 2. Case studies of ethical challenges in emergency medicine." CJEM 6, no. 05 (September 2004): 363–66. http://dx.doi.org/10.1017/s1481803500009672.
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ABSTRACT Unique ethical issues arise in the practice of emergency medicine, and common ethical problems are often more difficult to address in the emergency department than in other medical settings. This article is Part 2 of the Series “Ethics in the Trenches” and it presents and analyses 2 cases — each dealing with an ethical challenge that emergency physicians are likely to encounter. The first case deals with patient refusal of care. When a patient refuses recommended care, the emergency physician must ensure the patient’s decision is informed and that the patient comprehends the implications of his or her choice. The second case deals with patient involvement in criminal activities. Emergency physicians often encounter patients who have engaged in illegal activities. Although certain activities must be reported, physicians should be mindful of their responsibility to protect patient privacy and confidentiality.
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Rajamohanan, Remya Raj, Manjiri Phansalkar, and Sheela Kuruvila. "Awareness about medical ethics among undergraduates after introduction of humanities in curriculum." International Journal of Research in Dermatology 7, no. 5 (August 23, 2021): 636. http://dx.doi.org/10.18203/issn.2455-4529.intjresdermatol20213164.
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<p class="abstract"><strong>Background:</strong> Modern day medicine is full of ethical challenges. A structured training in ethics can help doctors in choosing the best course of action during an ethical dilemma. It will be interesting to explore the knowledge and aptitude regarding bioethics in medical students who are already undergoing structured modules on humanities.</p><p class="abstract"><strong>Methods:</strong> A cross-sectional study was done involving final year part I, final year part II medical students and interns using a validated semi-structured self-administered questionnaire. Questions were predominantly about doctor patient relationship which could be assessed using Likert scale.<strong></strong></p><p class="abstract"><strong>Results:</strong> Acceptable response of over 70% was seen only in response to two questions, both on respect for person. Majority of students did not have a clear concept about consent, privacy and confidentiality. However, most of them gave acceptable response to respecting patient and his wishes. There were many fence sitters in response to the questions regarding paternalistic attitude of doctors and physician autonomy. Majority of students did not give acceptable response in questions pertaining to beneficence and justice. No significant difference was seen between the various phases of medical education.</p><p class="abstract"><strong>Conclusions:</strong> The students were not clear about most aspects of doctor patient relationship like physician autonomy, confidentiality and consent. We need to revamp our teaching to increase understanding of ethics among our medical students.</p>
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Ersoy, Nermin, and Ümit N. Gündoğmuş. "A Study of the Ethical Sensitivity of Physicians in Turkey." Nursing Ethics 10, no. 5 (September 2003): 472–84. http://dx.doi.org/10.1191/0969733003ne6290a.
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In order to prepare bioethics and clinical ethics courses for clinicians in Turkey, we needed to know the attitudes of physicians when placed in ethically difficult care situations. We presented four cases to 207 physicians who are members of the Physicians’ Association in Kocaeli, Turkey. Depending on the decisions they made in each case, we determined whether they were aware of the ethical aspects of the cases and the principles they chose as a basis for their decisions. We aimed to gain information about their ethical tendencies and moral sensitivity. A small number of physicians stated that they would ‘show respect for a patient’s living will’ in the first case, but more stated that they would ‘let the patient refuse the treatment’ in the second. In the third case, where medical confidentiality was the significant ethical issue, most of the physicians said that they would act in order to maintain confidentiality. For the last case, more than half the physicians chose to ‘tell the truth’ to the patient. The paternalism shown in the doctors’ decisions on the first two cases was no longer observed in those made for the last two cases. We concluded that the physicians who participated in our study have low sensitivity to living wills (or advance directives) and patients refusing treatment. However, when issues of medical confidentiality and truth-telling are concerned, they take care to protect the autonomy of the individual and are relatively more aware of the ethical aspects of these cases.
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Jansen, Lynn A., and Lainie Friedman Ross. "Patient Confidentiality and the Surrogate's Right to Know." Journal of Law, Medicine & Ethics 28, no. 2 (2000): 137–43. http://dx.doi.org/10.1111/j.1748-720x.2000.tb00003.x.
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Physicians treating newly incapacitated patients often must navigate surrogate decision-makers through a difficult course of treatment decisions. Such a process can be complex. Physicians must not only explain the medical facts and prognosis to the surrogate, but also attempt to ensure that the surrogate arrives at decisions that are consistent with the patient's own values and wishes. Where these values and wishes are unknown, physicians must help surrogates make decisions that reflect the patient's best interests.
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Grabowska, Maria. "Wyjątki od obowiązku zachowania tajemnicy lekarskiej." Zeszyty Naukowe Uniwersytetu Rzeszowskiego. Seria Prawnicza. Prawo 29 (2020): 327–38. http://dx.doi.org/10.15584/znurprawo.2020.29.22.
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The purpose of this paper is to present statutory and non-statutory conditions that must be met in order for the disclosure of information covered by professional confidentiality in relation to the complex doctor–patient relationship to be legitimate. The article discusses the catalog of circumstances excluding the obligation of medical confidentiality, resulting from normative acts of the statutory rank (Act of 5 December 1996 on the professions of physician and dentist, Journal of Laws 1997 No. 28, item 152; Act of 6 November 2008 on patient rights and the Ombudsman for Patient Rights, Journal of Laws 2009 No. 52, item 417), as well as the provisions of the Medical Code of Ethics.
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Alan, Sultan, and Hasan Erbay. "Patient Privacy and Confidentiality in the Ambulance Services from the Perspective of Medical Ethics." Journal of Academic Emergency Medicine 10, no. 1 (March 1, 2011): 33–38. http://dx.doi.org/10.5152/jaem.2011.008.
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Beto, Judith A., Mark C. Geraci, Patricia A. Marshall, and Vinod K. Bansal. "Pharmacy Computer Prescription Databases: Methodologic Issues of Access and Confidentiality." Annals of Pharmacotherapy 26, no. 5 (May 1992): 686–91. http://dx.doi.org/10.1177/106002809202600515.
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OBJECTIVE: To examine methodologic issues of access and confidentiality regarding the use of pharmacy computer prescription databases (PCPDs) for participant selection to receive mailed, self-administered, hypertensive quality-of-life survey outside a primary-care setting. DESIGN: Two separate PCPD searches by pharmacist owners for patients prescribed at least one of 130 potential antihypertensive medications. The first PCPD used a nonrandom sample of all patients (n=635); the second PCPD used a random sample (n=100) of three specific antihypertensive drug groups. Research protocol was approved by the investigators' institutional review board. SETTING: Two independent, privately owned PCPDs. PATIENTS OR OTHER PARTICIPANTS: Individuals prescribed at least 1 of 130 PCPD medications potentially used in antihypertensive treatment. INTERVENTIONS: Individually addressed cover letter on pharmacy letterhead signed by a pharmacist requesting voluntary completion of the enclosed, self-administered, opinion survey on quality of life. MAIN OUTCOME MEASURE: Anonymous survey return to off-site post office box in envelope provided. RESULTS: Favorable or no opposition to PCPD methodology from pharmacist or participants. Ethical opposition was encountered when incorporating PCPD sampling technique into grant proposal. CONCLUSIONS: The American Pharmaceutical Association Code of Ethics is used as a basis to provide recommendations to examine and justify PCPD investigative use. Increasing availability of PCPD technology encourages more efficient and easier methods of research strategy. PCPD use, however, demands identical stringent guidelines used in traditional research and raises potential issues regarding pharmacist-patient confidentiality as well as the right of PCPD use by others.
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SHENOY, AKHIL, and JACOB M. APPEL. "Safeguarding Confidentiality in Electronic Health Records." Cambridge Quarterly of Healthcare Ethics 26, no. 2 (March 31, 2017): 337–41. http://dx.doi.org/10.1017/s0963180116000931.
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Abstract:Electronic health records (EHRs) offer significant advantages over paper charts, such as ease of portability, facilitated communication, and a decreased risk of medical errors; however, important ethical concerns related to patient confidentiality remain. Although legal protections have been implemented, in practice, EHRs may be still prone to breaches that threaten patient privacy. Potential safeguards are essential, and have been implemented especially in sensitive areas such as mental illness, substance abuse, and sexual health. Features of one institutional model are described that may illustrate the efforts to both ensure adequate transparency and ensure patient confidentiality. Trust and the therapeutic alliance are critical to the provider–patient relationship and quality healthcare services. All of the benefits of an EHR are only possible if patients retain confidence in the security and accuracy of their medical records.
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Sayeed, Hassen A. "Patient Confidentiality: Hospital’s Release of Alcohol Treatment Data Does Not Violate Regs." Journal of Law, Medicine & Ethics 30, no. 2 (2002): 319–21. http://dx.doi.org/10.1017/s1073110500008597.
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In M.A.K. v. Rush-Presbyterian-St. Luke's Medical Center, the Illinois Supreme Court reversed the appellate court and held that the phrase any physician, medical practitioner, hospital, clinic, health care facility or other medical or medically related facility, in a patient's signed consent form met the general designation requirement of the Code of Federal Regulations for the release of alcohol and drug abuse treatment records. Thus, the Illinois Supreme Court held that the medical center's release of a patient's records did not violate the federal Confidentiality of Alcohol and Drug Abuse Patient Records regulations.
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Våga, Bodil Bø, Karen Marie Moland, and Astrid Blystad. "Boundaries of confidentiality in nursing care for mother and child in HIV programmes." Nursing Ethics 23, no. 5 (August 2016): 576–86. http://dx.doi.org/10.1177/0969733015576358.
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Background: Confidentiality lies at the core of medical ethics and is the cornerstone for developing and keeping a trusting relationship between nurses and patients. In the wake of the HIV epidemic, there has been a heightened focus on confidentiality in healthcare contexts. Nurses’ follow-up of HIV-positive women and their susceptible HIV-exposed children has proved to be challenging in this regard, but the ethical dilemmas concerning confidentiality that emerge in the process of ensuring HIV-free survival of the third party – the child – have attracted limited attention. Objective: The study explores challenges of confidentiality linked to a third party in nurse–patient relationships in a rural Tanzanian HIV/AIDS context. Study context: The study was carried out in rural and semi-urban settings of Tanzania where the population is largely agro-pastoral, the formal educational level is low and poverty is rife. The HIV prevalence of 1.5% is low compared to the national prevalence of 5.1%. Methods: Data were collected during 9 months of ethnographic fieldwork and consisted of participant observation in clinical settings and during home visits combined with in-depth interviews. The main categories of informants were nurses employed in prevention of mother-to-child transmission of HIV programmes and HIV-positive women enrolled in these programmes. Ethical considerations: Based on information about the study aims, all informants consented to participate. Ethical approval was granted by ethics review boards in Tanzania and Norway. Findings and discussion: The material indicates a delicate balance between the nurses’ attempt to secure the HIV-free survival of the babies and the mothers’ desire to preserve confidentiality. Profound confidentiality-related dilemmas emerged in actual practice, and indications of a lack of thorough consideration of the implication of a patient’s restricted disclosure came to light during follow-up of the HIV-positive women and the third party – the child who is at risk of HIV infection through mother’s milk. World Health Organization’s substantial focus on infant survival (Millennium Development Goal-4) and the strong calls for disclosure among the HIV-positive are reflected on in the discussion.
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Ferguson, Angus H. "The Role of History in Debates Regarding the Boundaries of Medical Confidentiality and Privacy." Journal of Medical Law and Ethics 3, no. 1 (August 25, 2015): 65–81. http://dx.doi.org/10.7590/221354015x14319325750070.
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Medical confidentiality and privacy are often given a long pedigree as core issues in medical ethics that can be traced back to the Hippocratic Oath. However, it is only recently that focused historical work has begun to examine and analyse in greater detail how the boundaries of medical confidentiality and privacy have evolved within a variety of cultural contexts during the modern period. Such research illustrates the ways in which this process has been shaped by a range of issues, individuals, interest groups and events; and been influenced as much by pragmatic concerns as by theoretical arguments. This paper presents a case for the merits of promoting further historical work on these topics. It suggests that greater support for, and recognition of, historical research has a number of potential benefits. These include providing meaningful context to current interdisciplinary discussions of the collection and use of patient information; improving knowledge and understanding of the foundations on which current policy and practice are built; and promoting public engagement and understanding of the evolution of medical confidentiality and privacy as complex public interest issues.
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Raut, Shristi, and Anand Kumar. "Medical Ethics in Clinical Practice in Nepal: Challenges and Way Forward." Journal of Universal College of Medical Sciences 6, no. 2 (December 3, 2018): 69–72. http://dx.doi.org/10.3126/jucms.v6i2.22500.
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Ethics for health care professional have many components. Among them, medical ethics is one of the important but neglected component which deals with issues related to confidentiality, beneficence and non-maleficence between health care providers and stake holders. Four basic principles of medical ethics are autonomy, justice, beneficence and non- maleficence which form the foundation of ethical clinical practice. The level of knowledge on medical ethics that medical students receive during the training is meagre and inadequate. In recent years, clinical practice has become more challenging. This is primarily due to increased opposition, aggression and violence against medical professionals at health care settings. As a result, the gap between clinicians and patients is increasing leading to diminishing trust and real/perceived allegations. In addition, the widening gap between doctors and patients has provided a space for middle men/broker to meddle, oppose and flare up the violence against treatment providers. Doctors and other medical professionals have been increasingly facing such challenges leading to circumspection in their practice, despondence, psychosocial trauma and depression. There is an urgent need of incorporation of medical ethics in undergraduate curriculum and independent hospital ethics committee consisting of experts from the hospital and outside to monitor and provide rational reasons to minimize such challenges.
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Dowie, Al. "Whatever Ought Not To Be Spoken Of Abroad: Formation (of Medical Students) and Information (of Patients)." Journal of Medical Law and Ethics 3, no. 1 (August 25, 2015): 25–43. http://dx.doi.org/10.7590/221354015x14319325749991.
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Confidentiality has a pre-eminent status in the medical curriculum for ethics, law, and professionalism because it does not depend on prior clinical learning or scientific knowledge, and it provides students with the opportunity to engage in the work of self-formation in professional practice from the very beginning. The historical tendency to romanticise medical professionalism, and confidentiality in particular as a symbol for this, was able to thrive in previous eras as a result of uncertainty around the boundaries of disclosure. To some extent echoes of this romanticism can still be heard today in rhetorical appeals to the Hippocratic tradition despite the development of detailed clarification in frameworks of law, standards, codes, professional regulation, and guidance from the second half of the 20th century. This paper considers two iconic portrayals of medical professionalism from the romantic period of the Victorian past, contrasting that era with the present-day environment of normative codifications. While ethics is commonly approached in an intellectual mode as a discussion of theory, a purely cognitive understanding is deficient on its own since learning in professional ethics must by definition be reified as sets of practices. The shift to the clinical accountability of today means that practices are of central importance to the undergraduate medical curriculum, not least in the area of confidentiality, for which the General Medical Council guidance sets the UK agenda for medical educational approaches to teaching, learning, and assessment, before students repeat the Hippocratic Oath at graduation as they embark on their future careers as doctors.
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Stanberry, Ben. "The legal and ethical aspects of telemedicine. 1: Confidentiality and the patient's rights of access." Journal of Telemedicine and Telecare 3, no. 4 (December 1, 1997): 179–87. http://dx.doi.org/10.1258/1357633971931101.
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This paper reviews the principle of confidentiality and the rights of access by patients to their medical records. Confidentiality has been germane to the ethics of medical practice since the time of Hippocrates but the nature of the legal obligation of confidence does not have such a clear pedigree. The introduction of crossborder telemedical consultations presents a very real danger to maintaining the confidentiality of medical data. While both the common law and statute law can be used to prevent the unauthorized interception and disclosure of medical data and protect the patient's rights of access and ownership in the UK, it is the harmonization regime of the European Union that will bring comprehensive regulation and legal clarity to the protection of patients' rights within an increasingly international medical super-specialty'.
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Szmukler, George. "Ethics in Community Psychiatry." Australian & New Zealand Journal of Psychiatry 33, no. 3 (June 1999): 328–38. http://dx.doi.org/10.1046/j.1440-1614.1999.00597.x.
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Objective: The aim of this paper is to clarify the ethical challenges resulting from new models of community psychiatry and to examine practical approaches aimed at meeting them. Method: Review of the literature and observations both as clinician and medical director of community services. Results: Assertive community treatment presents ethical dilemmas relating to privacy, confidentiality, ‘coercion’ and conflicts of duty to the patient versus others, including carers and the wider community. Their acuity is influenced by the context in which services are provided, especially community fears of the consequences of care in the community for the severely mentally ill. Approaches to resolving ethical problems include increasing patient involvement in their care, clarifying the grounds for ‘paternalistic’ interventions, and re-examining grounds for acting to reduce the risk of harm to others. Conclusions: The ethical dilemmas are not new, but they present in sufficiently different guises to warrant reconsideration in their new context. There has been a reluctance to face them, but if community psychiatric practice is to survive, it must rest on a sound ethical base.
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Geller, Gail, Ellen S. Tambor, Barbara A. Bernhardt, Gary A. Chase, Karen J. Hofman, Ruth R. Faden, and Neil A. Holtzman. "Physicians' Attitudes toward Disclosure of Genetic Information to Third Parties." Journal of Law, Medicine & Ethics 21, no. 2 (1993): 238–40. http://dx.doi.org/10.1111/j.1748-720x.1993.tb01246.x.
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Confidentiality is a cornerstone of the physician-patient relationship. Breaches of confidentiality in the context of genetic testing are of particular concern for a number of reasons. First, genetic testing reveals information not only about a particular patient, but also about his or her family members. Second,genetic testing can label healthy people as “at risk,” subjecting them to possible stigmatization or discrimination by third parties. Third, as genetic testing becomes more widespread and is incorporated into primary care, breaches of confidentiality might inadvertently occur more frequently because primary care providers may not be trained to understand the uniqueness of genetic information. Until now, genetic services have been provided primarily by medical geneticists and genetic counselors. However, with the proliferation of new genetic presymptomatic and carrier tests, primary care physicians are going to become increasingly involved in genetic testing. Currently, little is known about physicians’ attitudes (other than those of medical geneticists) toward disclosure of confidential genetic information to third parties.
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Mair, Judith. "Duty of Confidentiality and HIV/AIDS." Health Information Management Journal 37, no. 3 (October 2008): 50–54. http://dx.doi.org/10.1177/183335830803700307.
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The duty to maintain patient confidentiality is an ethical and legal priority for all health professionals. There is a common law duty in addition to statutory duties imposed by various privacy statutes. An ethical dilemma can arise when a patient is diagnosed with HIV/AIDS because a practitioner becomes aware that third parties can be placed at risk of a serious infection if the patient passes the disease on to those parties. The question arises as to what extent a medical practitioner, should he or she suspect a patient to be a risk of being HIV positive, is legally and ethically obliged to counsel the patient to undergo HIV antibody testing. In a case heard in the New South Wales Supreme Court in 1999, BT v Oei (1999) NSWSC 1082, a medical practitioner was held to owe a duty of care to the sexual partner/s of a patient whom he should have counselled to have HIV testing, who in fact tested positive after a period of time and had in turn infected his wife.
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Johnson, Laura S., Jason Lesandrini, and Grace S. Rozycki. "Use of the Medical Ethics Consultation Service in a Busy Level I Trauma Center: Impact on Decision-Making and Patient Care." American Surgeon 78, no. 7 (July 2012): 735–40. http://dx.doi.org/10.1177/000313481207800709.
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The purposes of this study were to assess reasons for consultation of the Ethics Consultation Service for trauma patients and how consultations impacted care. We conducted a review of ethics consultations at a Level I trauma center from 2001 to 2010. Data included patient demographics, etiology of injury, and timing/type of the consult, categorized as: shared decision-making, end-of-life, privacy and confidentiality, resource allocation, and professionalism. Consultations were requested on 108 patients (age mean, 46.5 ± 20 years; Injury Severity Score mean, 23 ± 14; length of stay [LOS] mean, 44 ± 44 days), 0.50 per cent of all trauma admissions. Seventy-seven per cent of consultations occurred in the intensive care unit. End of life was the most common consultation (44%) followed by shared decision-making (41%). Average time to consultation was 25 days. Shared decision-making consults occurred much earlier than end-of-life consults as evidenced by a lower consult day/LOS ratio (consult day/LOS = 0.36 ± 0.3 vs 0.77 ± 0.3, P = 0.0001). Conclusions consisted of: 1) ethics consultation on trauma patients are most commonly for end-of-life and shared decision-making issues; 2) most ethics consultations occur while patients are in the intensive care unit; and 3) earlier ethics consultations are likely to be for shared decision-making issues.
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Sweeney, Latanya. "Weaving Technology and Policy Together to Maintain Confidentiality." Journal of Law, Medicine & Ethics 25, no. 2-3 (1997): 98–110. http://dx.doi.org/10.1111/j.1748-720x.1997.tb01885.x.
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Organizations often release and receive medical data with all explicit identifiers, such as name, address, telephone number, and Social Security number (SSN), removed on the assumption that patient confidentiality is maintained because the resulting data look anonymous. However, in most of these cases, the remaining data can be used to reidenafy individuals by linking or matching the data to other data bases or by looking at unique characteristics found in the fields and records of the data base itself. When these less apparent aspects are taken into account, each released record can map to many possible people, providing a level of anonymity that the recordholder determines. The greater the number of candidates per record, the more anonymous the data.I examine three general-purpose computer programs for maintaining patient confidentiality when disclosing electronic medical records: the Scrub System, which locates and suppresses or replaces personally identifying information in letters between doctors and in notes written by clinicians; the Datafly System, which generalizes values based on a profile of the data recipient at the time of disclosure; and the μ-Argus System, a somewhat similar system which is becoming a European standard for disclosing public use data.
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Mujovic-Zornic, Hajrija. "Challenges of traditional bioethical principles in the implementation of contemporary standards of medical law." Filozofija i drustvo 23, no. 4 (2012): 71–79. http://dx.doi.org/10.2298/fid1204071m.
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The paper focuses on issues of development dimensions of Medical Law and its ongoing process of standardization and harmonization on one hand, versus the traditionally rooted and available principles of biomedical ethics, on the other. The collision of new legal institutes and the spread of human rights protections is evident. This paper follows the theory and practice of medical ethics and medical law. The theoretical aspect points out medical ethics as one of the sources of medical law. Legal theory makes a distinction between formal and autonomous sources of medical law. Even though ethics is morally much higher, law prevails because it has stronger sanctions and legal power. In its practical aspect, this paper gives examples of different situations of medical decision-making processes. Ethical rules are of the utmost relevance in the domain of confidentiality and options of medical treatment. But, in concrete medical procedures, where legal positions of patients are evidently very significant, law has a more distinct function. Therefore, explaining particular cases from medical malpractice, such as cases of penal, civil or professional liability have an ethical dimension as well. Members of medical professions in Serbia often find these cases unfair. Mostly this is the consequence of ignorance in this kind of medical law and ethics relations. A discussion about practical cases has in that sense a self-learning component, which could be developed to strengthen ethical reasoning and judgment.
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Coşkun, Sevim, and Nüket Örnek Büken. "Medical Ethics during the COVID-19 Pandemic." Acta Medica 52, no. 2 (June 15, 2021): 92–101. http://dx.doi.org/10.32552/2021.actamedica.505.
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WHO states five ethical principles for the care of patients with COVID-19: Equal moral respect, duty of care, non-abandonment, protection of the community, and confidentiality. Healthcare professionals might have to make difficult decisions such as selecting patients and withholding or withdrawing mechanical ventilation of critically ill patients. In such difficult situations, a well-prepared action plan which considers ethical principles and prioritizes both public health and the safety of healthcare professionals, can help them. In this case, the development of an effective pandemic action plan, together with a triage plan based on emergency and disaster medicine is necessary. The only parameter of selection in this plan must be the correct application of triage, which respects every human life and depends on the criteria of clinical suitability. In this context, the fundamental ethical principles and human rights must be considered when allocating resources and prioritizing patients. Additionally, all protective measures for healthcare professionals must be taken, including all necessary equipment being adequately provided. If healthcare professionals become infected or face a life-threatening risk, then their obligations will be limited. Therefore, it is necessary to realize these limitations which may arise while providing appropriate health services.
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Merz, Jon F., Pamela Sankar, and Simon S. Yoo. "Hospital Consent for Disclosure of Medical Records." Journal of Law, Medicine & Ethics 26, no. 3 (1998): 241–48. http://dx.doi.org/10.1111/j.1748-720x.1998.tb01425.x.
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Physicians and other health care providers owe ethical and legal duties to patients to maintain the secrecy of the information learned during the course of patient care. This obligation is fulfilled by limiting access to such information to only those involved in the patient's care-that is, to those within the “circle of confidentiality.” As a general rule, providers may only disclose to others with the written prior consent of the patient. Exceptions may be “ethically and legally justified because of overriding social considerations,” when permitted or compelled by law. For example, eleven states permit providers to disclose identified records to approved researchers.’ Many states compel disclosure in cases where a patient threatens serious bodily harm to another; require reporting to health or law enforcement authorities of communicable diseases, gunshot or knife wounds, or child abuse; and mandate reporting of cancer or other health care cases to state registries (such as immunization, birth, and abortion).
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Wright, David, and Renée Saucier. "Madness in the Archives: Anonymity, Ethics, and Mental Health History Research." Journal of the Canadian Historical Association 23, no. 2 (May 23, 2013): 65–90. http://dx.doi.org/10.7202/1015789ar.
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Historians have long been vexed by the challenges of using patient records as primary sources. Lurking behind the many methodological and interpretative challenges are ethical questions involving the status and identity of the dead patient. What rights do the deceased maintain over their medical records? What ethical obligations do researchers have in analyzing these historical records and, in particular, to preserving the anonymity of patients? Do professional duties diminish the further back one goes in time? Do patients suffering from mental distress differ from other “medical” patients in the ethical regard owed to them? Now that we know about the care of the mentally ill outside of formal institutions during the era of the asylum, is there something intrinsically different about the status of individuals once they entered formal institutions? Or do the designations of “lunacy” or “idiocy” on extramural death certificates or in census enumerators’ schedules oblige a similar professional discretion? Is the concern over confidentiality giving way to a new emphasis on returning names (and agency) to vulnerable groups in the past? This paper explores these questions, ones that lie at the heart of what we do as historians of disability, medicine, and society.
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Solli, Hans Magnus, and António Barbosa da Silva. "Physicians in the double role of treatment provider and expert in light of principle-based social insurance medical ethics." Etikk i praksis - Nordic Journal of Applied Ethics, no. 2 (November 6, 2019): 81–97. http://dx.doi.org/10.5324/eip.v13i2.2911.
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GPs serve in a double role of treatment provider and expert in certain social insurance systems, such as the Norwegian one. Some physicians assert that the ethical obligations of the two roles conflict with each other. The objective of this article is to show that social insurance medical ethics (SIME), which are based on recognised principles of medical ethics, unite the physicians’ obligations associated with these roles. The method applied is a medical ethics conceptual analysis. The material consists of literature on normative SIME. The study shows that SIME expands the role of the treatment provider to a wider societal context. Here, physicians should attempt to balance the perspectives of sympathy with empathy, as treatment providers, with the impartiality in their role as experts. Five principles of medical ethics are fundamental. Respect for human dignity is the overarching principle of medical ethics. The four others are nonmaleficence, beneficence (including soft paternalism), autonomy, and social justice. The article discusses two areas where it is asserted that the roles of treatment provider and expert conflict with each other: the application of beneficence and justice, and the duty of confidentiality versus the duty to provide information to the National Insurance service. The study concludes that there are no basic ethical conflicts between the two roles. The ethical problems that may arise when exercising this duality should be viewed in the same way as other ethical problems in medicine. Actual application and balancing of the principles may necessitate negotiations between patients and physicians.
Keywords: dual roles, professionalism, deliberation, impartiality, medical principle ethics, values of welfare state
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Yousuf, Rabeya, Sheikh Muhammad Abu Bakar, Mainul Haque, Md Nurul Islam, and Abdus Salam. "Medical Professional and Usage of Social Media." Bangladesh Journal of Medical Science 16, no. 4 (August 19, 2017): 606–9. http://dx.doi.org/10.3329/bjms.v16i4.33622.
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Social media connect people by sharing text, photos, audio and videos among themselves. Medical professional and patients also communicate through social media; however, issues of privacy and confidentiality of medical professions in regards to medical and health care decisions contradict with the openness of the usage of social media. Member of the medical profession can use social media but need to abide by the code of conduct of medical ethics in order to render the best possible services. This paper emphasizes on the needs of inclusion of social media usage in future health care providers curriculum by the higher educational institutions in order to aware of the ethical and professional aspect.Bangladesh Journal of Medical Science Vol.16(4) 2017 p.606-609
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Gutierrez, Amanda M., Jacob D. Hofstetter, Emma L. Dishner, Elizabeth Chiao, Dilreet Rai, and Amy L. McGuire. "A Right to Privacy and Confidentiality: Ethical Medical Care for Patients in United States Immigration Detention." Journal of Law, Medicine & Ethics 48, no. 1 (2020): 161–68. http://dx.doi.org/10.1177/1073110520917004.
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Recently, John Doe, an undocumented immigrant who was detained by United States Immigration and Customs Enforcement (ICE), was admitted to a hospital off-site from a detention facility. Custodial officers accompanied Mr. Doe into the exam room and refused to leave as physicians examined him. In this analysis, we examine the ethical dilemmas this case brings to light concerning the treatment of patients in immigration detention and their rights to privacy. We analyze what US law and immigration detention standards allow regarding immigration enforcement or custodial officers’ presence in medical exams and documentation of detainee health information. We describe the ethical implications of the presence of officers in medical exam rooms, including its effects on the quality of the patient-provider relationship, patient privacy and confidentiality, and provider's ability to provide ethical care. We conclude that the presence of immigration enforcement or custodial officers during medical examination of detainees is a breach of the right to privacy of detainees who are not an obvious threat to the public. We urge ICE and the US Department of Homeland Security to clarify standards for and tighten enforcement around when officers are legally allowed to be stationed in medical exam rooms and document detainees’ information.
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Slabbert, MN. "Parental access to minors' health records in the South African health care context: concerns and recommendations." Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad 7, no. 2 (July 10, 2017): 164. http://dx.doi.org/10.17159/1727-3781/2004/v7i2a2854.
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Privacy and confidentiality have long been recognized as essential elements of the doctorpatient relationship. Patients should feel free to disclose the most intimate and private medical facts about themselves to their physicians in order to facilitate optimal patient care. Medical records, whether hand-written or electronic, also play an important role in other contexts, such as medical research, health care management and financial audit. In South Africa there is little consistency in approaches to patient confidentiality. There are also no national standards or policies on patient confidentiality, apart from specific ethical rules, some ad hoc statutory provisions and general constitutional provisions not directly related to the intricacies of the doctor-patient relationship. A closer look at the relevant statutory provisions reveal the existence of conflicting standards, most notably in respect of parental access to a minors' health records. The purpose of this paper is to examine the discrepancies and contradictory provisions relating to the access to and disclosure of health information, in particular parental access to health records of minors. In the final instance, some recommendations will be suggested.
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Rafique, Zoheb Rafique, and Urooj Bhatti. "Practice of Informed Consent, Confidentiality and Privacy by Physicians at a Tertiary Care Teaching Hospital." Bangladesh Journal of Bioethics 5, no. 3 (January 12, 2015): 1–5. http://dx.doi.org/10.3329/bioethics.v5i3.21531.
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Objective: The aim of this paper was to assess the practice of medical ethics by the physicians at a public sector hospital in Jamshoro Sindh. Material and methods: This survey was conducted at four medical units of tertiary care hospital at jamshoro in the month of august 2014. Participants were randomly selected from patients aged over 18 years. A structured questionnaire was designed and the participants were asked about their demographic profile and their physicians practice regarding informed consent, maintaining confidentiality, privacy and other treatment formalities. Written consent was taken from all the participants before interview.Results: A total of 100 patients were randomly selected for this study. The majority of patients reported that informed consent was taken from them. The patients also responded that privacy and confidentiality is maintained during their treatment. However, many patients agreed that they were not properly informed about the laboratory findings, role of proposed drugs and also side effects of drugs. Conclusion: There is marked improvement in the practice of medical ethics by physicians of this tertiary care hospital. However, awareness workshops should be conducted to update and improve the knowledge of medical ethics among physicians. This will surely help them translate the knowledge into practice. DOI: http://dx.doi.org/10.3329/bioethics.v5i3.21531 Bangladesh Journal of Bioethics 2014 Vol.5 (3): 1-5.
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Skirbekk, Helge, Marit Helene Hem, and Per Nortvedt. "Prioritising patient care: The different views of clinicians and managers." Nursing Ethics 25, no. 6 (January 29, 2017): 746–59. http://dx.doi.org/10.1177/0969733016664977.
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Background: There is little research comparing clinicians’ and managers’ views on priority settings in the healthcare services. During research on two different qualitative research projects on healthcare prioritisations, we found a striking difference on how hospital executive managers and clinical healthcare professionals talked about and understood prioritisations. Aim: The purpose of this study is to explore how healthcare professionals in mental healthcare and somatic medicine prioritise their care, to compare different ways of setting priorities among managers and clinicians and to explore how moral dilemmas are balanced and reconciled. Research design and participants: We conducted qualitative observations, interviews and focus groups with medical doctors, nurses and other clinical members of the interdisciplinary team in both somatic medical and mental health wards in hospitals in Norway. The interviews were recorded and transcribed verbatim. Ethical considerations: Basic ethical principles for research ethics were followed. The respondents signed an informed consent for participation. They were assured anonymity and confidentiality. The studies were approved by relevant ethics committees in line with the Helsinki Convention. Findings: Our findings showed a widening gap between the views of clinicians on one hand and managers on the other. Clinicians experienced a threat to their autonomy, to their professional ideals and to their desire to perform their job in a professional way. Prioritisations were a cause of constant concern and problematic decisions. Even though several managers understood and empathised with the clinicians, the ideals of patient flow and keeping budgets balanced were perceived as more important. Discussion: We discuss our findings in light of the moral challenges of patient-centred individual healthcare versus demands of distributive justice from healthcare management. Conclusion: The clinicians’ ideals of autonomy and good medical and nursing care for the individual patients were perceived as endangered.
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Morgan, James, Kirsty Mackay, and Ian Thomas. "Compromising Confidentiality: Where to Strike the Balance?" Studia Universitatis Babeş-Bolyai Bioethica 66, Special Issue (September 9, 2021): 128. http://dx.doi.org/10.24193/subbbioethica.2021.spiss.84.
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"Patient confidentiality is a central tenet of medical practice, fundamental to ensuring the maintenance of trust in medical professionals. Yet are there any circumstances where a duty of care to others overrides patient confidentiality and allows disclosure of medical information without consent from the index patient? We present the case of a patient with CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) a progressive, neurodegenerative condition that is inherited in an autosomal dominant manner. Admitted to ICU with a severe Traumatic Brain Injury (TBI), the patient ultimately had withdrawal of life sustaining therapy following discussion with family. The patient never regained capacity following admission and had never disclosed the diagnosis of CADASIL to his daughters. The question of whether to disclose the diagnosis to adult children and alert them to their potential risk of inheriting CADASIL (the knowledge of which could fundamentally affect their life choices) raises tensions around confidentiality and any duty of care to the patient’s daughters. Previously, for inheritable risks, the prevailing discourse gave prominence to patient confidentiality. However, a recent UK court case and professional guidance is challenging this notion. ICU clinicians faced the choice of disclosing the CADASIL diagnosis to the adult children, breaking patient confidentiality or remaining silent so allowing potential harm to befall them and even future generations. We examine the ethical issues this raises and suggest how clinicians, if faced with a similar situation in future, might proceed. "
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Appleyard, James. "Introduction to Ethical Standards for Person-centered Health Research." International Journal of Person Centered Medicine 3, no. 4 (May 12, 2014): 258–62. http://dx.doi.org/10.5750/ijpcm.v3i4.435.
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Trust in physicians is an essential part of the patient / physician dialogue, a relationship on which advances in medicine depend, be they new ideas or applications of old ideas to new situations. Trust is based on mutual understanding and a firm commitment by physicians to a code of ethics, which reflects the principles of beneficence, non-malfeasance, justice, fidelity and confidentiality with respect for the person. The four presentations at the 6th Geneva Conference by Dr. Otmar Kloiber, Secretary General of the World Medical Association; Dr. Marie-Charlotte Bouësseau from Global Health Ethics of the World health Organization; Professor George N. Christodoulou, World Federation for Mental Health; and Professor M.B. Vallotton, Council for International Organizations of Medical Sciences, illustrate four different perspectives and provide important lessons for the future.
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Schipper, Karen, Elleke Landeweer, and Tineke A. Abma. "Living with end-stage renal disease: Moral responsibilities of patients." Nursing Ethics 25, no. 8 (January 18, 2017): 1017–29. http://dx.doi.org/10.1177/0969733016687154.
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Background: Living with a renal disease often reduces quality of life because of the stress it entails. No attention has been paid to the moral challenges of living with renal disease. Objectives: To explore the moral challenges of living with a renal disease. Research design: A case study based on qualitative research. We used Walker’s ethical framework combined with narrative ethics to analyse how negotiating care responsibilities lead to a new perspective on moral issues. Participants and research context: One case was chosen from 20 qualitative interviews with renal patients in the Netherlands. Ethical considerations: Several actions have been taken to ensure the informed consent, privacy, anonymity and confidentiality of the patient in this article. More details are offered in this article. The study has been conducted in line with the recommendations of the Medical Ethical Committee of the VU Medical Center. Findings: A renal disease can force people to change their identity, relationships, values and responsibilities. The case study illustrates the moral challenges confronting renal patients. Discussion and conclusion:: Moral issues can be raised by the changes to identities, relationships, values and responsibilities caused by renal disease. Support services for renal patients and their relatives should pay more attention to these issues in order to promote self-management.
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TSARFATI, Becky, and Daniela COJOCARU. "ETHICS AND NURSING IN A WIRED WORLD." Social Research Reports 12, no. 2 (December 15, 2020): 17–26. http://dx.doi.org/10.33788/srr12.2.2.
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In recent years, healthcare givers and patients have extensively used computerized technologies and digital information. This changed the work environment and skills of nurses who learn to live with innovations, namely working with both “machines” and humans. Nursing is patient-centered, respecting human dignity and acknowledging patients' needs. Nurses are required to promote safe environment and health care, educate, and embrace a health policy for individuals of all ages and communities. Electronic health records are shared through network systems not only by patients but also by physicians, nurses, insurance personnel, government officials and more. This widespread access to health information requires finding ways for observing patients’ confidentiality and privacy by the users. This paper presents four central ethical issues stemming from the use of electronic records: the built-in conflict between nurses' quality care commitment to health system organization and their commitment to maintain patients' respect and privacy; the gap between the one-dimensional reporting of medical and therapeutic information through technological systems; the gap between the advantage of technological systems as being easy to operate and use and the risk of leaking confidential medical information, violating patients' privacy. 4) Conflict between nurses' classic professional identity as people who take care of and satisfy patients' needs and the new concept of nursing that advocates patients’ privacy, autonomy and dignity while learning new technological skills with all the advantages and disadvantages encompassed in it. This paper ends with a writes' point of view about ethical-technological solutions of the ethical issues.
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Séroussi, Brigitte, Kate Fultz Hollis, and Lina F. Soualmia. "Transparency of Health Informatics Processes as the Condition of Healthcare Professionals’ and Patients’ Trust and Adoption: the Rise of Ethical Requirements." Yearbook of Medical Informatics 29, no. 01 (August 2020): 007–10. http://dx.doi.org/10.1055/s-0040-1702029.
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Objectives: To provide an introduction to the 2020 International Medical Informatics Association (IMIA) Yearbook by the editors. Methods: This editorial provides an introduction and overview to the 2020 IMIA Yearbook which special topic is: “Ethics in Health Informatics”. The keynote paper, the survey paper of the Special Topic section, and the paper about Donald Lindberg’s ethical scientific openness in the History of Medical Informatics chapter of the Yearbook are discussed. Changes in the Yearbook Editorial Committee are also described. Results: Inspired by medical ethics, ethics in health informatics progresses with the advances in biomedical informatics. With the wide use of EHRs, the enlargement of the care team perimeter, the need for data sharing for care continuity, the reuse of data for the sake of research, and the implementation of AI-powered decision support tools, new ethics requirements are necessary to address issues such as threats on privacy, confidentiality breaches, poor security practices, lack of patient information, tension on data sharing and reuse policies, need for more transparency on apps effectiveness, biased algorithms with discriminatory outcomes, guarantee on trustworthy AI, concerns on the re-identification of de-identified data. Conclusions: Despite privacy rules rooted in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) in the USA and even more restrictive new regulations such as the EU General Data Protection Regulation published in May 2018, some people do not believe their data will be kept confidential and may not share sensitive information with a provider, which may also induce unethical situations. Transparency on healthcare data processes is a condition of healthcare professionals’ and patients’ trust and their adoption of digital tools.
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Khan, Mohammad Waseem. "Breach of confidentiality: unintentional common practice due to misunderstanding and unawareness." Bangladesh Journal of Bioethics 2, no. 3 (April 3, 2012): 16–18. http://dx.doi.org/10.3329/bioethics.v2i3.10259.
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Advancement in medical technology has helped man kind in several ways and no one can deny the contribution of medical technology in the field of medicine. On the other hand technology has also given rise to some ethical issues. The issue of confidentiality is one of those issues. Patients keeping their trust on physician reveals all concerned confidential information to their physician with surety that physician will not reveal it to other person and will keep it confidential. It has been common in practice that, physicians unintentionally breach their patients confidentiality by discussing cases and history of their patients in public places, hospital elevators, and with their students. In a busy hospital setting it can be difficult to maintain confidentiality for patients. Increasing workloads lead to discussions of patients in public areas which is not an acceptable excuse. The very next person present there listening the discussion could be a patient's friend, relative, or media member that is not entitled to this privileged information. In all these cases permission must be received from the patient prior to any disclosure.DOI: http://dx.doi.org/10.3329/bioethics.v2i3.10259Bangladesh Journal of Bioethics 2011;2(3):16-18
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Barkhordari-Sharifabad, Maasoumeh, and Narges-Sadat Mirjalili. "Ethical leadership, nursing error and error reporting from the nurses’ perspective." Nursing Ethics 27, no. 2 (July 22, 2019): 609–20. http://dx.doi.org/10.1177/0969733019858706.
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Background: Nursing errors endanger patient safety, and error reporting helps identify errors and system vulnerabilities. Nursing managers play a key role in preventing nursing errors by using leadership skills. One of the leadership approaches is ethical leadership. Aim: This study determined the level of ethical leadership from the nurses’ perspective and its effect on nursing error and error reporting in teaching hospitals affiliated to Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Research design: This was a cross-sectional descriptive study. Participants and research context: A total of 171 nurses working in medical-surgical wards were selected through random sampling. Data collection was carried out using “ethical leadership in nursing, nursing errors and error reporting” questionnaires. Data were analyzed with SPSS20 using descriptive and analytical statistics. Ethical considerations: This study was approved by the Ethics Committee for Medical Research. Ethical considerations such as completing informed consent form, ensuring confidentiality of information, explaining research objectives, and voluntary participation were observed in the present study. Findings: The results showed that the level of nursing managers’ ethical leadership was moderate from the nurses’ point of view. The highest and the lowest levels were related to the power-sharing and task-oriented dimensions, respectively. There was a significant relationship between nursing managers’ level of ethical leadership with error rates and error reporting. Conclusion: The development of ethical leadership approach in nursing managers reduces error rate and increases error reporting. Programs designed to promote such approach in nursing managers at all levels can help reduce the level of error rate and maintain patient safety.