The ethical dilemma that this paper will address is that of a mental health nurse who receives a phone call from a doctor that asks her to breach patient confidentiality. Firstly, the ethical and legal considerations of the dilemma will be presented. Secondly, the managerial qualities that the nurse in question should display will be provided. Finally, the implications of a chosen solution for the nurse's personal professional practice shall be highlighted.
The practice of mental health nursing requires scientific and technical knowledge, and also the ability to make value based judgments (General Medical Council, 2001; Thompson, Melia & Boyd, 2000). These judgments need to be critically analysed and evaluated in the same way that scientific information is assessed. The term ethics is a generic word used to represent a variety of methods for investigating and understanding moral life. As such, medical ethics requires that a mental health nurse go beyond the individual, and draw on presumed universal laws (General Medical Council, 2001). The United Kingdom Mental Health Act states that medical ethics must ensure that a patient is provided with reception, care and treatment, and adequate management of their property and related matters. It is postulated here that a patient's right to confidentiality is a matter that must be properly managed stipulated by the Act (General Medical Council, 2001).
Medical ethics can be summarized into four general principles: 1) patient autonomy; 2) beneficence for the patient; 3) avoidance of harm to the patient (non-maleficence); and 4) justice (General Medical Council, 2001). The principles are intended to guide the value judgments of the nurse, not to substitute judgment. As such, each principle is followed until it conflicts with one or more of the other principles, although no principle is ranked higher than any other principle. However, in recent times, justice has become a significant issue. Justice involves not only the fair distribution of benefits from medicine, but also legal justice and doing what is required of the law. This includes human rights which are grounded in the ethics of justice.
The current dilemma involves issues of patient confidentiality. It is argued here that the right of confidentiality would be included in the principle of patient justice, and their rights to confidentiality in regards to their medical treatments. A nurse's respect for confidentiality is vital to cultivate and maintain a sense of trust between themselves and their patients (British Medical Association [BMA], 1999). As such, a therapeutic relationship is unable to be conductive to the healing processes if the patient cannot be confident that their personal information will not remain confidential and private. The breach of confidentiality should only occur in the most exceptional of situations, and the medical professional who breaks confidentiality should be able to adequately justify their reason for doing so (BMA, 1999). The personal health information of a patient is collected by medical staff to provide the future care and treatment to the patient, in general, this information is not to be used for any other purpose if the patient has not been made aware of the other uses, and given permission fro their information