Confidentiality Case Study

Confidentiality is of most importance with respect to a healthy patient-healthcare provider (HCP) relationship. According to Fisher (2013), confidentiality is defined as “the obligation of HCPs to maintain the privacy of their patients by keeping the information patients disclose to them confidential…not absolute, may be breached in order to keep the individual from harming herself or others” (2013). The possibility of a healthcare provider breaching the confidential right of a patient is a concern of many, as they may feel their personal medical information could be used against themselves. The case study “Breaching Privacy to Save Lives: HCP Knowledge of Possible Risk to Non-Patient Family Members” found in Fisher (2013) showcases Peter, a 36-year-old man who has suffered blackouts and recently been diagnosed with Long QT Syndrome. This mutation is found in his LQT2 gene and may be the reasoning behind his father’s unexpected death at 40 years of age. Peter’s three siblings have a 50 per cent chance of having the same condition, as well as nine nieces and nephews. A life-threatening feature of the condition is sudden cardiac death and may be prevented by cardiac defibrillators, drugs, or a pairing of these methods. However, Peter says he will only tell his relatives of their risks if they experience blackouts. Otherwise, he does not want them to worry, as they are dealing with their own financial issues, such as inadequate healthcare insurance. Healthcare providers wonder if they are justified to tell Peter’s family members of their possible risk. In a situation such as this, confidentiality may be breached as the patient’s decision may cause harm to others involved. It is important for these providers to understand their liability, while using ethical theories, such as utilitarianism, to produce a valid decision. Utilitarianism is a foundational ethical theory whose main attitudes arise from an essential feature of utilitarianism: the principle of utility. According to Fisher (2013), this is the “belief that we ought to maximize benefit or good consequences and minimize harm or negative consequences…” It is important that an action or practice is right if it leads to the greatest possible balance for good consequences. As moral decision makers, HCP should consider the "standard of goodness” (Fisher, 2013), where the goodness or badness of the consequence is determined by moral values that do not change from one person to the next. This is a cost-benefit analysis, where it is desired for the greatest possible amount of value to be created over disvalue (Beauchamp et al., 2007). If the HCPs do not warn Peter’s family, they may all be harmed by the genetic disease with possible death, as the risk is high at 50 per cent. This means a maximization of harm and negative consequence, which does not follow utilitarian methods. In turn, if the HCPs breach Peter’s wishes and alert his relatives, they could be saved from experiencing blackouts and other symptoms of the illness; maximizing benefits and positive consequences. However, this does not mean that all negative consequences will arise if they are unwarned. The judging HCP who is considering their decision must take account for what can be expected, while providing the best utilitarian outcome of positive consequences (Beauchamp et al., 2007). Good consequences arise when all involved in the ethical decision are treated equally. Another important aspect of utilitarianism is impartiality. The utilitarian approach involves impartial consideration for everyone affected by the decision (Beauchamp et al., 2007). This is a form of universalism where everyone is treated equally, with an impartial moral judgment that is formed without personal preferences, advantages or disadvantages based on oneself. The judgement is through an open-minded assessment without regard to race, sex, nationality, economic circumstances, etc. (Beauchamp et al., 2007). Peter is unwilling to tell relatives of their possible health risks due to their lack of symptoms and stressful financial issues. This …show more content…
In T. Beauchamp, L. Walters et al (Eds.) Contemporary Issues in Bioethics. (7th ed.) Belmont, Ca: Wadsworth, pp. 140-144.
Beauchamp, T. & Walters, L. (2007) “Types of Ethical Theory.” In T. Beauchamp and L. Walters (Eds.) Contemporary Issues in Bioethics. (7th ed.) Belmont, Ca: Wadsworth, pp. 12-22.
Fisher, J (2013) Biomedical Ethics: A Canadian Focus. Toronto: Oxford University Press
Beauchamp, T. & Walters, L. (2007). “Ethical Principles.” In T. Beauchamp, L. Walters, J. P. Kahn and A. C. Mastroianni (Eds.) Contemporary Issues in Bioethics. (7thed.) Belmont, Ca: Wadsworth, pp.