Ethical Framework

Ethical Frameworks in Practice
Jeananne S. Reed
Grand Canyon University
Ethical Decision Making in Health Care
Michelle Silvers, MS, RN, CEN
July 17, 2011

Ethical Frameworks in Practice
Being entrusted with information is honorable.   But what if the promise of holding information could bring harm or deleterious consequences? This is an ethical dilemma frequently incurred by nurses.   What are the implications when a decision calls to breach or not to breach?   In the article: “Bitoethics on NBC’s ER: Betraying Trust of Providing Good Care   When is it ok to Break Confidentiality?,” Nurse Hathaway suffers such a dilemma when faced with exposing the cervical cancer diagnosis of a 14 year girl, Andrea, as well as “sex parties” reported to her by Andrea   (Nathanson, 2000).
The implications of a breach of confidentially are many.   Ethical principles such as fidelity: the duty to keep one’s promise, veracity: the duty to tell the truth, and confidentiality: the duty to hold entrusted information (Silvers, 2011) are plainly violated in a in a breach.   The violations could result in detrimental clinical consequences such as failure to seek care by the patient in addition to showing disrespect for individual privacy and autonomy rights by the clinician. But perhaps no consequence is as detrimental as the feeling of betrayal affecting both the patient and the nurse.   According to Julie Fitness, the feeling of betrayal is experienced at a visceral level not a cognitive one (Fitness, 2005).   Other studies suggest pain and hurt are amongst the first and most acute emotional reactions to the awareness that one has been betrayed.   Betrayal also instills guilt in the violator. Given the volatile emotional state of teenagers, a breach could alter any helpful interventions and effect positive outcomes.
Theories and Principles
In order to provide interventions that produce an amicable outcome a review of theories and principles can be addressed....