Practicum Journal Entry: Analyzing an Ethical Decision

Student’s Name

Institutional Affiliation

Introduction

Psychiatric-mental health nurses (PMHN) often encounter ethical issues in proving care for their patients. Ethical issues demand a morally rigorous response since they involve making difficult choices (Sidhu & Srinivasraghavan, 2016). Some of these ethical issues can affect medical treatment, practice, hospital management, and patient outcomes. Therefore, it is crucial that psychiatric nurses comprehend various types of ethical issues to be able to resolve ethical problems that they may encounter. One ethical issue encountered by PMHN is confidentiality.

Summary of the Ethical Issue

According to Bipeta (2019), confidentiality is a major ethical issue that governs the practice of PMHN. The effectiveness of a PMHN relationship with a patient, and therapeutic alliance relies heavily on this obligation. It is unethical and illegal for a PMHN to share any information discussed within the confine of the medical office, without the explicit and informed permission of the patient (Bipeta, 2019). In psychiatry, nurse often hears patients” innermost fears, worries, and desires, which imply that they expose their vulnerabilities, and discuss concerns that could expose them to prevalent stigma in society (Beltran-Aroca et al., 2016). As such, nurses must PMHN must always maintain the confidentiality of patients’ information unless where a patient gives consent to release such information.

Describe the Moral and Ethical Dilemmas Surrounding the Issue

Confidentiality is a vital component when dealing with patients, especially those suffering from mental disabilities. With intrusion into patients’ presumably private environment of the provider-patient relationship, it raises various moral, and ethical issues for the mental health nurses whose works is dependent on an atmosphere of trust. It is ethically and morally wrong to breach the confidentiality of a patient. According to Bipeta (2019), written informed consent should be mandatory before disclosing a patients’ information, including permission as to how much can be disclosed. Such written authorization from the patient may act to protect the psychiatrist in a Court of Law.

The ethical issue compared to the State Health Laws and Regulations

The Department of Human Services–Division of Mental Health in Illinois is committed to offering the utmost excellent care to all patients suffering from mental health conditions. The Mental Health and Developmental Disabilities Confidentiality Act (Act), which is a law in the state, is designed to prevent the disclosure of records relating to mental health, as well as developmental abilities services (Taylor, n.d). In Illinois, obligations of health care providers to confidentiality prohibit them from disclosing patients’ information unless where the Act permits it.

The process of ethical decision making

When deciding on an ethical situation around confidentiality, I would undertake the following steps. First, I would research to find facts about such situation to establish why a nurse breached the confidentiality of a patient’s medical record. Second, I would decide if the situation involves a legal or ethical issue by considering who has been affected by the action. The third step would be the identification of an ethical dilemma. These consequences may include a nurse losing his/her job, filling for a lawsuit against the nurse or taking other disciplinary actions such as suspension (Buppert, 2017). Lastly, I would be assessing the advantages and disadvantages of the listed options in the third step to determine which one would be appropriate for a particular situation.

Conclusion

Consequently, it is normal for PMNHs to encounter an ethical dilemma when handling patients with mental disabilities. Nurses must respect patients’ confidentiality at all times and seek consent before disclosing any patient information. Confidentiality is the core to preserve trust between the health care provider and their patients. Notably, it is necessary to engage the patients, as well as their family members where necessary when faced with such predicaments.

References

Beltran-Aroca, C. M., Girela-Lopez, E., Collazo-Chao, E., Montero-Pérez-Barquero, M., & Muñoz-Villanueva, M. C. (2016). Confidentiality breaches in clinical practice: what happens in hospitals?. BMC medical ethics, 17(1), 52.

Bipeta, R. (2019). Legal and ethical aspects of mental health care. Indian Journal of Psychological Medicine. Vol 41(2)

Buppert, C. (2017). Nurse practitioner’s business practice and legal guide. Jones & Bartlett Learning.

Sidhu, N., & Srinivasraghavan, J. (2016). Ethics and medical practice: Why psychiatry is unique. Indian journal of psychiatry, 58(Suppl 2), S199.

Taylor, S. J. (n.d.). Privacy of mental health records in Illinois: The mental health & Developmental disabilities confidentiality act. Illinois State Bar Association | The Association for Illinois Lawyers. https://www.isba.org/sections/mentalhealth/newsletter/2016/04/privacymenta