Decision Making and Confidentiality

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Ethical Decision

Nursing professionals have to make routine decisions bearing ethical principles and regulations in mind. Proper decision-making necessitates a grasp of the interface between nursing, laws, and ethics (Furlong, 2007, p. 29). But nursing professionals across the world face increasing difficulty when attempting to work with integrity amid the complicated ethical decisions and pressure they encounter. "Notes on Nursing" by Florence Nightingale describes the ethical obligations of communication, confidentiality, and the importance of fulfilling patient requirements (Ulrich et al., 2010)

Ethical / Moral Issue

Karen, a nurse practitioner (NP) fresh out of college, working in a little town, is visited by a first-time expectant mother (previous menstrual period -- 5 weeks ago), Susan Ruttley, aged 29 years. Karen wishes to begin prenatal care for the patient, who, although married, visits alone and claims she hasn't informed her husband of her condition, as he wished to postpone starting a family, owing to financial problems. As part of normal screening, the NP recommends testing her for HIV. But Susan declines, claiming the couple was tested six years back (a short while prior to their wedding) and have remained mutually monogamous for 8 years. Many weeks on, Karen is visited by a certain John Ruttley whose reason for visiting is his recurrent thrush, for which he had already obtained treatment half a year ago. He claims he was diagnosed HIV+ five years ago, that is wife is aware of his condition, and that the couple always has protected sex. John claims he visits a large-town infectious disease expert for his condition, and the expert recommended instant treatment, back home, for his symptom recurrence.

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When John leaves, Karen looks into Susan's chart, confirming he is her pregnant patient's husband (Kaplan, 2016).

Ethical and Moral Dilemma

The above example is one kind of ethical quandary encountered by NPs. Ethics codes guide them with regard to ethically-sound decision-making, but inherently fall outside explicit guidelines for wrong and correct actions. In case of John and Susan Ruttley, the conflicting decisions faced by the NP are: treating John with the required legal and professional confidentiality standards, versus warning Susan about her possibly being infected with HIV (Kaplan, 2016).

Comparison of Health Issue with State Health Laws and Regulations

The focus of ethical reflection is, usually, an analysis of previous cases having identical competing claims. Tarasoff v. California University Regents is a famous case involving confidentiality….....

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