This week's class topic was Ethical Practice and Privacy. During class we discussed a case study on whether or not it was legally okay to 'Google' a patient's information and the resulting discussion was something that surprised me. The conversation quickly turned from whether or not it was legal to whether or not it was ethical. The case study discussed was one where a man walks into a free clinic that predominantly sees women. Another nurse turns to you and says that they think the man is the same man who has had run-ins with the law regarding harming and abusing women, particularly those who work in the sex trade. Is it legal to "Google" his information to see if these allegations are true?
As I mentioned previously, most of my fellow peers approached this question from an ethical standpoint. Although it is in fact LEGAL to Google anyone's information online, many people said that it was just not ethical. Here's where things got tricky. According to the College of Nurses of Ontario (2009) Professional Standards,
"When a nurse learns information that, if not revealed,
could result in harm to the client or others, she/he must
consult with the health care team and, if appropriate,
report the information to the person or group affected." (p.9).
could result in harm to the client or others, she/he must
consult with the health care team and, if appropriate,
report the information to the person or group affected." (p.9).
By these standards, if this man is in fact a threat to the women in your clinic, then you are obligated to report the information in order to keep those women safe.
The question I raised was what if the male client, although possibly dangerous to the other clients in the clinic actually required some form of medical care? Would the stigma he created affect the care provided by the nurses? Would the nurses turn him away due to his reputation?
It's in my personal opinion that the outcome of each individual scenario is dependent on the scenario itself. I looked into other case studies to see what people thought about this. I found it interesting that according to Steele (2001), it would be a breach of confidentiality to disclose personal client information to a police officer but would not be a breach of confidentiality if requested by a court of law (p. 27). Do these rules change also if the client is in danger of harming himself or others?
I'm beginning to realize how these personal judgment calls are not always easy decisions to make, and that these decisions may end up indirectly harming other clients involved. I feel that it will be a career-long struggle in making the appropriate decisions when caring for my clients but by using my own evidence informed practice I may be able to make better decisions when considering ethical implications.
References
College of Nurses of Ontario. (2009). Professional standard: Confidentiality and privacy - personal health information. p. 1 - 13.
Steele, Morrie. 2001. Confidentiality. Nursing BC 33, (1) (02): 27, https://www.lib.uwo.ca/cgi-bin/ezpauthn.cgi/docview
