This report deals with the ethics of disclosing the information of HIV/AIDS patients to family members. This involves associated issues of individual ethics, codified ethics, social sensitivity, and respect for client privacy and confidentiality. Generally this confidentiality is something that is held in high esteem in healthcare social contracts and ethical codes. There is general agreement that one cannot leave the decision entirely up to the individual nurse or physician: there needs to be some kind of ethically and socially sensitive standard that the individual needs to be held to.
However, this is a problematic issue because ethics does involve personal characteristics among individuals, if it is not seen to include a sort of all-encompassing morality, as morality could be said to differ more from person to person (and culture to culture) than ethics, which is more relative among standards of humane behavior. In terms of patients with HIV/AIDS, multiple studies have found that these individuals, when they do disclose status, usually include family members among the first people who are told about the diagnosis.
However, many choose not to disclose their status at all, and this is their right as a free individual to make their own decisions. In one study, “Results showed that initially the men did not disclose their disease to others, and many of them continued not to disclose. They were concerned about negative consequences such as rejection, fear of contagion, and the recipients telling others. If and when they disclosed, it was likely to be to sexual partners, immediate family members, and health care providers” (Disclosures, 2008).
Just because many HIV/AIDS patients did want to tell family members among the first of disclosed, this does not mean that the healthcare professional should feel entitled to break client confidentiality in order to beat them to it. Issues of disclosure, privacy and confidentiality in HIV/AIDS cases are also complicated now by the widespread use of Electronic Health Records (EHR) in healthcare facilities.
Professionals working in the field therefore need to restrict access in this regard, even as many facilities are taking advantage of new technologies and systems to improve client care and make the organization and its staff work faster, better, and with more efficiency. One of these new technologies, developed in the last few decades and getting into common use presently, is the use of EHR. EHR are used by may different types of healthcare delivery systems, from hospitals to private practice.
By definition, “To be defined as an Electronic Health Record, an electronic approach to collecting storing and manipulating data must be able to accomplish: collection of patient health information and data, results management, order entry management, and decision support” (Ford et al. , 2005). Although this system often makes dealing with patient records more orderly and efficient, some have raised concerns over how the process of keeping these electronic records relates to issues of patient confidentiality and privacy, including AIDS cases.
Because there is so much more access to the information electronically, there is also more possibility that the information will wind up in the wrong hands without permission. This issue is relevant because today’s healthcare environment is one that is quickly changing as new technology is constantly being adopted, and this technology brings risks as well as rewards. Patient privacy and confidentiality also remain relevant concerns from an ethical as well as a legal perspective in the healthcare environment when treating patients with all illnesses including HIV/AIDS.
In today’s healthcare setting, “Computer systems designed for clinical use apply technology that is protective of data. In addition, an electronic patient record is backed up according to hospital policy… and as the chart is modified by caregivers, those changes are automatically saved and an audit trail created” (Ford et al. , 2005). But at the same time, this efficient means of keeping data could lead to possible compromises in patient confidentiality. This shows the tendency to want to turn a new page in terms of ethics. In addressing these issues it is important to know how ethics is different from
morality. Although ethics and morality are basically similar, ethics is more of a code of principles than a system of belief. Therefore, ethics is perhaps more society, as a person asked to list examples of their morality may be more prone to give an accounting of their personal beliefs than what they see to be a function of judging their behavior by a set standard. Like morality, ethics are assigned to a certain extent by the customs of the society in which the individual works and lives. Therefore, the rules and codes of the society in terms of generalized ethics must be followed by the individual to be a
reflection of the greater society of which both are a part, which should provide overall an ethical paradigm for the healthcare professional. But in healthcare, all too often, as one source points out, “The justice of the business contract requires the physician or the organization to deliver nothing more than is owed by the conditions of the contract with the plan” (Pellegrino, 2002). Socially positive behavior may be influenced by moral behavior, but it should not be confused with moral behavior. Ethics is more suited to the trope of a code that suggests principles, not the trope that enforces moral belief systems on people.
Ford, E, N Menachemi, and T Phillips (2005). Predicting the adoption of electronic health records by physicians. Journal of the American Medical Informatics Association. Newton, Lisa H. , and Maureen M. Ford (2002). Taking Sides: Clashing Views on Controversial Issues in Society. New York: McGraw-Hill. Pellegrino, E. D. (1998) Managed care: an ethical reflection. Century, January. Rosenbaum, S. , and S. Skivington (2002). Public health emergencies and the public healthcare challenge. Journal of Law, Medicine & Ethics, Fall. Disclosures of decisions—living with HIV/AIDS (2008). http://linkinghub. elsevier. com/retrieve/pii/S1055329006002445