Bioethics on NBC’s ER

Using “Bioethics on NBC’s ER: Betraying Trust or Providing Good Care? When Is It
Ok to Break Confidentiality?,” write a paper of 750-1,000 words in which you describe
your professional position regarding patient confidentiality.
1.Explain the ethical implications of a breach of confidentiality.
2.Provide ethical theories and/or ethical principles (from among those introduced in
your readings) to substantiate your position.
3.Identify a reasonable alternative to address the dilemma presented in the article using
a framework of ethical decision making presented in lecture or in your readings.
Explain the significance of applying this framework.
4.Explain how an ethics committee might approach the dilemma using ethical theories,
principles, and a collaborative approach to ethical decision making.
Prepare this assignment according to the APA guidelines found in the APA Style Guide,
located in the Student Success Center. An abstract is not required.

Bioethics on NBC’s ER

Confidentiality builds trust between health care providers and patients. There are
cases when patient confidentiality is breached as defined by the law. Breaching patient
confidentiality is a sign that the health care professionals do not respect the autonomy of
patients. Violation of confidentiality contributes to the patients feel betrayed by the medical
practitioners. Patients sensing confidentiality violation can subject the health care
professionals to criminal proceedings, civil proceedings or pursue the disciplinary proceeding
within the health care facility. Medical practitioners who are found guilty of breaching
confidentially according to the law are subjected to the disciplinary actions by the relevant

Ethical Implications of a breach of confidentiality

There are various cases when breach of confidentiality is considered right, in this
context; it is ethical to breach confidentiality. In the medical practice, there are cases when
medical practitioners may breach confidentially unintentionally (Glenn, 2012). Such
unintentional disclosure of patient information may occur in canteens, lifts, wards,
departments, patient notes and through electronic gadgets like emailing through a computer.
Confidentiality is the right of patients; some instances force the medical practitioners to

breach the confidentiality; when issues circle on the interest of patients and public interest. In
this context, breaching of confidentially is necessary (Saunders, 2006).
Ethical breach of confidentiality happens if the patient offers a consent; sharing of
critical clinical information with other medical practitioners with the intention of improving
the management of the patients, and if the patient has agreed to share the information with the
family members. Medical practitioners must report communicable diseases such as
tuberculosis, sexually transmitted diseases and meningitis among others (Saunders, 2006).
It is also ethical for the medical practitioners to breach confidentiality if the patient
intends to harm other people, and confidentiality is also breached if the patient intends to
harm himself or herself. Breach of confidentiality also happens if the medical case involves
traffic violations. Disclosure also happens in data protection in the health care facility and
confidentiality also takes place if the patient faces complex drug reaction. Disclosure of
information may happen if requested by government agencies such as tax departments among
others (Glenn, 2012).

Ethical Principles

Ethical principles are fundamental in moral actions and decision making. Ethical
principles are prominent to the medical practitioners in making moral judgments in the
professional practice. Ethics and moral are intertwined, in the sense that moral describes the
standards of behavior while ethics is defined by the study of morals. Health care practitioners
value ethical principles as the patients are concerned with the morality of health and medicine
(Glenn, 2012). Ethical dilemmas are common with multiculturalism and various situations.
Ethical principles are attached to respect for beneficence, autonomy, justice and non-
maleficence. Ethical rules are connected to confidentiality, honesty and professionalism as
part of the ethical principles (Saunders, 2006).

Medical practitioners face ethical dilemmas in the line of duty; there are cases when
providing good care conflicts with betraying the trust through breaking confidentiality.
Medical practitioners are faced with legal responsibilities and ethical responsibilities which
influence the decision making processes. Taking a critical look at respect for autonomy of the
patients, the medical practitioners must respect the decisions made by competent and
informed patients.

Framework of Ethical Decision Making
in addressing the Dilemma

Medical practitioners understand that breaching confidentially is ethically, morally
and legally wrong unless defined by law otherwise. Carol Hathaway came across two
teenagers who were not ready to be treated if confidentially was to be breached. Nurse
Hathaway convinced the teenagers that confidentiality will be maintained, no matter the
situation (Nathanson, 2000). Andrea, 14 years had Cervical cancer and human papillomavirus
(HPV). Diagnosis of Andrea and her friend are presenting a dilemma of involving the school
administration and parents in the medical intervention. The students had sex parties and the
students had multiple sex partners.
It is ethical to inform the school on the risk of sex parties involving multiple sexual
partners. HPV is considered to be a public issue in health matters. Andrea is a minor and
parents must be involved since parental consent is a prerequisite in treating cervical cancer. It
is wise to counsel Andrea on the importance of informing the school and the parents
(Nathanson, 2000). Hathaway should inform the school but hold the identity of Andrea; this
is critical in breaking the sexual parties to curb the spread of the disease. Hathaway identified

the ethical issue, gathered the facts, evaluated possible actions, made decisions, tested the
decisions and acted on the decisions made.

Ethics Committee

Members of ethics committee will use ethical principles and theories in making
collaborative decisions. The medical practitioners are expected to show respect, honesty and
loyalty in avoiding any chances of annoying the patients. Medical practitioners must respect
patient confidentiality in improving the physician-patient relationship (Nathanson, 2000). The
committee will borrow from Utilitarianism ethical theory, Deontology theory, Casuist ethical
theory, Rights ethical theory and Virtual ethical theory. The theories are influential in
decision making processes.
Breach of confidentiality destroys the patient-physician relationships, and it is
protected by law. A reasonable alternative of resolving dilemmas is requesting consent from
the patients, which is part of an ethical decision making framework. The framework is critical
in building trust in physician-patient relationships, which improves on the patient outcomes.



Glenn, R. (2012). Doctor-Patient Confidentiality. Kingstown: Kingstown Publishing.
Nathanson, P. G. (2000). BIOETHICS ON NBC’S ER: Betraying Trust or Providing Good
Care? When is it okay to break confidentiality?