Ethics in Global Health Lena

Ethics in Global Health Lena is a community health care nurse who works exclusively with HIV+ and AIDS patients. In the normal course of her job she sees confidential information about some of the patients at the clinic. During the course of a chart review, Lena learns that her sister's boyfriend, Mr. X., has tested HIV+. Lena is confounded with the issue of whether she can protect her sister while still retaining her ethical responsibility. We do not have information telling us if Lena's sister is sexually active with Mr.

X, but we must assume that that is a possibility. Lena does not know if her sister is having protected sexual relations, though, and since Mr. X has tested positive for the virus, realizes she must find a way to do something to protect her sister's health. Lena decides she must first do some research on the subject.

Due to a number of social and cultural factors, and the increasingly complex role the nurse has within the healthcare model, nursing ethics has risen to its own discipline, a branch of applied ethics. Nursing ethics has many philosophical principles in common with medical ethics -- beneficence, non-maleficence, and respect for autonomy -- but can be more properly distinguished by its emphasis on relationships, maintaining dignity, patient advocacy, and collaborative care.

Instead of using the model of "curing," nursing ethics focuses more on caring, and in turn, the relationship between the nurse and the person in care (McHale and Gallagher, 2003). The overall trend in nursing ethics, then, surrounds a more ethical approach that indicates the means of making the decision are almost as important as the decision. The combination of ethics of care and virtue ethics support relationships more than philosophical debate (Tschudin, 2003).

Thus, within the framework of this care model, we find that there are four major ethical paradigms that guide the process of ethical care and specific determination of actions in this case: autonomy, justice, beneficence and non-maleficence. Ethical Paradigm Issue Resolution Autonomy A rational individual has the right to make an informed, un-coerced decision. One's decisions must be respected by others. Patient's must understand informed consent and their responsibility as well as the healthcare organizations. Mr.

X has the right to privacy and to the decision to tell Lena's sister; his decision must be respected; Lena could meet with him confidentially and suggest that he either tell her sister or agree to have protected sex. She must be careful that her counseling does not fall in the line of coercion. Justice Fairness and equity in allocation of all healthcare services; social values are not part of the decision as to who receives care. Lena's opinion of the situation is not relevant; Mr.

X's individual rights take predominance, as does the quality of his care. Beneficence The primary goal of medicine, help -- or do no harm. What is the best healthcare decision for a person in their particular circumstances? To do no harm Lena has a moral obligation to protect her sister from infection; knowing that she may be doing emotional harm; however, since HIV is incurable, the choice is moot. Non-Maleficence Never harm intentionally and perform one's obligation to use any and all appropriate treatments to cure or prevent illness.

Lena's obligation is to prevent or cure illness; prevention is the key here. She can try with Mr. X., but ultimately she has the moral obligation to protect her sister's health. (Grace, 2008). Legal Perspective -- Under Provision 3.2 of the ANA Code of Ethics, the terminology reads that a nurse should maintain confidentiality of all patient information due to the.