NMC Code: Patient Confidentiality the Nursing and

NMC Code: Patient Confidentiality The Nursing and Midwifery Code sets the standards by which UK nurses and midwives should conduct themselves both ethically and professionally (NMC, 2010). The main principles are patient autonomy, patient confidentiality, patient collaboration in care, consent, professional boundaries, information sharing with colleagues, teamwork, effective delegation, and risk management. This essay will examine the principle of patient confidentiality and how this can affect practice. Patient Confidentiality Patients expect their personal information to be protected by doctors, nurses, and midwives.

This expectation is essential to the efficient functioning of the health services, because patients would otherwise be less forthcoming about their physical and mental health if they believed the information could be released to the public or family members without their permission (General Medical Council, 2009). If this were to occur then the ability of doctors and nurses to provide needed services would be significantly impaired. In a worst case scenario, a patient may even decide to forego seeking needed medical care and be irreparably harmed.

One of the more difficult contemporary issues surrounding patient confidentiality is balancing patient confidentiality with the need to protect the public harm. Kwong Chan (2013) provides four scenarios involving this ethical dilemma, each with a patient expressing a desire to keep their HIV status confidential. Patient A has no sexual partners, patient B. refuses to discuss sexual history, patient C. identified his sexual partners but refuses to inform them of his HIV status, and patient D. refuses to tell his wife.

Based on Chan's analysis, only the latter two situations present a doctor or nurse with an ethical dilemma. Guidelines under the General Medical Council allow for contacting sexual partners directly or involving law enforcement; however, no guidelines exist that govern the dilemma created by patient D. Chan (2013) argues that when patient confidentiality and a risk to public health collide, public health should take precedence. Cynthia Poindexter (2013) would probably argue that this paints an overly simplistic picture of the ethical dilemma.

When she asked HIV-positive African women who had immigrated to New Zealand about their experiences with medical services, more than a few reported discrimination and misinformation. One woman was told that if she declared her status she would receive support, but when she asked about the nature of the support the official was evasive. She stated that "I don't mind talking about my status, but I want to be able to choose who [sic] I say about it because it's me, it's my life." (Poindexter, 2013, p. 713).

Conclusions The ethical balancing act that faces many doctors and nurses is evident in the above examples. While guidelines are essential for helping medical professionals understand their ethical obligations, more seems to be needed in a modern and increasingly international.