Legal & ethical Essay
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This kind of essay is based on a case scenario and will vitally analyse the ethical problems that health and social proper care practitioner’s encounter with regards to: implications of consent, disclosure of private information and maintaining individual confidentiality. The legal areas of the situation will be talked about in relation to the breaching of confidentiality and exactly how the Data Safety Act (1998) can issue with other guidelines intended to guard patient’s rights.
In addition it will eventually identify the results of non-disclosure in comparison to disclosure without permission, whilst adhering to the General Medical Council (GMC) guidelines. Finally it will make clear the scenario from a utilitarian perspective as well as deontological perspective. Make sure you refer to appendix for case study. In the case circumstance, Dr Gomez’s patient Bob is diagnosed with Individual Immunodeficiency Virus (HIV), and has been encouraged to inform his partner File suit of his condition.
Prosecute is several months pregnant with their initially child. However , on a subsequent visit to the clinic, Bob has mentioned he have not notified his partner or previous sex partners of his HIV status. Dr Gomez once again tries to persuade Bob to divulge his condition, this individual emphasises the value of File suit being analyzed for HIV, and just since importantly the necessity to assess whether the baby is in risk.
In the mean time however , Bob is still insistent he will certainly not notify File suit and says that in the event his HIV is disclosed to her with out his consent he will discontinue his course of treatment, which started on the past visit. There are guidelines and legislation in position to assist the and cultural care specialist in making decisions. The law (GMC, 2001) states doctors will be legally fully commited and duty bound to maintain their patient’s confidentiality. In this situation the doctor can be presented with equally an ethical and legal dilemma. Relating to Sussex et al (2008) a great ethical issue arises when ever there is no clear solution to problems.
The ethical dilemmas that Dr Gomez is concerned with are the well-being of Greg, Sue, the unborn child and Bob’s previous sexual partners and ultimately the legal dilemma is definitely the possible breaching of Bob’s confidentiality simply by informing Drag into court of her partners HIV status. Gallant (2008) identifies HIV like a virus which usually attacks the immune system, thus deterioration the ability to combat infections and disease, ultimately the body turns into incapable of fighting off infection and this is if the Acquired Immune system Deficiency Affliction (AIDS) develops.
Gallant goes on to say there is not any cure intended for HIV however , if the condition is detected inside the early level, there is readily available treatment that assist the infected person live a longer life than they would with no intervention. Kourtis and Bulterys (2010) file HIV could be transmitted through unprotected sexual intercourse and also via mother to unborn kid. From that information it could be asserted that if the doctor did not inform Bob’s partner of his state then it could have serious wellness implications to her and the uncreated, unbegotten, unconceived child.
Thorne & Newell (2005) claim that if the mother was already afflicted the virus could be spread to the baby through a lot of ways, including; via the parias, during a intacto birth or when breastfeeding. The GMC (2001) declares that privacy is an important responsibility but not absolute, and they even more outline the behaviour predicted by medical professionals. In addition they state personal information could be disclosed with out consent in exceptional circumstances such as, when disclosure features interest for the public since they and also the patient could possibly be at significant risk.
The National Health Service Take action (2006), section 251 (Legislation 2006) magnifying mirrors the GENERAL MOTORS CO by declaring that privacy can be breached when a healthcare professional makes the decision to protect other folks, this is in full display in section 60 (1b) of the Health and Social Attention Act (2001) (Legislation 2001). In addition Aidsmap (2010) shows the Health and Social Attention Act (2008) made becomes the Public Health (Control of Disease) Work (1984) with the help of Part 2A. The article procedes say the up to date Act introduced what is known because the ‘all hazards’ strategy in relation to public welfare powers.
Therefore instead of indicating in regulation a list of infections to which public health powers could be applied, any kind of infection could possibly be subject to public well-being powers in case the infection ‘presents or can present significant harm to man health’ and if the attacked person ‘might infect others’ [Part 2A section 45G]. Eckstein (2003) signifies that the Data Protection Take action (1998) (Legislation 2012) gives guidance on the use and storage space of confidential information and in addition states conditions when secret information can be disclosed in order to protect others so long as the action of disclosure could be justified.
The Medical Safety Society (2012) states a justifiable cause of breaching a patient’s privacy would be each time a patient contains a communicable disease and is in danger of putting others in danger. Legislation can be not the only factor which will influences decision. Hepworth ou al (2011) indicates that it is important that professional healthcare staff understand that they could intentionally or unintentionally be prejudiced by their own ‘personal’ beliefs.
The Oxford Dictionary (2001) defines ‘value’ as: the worth, desirability or electricity of a point, or the characteristics on which these depend. As a result before making a choice on what direction to go, Dr Gomez will have to ensure that his ‘personal’ values will never influence his decision or even more importantly issue with his patient’s values or perhaps legislation. Clarke (2000) mentioned in Netherlands (2004) advises a doctor may well feel accountable for his sufferer refusing treatment if he discloses with no permission, because the patient is definitely his first priority and must come first.
At the same time Doctor Gomez can equally experience a discord of responsibility towards File suit and her unborn child, firstly since if the girl with not told of the scenario and then at a later time she and the child will be diagnosed with HIV, it would mean that their HIV status can be more advanced together with the prolonging of treatment. Secondly the child may have not sent the condition in the event that there was an early treatment. On the other hand if Bob discontinues with his treatment it could possess devastating and irreversible results. As reported by The HELPS Beacon (2011), consequences of interrupting or perhaps stopping therapies can have a detrimental effect.
Whilst Beauchamp and Childress (2001) describe autonomy as being akin to self-governance, one example is being able to appreciate, reason, planned and have the capability to independently select. To apply their particular definition for this situation Doctor Gomez ought to once again make an effort to persuade Bob to confer with Sue, even though informing him of and ensuring he understands the potential risks he imposes to her, the unborn child and him self if this individual discontinues treatment, thus strengthening Bob to act autonomously through understanding, currently taking responsibility and control of his situation.
Beauchamp and Childress (2001) even more argue that some people fail to self-govern in some conditions because of constraints caused by disease, depression or perhaps ignorance. If perhaps after supplying all this information to Joe and this individual still will not confide in his partner, it could result in the making of the doctor to act in a paternalistic way, meaning that he will have to make the decision for Greg. This in accordance to Knutson (2006) would infringe about Bob’s directly to autonomy.
Leading on out of this, it is essential the doctor should explore the reason why as to why Bob does not need to disclose to Sue. Based on the Free Dictionary (2009) to offer consent to something; signifies that the patient need to agree to the medical professional showing their health background. Research carried out by Cameron j. et approach (2005) shows that a person with HIV, reasoning for withholding permission could be because of the fear of being rejected by their partner, they go on to imply that a HIV reduced person is usually not withholding out of maleficence but rather that the individual may be planning to balance deontology with utilitarianism.
Bernat (2008) states, Kant was the founder of the modern school of deontology and he goes on to define deontology as a great ethical theory that the morality of an action should be based upon whether that action itself is right or wrong under a series of rules, rather than based upon the consequences from the action. Margen believed that we should never notify a lie no matter what the implications. According to Morrison (2009) critics of Kantianism argue that deontology is inflexible mainly because it means that an action is either correct or incorrect, with no double entendre whatsoever one example is; lying is often wrong, set up lie should be to avoid harming someone’s thoughts.
Ross (1994) cited in Littleton and Engebretson (2002), argues that deontology is inadequate to guide all decision making in ethical scenarios. Mill (2009) believes that utilitarianism is usually when a morally right take action has to cause the greatest joy for the majority of men and women. Though this individual did share that if an act was carried out when it comes to good purpose but later that act concluded having a negative effects then it would be deemed immoral. Both utilitarianism and deontology theories have strengths and weaknesses.
Williams a evaluate of utilitarianism (Smart and Williams, 1998) argues that happiness is an feeling which may not be quantified or perhaps measured which utilitarianism means any actions could be regarded moral inside the pursuit of joy such as genocide, torture and killing blameless people. Holland (2004) claims that when balancing the legal rights and wrongs of a condition it is called performing a utilitarianism calculations. This process is definitely achieved by taking into consideration both utilitarianism and deontological perspectives when coming up with an ethical decision.
Morrison (2009) declares that Kant believed a moral person is one that would be genuine and considerate and therefore he’d argue that your doctor would become acting immorally by wanting to disclose to Sue and thus breaking Bob’s rights to confidentiality. While from and utilitarian point of view Mill (2009) would believe Dr Gomez should breach Bob’s privileges in order to protect Sue and their unborn kid as it could possibly be argued that Dr Gomez would be doing this for the more good of numerous. In addition in the event that Dr Gomez did not notify Bob’s spouse of his HIV condition then he would also be breaking the General Medical Councils direction, as stated recently.
This failure could in that case lead to Doctor Gomez staying disciplined, as he is also responsible as a doctor to protect other folks from critical communicable conditions, which is a justifiable reason for breaching the privacy of a individual (GMC 2001). At the same time it could be reasoned Frank does not desire to disclose to Sue due to fear of elegance. The Terence Higgins Trust website (2012) states that the 2010 study revealed 66% of the community believed that there is still a stigma placed on HIV.
The findings carry on to say that the huge most discrimination is found within the National Health Assistance, encountered from the likes of healthcare personnel, dentists, standard practitioners and hospital personnel. It continues by expressing HIV misjudgment can bargain personal interactions and that dread and seclusion can lead the infected person to mental health issues including depression. The website goes on express the particular findings happen to be supported by a 2012 study which outlined one in 4 HIV contaminated people had a current depressive disorder.
The article further goes on to suggest that laws such as the Equality Act (2010) (Legislation 2010) gives people living with HIV protection against discrimination but likewise argues which it does not usually stop injustices, and when splendour occurs it might be expensive to consider legal action, especially with the present government reducing the legal aid finances. When it comes to producing a difficult decision it could be contended that health insurance and social care workers require the support of colleagues.
Doctor Gomez might which to seek advice to help guide him in the situation, plus the medical practitioner within the GMC (2001) guidelines is at his rights to discuss the specific situation with a colleague so long as this is certainly done anonymously when consent is not really given. This means that in accordance with the Data Protection Work (1998) the name, date of beginning, gender, treat and get in touch with detail will need to remain confidential. However , Doctor Gomez even now needs to shield his patient’s wishes to confidentiality even though consulting with one other medical professional for instance , Bob’s Doctor (GP).
Though HIV can be infectious it will not end up being deemed since putting the GP by unnecessary risk by not really disclosing, because universal safeguards, such as protecting gloves, will be in place to protect individuals coming from infection, this suggests that in case the GP comes after these precautions they will be protected from contracting the infection (GMC, 2001). As mentioned earlier on HIV can be spread by mother to unborn kid, this is another reason why both the doctor or Bob need to inform File suit, for both her as well as the child’s health and safety.
Tenir et ‘s, 2003, offered in Thorne and Newell (2005) present the studies of a 2003 study, which in turn indicated that two , 000, 000 women started to be newly contaminated with HIV mainly through heterosexual tranny and that 630, 000 kids acquired the problem mostly through mother-to-child transmitting in the same year. The content continues by simply stating that without antiretroviral therapy the median time between primary disease and the advancement AIDS is around ten years, and AIDS to death about two years. Thorne and Newell (2005) further more states and highlights the fact that use of antiretroviral therapy greatly delays the progression of HIV and they are highly effective in reducing the transmission coming from mother-to-baby.
In addition it also advises the baby be delivered via a great elective caesarean section, prior to the onset of labour and membrane rupture, furthermore it recommends the use of method feed rather than breast feeding. Finally, Thorne and Newell (2005) reveal that since 1999 all pregnant women can be found the option of getting tested intended for HIV as part of their antenatal care, again this emphasises the need for Sue to be aware of her partners state so as the lady can make the best decision whether or not or not she needs to be tested.
If Sue has not contracted HIV yet, she actually is still for great likelihood of doing so as HIV is definitely spread through infected sperm (NHS Choices, 2012), the lady and Bob may well be having unprotected sex due to her already being pregnant; as it is not necessary for them to make use of contraception to prevent an unexpected pregnancy. This all suggest Dr Gomez would be advised to take the practical perspective in case scenario, as there would be too many consequences to get him if he had taken the deontological approach. He could not officially or morally justify nondisclosure.
Finally, according to Rowe et al (2001), who also carried out research, on behalf of the earth Health Organisation, in order to determine any inequalities within the treatment of patients, recommend it would be highly recommended for the area authorities to execute a Overall health Needs Evaluation (HNA) of the local community. They will explain the stages being a process which will describes the health of the population, illustrates major risk factors and causes of sick health and pinpoints the actions which are had to address problems. Rowe et al embark on to recognise Bradshaw’s taxonomy of needs (Bradshaw 1972, cited in McLachlan 1972) they convey these kinds of needs while ‘normative’, as an example the medical meaning of HIV.
The ‘felt need’, such as the need to have advice in having safe sex, the ‘expressed need’ for instance looking for advice about safe sexual intercourse and finally the ‘comparative need’, offering a service that gives guidance on safe love-making, only to those of a legal age. Rowe ain al continue to argue that HNA is an important way of identifying inequalities within the local community. This kind of essay provides critically analysed the honest aspects of an instance scenario which has been based on the breaching of patients privacy. It reflects on the importance of consent and disclosure of confidential data and in addition it shows a balanced discussion for potential harm of nondisclosure for all parties included.
Furthermore it includes discussed and critically analysed the principles of legislation like the Data Safeguard Act 1998 and the conflicts that occur through different Acts, in particular the Human Rights Act 1998 and the Equality Act 2010. Penultimately this kind of essay talks about how the use of the functional and deontological perspectives will help an individual to formulate the best resolution. Finally the case scenario emphasises the necessity for unique codes of execute and laws in a health insurance and social care setting.
These are generally in place to guide the specialist to act in an appropriate legal and ethical manner.