Privacy and Confidentiality Flashcards
privacy
- the kind of information shared, bodies, personal space
- limit access to others of their private info
- the patient’s right
- opposite to public
- The patient is allowed to decide how much of their information they want to give you, because it’s theirs
- The patient is allowed to decide how much of their body they want to show you, because its theirs
Confidentiality
- what happens to the information
- public or private, both are confidential
- RPN’s obligation to patients not to disclose or access info without consent or permission
- tied to trust
- Hippocratic oath
an RPN’s obligation to keep a patients information confidential is which kind of right
positive claim right – RPNs have to protect the patients right
what are the 3 important reasons for confidentiality
- legal reasons (privacy laws)
- respect for persons
- vulnerability (our clients are vulnerable; bodies are vulnerable)
why are legal reasons important to confidentiality
a. Federal and provincial laws that respect patient’s privacy (privacy laws)
b. Patients must be aware of their privacy rights
why is respect for persons important to confidentiality
a. Same as Autonomy and truthfulness
b. Building trusting relationship
c. Our patients at more risk because of their psychiatric status
how is vulnerability important to confidentiality
a. Our clients are vulnerable
i. Bodies are vulnerable (relational ethics)
b. Bodies need privacy to fully be respected as part of a person
c. Vulnerable to information about them
i. Information needs to be secure
ii. Sharing any info is a risk, but health information poses even more of a risk – mental health information even more important to keep secure
what are ways RPNs can be considerate of patient privacy (vulnerability)
- Curtains, asking non-essential people to leave the patients room, speaking to patients quietly and closely to protect their privacy
- Consider cultural aspects/cultural norms regarding modesty e.g., nurses of the same sex
- Having a mental illness sometimes affects modesty (not wearing clothes, making inappropriate remarks etc.) – often engage in odd behaviour – regardless, you have to protect that patient’s modesty the same way you would anyone else.
When is it permitted to share patient information?
- With the patient’s permission (autonomy – asking the patient if its ok to share)
- Inside the circle of patient care (the healthcare team) “the need-to-know standard”
Two kinds of breaches of confidentiality
- Unintentional – the worst kind of breach because they happen when HCW are not using caution or common sense (being careless) e.g., talking in elevator, not being aware of who’s around, RPN’s gossiping about patients in public places etc.
- Deliberate – sharing patient information outside the circle of care on purpose (but only certain purposes are permitted)
- Generally, occurs when there is a duty to warn that overrides the duty to protect patient confidentiality
there are way less benefits for exposing patient information than maintaining confidentiality
utilitarianism
Examples of what happens when patient information is in the hands of the wrong people
- Negative stigma toward patient
- Patients are unable to buy extended life insurance
- Could be used against patients in a criminal trial or divorce or child custody proceedings
- Mental health can affect a person’s employment status or eligibility for housing and certain benefits
examples of when the duty to warn overrides the duty to protect patient confidentiality
- food illness (ER full of people with food poisoning who all ate at the same restaurant – need to tell the health authority about the restaurant)
- water borne illness (all patients in the ER with sickness, may be drinking from same water reservoir, need to put out health warning for people not to drink water/boil water beforehand)
- Infectious Disease (e.g., covid, chickenpox, STIs)
- If there is evidence of a serious crime such as sexual assault or knife of gunshot wound
when the duty to warn overrides the duty to protect patient confidentiality
= Utilitarianism (weighing bad outcomes against worse outcomes)
what is the RPNs job when it becomes necessary to break patient confidentiality
- Not RPNs job to do anything about it except for telling someone who knows what to do
- RPNs job to chart it (particularly abuse) provides evidence trail for potential criminal trials [chart accurately]
