Introduction Healthcare practitioners are obligated to comply with the legal jurisdictions, ethical standards and the prescribed professional conduct in order to fulfill their duties responsibly. The assignment discusses on such case study of Sharni and Carla which primarily deals with the issues of privacy, confidentiality and consent. The assignment evaluates the legal, ethical and professional issues that could rise in the situation by analyzing different legal, ethical and professional policies and standards set by different authoritative bodies in Australia. After, the evaluation the assignment is concluded with the key findings. Legal issues In the provided case scenario it seemed that Sharni Smith was curious about the health of her acquaintance, Carla who she knew from her Mum group. Out of curiosity she accesses her file to find out regarding her hospital admission and she came to know that she was operated for a ruptured ectopic pregnancy. Post-shift she offered condolences to Carla on Facebook. In doing so, it can be considered that she breached certain rights of Carla, namely the privacy and consent. The public and majority of the private healthcare sector needs to follow certain federal and State legislations for privacy management. The privacy Act 1988 controls the handling of personal information. This Act has set a definition for personal information. Any true or untrue information or opinion about and identified or reasonably identified person is personal regardless of being recorded in a material form or not (Allens, 2017). The medical and health records are also classified as personal information. Therefore, the information of rupture of ectopic pregnancy of Carla will be considered as personal information under the Privacy Act. Not only personal, the health information is specifically regarded as sensitive personal
information and for the most sensitive category of information, the Act holds additional safeguards for their management (Anon., 2017). The Privacy Act clearly specifies the “health services” it includes and one of them is record-keeping about an individual’s physical or mental health with the objective of evaluating, preserving, improving or managing the his/her health. It signifiesthatSharni must have takenCarla’sconsent before retrievingher information and posting about her condition on her Facebook account. Apart from that the Privacy Act includes ten National Privacy Principles which regulate the minimum privacy standards for personal information handling. The principles include various aspect of management of sensitive personal information like specific considerations should be given while passing the health information of a person to others. It also includes principle regarding securing and storing data of the person. The health care practitioners should fulfill these obligations or at the least ‘take reasonable steps’ to fulfill the obligations. However, it was clear that Sharni who is a registered nurse did not meet these obligations or even took reasonable steps to do so as by sharing about Carla’s miscarriage on her Facebook she revealed sensitive personal information about Carla to presumably numerous people without obtaining an informed consent from Carla. It can be argued that the other nurse who was appointedtoattendCarlamusthavetakenherconsentbeforecollectingherhealth informationbuttakingconsentalsoinvolvesthatpatientmustbeawarethathis/her information will be used for what other purposes. The other nurses evidently did not take consent to post about her miscarriage on a social media platform as she might herself didn’t know that. It can be considered that Sharni might not be aware regarding the legislations but it is essential for the healthcare providers to learn about the National Privacy Principles which are legally binding. It is also recommended that they take professional help if required. The Australian Commission states that in case of any clash and inconsistency between the state or
territory law and a Commonwealth law, the Commonwealth law predominates over them. Therefore,allthehealthcareorganisationsand healthcareprovidersin Australiamust familiarise themselves and abide by the provisions of the Commonwealth Privacy Act and the state or territory legislations. Sharni in her defence can argue that she posted about Carla’s health condition in her non- working hours and she did that not considering Carla as a patient but as an acquaintance. Ethical issues The logical and reasonable standards and values that differentiate between right and wrong to recommend a certain set of preferred behaviour in society are the ethics. The working code of conduct warrants fair conduct. While practicing in health and social care department, the professionals are imposed to follow the ethical principles of non-maleficence, beneficence, autonomy and justice. The element of non-maleficence suggests that the healthcare providers should do no harm which is not followed by Sharni as by posting about Carla’s condition withoutherconsentshemighthavebeencauseofpsychologicalharmlikestress, embarrassment, etc. The principle of autonomy includes the right of choice, freedom and privacy of the patient which was also not followed by Sharni as she breached Carla’s privacy without her choice. The ethical guidelines should be followed by the healthcare providers as these guidelines protects the service user’s human and civil right as well. Apart from the bioethical principles, the Australian Medical Association (AMA) Code of Ethics also mandates the healthcare providers to uphold a patient’s confidentiality. The ethics do make certain exceptions like serious risk, needed by law, approved research or outweighed societal benfit, etc. It is clear that Sharni’s act did not come under any of these exceprions.
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Therefore, when she disclosed Carla’ssensitivepersonal informationon social media platform to several people she breached the principle of non-maleficence, autonomy and AMAcodeofpatient’sconfidentiality.Maintenanceofprivacyandconfidentialityis significantinhealthcaresectorasthepatientmaybeconcernedwiththestigma, embarrassment and discrimination attached with their health condition which can also be case with Carla. Moreover, patients want to be aware regarding the choice of accessibility of their information to whom they prefer. In this case Carla did not get to make the choice of accessibility. It is also essential to maintain confidentiality as patients’ feel more comfortable and be honest when they are assured of information security. When the privacy protocols of a healthcare organisation encourages the trust and faith of people in that organisation and healthcare system in general. So Sharni’s act has not only legal, ethical and professional implications but also can build a poor image of the healthcare facility she works in. The Code of Ethics for Nurses in Australia identifies ethical management of the patient’s information as one of the code of ethics. The code suggests that Nurses should respect a service user’s privacy and confidentiality while maintaining health or safety. It clearly states that nurses can share the personal information of a patient only with his/her prior consent or with legal authorisation. Sharni did not take Carla’s consent or did not have any lawful authorisation before sharing her information to several people online therefore she clearly has bnot followed this code of ethic. It should have been understood by Sharni that she must respect Carla’s wish about with whom information may be shared so that she could protect her privacy (Anon., 2008). The ICN Code of Ethics for Nurses has four primary elements that formulate the norms of ethicalconductfornurses.Thefirstelementsuggeststhatthenursemaintainsthe confidentiality of a patient’s personal information and utilises his/her logical reasoning for sharing the information. Sharni could not abide by this part of the first element as she did not
maintain the confidentiality of Carla’s personal information and she did not make use of her judgement properly before sharing that information. It can be a source of inconvenience, embarrassment, or harm to the Carla or her family. Sharni could have offered her consolation in private (ICN, 2012). Professional issues The Nursing and Midwifery Board of Australia (NMBA) formulates specific norms, policies and guidelines to ensure professional and safe practice from nurses and midwives in Australia. One of the guidelines of NMBA was of obtaining informed consent from a patient beforesharinghis/herinformationtoother.ItcanbearguedthatCarlaisSharni’s acquaintance and wouldn’t have minded the Facebook post regarding her condition. But the norm suggests that it is essential to obtain a formal consent as Carla is not only an acquaintancebutalsoapatientadmittedinthesettinginwhichSharniworks.The Professional conduct obligates Sharni to obtain consent by properly explaining the act to Carla. She must be involved in the decision-making regarding any step related to her health condition. In a professional scenario, Carla’s choice is significant in knowing and sharing her personal information. Also, the NMBA suggests that safeguarding the privacy of people is ethical and legal duty of a nurse and the people have a right to expect that nurses will keep their personal information confidential. Sharni was obligated to respect the confidentiality and privacy of Carla by obtaining informed consent before revealing her information which also involves official documentation of consent. NMBA also suggests that privacy can be maintained when the health providers access a patient’s records only when they are professionally involved in the service provision to that patient. Sharni was not a part of care delivery to Carla, even then she accessedherrecordstoknowaboutherconditionandthenshelaterdisclosedthat
information online. Therefore, Sharni did not abide by the norms of NMBA of professional conduct (NMBA, 2018). The Australian Health Practitioner Regulation Agency (AHPRA) collaborated with various National Boards and executed the National Registration and Accreditation Scheme, under the Health Practitioner Regulation National Law. Both the organisations work with a shared goal of protecting public. This policy assists the healthcare providers in Australia to be aware of their duties while using social media. The registered health providers are prohibited to update any data which breaches certain obligations. One of those obligations is adhering to the patient’sconfidentialityandprivacy.Itinvolvesaspectslikediscussionsofpatient’s procedures, posting their pictures, mentioning case studies, etc. If the patient can be identified with the posted information and the health practitioner has not obtained consent prior to posting the information, then the practitioner has not followed the social media policy as prescribed AHPRA. So in Sharni’s case, she posted the information about her medical condition on Carla’s wall. So Carla is clearly identifiable in this scenario. It suggests that Sharni did violate the Social media policy in her nursing practice. Sharni is expected to understand the implications of her action in professional scenario even if the information could only be seen by specific group of people. As the information once updated on social media comes under the public domain irreversibly. In such circumstances the intention of posting the information becomes null and void. So, even if Sharni had good intentions and only wanted to offer consolation to Carla, this argument won’t matter as the privacy of Carla is breached and her sensitive information came in public domain. The policy also implicates that Sharni should have been aware of her ethical and regulatory duties during her online presence while using the social media or while communicating through the social media. Like she owuldn’t have talked to Carla about her condition in other people’s presence
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she should have also refrained herself from talking to her online where other people could see their conversation (AHPRA, 2017). Conclusion Sharni’s case is an example of breach of the Privacy Act which mandates safeguarding of the patient’s personal information and obtaining informed consent. Sharnis’s action further doesn’t abide by the bioethical principles of ethics, Code of ethics for nurses in Australia and ICN code of ethics for nurses. All of these promote privacy and right of choice. In the professional scenario also, Sharni’s actions are violation of codes of NMBA and the social media policy. Bibliography AHPRA,2017.Socialmediapolicy.[Online]Availableat: http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Policies/Social- media-policy.aspx[Accessed 4 May 2018]. Allens,2017.DataProtected-Australia.[Online]Availableat: https://www.linklaters.com/en/insights/data-protected/data-protected---australia[Accessed 4 May 2018]. Anon., 2008.Code of Ethics for Nurses in Australia. Melbourne : Australian Nursing and Midwifery Council; Australian College of Nursing; Australian Nursing Federation. Anon.,2017.OverviewofPrivacyLawinAustralia.[Online]Availableat: https://hallandwilcox.com.au/overview-of-privacy-law-in-australia/[Accessed2018May 2018].
ICN, 2012.THE ICN CODE OF ETHICS FOR NURSES. International Council of Nurses. http://www.icn.ch/images/stories/documents/about/icncode_english.pdf NMBA, 2018.Code of conduct for nurses. Nursing and Midwifery Board of Australia. http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Policies/Social- media-policy.aspx