Healthcare Ethics: A Case Study Analysis of Confidentiality Breach

This case study examines a breach of confidentiality involving a community nurse accused of leaking patient information. The analysis identifies key issues such as violation of bioethics and crossing professional boundaries, leading to potential mental health consequences for patients. Possible solutions include securing patient files, emphasizing client autonomy in information sharing, and improving online security measures. Nurses play a crucial role in maintaining patient privacy, adhering to ethical guidelines from organizations like the Canadian Nurses Association, and preventing future breaches through education and vigilance. The study emphasizes the importance of balancing data utility with the risk of disclosure, and the need for strict adherence to privacy laws to maintain trust and ensure positive health outcomes.

Running head: HEALTHCARE
Topic: HEALTHCARE
Student’s Name:
University Name:
Author’s Note:

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Table of Contents
Introduction............................................................................................................3
Discussion..............................................................................................................3
Case study analysis: Identification of main issue problems...................................3
Case study analysis: Analysis of issues.................................................................4
Case study analysis: Solution and their implementation........................................5
Case study analysis: Literature support..................................................................7
Case study analysis: Conclusion............................................................................9
References............................................................................................................10

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Introduction
Among the various case studies pertaining to violation of ethics the second case study,
B has been considered. The following case study revolves around member B who has been
charged for a case involving conduct which is unprofessional. Member B works as a
community nurse who have been accused of leaking personal information regarding health of
five individual’s .Various codes of conduct as well as professional boundaries also have been
surpassed by the accused professional, revealing the personal cell-phone and personal
information involved, of the members. This essay gives an account of the analysis of the
persisting problems and a possible pragmatic solution to the existing problems. Furthermore,
the upcoming paragraphs encompass role of nurses in handling the solutions along with
implementation of those possible solutions to the problem involving breach of confidentiality
alongside ways of preventing such situations from occurring in future. The need for ethical
and legislative frameworks, along with adherence to nursing competency standards in
accordance to the Canadian Nurses Association is also discussed (Sharmian et al., 2016).
Discussion
Case study analysis: Identification of main issue problems
The most important issue highlighted in this situation is breach of confidentiality.
Revealing any secret or personal information of clients during any business related
transaction is known as breach of confidentiality. In the given case study, Mr B have been
accused of revealing personal information of patients which is considered to be unethical and
against the usual bioethical principles involving nursing. Belonging to the expertise of
clinical nursing and healthcare professionals, the accused professional should have taken care
not to reveal any personal information of his client’s thus violating bioethics.

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The second problem which has been identified in the case study is crossing of
professional boundaries by the accused person. According to the following case study, Mr
B have revealed personal information regarding his patients and violated the ethics of
confidentiality. Moreover, he has also tried to leak the information of patients through their
personal belongings like cell phones thus showing extreme unprofessionalism. This has thus
caused a situation where breach of confidentiality is observed and totally against the ethical
principles of nursing as shown by the member. Hence, through judgements passed by the
tribunal he has been accused of such crime.
Case study analysis: Analysis of issues
According to Elger, Handtke & Wangmo, (2015), physicians do not have a legal
knowledge about the disclosure of confidentiality which impede the promotion of ethical
practices. Nurses, physicians and health care professionals would understand the importance
of ethical principles and address the motivations, behaviours which reduce or impede the
proper patient information. In most of the cases, breach of confidentiality impacts the patients
leading to severe consequences involving mental ailments like depression, isolation and in
some cases chance of committing suicide. Thus, the actions of the accused member is highly
disappointing and against professionalism.
Niezen & Mathijsen (2014) claims that sometimes there is sharing of vital information
due to overlapping of tasks and interventions which requires strict supervision which
ultimately leads to crossing of professional boundaries. Moreover, the doctors supervising the
nurses should be much more aware of disclosure of information than other healthcare
professionals. Furthermore, Kraft, Blomberg & Hedman, (2014) have found that crossing of
professional boundaries have a negative effect on the collaboration of healthcare
professionals causing a dis-balance between the patient, system thus supporting the fact that

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breaching of confidentiality and crossing of professional boundaries affects the healthcare
system negatively.
Case study analysis: Solution and their implementation
The possible solution for the issues containing sensitive issues like breach of
confidentiality should be implemented with strategic planning. First of all, individual files of
each and every patient should be carefully secured and locked. Moreover, the staff and other
people associated with treatment process given to the patient should not reveal the existence
of the file until and unless approved by the patient. Such ethical issues often arise due to poor
social determinants of health. According to Kaposi (2017), in many cases the clients face
confidentiality breaches due to poverty, trauma, racism, colonization. Substance use is often a
deciding factor. Privacy of information is the most important solution to cases involving
sensitive cases which involve breach of confidentiality. Clients should make the primary
decision of allowing their information to be shared with other professionals especially
regarding cases like sexual harassment or abortion. They might even keep it from their family
members so strictly maintaining their personal information is a necessary step and a possible
solution.
Always a balance has to be maintained between reducing risk of disclosure and data
utility ultimately leading to protection of confidentiality. These methods are considered as a
trade off because it has been generally found that when methods implemented are directed at
reducing disclosure risks, the utility of the given data is also reduced significantly (O’ Keeefe
& Rubin, 2015). According to research children and adolescents are also at risks during such
cases involving substance use and the confidentiality of such information is equally important
and should be implemented through proper strategies (Jenkins, 2015). Dheensa, Fenwick,
Luccasen (2017) believe that although a familiar approach to confidentiality is still not

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accepted, genetic information could be shared to the families of the patient only with proper
approval and under strict supervision of healthcare professionals.
Nurses play an important role in maintaining the privacy as well as confidentiality of
the information of their clients. They should strictly keep the information and the files to
themselves and only reveal it to senior professionals and the people involved. Moreover, they
should prevent online leakage of information by reducing issues like hacking and increasing
security through well protected passwords. Nurse’s application involving confidentiality
legislation have demonstrated enough knowledge and awareness about the severity of the
situation. However, further research is needed for the amalgamation of ethics and health care
legislations (Newman & Kjervick, 2016). They should strictly reduce chances of
misplacements of the files and protect it from getting in the hands of related officials.
According to research, nurse educators have a pivotal role in engaging in methodologies
utilising research and including technology in spite of maintaining the ethical standards
which have been developed in advanced of online internet based research (Beltran Aroca et
al., 2016). According to various studies in confidentiality breaches, almost half of the
computers used had been accessible to the patient very easily, even about the information
stored in their desktop. Moreover, as far as security of information online is concerned,
majority of the computers were easily accessed without any security and were saved under as
general name and password. There was an improvement in the intervention as few of the files
of the patients and the information contained within them was confidential (Sethi et al.,
2014).
In the future, nurses should maintain ways to reduce breach of confidentiality which
should be done in two ways, firstly protecting information by preventing online leakage by
hacking and related issues. According to Salihu, Yousouf & Halim (2018), apart from nurses
physians should also maintain the confidentiality of the patient ,regarding personal

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information especially dealing with cases involving sexual harassment, or incurable diseases
like HIV. Personal belongings like cell phones should be handled with care and not given to
anyone inclusive of the client’s family. The files containing the confidential information
should be saved and not shared part from higher professionals. Furthermore, the files should
not be misplaced especially when the cases are pertaining to sexual harassment or substance
abuse.
Case study analysis: Literature support
Nurses are the main agents of provision of care and have a primary responsibility
regarding their conduct ethically and their interaction involved with the care giver to the
clients. Self-reflections well as dialogue are important issues for nurses which has to be
maintained. Nurses should also work with each other collaboratively and lead to creation of
moral communities which allow provision of safe, competent, compassionate and ethical care
(Cna-aiic.ca, 2019). According to the studies conducted and their evaluation by statistical
studies, taking care of the patients is very important regarding the confidentiality of the
records of the patients. Violation of the bioethical laws involving confidentiality of patients
may harm the trust relationship which has been established between the nurse and the patient
and this can have a serious impact on the health of the patients related to mental ailments like
depression, isolation. Thus, various ethics and their laws are pivotal for the maintenance of
privacy of the patients and the confidentiality related.
In Canada provincial laws involving credit unions have been formed which include
provisions for the confidentiality of information related to the transaction of the members.
Moreover Canadian laws like Personal Information Protection and Electronic documents Act
(PIPEDA) have been passed for dealing with cases involving data privacy. It mainly governs

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the collection, use as well as disclosure of information of the clients mainly pertaining to
personal information mainly pertaining to the field of commercial business ("Summary of
privacy laws in Canada - Office of the Privacy Commissioner of Canada", 2019).
For the conductance of appropriate nursing practice aimed at achieving positive health
outcomes and quality standards in professional nursing evidence based practice, the
maintenance of privacy and confidentiality of patient personal details is of utmost importance
(Anderson et al., 2015). Hence, educational dissemination concerning the importance of
nursing practice of patient privacy maintenance remains one of the foundational cornerstones
in ensuring the same among newly enrolled nurses. Hence, the inclusion of educational
content concerning patient privacy and confidentiality maintenance is of essential
significance in order to enlighten newly enrolled nurses and prospective nursing students
concerning the same, hence paving the way for ethical nursing practice during transition to
nursing professional (Yeom, Ahn & Kim, 2017). Likewise, enrolled nurses’ transition to
professionalism associated with being promoted to high competency based positions of a
registered also required continuous practice of patient privacy and confidentiality (Boyko,
Carter & Bryant‐Lukosius, 2016). In such situations of increased competency and
professionalism, the role of the ‘Code of Ethics for Registered Nurses’ formulated by the
Canadian Nurses Association (CNA) holds great significance in ensuring nursing adherence
to competency and professionalism practices. Maintenance of the confidentiality and privacy
of the patients is one the salient nursing values and ethical responsibilities outlined in the
CNA’s Code of Ethics (Sharnian et al., 2016). In accordance to such standardised
competency values, registered nurses must strictly adhere to privacy laws and maintenance of
anonymity during patient information disclosure to additional health professionals along with
careful discussion of patient information without referring to personal patient identities. In
accordance to these CNA ethical nursing competency standards nurses must never engage in

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abusing their access to patient personal information for reasons beyond the scope of their
professional nursing duties and responsibilities (Chachula, Myrick & Yonge, 2015).
Case study analysis: Conclusion
Thus from the following paragraphs, it can be concluded that breach of confidentiality
is a serious issue regarding the violation of bioethics. Such issues can pertain to various age
groups and can have various side effects like increased chances of suicide. Thus nurses play
an important role in preserving the information of the clients and not revealing them even to
their family members. Other legislative laws and rules have been passed in relation to
reduction of cases pertaining to confidentiality breaches. Hence, if such measures are taken
and implemented seriously then it can reduce such cases .Furthermore, the people mentioned
in the case study should also be punished severely thus reducing cases pertaining to such
issues.

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References
Anderson, J., Malone, L., Shanahan, K., & Manning, J. (2015). Nursing bedside clinical
handover–an integrated review of issues and tools. Journal of Clinical Nursing, 24(5-
6), 662-671. doi: https://doi.org/10.1111/jocn.12706.
Baykara, Z. G., Demir, S. G., &Yaman, S. (2015). The effect of ethics training on students
recognizing ethical violations and developing moral sensitivity. Nursing ethics, 22(6),
661-675.DOI: 10.1177/0969733014542673
Beltran-Aroca, C. M., Girela-Lopez, E., Collazo-Chao, E., Montero-Pérez-Barquero, M., &
Muñoz-Villanueva, M. C. (2016). Confidentiality breaches in clinical practice: what
happens in hospitals?. BMC medical ethics, 17(1),
52.https://doi.org/10.1016/j.profnurs.2013.06.007
Boyko, J. A., Carter, N., & Bryant‐Lukosius, D. (2016). Assessing the spread and uptake of a
framework for introducing and evaluating advanced practice nursing
roles. Worldviews on Evidence
‐Based Nursing, 13(4), 277-284. doi:
https://doi.org/10.1111/wvn.12160.
Chachula, K. M., Myrick, F., & Yonge, O. (2015). Letting go: how newly graduated
registered nurses in Western Canada decide to exit the nursing profession. Nurse
education today, 35(7), 912-918. doi: https://doi.org/10.1016/j.nedt.2015.02.024.
Cna-aiic.ca. (2019). Retrieved from https://www.cna-aiic.ca/-/media/cna/page-content/pdf-
en/code-of-ethics-2017-edition-secure-interactive.pdf
Dheensa, S., Fenwick, A., & Lucassen, A. (2017). Approaching confidentiality at a familial
level in genomic medicine: a focus group study with healthcare professionals. BMJ
open, 7(2), e012443.doi.org/10.1136/bmjopen-2016-012443

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HEALTHCARE
Eren, N. (2014). Nurses’ attitudes toward ethical issues in psychiatric inpatient
settings. Nursing ethics, 21(3), 359-373.doi.org/10.1177/0969733013500161
Jenkins, P. (2015). Client confidentiality and data protection. In Handbook of professional
and ethical practice for psychologists, counsellors and psychotherapists (pp. 65-75).
Routledge.doi.org/10.1007/s00787-014-0526-y
Kaposy, C., Greenspan, N. R., Marshall, Z., Allison, J., Marshall, S., & Kitson, C. (2017).
Clinical ethics issues in HIV care in Canada: an institutional ethnographic
study. BMC medical ethics, 18(1), 9. doi.org/10.1186/s12910-017-0171-3
Newman, A. B., & Kjervik, D. K. (2016). Critical Care Nurses’ Knowledge of
Confidentiality Legislation. American Journal of Critical Care, 25(3), 222-
227.doi: 10.4037/ajcc2016518
Niezen, M. G., & Mathijssen, J. J. (2014). Reframing professional boundaries in healthcare: a
systematic review of facilitators and barriers to task reallocation from the domain of
medicine to the nursing domain. Health policy, 117(2), 151-169.
O'Keefe, C. M., & Rubin, D. B. (2015). Individual privacy versus public good: protecting
confidentiality in health research. Statistics in medicine, 34(23), 3081-
3103.https://doi.org/10.1002/sim.6543
Salihu, S. I., Yusof, Y., & Halim, R. (2018). Disclosing HIV Status: Confidentiality, Right to
Privacy and Public Interest. Pertanika Journal of Social Sciences &
Humanities, 26(2). doi.org/10.1016/j. socscimed.2006.11.004
Sethi, N., Lane, G., Newton, S., Egan, P., & Ghosh, S. (2014). Disaster easily averted?–Data
confidentiality and the hospital desktop computer. International journal of medical
informatics, 83(5), 385-391.https://doi.org/10.1016/j.ijmedinf.2014.02.002

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HEALTHCARE
Shamian, J., Kerr, M. S., Laschinger, H. K. S., & Thomson, D. (2016). A hospital-level
analysis of the work environment and workforce health indicators for registered
nurses in Ontario's acute-care hospitals. Canadian Journal of Nursing Research
Archive, 33(4). Retrieved from: http://cjnr.archive.mcgill.ca/article/view/1657/1657.
Siminoff, L. A., Wilson-Genderson, M., Mosavel, M., Barker, L., Trgina, J., &Traino, H. M.
(2017). Confidentiality in biobanking research: a comparison of donor and
nondonorfamilies' understanding of risks. Genetic testing and molecular
biomarkers, 21(3), 171-177.doi: 10.1089/gtmb.2016.0407
Summary of privacy laws in Canada - Office of the Privacy Commissioner of Canada. 2019.
Retrieved from
https://www.priv.gc.ca/en/privacy-topics/privacy-laws-in-canada/02_05_d_15/
Wallace, I. M. (2015). Is patient confidentiality compromised with the electronic health
record?: a position paper. CIN: Computers, Informatics, Nursing, 33(2), 58-62.doi:
10.1097/CIN.0000000000000126
Yeom, H. A., Ahn, S. H., & Kim, S. J. (2017). Effects of ethics education on moral
sensitivity of nursing students. Nursing ethics, 24(6), 644-652. doi:
https://doi.org/10.1177%2F0969733015622060.