Ethical Dilemma: Confidentiality vs. Beneficence in HIV Disclosure

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ETHICAL CASE STUDY

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Contents
Case study.......................................................................................................................................3
References.......................................................................................................................................6

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Case study
The overall scenario is based on the discussion and moral principles that come in the picture to
deal with the needs of the situation. The application of knowledge to deliver an appropriate
decision based on the location. In the given case while working for HIV patients, some cases
come that not only judges one's capabilities to deal with life but also put us in an ambiguous
situation where it is difficult to choose between principles and rules. In the case of the middle-
aged man keeping the information of him being positive in HIV from his girlfriend is equally
disruptive. This situation has helped in the application of four major principles of ethics known
as beneficence, Non-maleficence, respect, autonomy, confidentiality. These are the significant
aspect that was used by me while analyzing the situation. I believe that for every patient it is
necessary for them to maintain the confidentiality of their health and work. Thus the same
condition affects the perception of putting someone else’s life because of one's decision.
The principle of beneficence states that one should either get benefitted from the choice or they
should provide balance to the other person involved. In this case, this decision of the man with
HIV positive status is endangering the life and respect of his girlfriend. He is thinking about his
image and his value in the eyes of his girlfriend avoiding the facts that she will come to know
about that eventually and she might get more hurt and might take some serious action against
him. The man should take some time to tell the same to his girlfriend if he is not comfortable, but
he should not keep this information to himself (Page, 2012). There can be appropriate help
available for him to fight this situation. Another ethical principle that came across was Non-
maleficence which states that one must not do any harm to others at first. If I confront him about
this decision, this might instigate them to take a further step and then develop an additional string
of choices associated with this issue. That man might be thinking of revealing the case of his
health to his girlfriend in the future but he might never tell her, and in that case, the situation will
be more unethical. The confusion arises when initially I want to say to that girl myself, but at the
same time, I would like to keep the right to reveal with the man himself. What I can do is trying
and makes him understand the importance of personal space and decisions of others as well. This
can help him to talk to his girlfriend about the issue (Page, 2012).

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Another ethical principle is the importance of respect in one’s life and also respecting the
choices and needs of the people around you. The man is supposed to not only recognise his
decisions and opportunities but also for others thus helping each other to know the situation. By
talking to the man, I do not want to disrespect him, but at the same time I feel sorry for his
girlfriend and do not support his decision to keep information from him. The only output that can
be achieved from this situation is to develop effective communication between both the parties
and applying the knowledge effectively. This can also be done by educating him about the
seriousness of the situation and how much that affects the lives of people around them.
Respecting the choices of each other is a mutual decision of every patient and their doctors. Thus
this will be ultimately his choices, but my opinion will be to help the man with all the needs he
has to deal with this situation (Ivanov & Oden, 2013).
One of the concepts that crossed my mind was the maintenance of autonomy in the situation.
This can help in the decision related to the disclosure of information with his girlfriend. That
man can maintain independence and at the same time disclose the news to his girlfriend, this will
help him face the emotional dilemma, and at the same time, he can develop an appropriate
decision on the amount of information and with what intensity he wants to use to reveal the
information (Grace, 2017). This situation can be used in a contrary method when he maintains
autonomy and does not disclose any information to his girlfriend. This kind of situation will help
him develop various aspects of his life and making practical application of the thought process
he wants to apply to deal with the situation and creating an active choice in terms of the
information they want to reveal. This information might be of less intensity, and the girl can take
the appropriate time to react to the decision and make practical application of her understanding.
This autonomy will help the man to maintain his secrecy. Thus I believe that if the final output is
bringing the girl in the light, it is useful in all forms.
Whenever there is a situation of high-end disease and its impact on the people around them the
major question arises is whether to maintain confidentiality or to help others. This situation
becomes even worse when the patient insists on keeping the secrecy, but the same is very
unethical for people around them. The man can have full right to maintain confidentiality, but
this will eventually put a significant setback to people around them. The patient is needed to

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know the aspect involved in the maintenance of privacy and till what character the same can be
harmful to others around.
In the end, I would say that I do not support the patient’s decision to keep the information with
him as this will be highly unethical for his girlfriend. Every individual has the full right to know
about the health situation of their and dear ones especially when the illness is fatal.

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References
 Grace, P. J. (Ed.). (2017). Nursing ethics and professional responsibility in advanced
practice. Jones & Bartlett Learning.
 Ivanov, L. L., & Oden, T. L. (2013). Public health nursing, ethics and human
rights. Public health nursing, 30(3), 231-238.
 Page, K. (2012). The four principles: Can they be measured and do they predict ethical
decision making?. BMC medical ethics, 13(1), 10.