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Health, Medicine, Nursing
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Legal and Ethical Conduct (Essay Sample)

Instructions:

As emphasized in this week’s media presentation, all nurses need to be familiar with the laws and regulations that govern their practice: their state’s Nurse Practice Act (NJ state), ANA’s Nursing: Scope and Standards of Practice, specialty group standards of practice, etc. In addition, basic ethical principles guide nurses’ decision-making process every day. ANA’s Code of Ethics and ANA’s Social Policy Statement are two important documents that outline nurses’ ethical responsibilities to their patients, themselves, and their profession. This said, there is a dilemma: The laws are not always compatible with the ethical positions nurses sometimes take. This week’s Discussion focuses on such a dilemma.
To prepare:
Review this week’s Learning Resources, focusing on the information in the media presentation about the relationship between the law and ethics.
Consider the ethical responsibility of nurses in ensuring patient autonomy, beneficence, non-malfeasance, and justice.
Read the following scenario:
Lena is a community health care nurse who works exclusively with HIV-positive and AIDS patients. As a part of her job, she evaluates new cases and reviews confidential information about these patients. In the course of one of these reviews, Lena learns that her sister’s boyfriend has tested HIV positive. Lena would like to protect her sister from harm and begins to consider how her sister can find out about her boyfriend’s health status.
Consult at least two resources to help you establish Lena’s legal and ethical position. These resources might include your state’s Nurse Practice Act, the ANA's Code of Ethics, ANA’s Nursing: Scope and Standards of Practice, and internal or external standards of care.
Consider what action you would take if you were Lena and why.
Determine whether the law and the ANA’s standards support or conflict with that action.
ANA's Foundation of Nursing Package - (Access this resource from the Walden Library databases through your NURS 6050 Course Readings List) 

source..
Content:

LEGAL AND ETHICAL CONDUCT
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The issue of HIV status and reporting procedures raises several legal questions that relate to patient confidentiality and privacy concerns. It is important to note that legal protection of patient confidentiality depends on whether or not health concerns for the general public supersede the interest of preserving the patient-provider privilege. The balancing of these two fundamental interests is a grave challenge when it comes to privacy concerns that associate with HIV status.
A fundamental legal dilemma in the case of HIV status is making a determination as per when the need to protect third parties such as sex partners to whom the patient in question is likely to transmit the disease overrides the patient’s right to privacy. In the case of Lena, the challenge becomes even more complicated given that there are some very important personal interests that accompany the case, given that the person most likely to suffer from non-disclosure of information is no other than her biological sister. Thus, the dilemma encompasses the safeguard of personal interests, ethics of nursing practice, and legal requirements. In order for For Lena to navigate through this dilemma, it would be plausible to make inference to the New Jersey state HIV reporting requirement that mainly entails the confidential name-reporting procedure. By resorting to this direction, the nurse will be able to safeguard her personal interests, while at the same time acting within the required code of conduct that regulate nursing practiced in her state of jurisdiction.
HIPAA Act
For the case of Lena, it should be noted that when disclosure is very much important, the physician has the right to disclose the information, which is protected under health information principles with legal backing from several federal regulations such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA). It is notable that punitive damages have been allowed in the past for wrongful disclosure of a patient’s HIV status due to violation of the confidentiality statute. However, reporting to public health agencies or other public health agencies under state regulations does not constitute violations under HIPAA. This is a precise avenue that Lena can utilize in order to make the disclosure to her sister.
AMA Code of Medical Ethics
When one turns to the AMA Code of Medical Ethics, the clause at Opinion 5.05 stipulates that disclosure of information should be treated as confidential, but subject to particular exceptions that are legally and ethically justified due to overriding societal concerns. This appears to be applicable in the case of HIV given the magnitude of the threat to public safety, which in this case appears to be immediate and clear. In fact, the Code states that a communicable disease should be reported as stipulated by applicable law. Therefore, this utilitarian approach achieves the duty of the physician to remain as an agent of the individual patient, while at the same time remaining in the context of the potentially greater good of the society at large in which the practitioner operates.
The AMA Code of Medical Ethics pays particular attention through Opinion E-2.23 where it states that in instances where the practitioner is aware that ...
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