STO. DOMINGO, Juan Miguel N.
Bachelor of Science in Nursing 2
La Consolacion College of Daet, Inc.
October 12, 2021
Health Care Ethics (Bioethics)
Course Outline: Principles of Confidentiality and Truthfulness
Confidentiality as part of respect and autonomy
What is confidentiality?
Why bother with confidentiality?
- Keeping information to yourself
- Keeping something secret that
someone else has told you
- Important information not told to other
people
- Personal information about someone
else not to be disclosed.
Comes from the Latin words con which means
completeness and fidere meaning to trust, to be
faithful, so Confidentiality implies giving
information to someone who is considered
completely trustworthy and loyal.
The moral justification of confidentiality
includes:
1. The duty to keep promises
2. The duty of fidelity
3. The right to privacy, which implies a right
to confidentiality
4. When the consequence of any release of
sensitive information causes effects for the
person concerned or for other people
(consequentialism)
5. Respect for the person and autonomy is
given due regard as the information is
personal.
In nursing, information about a person may be
disclosed to the person themselves such as the
fact they have a child from other relations that
their present partner does not know.
Information may also be gleaned from a
 person’s medical records such as diagnosis of
HIV or relatives may divulge information
about the person. Whatever the source,
information is respected as being sensitive and
care is taken to ensure that it is not
inadvertently overhead by other people who
are not involved in the care.
When can information be disclosed in The NMC quote Article 8 (Right to respect for
healthcare? private and family life) of the European
Convention on Human Rights states that:

“… there shall be no interference by a public

authority with the exercise of this right except
such as in accordance with the law and is
necessary in a democratic society in the
interests of national security, public safety, or
the economic well-being of the country, for the
prevention of disorder or crime,, for the
protection of health and morals. Or for the
protection of the rights and freedom of
others.”

This dictates when confidential information

should be disclosed. Disclosure should always
be though carefully. Any disclosure of
confidential information may have serious
consequences to the trust that people have in
that community, family, and professionals,
including nurses. Disclosure can obviously
occur with the person’s consent of their legal
advisor or their appointed advocate gives
consent.
TRUTHFULNESS
Truth-telling is a key issue within the nurse-patient relationship. Nurses make decisions on
a daily basis regarding what information to tell patients. This paper analyses truth-telling within
an end of life scenario. Virtue ethics provides a useful philosophical approach for exploring
decisions on information disclosure in more detail. Virtue ethics allows appropriate examination
of the moral character of the nurse involved, their intention, ability to use wisdom and judgement
when making decisions and the virtue of truth-telling. It is appropriate to discuss nursing as a
'practice' in relation to virtue ethics. This is achieved through consideration of the implications of
arguments made by Alasdair MacIntyre who believes that qualities such as honesty, courage and
justice are virtues because they enable us to achieve the internal goods of practices.

Honesty
Nurses are honest. When a prognosis is poor, nurses are the ones who are there to tell the truth to
patients and family. One important part of nursing is interpreting what the doctors say. Often,
doctors don’t really understand how to communicate with a patient. They spout medical
terminology, and that doesn’t get through to the patient. This is why it is so important for a nurse
to be present when a doctor speaks to a patient. They will usually turn to the nurse to understand
what was just said, and sometimes that interpretation requires hard truths.
Patients expect nurses to be honest because the connection between the two is often so intimate.
You have to trust someone to let them insert a foley or start an IV. Patients trust nurses to be honest
about the medications they are administering and that they do so in a safe manner. It is hard to be
a patient, and the honesty of a nurse makes them feel more secure. No one can feel secure if they
believe they are not being giving complete truths.

EXCEPTIONS REQUIRED BY STATUTE LAW: THE EXCEPTIONS TO

CONFIDENTIALITY

Mandatory Exceptions To Confidentiality

Most of the mandatory exceptions to confidentiality are well known and understood. They include
reporting child, elder and dependent adult abuse, and the so-called "duty to protect." However,
there are other, lesser known exceptions also required by law. Each will be presented in turn.
Common exceptions are: Psychologists may disclose private information without
consent in order to protect the patient or the public from serious harm — if, for example, a client
discusses plans to attempt suicide or harm another person. Psychologists may release information
if they receive a court order.