Nicole Spence

Intro to HIT
Module 11 Assignment 4: Ethical case
Steps
1. What is the
question?
2. What are the
facts?

3. What are the

values?

ETHICAL PROBLEM: Family and Friends: Should I tell

Information
Should Mary release information about Ruth suffering from domestic abuse to her mother to earn bonus points
with her? Should Mary release information about Rons drug abuse and HIV+ status to his soon-to-be wife?
KNOWN
TO BE GATHERED

Ruth is suffering from domestic abuse

In Ruths case, does the principle of privacy

outweigh a duty to keep her safe?

Ruth has been hospitalized twice in three

Was Ruths other hospitalization in the three months

months
caused by domestic violence?

Marys mom wants to know this

What are the laws regarding warning a potential

information without asking for Ruths
permission
sexual partner about ones HIV status?

One reason Mary is tempted to tell her

What are the laws regarding a health professional

mom is for bonus points with her
warning a potential sexual partner about a patients
HIV status?

Ron is HIV+ and hasnt told his partner

When two ethical principles are opposing one

about it
another (Rons HIV+ status vs the duty to warn

Ron is also abusing drugs without telling

Patricia), which should be followed?
his partner about it

Does not addressing Ruths domestic abuse issues

Mary wants to warn Patricia about Rons

and not telling Patricia about Rons HIV status
condition without asking for Rons
violate a principle of doing no harm?
permission first

In a legal sense, are medical professionals liable if

Privacy is one of the core values HIM and

they did not report Ruths domestic abuse and she
Healthcare professionals should respect
was seriously injured?
The safety of patients and the public is

Are they liable if Patricia contracts HIV from Ron,

also a major priority of Healthcare
since they knew about it and didnt warn her?
professionals
Patient: Patient and physicians are able to have honest communications about different issues (i.e. Ruth disclosing
that she was domestically abused and Ron disclosing his drug abuse to the physicians assisting them) with the
understanding that their information will be protected and not disclosed without their express permission. This honest
communication that helps physicians in the diagnosis process would not be able to exist otherwise.
HIM Professional: One of the core values of an HIM professional is to respect a patients privacy and the
confidentiality of their medical record in general. Ruth is able to have privacy by choosing not to receive help or have
it disclosed that she is being physically abused and Ron is able to have his privacy by choosing not to have his drug
problem or medical status disclosed as well.
Healthcare Professionals: Have a duty as a core value to respect a patients privacy and the confidentiality and
security of their healthcare-related data. Physicians specifically take the Hippocratic oath which states (in part), I will
respect the privacy of my patients, for their problems are not disclosed to me that the world may know. However,
specifically in regards to Rons HIV status, a doctor is also supposed to help prevent serious harm of another
person. In this specific case, a doctor would be allowed to disclose the HIV status to Patricia, since contracting HIV
would place serious harm to her. In many states, doctors also have a duty to warn people who are sexual partners
with a person who tests positive for HIV.
Administrators: Have a duty as a core value to respect a patients privacy and the confidentiality and security of
their healthcare-related data.
Society: Society as a whole puts trust into the medical professionals to respect laws such as HIPPA and oaths such
as the Hippocratic oath. Society has put in place laws that value a patients privacy that have serious repercussions
for breaking (such as being banned from the medical field), showing how heavily they feel this value is important.

4. What are my
options?

Tell someone about Ruths issue to get her help

Value Ruths privacy and do not disclose this information unless Ruth has given express permission
Tell Patricia about Rons issues to give her a chance to protect herself (so she doesnt have unprotected
sex with Ron)
Respect Rons privacy and do not disclose any of the information unless Ron has given express
permission to do so

5. What should I
do?
6. What justifies
my
choice?

7. What can I do
to prevent this
ethical problem?

Respect Rons privacy regarding the drug abuse, but also prevent serious harm to Patricia by telling her
about his HIV status.
Value Ruths privacy and do not disclose the information. Also, value Rons privacy and do not disclose the
information about his drug abuse. In regards to Patricia, it is a clinicians duty (in many states) to tell a sexual
partner, not a HIM students. Mary could talk to the clinician who treated Ron, who may then be required to inform
Patricia if Ron is unwilling to (again, depending on the state).
JUSTIFIED
NOT JUSTIFIED

Ruth, Ron, and every patient have the right to

Violating Ruths privacy, even with good

privacy
intentions to get her help

In turn, the healthcare professionals

Violating Ruths privacy to get brownie points

responsible for their care at any stage have the

Violating Rons privacy regarding his drug

duty to keep their information private and
abuse, even if its to get him help
secured.

Ignoring the serious health risk that Patricia

Ruth and Ron did not give any permission for

could face
their information to be disclosed.

Specifically in regards to his HIV+ status,

Mary could have told her mother upfront that it is illegal and unethical for her to violate Ruths privacy in that way.
When asked by her mother, she could have instead urged her to just go over and talk to Ruth if she would be
willing to discuss the issue. In general, Mary should also detach her personal life from her professional life, or, if
this is too difficult, should transfer to another location further away from her smaller community so that she does
not feel compelled to disclose this information.

Sources used for helping make this ethical decision:

http://www.aidsmap.com/Confidentiality/page/1255091/
http://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html
http://journalofethics.ama-assn.org/2005/10/hlaw1-0510.html