1. Ethics in the
2. Learning Objectives
• Discriminate between confidential and
nonconfidential patient information
• Discuss basic actions every nurse must implement to
protect patient confidentiality
• Analyze special threats to patient confidentiality
from the health care environment and information
• Propose solutions for protecting patient
confidentiality during special circumstances
3. Confidentiality Defined
Defined in many different ways:
• Keeping the secrets of patients
• Controlling access to sensitive personal
• Holding in confidence all personal matters
committed to keeping and all family affairs coming
to knowledge in the practice of ones calling.
• Keeping something classified, restricted,
undisclosed, secret or private.
4. Rationale for Keeping
• ANA- Associated with the right to privacy,
the nurse has a duty to maintain
confidentiality of all patient information.
• It is a legal right, founded in the ethical
principle of non-maleficence
• To maintain a trusting relationship.
5. Rationale for Keeping
The Health Information Portability and
Accountability Act (HIPAA)
• First federal privacy standards to protect patients’
medical records and other health information
provided to health plans, doctors, hospitals, and
other healthcare providers.
• Took effect April 14, 2003.
6. Rationale for Keeping
• The standards for privacy of individually
identifiable health information was created in
response to the 1996 HIPAA Law.
• Addresses how health care providers, health
plans, and health care clearing houses convey
patient information electronically.
• Laws that provide a minimum acceptable standard
related to how a patient’s medical records and
personal health information are to be kept
7. Who can access Confidential
• Disclosure of any and all health information, by
law, is to be disclosed only on the need to know
• The nurse should consider, can this person do his
or her job safely and knowledgeably without this
• If yes, then the nurse does not need to know.
• If no then the nurse needs to know the information.
• Maintaining confidentiality is a fundamental
obligation for every nurse during every patient
• Patient information should only be shared on a need
to know basis.
• Confidentiality is necessary in establishing trust in
the nurse-patient relationship.
• Maintaining confidentiality can be complex given the
many platforms used for communication of