Health Priority: Confidentiality or Patient Safety?

Identifying the Issue and Stating the Ethical Position

The issue of confidentiality is one of the critical principles that guide the practice in the healthcare sector. The practitioners are legally and ethically required to protect patients’ information from third parties unless authorized to do so by the patient or a court of law. However, I believe it is important to reconsider this confidentiality law, especially when a practitioner feels that a patient’s condition may put the lives of others at risk. The professional code of conduct demands that after diagnosis and recommending medication, the patient’s condition should remain confidential (Beckmann, 2017).

However, conflict arises when the practitioner feels that keeping the condition may be a direct danger to members of the public. For instance, when a practitioner determines that a patient is mentally impaired and cannot work as a driver or a pilot, conflict of interest arises. The physician is required to keep the information from the public. In so doing, the lives of many people may be jeopardized if the person decides to continue working without sharing his or her condition with the employers. I strongly believe that public safety and the safety of the patient should be given priority over the issue of confidentiality.

How the Scenario May Play Out in My Role as a Nurse Practitioner

In many cases, nurses find themselves handling patients whose conditions may affect others. It may be a highly communicable condition such as tuberculosis, HIV, or Ebola. A nurse is expected to embrace the concept of confidentiality, hoping that the patient will be open to others about his or her condition and protect the public from a possible spread. However, that is not always the case. Some people even infect others deliberately because of mental impairments or personal reasons. It changes from being a problem of just one person to being a problem of the mass (Barnhorst, Wintemute, Betz, 2018). It endangers the lives of many primarily because the confidentiality of the patient had to be protected.

Defending My Position with Legal, Ethical, and Professional Evidence

I strongly believe that the laws of confidentiality should be considered inferior to the laws governing safety and security of the masses. On March 24, 2015, Germanwings Flight 9525 (Airbus A320-211) with 144 passengers and six crew members flying from Spain to Germany was deliberately crashed by a co-pilot, Mr. Andreas Lubitz. It was established that the co-pilot had suicidal tendencies that had been confirmed by his doctors. He was declared unfit to fly a plane. However, the report was handed to him as a legal requirement, and it never reached his employer. Doctor-patient confidentiality law and ethical requirement led to the loss of 150 lives. It was an indication that although Health Information Portability and Accountability Act of 1997 (HIPAA), reviews may be necessary to prioritize the safety of the masses (Sue, 2017).

Strategies and Solutions for Addressing the Issue and Other Ethical Concerns

New laws and code of professional conduct should be put in place to regulate the issue of patients’ confidentiality. If the condition of a patient does not put a threat to safety and security of the masses, then practitioners should be allowed to embrace the confidentiality requirement. However, when it is established that the condition is a threat to others, a mechanism should be created that allows for an effective sharing of the information primarily with the aim of protecting the masses.


Barnhorst, A., Wintemute, G., Betz, M. (2018). How should physicians make decisions about mandatory reporting when a patient might become violent? American Medical Association Journal of Ethics, 20(1), 29-35. Web.

Beckmann, D. (2017). What are physicians’ responsibilities to patients whose health conditions can influence their legal proceedings? American Medical Association Journal of Ethics, 1(9), 877-884. Web.

Sue, K. (2017). How to talk with patients about incarceration and health. American Medical Association Journal of Ethics, 19(9), 885-893. Web.

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