E-Ethics & nursing
As technology continues to expand, so do the ethical concerns. Ethics is a branch of knowledge that utilizes conceptual tools to assess situations and morally guide decision-making (Simpson, 2005). Ethics specific to Health Information Technology (HIT) are also called e-ethics or infoethics (Layman, 2003). HIT creates clashes between the ethics of beneficence, autonomy, fidelity, and justice (Layman, 2003). The Hippocratic Oath, primom non nocere (first, do no harm), promised by healthcare professionals solicits the question, can HIT cause harm (Simpson, 2005)?
Without a doubt, HIT will continue to impact health systems and necessitates great leaders and thinkers to assess the ethics of new technological breakthroughs. Nurses are prepared both academically and experientially to confront these ethical questions while ensuring excellent patient care. According to theAmerican Nurses Association (ANA) (2008), nursing informatics uses nursing science, computer science, and information science to communicate wisdom into nursing practice as a means to support patients, nurses, and other healthcare providers (ANA, 2008).
Common ethical dilemmas within the field of nursing informatics include the confidentiality and privacy of electronic medical records, the public’s use of the Internet for health advice, the patient-provider relationship within cybermedicine interactions, and access to decision-support software (Layman, 2003). Another frequent ethical concern includes information security on portal devices such as cellphones, tablets and laptops. This blog post elaborates on this ethical concern and provides recommendations that align with the ANA’s code of conduct.
Published by the ANA, the Code of Ethics for Nurses delineates the goals, values, and obligations of the nursing profession (ANA, 2001). Provision three section one and two (3.1 & 3.2) outlines the nurse’s responsibility to safeguard the patient’s privacy and right to confidentiality (ANA, 2001). Dr. Laurie Badzek, director of the ANA Center for Ethics and Human Rights, also emphasizes the nurse’s duty to guard and protect the patient’s identifiable health information (Badzek, 2003). Dr. Badzek stresses that maintaining a sense of trust between the nurse and patient begins with ensuring privacy and confidentiality (Badzek, 2003).
In 1999, the Institute of Medicine (IOM) published a seminal book titled For the Record: Protecting Electronic Health Information. This text recognizes the growing use of information technology within the healthcare sector. The IOM (1999) emphasizes the vulnerabilities of HIT, especially the potential ethical concerns regarding privacy and confidentiality. Privacy is identified as a fundamental right of an individual by the IOM (IOM, 1999). Likewise, the ANA calls nurses to serve as advocates for patient’s right to privacy by lobbying for policies and regulations that protect the confidentiality of information (ANA, 2001).
The Office of the National Coordinator for Health Information Technology (ONC) provides a helpful list of recommendations for aid nurses in protecting their patient’s private health information (ONC, 2014). First, cell phones, tablets, and laptops should use a password or other type of user authentication (ONC, 2013). The devices should have encryption installed and enable to protect the data while it is stored on or sent by the mobile device (ONC, 2013). Remote wiping and remote disabling features should be activated. File sharing applications should be disabled and a personal firewall should be enabled to prevent unauthorized connections (ONC, 2013). Security software should be installed and updated regularly as well (ONC, 2013). Finally, any stored health information should be deleted before the device is discarded or reused (ONC, 2013).
With a focus on HIT and the evolving ethical concerns regarding its use, this blog post discussed the importance of securing portable devices containing private health information. The post provided insights regarding e-ethics and the moral questions facing not only nurses but all healthcare providers. With their extensive education and strong foundation in patient care, nurses are positioned perfectly to solve the ethical dilemmas that arise from HIT.
References
American Nurses Association. (2001). The code of ethics for nurses. Washington, DC: Nursesbooks.org.
American Nurses Association. (2008). Nursing informatics: Scope and standards of practice. Washington, DC: Nursesbooks.org.
Badzek, L. & Gross, L. (1999). Confidentiality and privacy: At the forefront for nurses. American Journal of Nursing, 99(6), 52-54
Hebda, T. & Czar, P. (2013). Handbook of informatics for nurses. Upper Saddle River, NJ: Pearson Education, Inc.
Institute of Medicine. (1999). For the record: Protecting electronic health information. Washington, DC: National Academies Press.
Layman, E. (2003). Health informatics ethical issues. Health Care Manager, 22(1), 2-15.
Simpson, R. L. (2005). Nursing informatics. patient and nurse safety: How information technology makes a difference. Nursing administration quarterly. 29(1), 97-101.
The Office of the National Coordinator for Health Information Technology. (2013). How can you protect and secure health information when using a mobile device? Retrieved from:http://www.healthit.gov/providers-professionals/how-can-you-protect-and-secure-health-information-when-using-mobile-device
The Office of the National Coordinator for Health Information Technology. (2014). About ONC. Retrieved from: http://www.healthit.gov/newsroom/about-onc
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