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Possible solutions:

1. Disclose patient's condition in a suitable extend, with his agreement.

2. Provide some professional advice on how to minimise risks of HIV diseases to patient, without disclosing any information.

All of these requires discussion with patient, and his opinions must be respected.

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Clinical Ethics Network (N.D) Case Studies. Available at: http://www.ukcen.net/main/case_studies/overview

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K Blightman. (2013) Patient Confidentiality, Education in Anaesthesia Critical Care & Pain, Volume 2 , (p52-p56)

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Breaching confidentiality to protect others (solution)

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Breaching confidentiality to protect others (solution)

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Risks for disclosure:

Patient may lose trust in doctor and stop treatment, affecting more people in the future.

Serious health risk for patient.

Risks for confidentiality:

Patient's partner may not be aware of the illness, actions may not be done to minimise risks to their baby.

Patient's former partners may not be informed, which may spread the disease.

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-freedom of choice
-people should have the right to control their own body and life

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Arguments for and against euthanasia - Euthanasia and Assisted Suicide - Issues Online

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Arguments for euthanasia and assisted suicide There are several main types of argument used to support the practices of euthanasia and assisted s.........

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Issues online (N.D) "Arguments for and against euthanasia". Available at: http://www.issuesonline.co.uk/articles/arguments-for-and-against-euthanasia-4508#

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NHS UK (N.D). Principle and Values that guide the NHS. Available at:
https://www.nhs.uk/NHSEngland/thenhs/about/Pages/nhscoreprinciples.aspx

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Kelly, T (N.D) Privacy, dignity and respect in care. Available at:
http://www.cmft.nhs.uk/directorates/mentor/documents/PrivacyandDignityinCareTK.pdf

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Avoid stereotyping people

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Respect personal space and possession.

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Involve patients in decisions relating to their health, by not doing so, the patient will feel disconnected and unvalued

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- To make sure that all personal information of the patients are kept confidential, this is a way of respect to patients.

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- Address patients correctly, with their correct titles.

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Breaching Confidentiality to protect to others

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Breaching Confidentiality to protect to others

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Situation: Patient is tested positive with HIV, and refuses to inform his partner, who he will be expecting a baby with. He states if she is told without his consent, he will stop his treatment.

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Situation: Patient needs a dialysis, and the patient refuses treatment as she is afraid of the treatment and also finds it invasive.
However, patient understands that by refusing treatment, that she will die, leaving her daughter behind that is 15 years of age .

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Who should have the intensive care bed? (solution)

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Who should have the intensive care bed? (solution)

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Factor to be considered:

Condition of patient in a short period of time for the transfer.

Condition of other patients to see if any of them are willing to provide a unit in hospital.

Patient and his family's will of getting an intensive care treatment in a short period of time.

Possible solutions:

1. Transfer patient to another hospital with the his agreement to get treatment immediately.

2. Transfer a more stable patient, with his agreement, to provide a place for the patient's treatment

3. Follow the patient's will if he hopes to wait for a free intensive care unit.

Condition of patient must be be informed before any decisions are made by the patient, and his reasonable decision must be respected.

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A Competent Patient Refuses Treatment (solution)

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A Competent Patient Refuses Treatment (solution)

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- Although the decision made will make the patient's condition deteriorates, if he/she is competent to make decision, it should be respected.
- If the patient becomes incompetent through illness, the decision made when he/she were competent should also be respected.
- The family members of the patients can also be involved in the discussion.

Conclusion:
Since the clinician had honestly told Mrs X the consequence if she do not accept the treatment and he had respected Mrs X decision at last. Therefore, the clinician has met respect and dignity in this situation.

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 Who should have the intensive care bed?

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 Who should have the intensive care bed?

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Contention: Respect a patient's autonomous wishes
Situation: the patient is in urgent need because without intensive care treatment he will die

Dilemma:
1. Patient or patient's relatives refuse to transfer patient to another hospital (Patient's autonomy vs Responding the need)

2. Patient wish to stay in the hospital to receive appropriate care but the hospital is full and patient require intensive care until he is fully recovered. (Patient's autonomy vs Duty of care)

Conclusion: In terms of acceding to patients’ or relatives’ wishes, the principle of autonomy is not particularly helpful in this situation

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- Patents wishes and needs must be respected and accomplished
-The consequences of these wishes on other individuals must also be taken into consideration.
- Disclosing information about a patient without his permission is forbidden however not doing that might limit the ability of other people who are affected in seeking medication.
- In both situations respect and trust towards the doctor will be lost by either side of patients.

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1.Value each person as an individual, respect their aspirations and commitments in life
2. Seek to understand their priorities, needs, abilities and limits
3. Take patients into account when designing and delivering services
4. Take what others have said seriously.
5. Be honest about our point of view and what we can and cannot do
6. Be candour and create a culture of humility, openness and honesty, where staff communicate clearly and openly with patients, relatives and carers.

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Respect and Dignity is one of the most important values for the NHS.
This means that each patients needs and wants must be met, also they must be treated with respect regardless of their ethnicity, gender and religion.

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by Mahdi, Pedro, Deborah, Joyce and Jeslyn