Core principles of the NMC code of conduct and professional practice

NMC Code: Patient Confidentiality

The Nursing and Midwifery Code sets the standards by which UK nurses and midwives should conduct themselves both ethically and professionally (NMC, 2010). The main principles are patient autonomy, patient confidentiality, patient collaboration in care, consent, professional boundaries, information sharing with colleagues, teamwork, effective delegation, and risk management. This essay will examine the principle of patient confidentiality and how this can affect practice.

Patient Confidentiality

Patients expect their personal information to be protected by doctors, nurses, and midwives. This expectation is essential to the efficient functioning of the health services, because patients would otherwise be less forthcoming about their physical and mental health if they believed the information could be released to the public or family members without their permission (General Medical Council, 2009). If this were to occur then the ability of doctors and nurses to provide needed services would be significantly impaired. In a worst case scenario, a patient may even decide to forego seeking needed medical care and be irreparably harmed.

One of the more difficult contemporary issues surrounding patient confidentiality is balancing patient confidentiality with the need to protect the public harm. Kwong Chan (2013) provides four scenarios involving this ethical dilemma, each with a patient expressing a desire to keep their HIV status confidential. Patient A has no sexual partners, patient B. refuses to discuss sexual history, patient C. identified his sexual partners but refuses to inform them of his HIV status, and patient D. refuses to tell his wife. Based on Chan's analysis, only the latter two situations present a doctor or nurse with an ethical dilemma. Guidelines under the General Medical Council allow for contacting sexual partners directly or involving law enforcement; however, no guidelines exist that govern the dilemma created by patient D.