Applying Ethical Framework in Practice
Rodd Tooke
Grand Canyon University: NRSv437
September 2, 2013

Applying Ethical Framework in Practice
Reading the “Bioethics of NBC’s ER” this writer feels the ethical implication of breaching the confidentiality of not only Andrea but everyone in the school who participated in the sex group. Ethical Implication Of A Breach Of Confidentiality
A breach of confidentiality is a disclosure to a third party, without patient consent or court order, of private patient information ("Patient confidentiality," 2010). Before Nurse Hathaway can disclose any information about Andrea health to anyone including her parents, Andrea must sign a release of information which can be verbal or written. This writer feels that when a minor informs an adult or someone they feel they can trust in a situation that can be harmful to the minor child it’s important to explain to the child how important the situation can be to his or her health and inform the child at that time of a consent being need to obtain the necessary medical attention that may be needed. During the disclosure of information the adult must inform the child that under certain situation the parent may or may not be notified depending of the severity of the problem. If Nurse Hathaway breaches the confidence of Andrea she may no longer trust someone she beliefs and could confine in to keeping a secret. She may also be afraid to seek help in the future for thinking a breach of confidentiality may occur again. This writer feels if medical providers breach confidentiality, it would be difficult to trust another medical provider.

Ethical Theories and Principles
The Tarasoff v. Regents case where a Supreme Court judge over rule a decision calling for a “duty to protect” the intended victim from harm (Nathason, 2000) is why this writer feels Nurse Hawthorne has a duty to protect other students from possible catching STD from each other. This writer feels the dilemma would be signaling out a student who may or not have a sexual transmitted disease and also informing other students who may not be engaged in a sex group. Another dilemma would be the parents of Andrea may not want others to know their child is sexual active or may have cervical cancer from not receiving treatment from a STD. This writer feels the only way to keep confidentiality in a situation like this would be to ask Andrea to get tested and if the results come back positive she then needs to inform each member of the group herself of them needed to be tested to rule out STD which in some cases can go without any signs or symptoms of having a disease. This writer had known some who was slightly mentally delayed, who was diagnosed with kidney disease in her late teens due to an untreated STD. This young girl never told her parents that she was having unprotected sex, and may not have known that she had a STD since having no any signs or symptoms of having a sexual transmitted disease. This young girl was actually my niece who went on dialysis and later died at the age of twenty-six for kidney complications. This writer feels strongly that each parent should be informed of a minor child medical problem along with every person that may have come into contact with unprotected sex. This Informing can be kept confidently by sending them a letter via mail after receiving the names and addresses of each person she had sex with stating that they should be tested for a possible transmitted disease, and if they bring in the letter with them the testing will be free of charge. By having them bring the letter this keeps everything confident since the letter will have a special coding on what test should be test needs to be performed.

Alternative to Address the Dilemma
There are six main steps with addressing an ethical dilemma based on the National Association of Social Workers (Murphy, 1997). The step involves are Determining, Identify, Rank, Develop, Implement, and Reflect. In the case of Nurse Hathaway and Andrea we know that nurse Hathaway has a responsibility in informing the school and parents of the medical care needed for her. This is ethical the right decision based on her diagnosis of HPV. Without proper care Andrea could develop kidney failure and risk the chances of her being unable to have children with the increased amount of scar tissue that can develop with a untreated disease in her cervical area. Nurse Hathaway is being told by her supervisor who is the doctor that she must inform her parents. Since this is a public health issue and nurse Hathaway is a nurse at the clinic and is not affiliated with the school, nurse Hathaway should contact the center for disease control and prevention (CDC) and inform them of the sex parties being held at the school and that one girl has test positive for HPV and cervical cancer. The CDC mission is to protect American from health, safety and security threats, whether a disease starts at home or somewhere else. (CDC , 2010) the CDC has special funding that assist with deliver information to the schools on how to avoid STD and pregnancy. This funding called Division of Adolescent and School Heath (DASH) includes special knowledge and skills for the teaches to use on how to teach students on how to protect themselves and a number of supportive services. This could help and prevent this from happening in the future. Nurse Hathaway should also start a curriculum based program that educates students on HIV/STD prevention programs. The program should help students how to solve problems, how to use condoms and or contraceptive and about waiting to have sex until you are older or married.
Ethics Committee
An ethical committee has people from different walks of life from a diverse background that way each people can give their views on the topic. The main function of an ethics committee is to provide consultation, develop and/or revise a police, and to educate about the issue being brought to them. This writer feels since the communities would include a diverse background of people including men, women, and young adults they could come up with a plan how to address the dilemma on safe sex practices.

Reference
Murphy, K. (1997). Essential steps for ethical problem-solving. Resolving ethical dilemmas, Retrieved from http:www.naswma.org/displaycommon
Office of the associate director for communication. (2010). Schools play key role in hiv/std prevention. Center for Disease control and prevention, Retrieved from http:www.cdc.gov
Nathason, P. (2000). Bioethics on nbc's er. Betraying trust or providing good care?, Retrieved from http://www.web.archieve.org/web/2011076061043
(2010). Patient confidentiality. American Medical Association , Retrieved from http://www.ama-assn.org