Human service is a challenging profession that deals with responding to human problems and medical needs. It is a profession characterized by people who have an appreciation for ethnic, cultural and racial diversities. Additionally venturing into human service requires a person with a human heart which will drive him or her into assisting clients within their area of specialty. This field of study further revolves around giving service to communities and caring for the environment. As a result, human service practitioners, professionals, students and faculties are encouraged on the need to promote unique characteristics and values that are pertinent to individual and industrial growth (Weaver, 2005). By so doing, the whole field of study will be disciplined enough to observe integrity, responsibility, as well as ethical conduct in their line of duty. Likewise, the field encourages its students to be partakers of constructive criticism, which has proved essential in identifying medical loopholes, and which can be dealt with to enhance efficient service to humanity. It is because of these requirements that the issue of confidentiality has elicited much debate in the recent past.
According to the definition stipulated by the NASW Code of Ethics, confidentiality refers to the ability of a medical practitioner to keep secrets relating to their medical practices and career in general. Moreover, the NOHSE Code of Ethics states that confidentiality is a very pertinent requirement among practitioners in the field of human service. Relatively, confidentiality supported by the freedom to privileged communication has become a measure of professionalism among medical counsels and therapists. This is because codes of ethics regulating human services prohibit the sharing of information that has been confided by a client or a patient. The code further gives professional health workers the responsibility of warning any person that might be affected by a certain medical procedure. This duty makes the work of human service professionals tricky because it contravenes the rule of autonomy which gives the medics powers to make quick decisions especially when faced with an emergency (Linzer, 2007).
Despite the confidentiality laws that protect patients from exposure of medical records that might lead to abuse, segregation or stigmatization, there are situations where human service professionals are supposed to inform the public especially in the event that one of their clients is suffering from a communicable disease or one that requires research and containment so as to avoid spreading it. In such a situation, the ethical principle regarding confidentiality is outweighed by the need for public education (Weaver, 2005). The second situation that can allow for disclosure of medical information is in the event that medic needs to warn the family, caretakers, or relatives to the patient of certain personal behaviors that the client is possible of committing. For instance, during my line of duty as a personal practitioner working with patients afflicted by severe mental disorders and those on rehabilitative programs caused by excessive use of substances of abuse, I was forced into a situation that needed emergency measures. After being is several cubicles attending to patients and administering their daily dosages together with sharing in their personal experiences, I entered one room, which was assigned to a patient suffering from mental disorders caused by excessive abuse of marijuana.
To my surprise I was shocked to realize that the patient was missing from the room. I had to inform security officers on the need to be vigil because a client had gone missing. Given his state of mind, he was capable of doing anything. It is after several medics were on alert that we realize the patient was hanging on the rafters ready to take his life. This was obviously a case of suicide, and it would have been hard to explain to her caretakers that he had taken his life because of his unsound state of mind. As a counter measure, I had to inform the administration to the facility so that action could be taken and the patient taken to a more enclosed and restricted area to prevent such a reoccurrence. In addition to the precautionary measures that were undertaken by the medical facility, the caretakers to the patient as well as some trusted relatives were informed on the case of their patient (Reamer, 2003). This instance of breaching confidentiality is supported by the fact that the patient was endangering his life and possibly he would have endangered that of the people around him; therefore, there was the need to inform trusted parties to help resolve the issue.
The third case under which confidentiality can be disregarded is through a court order demanding that medics produce medical records as evidence. Even though these rules are varied from one state or country to the other, the code of confidentiality can vary based on the clients or patient’s age. Children rarely have confidential information because their parents are allowed by law to access confidential medical records concerning the health of their children (Maluccio, Pine & Tracy, 2013). Again issues arise when children expect their human service counselors to keep their information confidential from their parents. In the event that they share this information with the parents, they risk losing their trust thus making them hard to open up on their medical condition. Thus, the idea of confidentiality requires service professionals to practice ethical decision making from time to time because the ethical dilemmas and issues experienced in the field of human services are too many to be documented. Furthermore, not all ethical codes are legal documents thus legal process might not come in handy in shaping the behavior of service professionals into embracing confidentiality.
Among the parameters and limitations embodied in the concept of confidentiality is the need to understand the four basic principles encompassed in the Human Service Program. The first principle is that of respect for privacy. Second is the need by practitioners to respect the human relationships which might be jeopardized by sharing of personal information. This is in the event of a couple where one is infected with the HIV virus while the other spouse is unaware. The third principle is that of appreciating confidentiality as a tool to preserving a peaceful mind among both the individual affected and society as a whole. The fourth principle is the need to remain trustworthy after promising the patients that their information will be secretive (Maluccio et al 2013). This principle is also supported by the fact that confidentiality plays the role of uniting people on the basis of trust thus once the trust is lost then people are bound to hurt each other because some information archived in the medical records is classified and the public cannot be allowed access. The need for confidentiality is further elucidated by Linzer, (2007) who states that some confidential information is likely to cause a health scare or massive damages if left unguarded thus there is a need for professional ethics in managing medical information.
Based on the four principles guiding the medical code of conduct, it becomes prudent for human service workers, psychologists, priests and lawyers to practice confidentiality while dealing with their clients. Linzer supports that the NASW code of ethics is applicable in varied fields of study because confidentiality is like a thread that holds the society together. The concept of confidentiality is further supported by the legal regulations restraining the Release of Information abbreviated as ROI (Weaver, 2005). There is also the need for mandated reporting, which restricts not only medical practitioners but also priests, psychologists, counselors and lawyers from sharing secretive information. This law acknowledges the role played by teachers, health workers, human service workers and pastors in educating the public and reporting issues related to abuse, negligence, and even disabilities, but they are restricted from sharing such information to the public because it is sensitive.
With the growing cases of modernity and globalization, confidentiality of information is paramount because it can easily cause major conflicts. This is another reason why the role of confidentiality remains the same across people of all ages, ethnicity, race, religion, cultural beliefs and their mental capabilities (Reamer, 2003). Apparently most countries have enacted laws to protecting the right to choice among other personal privileges thus human service workers are required to have a broad background knowledge relating to their customers cultural beliefs and practices so as to avoid cases of preconceived misunderstandings. In order to avoid such disagreements, human service workers have a duty to protect not only confidential information but also the health of their customers and the safety of societies. The duty to protect is a noble guide towards professional autonomy among medics. This concept is supported by the necessity of patients’ informed consent. This means that the medic has to explain to the client or patient his or her medical condition, counsel and advise them on the options available. The practicability of this exercise is safeguarded using a privileged communication channel where a client or patient is given the liberty to choose whom they want to confide in. The client then selects the best professional service depending on the information they are given. With an informed consent, a patient can then decide if they want their information to be confidential or not.
Linzer, N. (2007). Resolving ethical dilemmas in social work practice. Michigan: Allyn and Bacon Press.
Maluccio, N., Pine B. & Tracy, E. (2013). Social Work Practice with Families and Children: Foundations of Social Work Knowledge Series. Columbia: Columbia University Press.
Reamer, F. (2003). Boundary issues in social work: Managing dual relationships. Social Work. 48(1), 121-133, retrieved from EBSCO database.
Weaver, H. (2005). Explorations in Cultural Competence: Journeys to the Four Directions. New York: Thomson Brooks/Cole.