Confidentiality and Autonomy, Nursing Ethics

Walden University

There are numerous issues that have an impactof the modern work environment. Nurses and other care givers have oneof the most challenging but fulfilling duties. However, theeffectiveness of a care giver to deriver and have a fulfilling careeris dependent on his or her ability to deal with the issues thatemerges in their work environment. Some of these issues have ethicaland legal implications as a result there are local, national andinternational codes of conduct and codes of ethics that guides thenursing profession (Huston, 2014). Thepurpose of this paper is to explore confidentiality and autonomy innursing practice in reference to local and national code of ethics.

Confidentiality and autonomy in nursingpractice

One of the most important nursing ethics issuesin the modern medical practice is the autonomy and confidentiality.Although they may be viewed as two different issues, they are closelyrelated and are associated with the dignity of the patient. Theuniversal nursing ethics are committed to the autonomy of thepatients and the confidentiality of the nursing professional. Thepatient has the autonomy in making decisions in relation to thechoices of treatment. Also, the nursing ethics guarantees theconfidentiality of the patient autonomy. Although the consent of thepatient or close family members is required, they may not have thenecessary medical knowledge to make decisions. As a result, evidencebased practices in nursing suggests that an informed consent improvesthe quality of patient care. This is based on the ethics of care asopposed to the ethics of curing. In the best interest of the patient,the nursing practitioner may make the decision based on his or herknowledge and experience (Gastmans, 2013).However, without the consent of the patient, the nurse is consideredto be unethical. It is the responsibility of the nurse to uphold thedignity of the patient by providing information necessary for thepatient to make informed decisions. Protecting the dignity of thepatient is also related to confidentiality. Nursing ethics requiresthat the nurse keep all information relating to the patient asconfidential. For example, the patient has the right to decide whoshould be informed about their illness. The autonomy of the patientin regard to choice of treatment and confidentiality of his conditionshould not risk the life of the patient. In cases where the patient’sdecisions are risky, there are appropriate channels that arerecommended for intervention (Mason et al, 2014).

Texas Board of Nursing, code of ethics

Texas Board of Nursing plays an importantrole in regulating the nursing profession in the Texas state. Theboard has been in existence for over a century and is aimed atensuring that there are safe nursing practices in the state. Theboard has the mandate of enforcing local, national and internationalnursing ethics. This is aimed at protecting the general public withinthe state from unsafe practices as well as unethical behaviorsrelating to the nursing profession. In addition to providingguidance to the nurses on the universally acceptable nursing ethics,the board has the regal mandate of approving nursing trainingprograms as well as testing and licensing nurses within itsjurisdiction. The Texas Board of Nursing hasthe responsibility of enforcing the minimum nursing standards ascontained in the nursing practice act of 2011 as well as other codesof ethics related to the nursing profession. According to the nursingethics acts, the nurse is required to treat the information relatingto the client with confidentiality, unless the disclosure of suchinformation is allowed by the law and regulation. The act alsorequires the nurse to act is such as way that he or she promotesknowledge and counseling to the patient and the family members tofacilitate informed consents. In general, the Texas Board of Nursingenforces locally and nationally acceptable nursing code of conductsand code of ethics and takes disciplinary actionsagainst individual nurses or organizations violating them (TexasBoard of Nursing, 2014).

American nurses association code of conduct

The American nursing association code of conducts outlines the codeof conducts expected of a nursing profession practicing in the UnitedStates. Although are other codes of conducts and code of ethics, itprovides an important guide to nurses and care gives in the unitedstates and other parts of the world. The code of ethics identifieshuman dignity and the rights of the patient as the most importantaspects of care giving. Basically, in addition to protecting theintegrity of the nursing profession, the code of conduct fundamentalfunction is to ensure that nurses uphold human dignity and rightswhen dealing with the patients. Therefore, autonomy andconfidentiality ethical issues are captures in the American NursesAssociation code of conduct. According to provision 1 of the code ofethics, nurses should take into account the needs and values of theirclient before making any treatment decisions. This means that thecode identifies the universal regulations that give the patients theautonomy in decision making (Huston,2014). Consequently, the treatment elements should take intoconsideration the religious and social backgrounds as well aspersonal preferences of the patient without biasness or prejudice.This allows the patient or the family to exercise autonomy duringcare giving. However, the same provision argues that the nurse shouldnot agree or condone all suggestions and choices made by the client.The consent of the patient should be based on informed choices. Whilerespecting the patient dignity as a person, the nurse should exercisehis or her authority as a trained care giver (AmericanNurses Association, 2011).

Provision 3 of the code of ethics requires the nursing professionalsto uphold their client’s right to privacy. The fact that a patienthas sought medical care does warrant unjustified intrusions into hisor her private life. The care givers should advocate and provideenvironment that ensure that there is sufficient privacy duringdiscussions or personal care. This is in line with the universal codeof ethics that requires the nurses to treat any information relatingto their client with confidentiality. According to the code of theethics, “the patient’s wellbeing could be jeopardized and thefundamental trust between patient and nurse destroyedby unnecessary access to data or by the inappropriate disclosure ofidentifiable patient information”. For example, disclosure ofpatient information by a nurse may lead to stigmatization andprejudice in the society. The code of ethics also states that “thestandard of nursing practice and the nurse’s responsibility toprovide quality care require that relevant data be shared with thosemembers of the healthcare team who have a need to know” (AmericanNurses Association, 2011). This means that confidentiality is notabsolute and may be broken in the interest of the society or in somecases the best interest of the patient. It is also important to notethat information disclosure for the purposes of “peer review, thirdparty payment and other quality improvement or risk management”should be strictly guided by established protocols and policies(American Nurses Association, 2011).


Nursing ethicsconstitute an important aspect of the nursing profession, due to thenature of the client. Confidentiality and autonomy is a key facet ofthe nursing ethics. The state board of nursing is a body mandated toenforce laws and regulations relating to the nursing practice.Additionally, the American nurses association has established a codeof ethics that guides the nurses on the best practices in relation topatient autonomy and confidentiality of information.


American Nurses Association (2011). Codeof Ethics Overview.

Gastmans, C. (2013). &quotDignity-enhancing nursingcare: A foundational ethical framework&quot. NursingEthics 20 (2): 142–149

Huston, C. J. (2014). Professional issues in nursing: Challengesand opportunities (3rd ed). New York: Lippincott, Williams &ampWilkins.

Mason, D. J, Leavitt, J. K., &amp Chaffee, M. W. (2014). Policy andpolitics in nursing and health care (6th ed). St. Louis, MO: ElsevierSaunders.

Texas Board of Nursing (BON) (2014).Rules and regulations relating to nursing education, nursinglicensure and practice. Austin, TX: TexasBoard of Nursing.