Question

You have a busy family physician within your healthcare facility, and one day a nursing staff member hands you a phone message in the middles of your busy day. The spouse of one of a patient that has had care in your facility has called to discuss concerns about the health of her husband, Sam. She informed a nurse that she thinks that her husband is addicted to prescription pain medications and would like to know if anyone else has observed any signs of addiction during his last visit. You spoke to the physician who saw Sam 2 weeks ago, and he advised that he did think that Sam was behaving strangely. The physician noted that Sam seemed very preoccupied and disengaged. In addition, he seemed sad, and both the physician and nurse inquired with family members about his emotional health because he was very out of character. Sam denied any depression. You and your administrative team have to discuss the ramifications of discussing Sam’s care with his wife and also the following issues.

You should discuss this case as if you are in a committee meeting. Think about all the different stakeholders and their perspectives on the case. Be prepared to think of both sides of the discussion. There should be 1 document written up to address the Summary of your thoughts of this case that also should include answers to the following questions.

There are a number of considerations here. You should write up your class case that specifically addresses the following:

What are the ramifications of discussing Sam’s case with his wife?

How does confidentiality impact EACH stakeholder in this case?

Is there a US federal regulation/legal considerations with regard to patient confidentiality? If so, explain how it impacts this case.

What are the ethical considerations regarding the theories that are applicable to this case? Identify the theory, define it and explain how it relates to this case. You should have at least 2 theories.

Answer 1

Discussing the Sam's case with his wife gives the positive consequence in treating the patient aspect.Unless we discuss with the family members(wife) we can not assess,diagnose and provide treatment to the patient especially mental health problems.
confidentiality must be maintained with the patient,for protecting the patient right.But part of the treatment physician/nurse must involve the family memebers as a main source and care promoters.
without losing the confidence of the patient,must get the needed information from wife and give instructions regarding the health condition of the client.Because wife also plays an important role in depression management of this patient.
US federal regulation/legal considerations with regard to patient confidentiality ,make access to disclose confidential information when the patient is at risk of harm him self or others.In this particular case also Sam looks preoccupied and disengaged and even sad,so there is chance of self harm,in this view physician can disclose the information with his wife to take necessary actions to prevent self harming issues and provide treatment also.

the theories which can be applied to this case are,
1.Interpersonal theory - Defines nurse patient relationship.according to this theory,nurse work out on the situation based on the need of the patient by 4 steps like,
*orientation,(knowing about the patient condition)
*identification,(identifying the need to involve wife in treatment)
*exploitation and (disclosing the details to treat the patient)
*resolution. ( finally problem resolves)

2.Self care theory-orem's version of health is a state characterized by wholeness of developed human structures and of bodily and mental functioning.her assumptions include that people should be self reliant and responsible for their own care and care of other people.she said that a person's knowledge of potential health problem is necessary for promoting self care behavior.
caring other people means,when some one knows the problem of the patient only he/she can provide care to him/her.