In the case of Donna, her attending nurse practitioner should not disclose sensitive information to her mother. While it is in the interest of the mother to demand and know if Donna discussed her sexual activity with her boyfriend to the NP, the NP should not sacrifice patient confidentiality in favor of the mother’s eagerness to know the sexual activity of her child. Moreover, the NP should not discuss with the mother the request of Donna for a prescription for birth control pills. Not only does the act of disclosing sensitive information against the will of the patient.
It is also against the constitutional right of the minor to privacy. The 1977 Court ruling in the case of Carey v. Population Services International clearly states that minors have the basic right to choose for themselves whether or not to beget or bear a child. The Court ruling also led to the protection of the right of minors to confidential contraceptive services, thereby setting a significant precedent for cases involving minor confidentiality in the face of disclosure of contraceptive services.
The case of Donna is well protected by the Court ruling and the United States Constitution. Apparently, the decision of the NP to deny the disclosure of information to Donna’s mother will directly and immediately affect the mother. Denying information to the mother is not equal to the unethical practice of lying or making deceitful claims. Rather, the NP’s refusal to reveal sensitive information is keeping in good faith towards the vested duty of healthcare professionals to maintain client confidentiality whether the case involves minors or otherwise.
It is no less than an ethical way for the NP to respond in that manner precisely because the welfare of Donna is paramount. That is not to say that the interest of the parent holds no value. On the contrary, it can be seen that the interest of the parent is also taken into consideration. Since it is in the interest of Donna’s mother to secure the healthy and safety of her daughter, giving her the appropriate medical services is only proper and is parallel to the interests of the mother.
Whether or not the mother is aware of the sexual activity of Donna, giving her prescriptions for birth control pills remains beneficial to the physical health of Donna. However, it is not in the same league as tolerating the sexual activities of a minor. While healthcare professionals have no right to bar minors from engaging in sexual activities, they can provide them with relevant information as well as warnings for health risks at the least. In the end, the right to self-determination lies on the patient and patient-confidentiality does not preclude minors.
In responding to the more significant ethically relevant factors involved in the case, the NP therefore ought to allow patient-confidentiality to take precedence over the interests of the parent without having to make false claims just to satisfy the desire of the parent to know Donna’s sexual activity. The NP can simply make a statement saying that it is not in her vested duty to deprive her patient of confidentiality inasmuch as it is also not within the bounds of law and ethics.
While maintaining patient-confidentiality, the statement is also aligned with the duty of the NP to inform the stakeholders in the case, especially the mother. Informing the mother about the confidentiality of sensitive patient information is not the same as depriving the mother of any information at all. Rather, informing the mother goes parallel with the duty to inform stakeholders such as the mother about the general status of the case and about what can and what cannot be disclosed.
While exceptions can be made on cases with similar grounds, the specific case of Donna still does not warrant exceptions as far as the fundamental rights to privacy and confidentiality are concerned.
References
Carey v. Population Services International 431 U. S. 678 (Supreme Court 1977). Maradiegue, A. (2003). Minor’s Rights Versus Parental Rights: Review of Legal Issues: Privacy and Confidentiality for Minors. Retrieved June 1, 2009, from http://www. medscape. com/viewarticle/456472_6