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Professional nursing is defined as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” (Epstein & Turner, 2015, para. 2). This definition comes from the American Nurses Association (ANA). The ANA has been responsible for supporting nursing practice through developing and applying policies, establishing the standards and scope with which nurses can practice, and the implementation of the Code of Ethics for Nurses. Nurses have responsibilities to advocate for their patients regardless of their own beliefs and values. This can result in conflicting and ethical challenges for the nurse; such is the case in this scenario with the community health nurse, Lena.
In this scenario, it is imperative to observe what ethical responsibilities Lena has as a professional nurse, as defined by the ANA. Provision 3 of the Code of Ethics for Nurses states, “the nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient,” (Fowler, 2015, p. 42). Her responsibilities include ensuring patient autonomy which gives the patient the right to self-determination. Beneficence refers to the actions that promote the well-being of others and ties into non-malfeasance meaning to ‘do no harm.’ Lastly, Lena’s ethical responsibilities boil down to justice, which I feel plays the largest role in this scenario and it means to uphold and follow the laws in place that govern how a nurse practices. Lena must decide in this situation if she is going to inform her sister of her boyfriend’s HIV status or maintain the integrity of the patient which is her ethical duty as a nurse. There are statutes in place in the state of Florida that would help Lena to uphold her ethical responsibilities but also her moral duties to her sister. Florida statute 384.24 (2) states that it is unlawful for an individual who knowingly has HIV and has been informed that the disease is transmissible and can be passed on to another individual through sexual intercourse unless the other person has been informed and consents to the interaction.
If I were in Lena’s place, I would first verify the patient’s identity and all pertaining results. Once I have all accurate information in hand, I would contact the patient (sister’s boyfriend) and have him come into the clinic where he would be informed of all results, treatment options, and the importance of informing all partners of HIV status. I would impress upon the patient the consequences of not abiding by the Florida law and how the patient can be required to pay fines of up to $5,000 and face up to five years of prison time (The Center for HIV Law & Policy, n.d.). I would reiterate the fact that I would abide by his rights to privacy and confidentiality but that it is unlawful not fully to disclose HIV/AIDS status to all sexual partners.
References
Epstein, B., & Turner, M. (2015). The nursing code of ethics: Its value, its history. The Online Journal of Issues in Nursing, 20 (2). https://doi.org/10.3912/OJIN.Vol20No02Man04
Fowler, M. D. (2015). Guide to the code of ethics for nurses with interpretive statements: Development, interpretation, and application (2nd ed.). Silver Spring, MD: Nursebooks.
Official Internet Site of the Florida Legislature. (2018). The 2018 Florida statutes: Sexually transmissible diseases. Retrieved January 22, 2019, from http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0300-0399/0384/0384.html
Schroeder-Back, P., Duncan, P., Sherlow, W., Brall, C., & Czabanowska, K. (2014). Teaching seven principles for public health ethics: Towards a curriculum for a short course on ethics in public health programmes. BMC Medical Ethics, 15, 73. https://doi.org/10.1186/1472-6939-15-73
The Center for HIV Law and Policy. (n.d.). Florida: HIV-specific criminal laws. Retrieved January 22, 2019, from https://www.hivlawandpolicy.org/states/florida
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