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1. Nursing Ethics – 2nd Year/ 4th Semester Confidentiality And Informed Consent By: Rawal Rafiq Leghari BSN, CCC, CCE, PPICIP, PCS (IUB, AKU,Shifa International Hospital Islamabad) MEDICOSE NURSING ACADEMY

2. Objectives Discuss barriers of effective informed consent Discuss the roles and responsibilities of a nurse in consent process Discuss the informed consent process Discuss the importance of confidentiality and informed consent Discuss barriers of effective informed consent Discuss the roles and responsibilities of a nurse in consent process Discuss the informed consent process Discuss the importance of confidentiality and informed consent 7/11/2024 2

3. Definitions Confidentiality: “Confidentiality is one of the ethical values needed for providing good care and is concerned with protecting the private information of the patient that is obtained during the course of professional practice.” Important terms which are used in confidentiality are : *Informed consent *Private *Indiscretion *Privileged information *Breach of confidentiality 7/11/2024 3

4. Informed consent : It is a legal document signed by the patient after detailed explanation about the procedure to be done to the patient and its risks, consequences, etc. It is a permanent legal document or record of the patient. Breach of confidentiality : It refers to sharing information verbally or in written form regarding a client with someone who is not on his/her care team, or who does not have a release of information form him/her. 7/11/2024 4

5. Private: It is defined as information that is not available for public viewing or knowledge. Privileged information : It is a term that refers to all information shared between an attorney and his client. This information is considered confidential and is not admissible in court. 7/11/2024 5

6. Principles of confidentiality The following are the importance principles of confidentiality: Central to trust in nurse–patient relationship Share accurate information Create faith and trust towards hospital care Assurance in patient–nurse relationship 7/11/2024 6

7. Central to trust in nurse–patient relationship: Patients should have faith and trust in the nurse. A nurse should act and perform in such a way that trust exists between him/her and the patient. If this is not maintained, the patient may hesitate and feel reluctant to seek medical care. Share accurate information: A nurse should provide adequate explanation clearly if any confidential matter is to be given to any kind of audit. 7/11/2024 7

8. Create trust and faith towards the hospital care: Confidentiality leads to trust and faith. Once it is established, measures should be taken to sustain it throughout life. It should not be breached at any time. Once faith is lost, a patient will never ever approach the hospital again for treatment. 7/11/2024 8

9. Assurance in patient–nurse relationship: Patients have to be assured of quality nursing care right from admission until discharge. An assured patient will feel comfortable and will cooperate well since he/she has confidence in the care provided. 7/11/2024 9

10. Informed consent Definitions: “It is defined as a legal document that includes details of invasive procedure to be done on the patient and the risks and benefits of the procedure and states that the contents of the informed consent have been read and clearly understood by the patient before obtaining his/her signature with date and time.” 7/11/2024 10

11. Principles of informed consent There are six important principles that define informed consent: Competence to understand and to decide the matter Voluntary decision-making by the person who gives consent Disclosure of material information that is explained in consent Recommendation of the plan in the consent Comprehensions of terms and conditions in the consent Explain the risk and benefits in the content of the informed consent A valid and legal informed consent must meet all these requirements. 7/11/2024 11

12. Types of informed consent Oral consent : Oral consent follows written consent. Written consent : Printed legal document that contains the details of treatment, reason for the treatment, risks and benefits of the treatment, and the agreement for the treatment by the patient. 7/11/2024 12

13. Barrier to effective informed consent There are many factors that affect or hinder the patient from signing the informed consent. 7/11/2024 13 Education level of patient conscious level of patient

14. (Barrier to effective informed consent contd…) 7/11/2024 14 Mental status of patient Religious beliefs Language

15. (Barrier to effective informed consent contd…) 7/11/2024 15 Disability of the patient Culture Age

16. Responsibilities of nurse in getting informed consent signed The following are the responsibilities of a nurse in getting the informed consent signed by the patient: Use good communication skills, maintain good interpersonal relationship, and introduce, orient, and explain the details of the consent form to the patient. Get the sign of the witness with date and time. Never barrier or neglect any questions asked by the patient. 7/11/2024 16

17. Use his/her skill in handling the medico-legal cases carefully, for example, rape cases, where the patients are very sensitive and finds it difficult to answer the questions in the form. Keep the details of the informed consent confidentially and never disclose them to anyone without the consent of the patient. Act as a mediator between the doctor and the patient. A nurse clarifies all the patient’s doubts and bridges the gap between the doctor and the patient, thus helping to get the informed consent signed smoothly. 7/11/2024 17

18. Informed consent process 7/11/2024 18

19. Importance of confidentiality and consent Imagine if the person you trusted most decided to share all your secrets with your worst enemy? You probably wouldn’t ever trust that person again. It might even make you stop trusting people altogether 7/11/2024 19

20. When you believe that your doctor isn’t going to share anything about your health, illnesses or personal habits with others, you’re more likely to be completely honest and to your doctors, it will help them figure out what’s going on and help you get better. Some diseases have stigmas attached to them that could make people think less of you. For example, back in the 1980s, many people who had symptoms of HIV and AIDS were afraid of being found out. They didn’t go to their doctors until it was too late,if you know your health records are private, you’re probably more likely to seek treatment for whatever you have. 7/11/2024 20

21. The patient confidentiality doesn’t just help you the individual,it can help the whole country! When people are confident that what they say to healthcare professionals is private, they’re more likely to participate in studies and healthcare initiatives. That helps fight disease and lessen the spread of epidemics. No one can guarantee positive outcomes in healthcare settings, but informed consent at least ensures patients understand the risks they undertake with treatment. It is also the law 7/11/2024 21

22. (Importance of confidentiality and consent contd…) Informed consent creates trust between doctor and patient by ensuring good understanding It also reduces the risk for both patient and doctor. With excellent communication about risks and options, patients can make choices which are best for them and physicians face less risk of legal action. 7/11/2024 22

23. References Clement,N.(2013). Nursing ethics:Concepts,trending and practice .Pearson Education India. 7/11/2024 23

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