Question

Paul is a 12-year-old male diabetic. He maintains his personal digital assistant (PDA), hand-held device, that interfaces with his glucometer and provides information based on inputted data from him and his parents. This information is transmitted to his MD/hospital, school nurse, case manager (CM), and to the parents’ home computer. All in an attempt to better control his diabetes. You are his CM. The PDA sends an update to you since Paul's blood glucose levels have been steadily rising for the last 5 days. The physician has left a message for you to contact this family and have they come in for an evaluation. You know that both of his parents work so you send an e-mail message to the parents' via their home computer asking them to bring Paul in for an assessment. Since you are in a hurry and will be seeing other patients when they return from work, you decide to add more information to the message than normal reviewing with them the importance of maintaining control over the diabetes and expressing your concern since Paul has not checked in with you lately. You tell them that you think he might be over-doing it since he is trying to play football. You ask how they are doing and if they are still attending their counseling sessions. Paul's 4-year-old sister, Lilah, sends your email out to all of the diabetic lists that both Paul and his parents belong. They interact with people on these lists regularly. The parents call everyone including you and are outraged that this information was sent everywhere. Consider the following: How would you feel in this situation? What is the problem? (Clearly state the problem) What ethical principles would guide you in this case? What are the alternatives for solving this dilemma? What are the consequences for each alternative generated? In your opinion, what is the first choice from the alternatives and why? Does your choice take into consideration all of the persons involved and the consequences to each of them? If the worst case scenario would occur based on your choice, could you live with your decision? Based on your choice, what is your plan of action?

Answer 1

1. It would be an extremely unhappy and despairing situation for me because they are blaming for the mistake which is not done by me .

2. The problem is the breach of health information . It was not committed by the nurse . The nurse send the mail to Paul's parents regarding his diabetes and his sister Lilah forwards the mail to other people of the diabetic list leading to leak of health information .

3. Ethics are the principles which guide to differentiate between wrong and right ,good and bad etc

The ethical principles that guide me in this case are beneficence , accountability and confidentiality .

Beneficence is doing good for the patient

Accountability is the act of taking responsibility

Confidentiality is keeping the information confidentially.

4. The alternative for this situation is to check the system from which the mail was send including timing , login ID , etc to ensure who is the culprits behind this .