Genetic and Genomic Healthcare: Nurses Ethical Issues


Genomic medicine is one of the most significant ways of tailoring healthcare at a personal level. The use of genomic information aids in the diagnosis and treatment of exceptional common infections. The patient’s genomic information helps in identifying genetic factors linked to the disease. This enables healthcare personnel to design drugs that are more useful for patients. In addition, genomic information helps health practitioners to prescribe suitable treatment for patients (Calzone, Cashion, Feetham, Jenkins, Prows, Williams, & Wung, 2010).

However, genomic information can cause various ethical issues in the nursing profession. For instance, the use of genomic information poses a dilemma on privacy and confidentiality for nurses. Nurses are increasingly exposed to ethical issues when dealing with patient genomic information, which is hereditary. This paper will explore nursing ethics concerning genetic information (Lea, 2008).

Explain how nurses can be familiar with the nature and sources of genetic information so that they can assure privacy and confidentiality for their patients?

Nurses are tasked with the responsibility of providing quality care. In this regard, they are required to provide assurance to patients that their genetic information is safe with them. Achieving this objective can be tasking. However, nurses are uniquely trained to handle genetic information utilizing their nursing professional code of ethics. Therefore, nurses are required to be familiar with their professional, ethical codes of conduct to aid them in conduct caregiving their roles (Zahedi, Sanjari, Aala, Peymani, Aramesh, Parsapour, Maddah, Cheraghi, Mirzabeigi, Larijani, & Dastgerdi, 2013).

In addition, nurses need to have the essentials of ethical decision making to guide them in protecting the rights of patients to privacy and confidentiality. For nurses to known the type and origin of genetic data, they need to have knowledge in genetic evaluation. In addition, nurses need to be knowledgeable in research, testing, and treatment of genetic information. The nurse should also participate in policy and program development (Lea, 2008).

Moreover, nurses should also recognize the fact that they share the responsibility of ensuring equal access to genetic and genomic information without contravening issues pertaining to privacy and confidentiality of patient information. Essentially, nurses need to increase their knowledge and understanding of genetics and genomes in order to incorporate it into their nursing practice effectively.

Growing accessibility to genetic information through technology has helped to increase awareness of the importance of genetic information (Cassells, Jenkins, Lea, Calzone, & Johnson, 2003). Nurses would work effectively if they ensure informed decision-making is guaranteed while gathering genetic information. Moreover, nurses would be required to ensure the informed consent of patients before performing genetic testing (Delaney & Christman, 2016).

Besides, nurses would be required to ensure that the privacy and confidentiality of genetic information from patients are maintained. In essence, nurses who incorporate these activities will be familiar with nature and sources of genetic information. Furthermore, the nurses would be best placed to maintain the privacy and confidentiality of genetic information (Cassells et al., 2003).

Describe how your ANA Code of Ethics book defines Privacy?

ANA code of ethics refers to the provisions for safeguarding patient information. ANA’s code has the longest provision in its 2001code. This emphasizes their need to protect patient information. Moreover, the ANA codes of ethics alienated the description of confidentiality from that of privacy. In this regard, the code of ethics considers privacy to be allied to those features of the individual’s data or life, which he or she is capable of managing.

Therefore, nurses are required to assist in safeguard the “control” aspect of the patient. In this regard, nurses are expected to honor their patients’ privacy. In essence, this amounts to asking only relevant questions that pertain to the patient’s health. Besides, it can involve the development of policies aimed at maintaining privacy. In addition, the ANA code of ethics defines confidentiality as the ability of a nurse to share the patient’s personal data only in ways authorized by the patient (Fowler, 2010).

However, it should be noted that there are situations where a nurse’s duty to maintain confidentiality is not absolute. For instance, there is a moral and legal duty for the nurse to safeguard the other person if there is evidence that withholding information would harm him/her.

This provision complicates nursing duties concerning ethical issues. Therefore, nurses should understand their duty and understand the moral and legal dimensions of their decisions. Moreover, different states have provisions for instances when confidentiality can be breached. In addition, nurses cannot withhold information pertaining to the safety of the patient’s health, such as diabetic patient, among others. Essentially, privacy pertains to information that the patient can control (Fowler, 2010).

A woman who tests positive for hereditary breast/ovarian cancer informs you, her nurse that she does not wish to share this information with her sisters and her mother, as she does not get along with them. The concern for her sisters and mother is that each of them now has a 1 in 2 chance to carry the same breast/ovarian cancer gene mutation that confers a significantly increased risk to develop breast/ovarian cancer. Defend how you, the nurse, can be guided by the ANA Code of Ethics for Nurses to seek help and counsel from experienced individuals of the Ethics Board within your institution.

ANA code of ethics values privacy and confidentiality of patient information. However, there are some instances where the nurse is at liberty to exercise moral and legal dimensions to the issue of privacy. Besides, different states have different jurisdictions regarding disclosure of patient information. For instance, some states make it mandatory for nurses to report child abuse or instances of domestic abuse.

Moreover, some states also authorize nurses to report information privy to health of the elderly. In essence, this shows that withholding of patient information is not absolute. The case above shows a patient with hereditary breast/ovarian cancer who wants her privacy maintained. Nonetheless, it is very clear that she poses great risk to her sisters whom she claims to be in a bad relationship with her. Moreover, she also poses dangerous health risk to her mother if this information is withheld. From the ANA code of ethics, it is very clear that third party is affected by the information from the patient.

In this regard, it is within the moral and legal confines of the nurse to request assistance from ethics board before making final decision. Because nurses are mandated to safeguard patients’ life, it is necessary that information on hereditary breast/ovarian cancer be utilized to help third party individuals. The dilemma would be whether to disclose the information to the patient’s siblings or to seek ways of testing the patients’ siblings for breast/ovarian cancer without disclosing the patient’s information (Fowler, 2010).

Do you, the nurse, have “the legal authority to breach the confidentiality of the client-nurse relationship to disclose genetic information about one individual to another individual”?

According to the ANA code of ethics, nurses are required to do their best to protect confidentiality of patient information. In fact, the code of ethics provides guidelines through its third provision for nurses to exercise professional ethics in dealing with circumstances pertaining to patient confidentiality. However, it can be argued that nurses have the legal and moral authority to breach the confidentiality of the client-nurse relationship to disclose genetic information about the patient to a third party. Nonetheless, this has to be done within the legal framework allowed by nursing code of ethics.

Nursing code of ethics states that confidentiality is not absolute. This idea is also enshrined in most states in the United States. Breaching the confidentiality of nurse –client relationship can happen if there is evidence that withholding the information in question has the ability to harm third party individuals. Moreover, breaching the confidentiality of nurse-client relationship can also be done if there is evidence that withholding such information would cause harm to the patient.

For instance, if there is evidence that information from the patient can lead to the saving of lives of other individuals. The case above is a vivid example of a situation where breach of confidentiality is possible. Release of such information to other practitioners would help in finding ways to assist the siblings of the patient. Therefore, it can be argued that nurses have the legal authority to breach confidentiality between them and patients if the information would save life (Zahedi et al., 2013).

Propose how a solution for this ethical dilemma that arises for nurses and other healthcare providers when a patient does not choose to share genetic information with other family members when it may be important to their health

One proposal to this nursing dilemma would be to request the siblings of the patient to come for voluntary hereditary breast/ovarian cancer test without disclosing information pertaining to the patient. If this proposal were successful, the nurse would triumph in achieving both objectives. Firstly, the nurse would have maintained confidentiality of the patient’s health condition. Secondly, the nurse would have managed to save the lives of the patient’s siblings.

However, in this case, the nurse should inform the patient prior so that the latter would not think that her information has been disclosed. However, the nurse can proceed with requesting additional help from the ethics committee if the patient has refused the initial proposal. If the committee gives the go ahead, then the nurse can breach the confidentiality agreement as this would save other lives (Fowler, 2010).

Professional nursing ethics has provisions that enable nurses to handle dilemma that arise in different privacy and confidentiality cases. At the same time, various government agencies also have provisions that help nurses to handle dilemma in privacy cases. Furthermore, healthcare facilities have enshrined policies that deal with privacy and confidentiality. In the case above, it is necessary to have healthcare policies that deal with protection of third party individuals in addition to the nursing code of ethics.

This would give nurses additional confidence in decision-making. Moreover, having ethics committee is important in healthcare facility to handle complicated cases. ANA code of ethics has grounds for disclosure of patient information. In addition, all states require nurses to report some nursing information that pertains to patient health (Kirk &Tonkin, 2009).

Contrast respect for the patient’s confidentiality, while on the other hand the duty to warn other family members of their potential health risks

While maintaining confidentiality is good of trust between patients and nurses, warning family member is also necessary because it helps save lives. In as much as respecting the patient’s confidentiality can improve his or her wellbeing, breaching it for the sake of another life would be more suited to the nurse’s line of work. Nursing ethics provides for holistic approach and safeguarding of patient life. In addition, it provides for commitment to uphold the highest esteem when dealing with patients. The nurse’s sole goal is to safeguard patient’s health in a holistic way. In this regard, nurses are expected to respect patient’s confidentiality.

Nurses want to have a positive impact on patient’s wellbeing. Moreover, nurses act as ambassadors of patients as they improve health care (Kirk &Tonkin, 2009). Therefore, respect for patient’s confidentiality is essential for every nurse. Nurses take upon themselves to ensure confidentiality of patient’s information. Respect for patient’s confidentiality assures them of complete regard for their needs. It gives the patient full trust and it allows the patient to disclose everything that pertains to his or her health. In addition, the patient is assured that his or her self worth would be retained by means of withholding personal health details.

Respect for patient’s health information is essential in ensuring patient trust. Moreover, it gives nurses ability to work freely with patients. In contrast, cautioning siblings of impending health issues is also necessary for nurses as a moral as well as a legal responsibility. Warning families of potential risks would help save their lives. Moreover, it would work well with nurses’ holistic approach to care giving (Lea, 2008).

Explain the impact of genetic information. How does a person’s genetic information affect that individual and society’s perception of that individual?

Genetic information is essential to the health of patients. Genetic information provides data, which shows if a patient is prone to a certain kind of disease. This enables the nurses to help restore the patient accordingly. Genetic information can help health practitioners to tailor the right healthcare for the individual (Green, Lautenbach, & McGuire, 2015). This would increase the effectiveness of healthcare on patients.

Genetic information helps health practitioners to design drugs that are more useful for patients by identifying genetic factors associated with their illnesses. Moreover, by identifying the associated factors, health care personnel can prescribe more useful treatment methods for patients. Moreover, this also enables nurses to recognize and observe individuals with high chances of infection. Moreover, genetic information can assist in minimizing prescription of drugs with undesirable reactions (Lea, 2008).

A person’s genetic information makes the individual aware of himself or herself concerning health risks and immunity. People who know their genetic information have better ways of improving their health through constant monitoring of their progress levels.

Patients with knowledge of genetic information can seek help from health practitioners quickly as compared to those who do not know their genetic information. However, if such information is to be seen by the public then the individual’s privacy is exposed. This can cause undue emotional damage to the individual. Moreover, society can view such individuals variously depending on the individual’s condition (Calzone et al., 2010).

Reference List

Calzone, K., Cashion, A., Feetham, S., Jenkins, J., Prows, C., Williams, J., & Wung, S. (2010). Nurses transforming health care using genetics and genomics. Nursing Outlook, 58(1), 26-35.

Cassells, J.M., Jenkins, J., Lea D.H., Calzone, K., & Johnson, E. (2003). An ethical assessment framework for addressing global genetic issues in clinical practice. Oncology Nursing Forum, 30(3), 383-90.

Delaney, S., & Christman, M. (2016). Encouraging physician adoption of genetic testing for precision medicine. Personalized Medicine, 13(3), 201-204.

Fowler, M. (2010). Guide to the code of ethics for nurses. Web.

Green, R., Lautenbach, D., & McGuire, A. (2015). GINA, Genetic discrimination, and genomic medicine. The New England Journal of Medicine, 372(1), 397-399.

Kirk, M., &Tonkin, E. (2009). . Web.

Lea, D, (2008). Genetic and genomic healthcare: Ethical issues of importance to nurses. OJIN: The Online Journal of Issues in Nursing 13 (1). Web.

Zahedi, F., Sanjari, M., Aala, M., Peymani, M., Aramesh, K., Parsapour, A., Maddah, S., Cheraghi, M., Mirzabeigi, G., Larijani, B., & Dastgerdi, M. V. (2013). The Code of Ethics for Nurses. Iranian Journal of Public Health, 42(1), 1-8.

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