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School
California State University, Los Angeles *
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Course
3100
Subject
Information Systems
Date
Dec 6, 2023
Type
docx
Pages
7
Uploaded by ProfessorWombatMaster914
Perspectives called Ethical Frameworks are helpful for debating what course of action could result in the
greatest moral end. Many times, a person will act on instinct alone rather than using logic to determine
what is best at the moment.
A choice is considered ethical if it respects the numerous parties it may impact and has been made after
a proper evaluation of risk and reward. The goal is to promote justice, accountability, cooperation, and
trust. A moral choice is one that minimizes unwarranted negative impacts on other people or the
environment.
As per your request, I will provide the 7 questions to determine the best option in the given
circumstances using the framework for ethical decision making.
Step-by-step explanation
Step 1: Define the Ethical Question
Should the CEO be informed about the Vice President and Chief Nursing Officer's troubling pattern of
EHR access, despite the possibility of backlash and damage to their working relationship and job, in
order to preserve moral standards and safeguard patient privacy?
Step 2: Gather Information and Identify Stakeholders
Known Facts:
The VP/CNO has had access to certain clients' outpatient addictions program records.
Over the past six months, the VP/CNO has repeatedly accessed the same specific client records.
Some of these clients are related to other workers at the facility.
The VP/CNO and the Director of Health Information and Registration get along well professionally.
According to the VP/CNO, the accesses were a result of clinical staff members' examinations of their
related paperwork.
The VP/CNO has threatened to report this as harassment to the CEO if the Director of Health Information
and Registration continues to inspect any of her EHR accesses.
The Director of Health Information and Registration is concerned about possible effects on their ability to
remain in their current position.
Unknown Facts:
The justifications for the VP/CNO's recurrent access to particular customer records.
The extent of the VP/CNO's access rights to documents.
The CEO's position on EHR access audits and the possible consequences of disclosing such infractions.
Stakeholders:
The patients whose records were accessed
The VP/CNO
The Director of Health Information and Registration
Other facility employees who may have family members in the out-patient Addictions program
The CEO
The health care facility as a whole
Step 3: Identify Relevant Ethical Principles (as mentioned in Table Format)
Ethical Principle
Explanation
Application to Case
Autonomy
Respect for individuals' right to self-determination and making informed decisions
Patients' privacy and confidentiality must be respected, and access to their health information must be
restricted to those who need it for operations, payment, or treatment. The VP/CNO's frequent
unauthorised access to certain client data undermines patients' autonomy by possibly disclosing their
private information.
Non-Maleficence
The obligation to do no harm and prevent harm
The VP/CNO repeatedly accessing certain client data without a valid purpose is against the rule of non-
maleficence since it might expose their private information and erode their faith in the medical centre.
Beneficence
The obligation to act in the best interest of the patient and promote their well-being
By preserving the patients' anonymity and privacy and fostering their confidence in the healthcare
institution, reporting the VP/CNO's access to individual client records to the CEO will respect the
beneficence principle.
Justice
Fair and equal treatment for all individuals and protection of their rights
All people must be treated equally and fairly, and their secrecy and privacy must be protected, according
to the concept of justice. By possibly disclosing sensitive information about select patients over others,
the VP/CNO's frequent unauthorised access to particular client data contradicts the idea of justice.
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Step 4: Determine the Possible Course of Action
Despite possible backlash and harm to the employment relationship and professional relationship, let
the CEO know that the VP/CNO has access to particular client records.
To prevent any ramifications, stop auditing any of the VP/CNO's EHR accesses and do not disclose her
access to individual client data.
Step 5: Evaluate the options
Option 1: Do nothing and keep the information to yourself
Pros: Avoid conflict and its possible harmful effects.
Cons: Breaches the ethical standards of non-maleficence and secrecy; damages patient confidence in the
healthcare system; and might be seen as endorsing improper conduct by a senior staff member.
Option 2: Report the VP/CNO's actions to the CEO or other appropriate authority
Pros: Safeguards patient privacy, upholds the moral values of confidentiality and non-maleficence, and
shows a dedication to the HIM industry's professional standards.
Cons: May harm business ties with the VP/CNO, bring about unfavorable outcomes like job loss or
retribution, and may foster a hostile work atmosphere for coworkers who are linked to the patients in
question.
Option 3: Seek advice from a trusted mentor or colleague
Pros: gives the chance to get information and counsel from a reliable source, which may assist to make
the best course of action clear.
Cons: may cause action to be delayed, may not have a clear resolution, and may still call for a tough
choice to be taken.
Step 6: Evaluate the Alternatives (as mentioned in Table Format)
Alternative
Pros
Cons
1. Do nothing and continue auditing the VP/CNO's EHR access
Respects the ethical responsibility of the HIM professional to safeguard patient confidentiality and
privacy.
Makes ensuring that HIPAA and other legal and regulatory standards are met.
Keeps the profession's credibility and sense of trust intact.
May result in a poor working relationship with the VP/CNO and possible job repercussions for the HIM
expert.
The possible loss of patient confidentiality and privacy might not be adequately addressed.
May cause harm to the patients whose records were improperly accessed.
2. Report the VP/CNO's EHR access to the CEO and/or the facility's compliance officer
Respects the ethical responsibility of the HIM professional to safeguard patient confidentiality and
privacy.
Makes ensuring that HIPAA and other legal and regulatory standards are met.
Responsibility and openness in handling possible violations of patient confidentiality and privacy.
Could stop unauthorised access to patient records in the future.
May result in a poor working relationship with the VP/CNO and possible job repercussions for the HIM
expert.
May have detrimental effects on the VP/CNO's job and reputation in the industry.
May lead to conflict and stress inside the facility.
3. Seek guidance from professional associations and/or legal counsel
Ensures adherence to all statutory, legal, and ethical standards.
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Gives knowledgeable counsel and direction on how to handle potential privacy and confidentiality
violations involving patients.
May avert detrimental effects on the VP/CNO and the HIM professional.
Possibly expensive and time-consuming.
Possible lack of a clear course of action.
May result in hostility and strife inside the facility.
Step 7: Choose and Implement a Course of Action
The HIM professional should select and carry out the best course of action after weighing the available
options. According to the ethical standards and values at play in this situation, the HIM specialist should
inform the CEO and/or the facility's compliance officer about the VP/CNO's EHR access. It is important to
uphold the HIM professional's ethical duty to protect patient privacy and confidentiality, ensure
compliance with legal and regulatory requirements, and stop future unauthorised access to patient
records, even though doing so might have negative consequences for both the HIM professional and the
VP/CNO. In line with the norms and procedures of the institution, the HIM professional should
additionally record the occurrence and the actions taken to remedy it.
To the best of my knowledge, I am providing this summarized information. I hope this would help you.
Thanks & All the Best