Breach of Confidentiality in Nursing Practice


Healthcare safety and security are delivered through multiple ethical and legal dimensions. The legal issues are critical to limit the health risks, non-compliance risks, and the possibility of harm exposed to patients and clinicians by medical operations and the environment. Confidentiality granted and supervised under the Health Insurance Portability and Accountability Act (HIPAA) and as a pivotal ethical principle in nursing is often breached by nurses. It is especially frequently observed under the influence of the collision of compliance to several conflicting provisions or due to the lack of proper legal knowledge in the nursing staff. This reflective essay is designed to explore the case of breach of confidentiality in nursing practice, apply appropriate legal issues, and recommend actions to mitigate the risks of a confidentiality breach.

Event Description

The event at the center of this case study reflection is the one involving a patient diagnosed with HIV. The patient is a male in his thirties who has tested positive for HIV test and was appointed to necessary treatment procedures. Since HIV is a sexually transmitted disease, the nurse working with the patient was concerned with the health risks faced by the patient’s partner, who was obliged to be informed of the potential risks from the perspective of the principles of beneficence and justice. The nurse decided to contact the patient’s girlfriend and deliver to her the details of her boyfriend’s diagnosis. This event is an example of a breach of confidentiality and should be analyzed from the point of view of the relevant legal considerations.

Legal Issues Involved in the Case

The event presented in the case study involves the breach of confidentiality based on the nurse’s inappropriate disclosure of the health data of the patient to third parties as well as non-compliance to the confidentiality ethical principle and HIPAA. HIPAA was proposed to safeguard patients’ rights and protect patients’ health data by enhancing privacy and confidentiality (Vanderpool, 2019). The proposed update also enhances the reputation of health facilities when complied with as the providers are also secured from risks associated with healthcare. The document holds that the patient has the right to take notes or pictures of their protected health information and time reduction to the patient’s request to access the materials. The Office of Civil Rights (OCR) investigates acts of negligence related to the failure to disclose health records. According to the Department of Health and Human Services (HHS), the disclosure period provides that the report be given at least within 30 days. Nonetheless, the nurse in the case did not comply with the law because she disclosed patient data without his consent.

Another legal consideration involved in the case is the Duty to warn. This aspect engages in a collision with the compliance to confidentiality rights and the health interests of partners when one of them is diagnosed with a sexually transmitted disease. Indeed, according to the Centers for Disease Control and Prevention (CDC) (2021), the duty to warn is the obligation of a nurse to facilitate the health benefits of individuals at risk of being impacted by a disease. The nurse in the case study must have considered the interests of the girlfriend under the duty to warn, which is why she disclosed the data of the patient. However, “all patients diagnosed with an STD are covered by patient confidentiality, and specially trained health department staff conduct contact tracing and partner notification while maintaining confidentiality” (CDC, 2021, para. 11). the duty to warn should be followed without breaching confidentiality. Thus, the nurse should have obtained written consent or authorization from the patient that would have been a legal basis for disclosing health data.

Case Study Reflection

I was first surprised by the nurse’s misconduct due to the clarity of the necessity to comply with the legal considerations of respect for confidentiality. However, when I studied the case closer and set the misconduct into the context of HIV patients and it being a sexually transmitted disease, I was challenged with a similar decision-making dilemma as the nurse in the case. Indeed, on the one hand, I felt that the patient’s privacy and confidentiality should be respected by all means; and only the patient’s consent might empower a nurse to disclose information. On the other hand, I felt concerned about the health of the patient’s partner who was evidently at a high level of risk of being contaminated with HIV. I felt that it was unjust to ignore the severity of the illness under such confidentiality and neglect to inform the partner. Now that I have applied legal issues to the case, I am aware of the importance of balancing both legal aspects and the interests of both of the involved partners while not violating their rights to confidentiality.


I think that the ethics and conduct of compliance rely on the culture of a facility and its effectiveness in communication, as well as the education of the nursing staff. Patients are supposed to be treated with dignity and concerning their privacy and confidentiality. I think adherence to legal rules and policies, as well as ethical principles by healthcare providers and patients, is essential to prevent risks.

There should be effective communication at the healthcare facility at all levels to ensure all staff is well conversant with the rules and regulations of compliance. Professional ethics is to be adhered to by workers to ensure patient safety (Asare et al., 2022). There should be early assessments of issues raised for the facility to be able to resolve a problem as early as possible and prevent further risks. Regular training of employees on the compliance rules and regulations to avoid the risks associated with work. In case of errors, there should be transparency and clarity to avoid further damage. The human resource is to be vigilant on the values of an institution and be able to note any kind of unethical behaviors in a facility and deal with them promptly to avoid damage.


In summation, compliance with laws and ethical principles is the pivotal element of safe and ethical nursing practice. Effective training should be provided to nurses to maximize their understanding of ethical and legal issues in practice, as well as make informed decisions in ethical dilemmas. In such a manner, it will enhance a compliance culture in an organization and avoid incidences of negligence or other unethical behaviors that result from a lack of knowledge. The responsibility is to ensure the patients are treated with the utmost dignity and their privacy is respected as per the act of privacy and confidentiality. Compliance with all rules and regulations must be the core of any healthcare facility.


Asare, P., Ansah, E., W., & Sambah, F. (2022). Ethics in healthcare: Knowledge, attitude and practices of nurses in the Cape Coast Metropolis of Ghana. PLOS 17(2), e0263557.

Centers for Disease Control and Prevention. (2021). Duty to warn.

Vanderpool, D. (2019). HIPAA Compliance: A common sense approach. Innovations in Clinical Neuroscience, 16(1-2), 38-41.

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