Ethical Legal Issue In Nursing Education and Fair Treatment, Confidentiality and Privacy

What is Fair Treatment In Nursing Education for Ethical Legal Issue

    Students
have the right to expect that they will be treated fairly, consistently, and
objectively. Standards of expectations for the course provide the objective
guide for evaluation and must be communicated to students early and often. 

    Course requirements should be consistent for all students, including classroom
and clinical assignments. Students should receive equivalent assignments, even
if they are not identical, that allow them to demonstrate progress toward
meeting course objectives. In addition, students must be provided with
opportunity and an appropriate time to demonstrate the outcomes required in the
course. 

    Students cannot be held accountable for end of course outcomes on the
first day of class and the same principle applies in the clinical setting.
Students must be provided with time to learn before evaluation can take place;
students must clearly understand the difference in the learning and the
evaluation portion of the clinical experience.

    An
example of violating fair treatment might occur when a faculty allows one
student extra credit in a course, but does not afford the same opportunity to
all students to increase their grade. Clinically, holding students to different
standards of evaluation will be considered a violation of fair treatment. 

    If
the instructor consistently gives a student fewer challenging assignments and
then evaluates the student as not providing a complex case, the issue of
fairness is relevant again.

Confidentiality
and Privacy for Ethical Legal Issue In Nursing Education

    Legislation
that has been passed to protect health information and the privacy of patients
should remind faculty of their obligation to protect information from and about
students. The need for confidentiality in the faculty role is based in the same
code of ethics that guides all nurses. ‘

    Students have a right to expect that
information about their progress in the program, their academic and clinical
performance, and their personal concerns will be kept confidential.

    In
the course of the teaching role, faculty are often privileged to information
about students that is of a personal and private nature. Students often confide
in faculty about events that may influence their performance in the classroom
or may simply seek advice from persons they feel they can trust. 

    This
information, as in a nurse patient interaction, must be guarded and held in
confidence. Morgan (2001) pointed out the conflicts that nursing faculty often
feel when deciding whether it is in the student’s best interest to divulge
information of a personal nature. She suggested that there should be a
“compelling professional purpose” (p. 291), such as protection of patients. 

    This conclusion is consistent with the legal precedent set in Tarasoff regents
of the University of California (1976). In Tarasoff, the court held that the
patient provider confidentiality rule did not apply when there was a reasonable
belief of impending harm to another individual caused by a patient disclosure. 

    It is easy for caring faculty to disclose private student information based on
the belief that it is in the student’s best interests. But without the
student’s consent or the Faculty’s reasonable belief that harm may come from
nondisclosure, the faculty would be violating the student’s right to privacy to
share confidential information without student consent. 

    Faculty are often
anxious to share a student’s strengths and weaknesses with other faculty
members who will have the student in subsequent semesters. Faculty
must seriously consider the implications of such a practice as a standard
approach. A student’s performance or challenges in one class will not
necessarily follow him or her to the next class. 

    Informing other faculty
members about an individual student’s strengths or weaknesses may provide
prejudicial information and could be interpreted as unjust and violate the
student’s right to privacy. However, alerting faculty to information that may
affect patient or student safety may warrant discussion. In addition to
confidentiality, privacy, especially of student records, is essential. 

    Federal
Educational Rights and Privacy Act of 1974 (FERPA), often referred to as the
Buckley Amendment, provides the basis for protection of student records. This
law was enacted to ensure that students older than age 18 have access to their
educational records and to ensure that they have some input about who can
receive information in that record without their consent. 

    The amendment also
mandates that a procedure be in place that allows students to contest
information in the record that is inaccurate or that they do not agree with. In
actual practice, one of the most frequent applications of this law occurs when
parents seek information about student progress or grades without student
permission. 

    Parents are often dismayed to find that they have no “right” to
information about student progress, unless the student provides permission. It
is imperative that faculty understand the components of this legislation and
follow it implicitly. 

    For example, faculty cannot post grades in any form in
public, leave graded materials for students to retrieve in a public place, or
circulate a printed class list with student IDs or social security information
as an attendance list. 

    All of these constitute violations of FERPA and make
faculty and their institutions subject to prosecution. Schools of nursing must follow the guidelines of the institution
regarding FERPA, but they must also give particular attention to guarding
student health records. 

    These health records are usually kept in a separate
file and should follow Health Insurance Portability and Accountability Act,
1996 (HIPAA) guidelines. Student records and evaluation notes maintained by
faculty during the process of course evaluation must also be guarded to protect
privacy.

    Student
privacy must be strictly guarded. Whether based in common law privacy
standards, FERPA, or HIPAA, students have a legal right to have their
information protected within the educational system.