In what instance may a nurse breach confidentiality without patient consent?

A nurse may breach confidentiality without patient consent in circumstances where there is a risk of harm to the patient or others. This principle is grounded in the ethical and legal responsibilities of healthcare professionals to prioritize safety and well-being over confidentiality when necessary. For instance, if a nurse learns that a patient poses a danger to themselves or to others, it is their duty to take appropriate actions that may involve disclosing information to protect those at risk. This aligns with the public health and safety objectives of the healthcare system, emphasizing the need to intervene in situations that threaten life or health.

The other choices represent situations where confidentiality should generally be maintained. A patient requesting a copy of their medical records does not constitute a breach since patients have rights to access their own health information. Similarly, disclosing medical information to a family member without the patient’s consent breaches confidentiality unless the patient has provided explicit permission or if there are health-related reasons that justify sharing such information. Lastly, a nurse's personal judgment about what constitutes the "best interest" of the patient does not provide sufficient grounds for breaching confidentiality without consent; such decisions need a foundation in professional ethical standards and often require patient involvement.