Ethics has been defined as “a branch of philosophy that deals with thinking about morality, moral problems, and judgements of proper conduct” (Frankena, 1973). Ethics is traditionally a branch of philosophy dealing with moral problems and moral judgments. White (1988) defines ethics as the evaluation of human actions. In doing so, we assign judgments to behavior as “right” or “wrong” and “good” or “bad” according to the perspective of a moral principle or ethical guideline. Although we may all strive to be right and good, a gap often exists between the ideal outcome and what can realistically be accomplished.
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We acknowledge that ethical perfection lies beyond reach for virtually all of us humans, even if we could completely agree on the ethically correct response in every situation. And, unfortunately, good intentions may prove insufficient to ensure that wrongs will not occur. An effective response requires developed skills, planned resources, the right information, and a pre-established ethical and self-awareness. Koocher, (2012)
Some potential issues with this case study that seems to be transpiring into an unethical manner would be the confidentiality issues as well as the informed consent, other ethical issues would be like professional boundaries, limited resources and limits of competence, community expectations and values working with peer and other community helpers, and burnout are among these issues. (Schank, 1998)
Mr. Albertson is a 54 year old male who came to Dr. Jones for Depression at the time of admission to her clinic, she should have had Mr. Albertson sign his consents so that she would have on file his next of kin no matter where they were located in case of an emergency such as his getting hurt at work. There are many forms and consents that needed to be signed immediately before Dr. Jones took Mr. Albertson as a client in her clinic.
When you admit whether it is for inpatient or for an outpatient you must always have the client sign a consent for treatment, as well as the HIPPA consents, and then you explain the rules and regulations to the client especially if they don’t know what it means. According to the American Psychological Association at your first visit, a psychologist should give you written information explaining privacy policies and how your personal information will be handled. This information will explain that in some cases, there are exceptions to the privacy rule.
Mr. Albertson went to see Dr. Jones for Depression but, when Mr. Albertson got hurt at work and suffered a concussion the Dr. decided at that time to have her client Mr. Albertson to sign a consent to release information which now is the wrong time because, the client now has an impairment that does not let him understand what is happening. He is also having issues, concentrating and is easily confused and is having trouble understanding these concepts.
Dr. Jones wants Mr. Albertson to sign a release of information so she can talk to an attorney but, what about the Dr. That is, treating Mr. Albertson for his concussion and injury he suffered at work, so she can better find out what happened to him, so she can understand what or how she should proceed with his treatment for depression. The client does not understand what is wrong, but, the Dr. asked him to sign a release to speak with his co-worker and his lawyer in which the co-worker found for him.
The Lawyer has no idea what he is dealing with at this time because, he has never spoken to Mr. Albertson, but, online and through phone calls. Principle of Ethics I, Rule J states “Individuals shall not guarantee the results of any treatment or procedure, directly or by implication; however, they may make a reasonable statement of prognosis.” American Speech-Language-Hearing Association (1997-2014).
Principle of Ethics III states “Individuals shall honor their responsibility to the public by promoting public understanding of the professions, by supporting the development of services designed to fulfill the unmet needs of the public, and by providing accurate information in all communications involving any aspect of the professions, including the dissemination of research findings and scholarly activities and the promotion, marketing, and advertising of products and services.” American Speech-Language-Hearing Association (1997-2014).
Dr. Jones is not beyond the limits of her competency as of yet because by providing services to individuals for whom appropriate mental health services are not available and for which Dr. Jones has not obtained the competence necessary, will work closely with the community who may have the related prior training or experience and Amay provide such services in order to ensure that services are not denied if they make a reasonable effort to obtain the competence required by using relevant research, training, consultation. American psychological association (2015).
According to the State of Texas licensing bureau of psychologists, Dr. Jones should provide only services for which she has the education, skills, and training to perform competently. Competency includes the ability to provide services concerning a specific individual that takes into account characteristics of that individual including age, gender, ethnicity, national origin, disability, language, and socio-economic status. Dr. Jones maintains current knowledge of scientific and professional information that ensures competency in every area in which she provides services. http://texreg.sos.state.tx.us/public (2012).
A psychologist who lacks the competency to provide particular psychological services to a specific individual must withdraw and refer the individual to a competent appropriate service provider. In emergencies, when psychologists are asked to provide services to individuals for whom appropriate mental health services are not available and for which the Doctor has not obtained the necessary competence, doctors may provide such services only to the extent necessary to ensure that services are not denied. If ongoing services are provided, doctors must comply with subsection (d) of this section as soon as practicable or refer the patient as per subsection (h) of this section. http://texreg.sos.state.tx.us/public, (2012).
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Psychologist must refrain from initiating or continuing to undertake an activity when they know or should know that there is a substantial likelihood that personal problems or conflicts will prevent them from performing their work-related activities or producing a psychological report in a competent and timely manner. When Psychologists become aware of such conflicts, they must immediately take appropriate measures, such as obtaining professional consultation or assistance in order to determine whether they should limit, suspend, or terminate the engagement in accordance with Board rule §465.21 of this title (relating to Termination of Services). This is from the State of Texas Licensing Board. http://texreg.sos.state.tx.us/public, (2012).
No, she is not practicing outside of her scope of practice because she as a doctor will talk with the Primary Care Physician in order to place Mr. Albertson into an assisted living facility. But, she is working outside of her practice finding this client a guardian. If she would have had the papers already signed she would have already had the guardian whether it would be the friend or a family member. Consents are very important in the medical field as well as the substance abuse field.
As for conflict of interest this case could be because the people that the doctor speaks with everyday are those that are in the community, and they all would probably know each other so they will be talking about things that maybe personal to the client. As for legal as long as the doctor has the consent signed and the client understood what he has signed the doctor may speak with the lawyer.
Dr. Jones should have made sure all documentation was completed in the office before the sessions started with the client’s depression, this is number one in all areas of the medical practices. You cannot make a patient sign something he/she does not understand, and if there are other issues such as cognitive deficits then it will make it much harder to help this patient unless you have the documents signed beforehand and you have a guardian for this reasoning. Also be very careful of the No-Harm clause in the ethics and code of conduct for psychologists and licensees.
References;
American Psychological Association. (2014). Ethical principles of psychologists and code of conduct. Retrieved from http://www.apa.org/ethics/code/index.aspx
American Speech-Language-Hearing Association (ASHA). Copyright 1997-2014. http://www.asha.org/about/contacts/
Frankena, WK (1973) Ethics (second edition), quoted in Nunn, J (1998) Laboratory Psychology, East Sussex: Psychology Press Ltd. McLeod, S. A. (2007). Psychology Research Ethics. Retrieved from http://www.simplypsychology.org/Ethics.html
Schank, J. A., & Skovholt, T. M. (1997). Dual-relationship dilemmas of Rural and small town psychologists. Professional Psychology: Research And Practice, 20, 244 –247.
http://texreg.sos.state.tx.us/public
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