Case Study Two Worksheet Respond To The Following Questions

Case Study Two Worksheetrespond To The Following Questions In 1250 To

Respond to the following questions in 1,250 to 1,500 words. 1. Why is this an ethical dilemma? Which APA Ethical Principles help frame the nature of the dilemma? 2. How might Irina’s age and parents’ involvement in the referral affect how Dr. Matthews can resolve the dilemma? How might the state law on treatment of minors and HIPAA rule on access of guardians to a minor’s health care record influence Dr. Matthews’ decision? 3. How are APA Ethical Standards 2.01a b, and c; 2.04; 3.04; 3.06; 4.01; 4.02; and 10.10a relevant to this case? Which other standards might apply? 4. What are Dr. Matthews’ ethical alternatives for resolving this dilemma? Which alternative best reflects the Ethics Code aspirational principle and enforceable standard, as well as legal standards and Dr. Matthews’ obligations to stakeholders? 5. What steps should Dr. Matthews take to ethically implement her decision and monitor its effects? Reference Fisher, C. B. (2013). Decoding the ethics code: A practical guide for psychologists . Thousand Oaks, CA: Sage.

Paper For Above instruction

In the realm of psychological ethics and clinical practice, resolving dilemmas involving minors’ confidentiality and treatment requires a nuanced understanding of ethical principles, legal statutes, and professional standards. The case of Dr. Matthews and her involvement with Irina—whose age and parental involvement complicate confidentiality and treatment decisions—presents a quintessential ethical dilemma. This paper examines the nature of this dilemma, explores relevant ethical principles and standards, considers legal influences, and discusses potential resolutions, culminating in ethically sound steps for Dr. Matthews to take.

Understanding the Ethical Dilemma

The core ethical dilemma in this case revolves around balancing Irina’s right to confidentiality and autonomy with her parents' right to be involved in her healthcare decisions. Confidentiality is a cornerstone of psychological practice, essential for fostering trust and openness (Fisher, 2013). However, when treating minors, practitioners must also respect legal provisions that allow or restrict parental access—raising questions about whether to disclose sensitive information to Irina’s parents or keep certain details confidential. This conflict pits the ethical principle of Respect for Persons—which emphasizes autonomy and informed consent—against the legal and ethical imperative to involve family members in minors’ care, especially when safety concerns are present.

This dilemma becomes more complex when considering Irina’s age; as a minor, her capacity for decision-making may be limited, thus justifying parental involvement under the principle of beneficence—acting in the client’s best interest (American Psychological Association [APA], 2017). Nonetheless, adolescents may have increasing capacity for independent judgment, advocating for confidentiality to promote honest disclosure and engagement in therapy. The dilemma is ethically charged because maintaining confidentiality could undermine Irina’s trust or safety, while breaching confidentiality could damage her sense of autonomy.

Impact of Age, Parental Involvement, and Legal Frameworks

Irina’s age significantly influences how Dr. Matthews can navigate her ethical obligations. If Irina is an older adolescent, say 16 or 17, there is a stronger argument for respecting her emerging autonomy, consistent with APA guidelines that recognize adolescents’ rights to confidentiality for certain issues (APA, 2017). Conversely, if Irina is younger, parental involvement is more ethically and legally justified.

The involvement of Irina’s parents also influences Dr. Matthews’ decision-making process. Legally, statutes governing minors’ healthcare disclosures vary by state, with some jurisdictions requiring the withholding of certain information unless the minor consents, while others permit greater parental access. For example, state laws on minors’ consent to mental health services or reproductive health influence what can be disclosed (Fisher, 2014).

Furthermore, HIPAA mandates that minors’ health records are protected, but also allows minors to access their health information depending on the state law and the minor’s age and maturity (U.S. Department of Health & Human Services, 2016). If the state law permits minors to consent to treatment and access their records, Dr. Matthews must navigate whether disclosing information to parents aligns with legal rights and the adolescent’s best interests. If the law restricts parental access in certain circumstances, Dr. Matthews has a legal obligation to honor those restrictions.

Relevant Ethical Standards and Additional Considerations

Several APA Ethical Standards guide this scenario. Standard 2.01a emphasizes maintaining confidentiality, while 2.01b discusses exceptions, such as when the client’s safety is at risk (APA, 2017). Standards 2.04 and 3.04 address obtaining appropriate informed consent and providing accurate information about confidentiality limits. Standard 3.06 mandates that psychologists clarify the limits of confidentiality, especially with minors.

Standards 4.01 and 4.02 relate to maintaining competence and respecting legal requirements. Standard 10.10a emphasizes emergency consultation and disclosure in cases of imminent harm. Other standards—such as Standard 3.05 (disclosures to parents of minors)—may also apply, especially considering the context and the minor's age.

Additional standards that could be relevant include Standard 4.05 (to prevent exploitation or harm) and Standard 10.09 (on reporting abused or neglected minors). Respecting cultural differences and the minor’s developmental level also falls under standards emphasizing cultural competence and appropriate intervention (APA, 2017).

Ethical Alternatives and Their Evaluation

Dr. Matthews can consider several ethical options:

1. Maintain confidentiality and discuss with Irina the importance of her privacy, encouraging her to involve her parents voluntarily.

2. Disclose limited information to the parents—such as general progress—without revealing sensitive details, respecting Irina’s emerging autonomy.

3. Seek a legal opinion or consult with colleagues, especially if safety concerns are pressing, to determine what can be lawfully disclosed.

4. Delay or avoid disclosure if it endangers the therapeutic relationship or Irina’s safety, while carefully monitoring her well-being.

5. Involve ethical consultation or an ethics committee when the dilemma is particularly complex.

The optimal choice aligns with the APA's aspirational principles—such as respecting dignity and promoting beneficence—and complies with enforceable standards. The most ethically and legally sound alternative would likely involve balancing confidentiality with safety considerations: respecting Irina’s developing autonomy while involving parents appropriately, within legal boundaries.

Implementation and Monitoring

Dr. Matthews should follow a structured plan. Firstly, she must clearly inform Irina about the confidentiality boundaries, emphasizing her rights and limitations as per applicable laws. This transparency builds trust and helps Irina understand the importance of involving her parents when necessary.

Secondly, if confidentiality is maintained, Dr. Matthews should document the discussion, including the rationale for confidentiality, noting any safety concerns prompting potential disclosure. She should develop a safety plan if Irina’s wellbeing is at risk, including involving emergency services if needed.

Regular monitoring of Irina’s condition, ongoing assessment of her safety, and review of the legal/ethical landscape are essential. Dr. Matthews also should consult with colleagues or supervisors to ensure decisions are ethically justified. Ultimately, engaging Irina in decision-making fosters her autonomy and supports therapeutic progress (Fisher, 2013).

In conclusion, navigating this ethical dilemma requires careful balancing of legal statutes, ethical principles, and situational factors. Dr. Matthews’ approach should be guided by transparency, respect, legal compliance, and a commitment to her client’s welfare—adhering to the highest standards of psychological practice.

References

• American Psychological Association. (2017). Ethical Principles of Psychologists and Code of Conduct. APA.
• Fisher, C. B. (2013). Decoding the ethics code: A practical guide for psychologists. Sage.
• Fisher, C. B. (2014). Decoding the ethics code: A practical guide for psychologists. Thousand Oaks, CA: Sage.
• U.S. Department of Health & Human Services. (2016). Summary of the HIPAA Privacy Rule. HHS.gov.
• American Psychological Association. (2014). Guidelines for Using Telecommunications Technologies in Psychology Practice.
• Knapp, S., & VandeCreek, L. (2006). Informed consent in psychotherapy: A review of the literature. Professional Psychology: Research and Practice, 37(3), 322-336.
• Hood, A. B., & Reich, M. (2019). Ethical decision-making in adolescent psychotherapy. Journal of Ethics in Mental Health, 14(2).
• McLeod, J. (2013). An introduction to counseling theories. Pearson.
• Sleeth, M., & Russell, J. (2015). Ethical issues in adolescent counseling. Journal of Counseling & Development, 93(2).
• Mackenzie, C. S., Gekoski, W. L., & Knox, V. J. (2006). Age, gender, and the underutilization of mental health services. Journal of Counseling & Development, 84(3), 212-219.