Psy699 Master Of Arts In Psychology Capstone Week Five Discu

Psy699 Master Of Arts In Psychology Capstoneweek Five Discussion Case

Client: Victoria, 16-year-old HIV positive Latina. The case involves the ethical dilemma of disclosure of Victoria’s HIV status. Four years ago, the clinic decided to honor her mother Tina’s request not to disclose her HIV status to her when Victoria was 12. Currently, Victoria is sexually active with her boyfriend, aware that they do not always use condoms, but remains unaware of her HIV-positive status. The physician has not disclosed Victoria's HIV status directly but expressed to Tina that it is time for Victoria to know, considering her age and potential risk to her partner. Tina objects, citing her religious beliefs and Victoria’s perceived innocence and abstinence until marriage. The clinic staff are contemplating whether to disclose Victoria’s HIV status to enable her to make informed decisions about her sexual health and prevent transmission to her partner, despite legal and ethical concerns about overriding her mother’s wishes and Victoria’s minor status.

Paper For Above instruction

The ethical considerations surrounding HIV disclosure in minors present complex challenges for healthcare professionals. Balancing the principles of autonomy, beneficence, non-maleficence, and confidentiality requires careful navigation, especially in cases involving minors where family dynamics and legal standards intersect with ethical obligations. This essay explores the ethical dilemmas faced by the clinic staff in the case of Victoria, a 16-year-old who is unaware of her HIV-positive status, and discusses the implications of disclosure or nondisclosure from an ethical and clinical perspective.

Introduction

The case of Victoria encapsulates a quintessential bioethical dilemma centered on confidentiality, autonomy, and the duty to prevent harm. Victoria, a 16-year-old sexually active adolescent, is at risk of unknowingly transmitting HIV to her partner, which underscores the importance of disclosure for informed decision-making. Conversely, her mother, Tina, insists on nondisclosure, citing her religious beliefs and a desire to protect her daughter from emotional harm. Healthcare providers are caught between respecting the family’s wishes and their obligation to safeguard Victoria's health and autonomy. This situation exemplifies the tension between parental authority and adolescent rights, especially within the context of public health and legal considerations.

Autonomy and Confidentiality

Autonomy, a cornerstone of medical ethics, emphasizes a patient's right to be fully informed about their health condition to make autonomous decisions (Beauchamp & Childress, 2013). For minors, autonomy is typically balanced with parental authority, but ethical principles suggest that adolescents capable of understanding their health should have a degree of informational rights. In this case, Victoria is approaching legal adulthood and appears capable of understanding her health, suggesting that her right to know should be prioritized. Maintaining confidentiality aligns with respecting her emerging autonomy, yet this right is challenged when parents invoke their rights to control health information.

Beneficence and Non-Maleficence

Healthcare providers have a duty to promote the well-being of their patients (beneficence) and to prevent harm (non-maleficence). Disclosing Victoria’s HIV status could enable her to adhere better to medication regimens, reduce transmission risk, and take informed precautions, thereby promoting her health and safety. Conversely, nondisclosure might preserve her emotional well-being in the short term but could result in greater harm if she unknowingly transmits HIV, or if she encounters health crises that could have been mitigated through awareness (Bayer, 2016). The ethical obligation, therefore, leans toward disclosure to promote beneficence but must consider potential psychological distress.

Legal and Ethical Standards

Legally, minors' rights to health information vary by jurisdiction. Many regions recognize a minor's capacity to consent to certain health interventions but still impose restrictions on disclosing confidential information without parental consent (Committee on Bioethics, 2016). Ethical guidelines from bodies such as the American Academy of Pediatrics support disclosure to minors who are capable of understanding their condition, especially for communicable diseases like HIV that pose public health risks (AAP, 2014). These legal and ethical standards suggest that withholding critical health information from Victoria may be unethical and potentially illegal.

Parental Rights versus Adolescent Rights

The conflict between Tina’s parental rights and Victoria’s emerging independence complicates the decision-making process. Tina’s religious beliefs and her perceived role as protector motivate her insistence on nondisclosure. However, research indicates that adolescents benefit from informed health knowledge, which enhances adherence and empowerment (Holtzman, 2012). While parents have a right to guide their children, this does not justify withholding information essential for the adolescent's health and safety. A balanced approach involves respecting the parent’s role while prioritizing the adolescent’s best interests, particularly in legally and ethically sanctioned contexts of disclosure.

Implications for Clinical Practice

Healthcare professionals should undertake a structured ethical analysis, considering the maturity and comprehension level of Victoria. Engaging Victoria directly, in a developmentally appropriate manner, to discuss her health status can foster trust and empowerment. Clinicians may also facilitate a family-centered approach, involving counseling to address Tina’s concerns and beliefs while advocating for Victoria’s right to be informed. Multidisciplinary teams, including ethics consultants and legal advisors, can offer guidance in complex cases such as this (Fisher & Faden, 2015). Ultimately, ethically sound practice involves transparent communication, informed consent, and respect for the adolescent’s emerging autonomy, balanced against parental rights.

Conclusion

The case of Victoria highlights the critical importance of balancing ethical principles in adolescent healthcare. Respecting adolescent autonomy, safeguarding confidentiality, and adhering to legal standards point towards disclosure of Victoria’s HIV status to facilitate her autonomous decision-making and health management. While parental rights and beliefs matter ethically and legally, they should not infringe upon the adolescent’s right to be informed, especially in cases with significant public health implications. Healthcare providers must employ an ethical framework that prioritizes the minor’s best interests, supports informed decision-making, and fosters open communication within the family structure. Ultimately, the goal is to promote Victoria’s health, autonomy, and well-being through ethically justified disclosure, supported by professional guidelines and legal statutes.

References

• American Academy of Pediatrics. (2014). HIV and adolescents: The ethical imperative for disclosure. Pediatrics, 134(3), e888–e894.
• Bayer, R. (2016). Ethical dilemmas in HIV disclosure: Balancing confidentiality with public health. Journal of Medical Ethics, 42(1), 13–16.
• Beauchamp, T. L., & Childress, J. F. (2013). Principles of biomedical ethics (7th ed.). Oxford University Press.
• Committee on Bioethics. (2016). Ethical considerations in adolescent health care. Pediatrics, 138(3), e20162152.
• Fisher, J. D., & Faden, R. (2015). The limits of consent: HIV research and the adolescent’s right to information. Hastings Center Report, 45(7), 33–41.
• Holtzman, D. (2012). Adolescents’ rights to health information and decision-making. Journal of Adolescent Health, 50(5), 385–388.
• National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. (1979). The Belmont Report. Department of Health, Education, and Welfare.
• Siegel, D., & Brody, H. (2010). Ethical challenges in adolescent HIV disclosure. Journal of Ethics in Medical Research, 1(2), 45–50.
• WHO. (2013). Guidelines on HIV disclosure to adolescents. World Health Organization.
• Yong, S., & Wang, L. (2018). Balancing parental authority and adolescent autonomy in healthcare: Ethical considerations. Journal of Medical Ethics, 44(2), 103–107.