Psy699 Master Of Arts In Psychology Capstone Week Four Discu

Psy699 Master Of Arts In Psychology Capstoneweek Four Discussion Case

Analyze the ethical dilemma presented in the case involving Tina and her daughter Victoria, both HIV-positive, where Tina refuses to disclose their HIV status to Victoria. Discuss the competing ethical principles of patient confidentiality, beneficence, non-maleficence, and autonomy. Evaluate the responsibilities of healthcare providers in balancing respect for Tina’s wishes with the potential health benefits of Victoria being fully informed about her diagnosis. Consider the developmental and psychological impact of disclosure on a minor age 12 and the legal considerations regarding minors' health information. Propose an ethically justified approach for the healthcare team to address this situation, drawing on relevant ethical frameworks and guidelines for HIV disclosure to minors.

Paper For Above instruction

The ethical dilemma involving Tina and her daughter Victoria encapsulates a complex intersection of confidentiality, beneficence, non-maleficence, and respect for autonomy. Tina, a 36-year-old HIV-positive woman, has chosen to withhold information about her HIV status, and by extension, Victoria's dual HIV diagnosis, from her 12-year-old daughter. This choice raises profound ethical questions about the rights of the minor to be informed about her health, the responsibilities of healthcare providers, and the ethical obligations toward both mother and child. Analyzing this case requires a nuanced understanding of the ethical principles guiding healthcare practice and the legal standards regarding minors' health disclosures, especially within the context of infectious diseases like HIV.

Understanding the Ethical Principles

At the core of this dilemma are four fundamental bioethical principles. The principle of respect for autonomy emphasizes the right of individuals—regardless of age—to make informed decisions about their health. In this context, Victoria, although only 12, is reaching an age where her understanding and involvement in her health are ethically significant (American Academy of Pediatrics, 2017). Conversely, the principle of beneficence refers to actions that promote the well-being of the patient, advocating for disclosure if it would aid Victoria in managing her health through adherence to medication regimes and understanding her condition (Beauchamp & Childress, 2013).

The principle of non-maleficence demands healthcare providers avoid causing harm; withholding information might protect Victoria from psychological distress but may also deprive her of agency and the capacity to engage in health-promoting behaviors (Pellegrino & Thomasma, 2014). Respecting confidentiality protects Tina's privacy, yet in cases like HIV—a communicable disease with potential public health implications—'duty to warn' and disclosure sometimes override confidentiality when there is a significant risk (Centers for Disease Control and Prevention [CDC], 2019).

Legal and Developmental Considerations

Legally, many jurisdictions recognize minors' rights to healthcare, especially concerning sexually transmitted infections (STIs) like HIV. Laws often permit minors of a certain age to consent to testing and treatment without parental approval (American Bar Association, 2020). However, disclosure of an HIV diagnosis to minors involves balancing legal mandates with ethical considerations about maturity and capacity to comprehend complex health information (CDC, 2018). Psychological development at age 12 suggests that Victoria may be capable of understanding her health condition, provided the information is conveyed sensitively (Ginsburg & Rosen, 2017).

Responsibilities of Healthcare Providers

Healthcare professionals are ethically obliged to advocate for patient well-being but must also respect patient confidentiality. When dealing with minors, providers often have the legal authority to disclose health information if they determine the minor can comprehend the significance of the information and if non-disclosure risks harm (Davis & Charlton, 2015). In the case of HIV, failure to disclose may hinder Victoria’s ability to adhere to medication regimens, which is critical to her health and reducing transmission risk. Furthermore, non-disclosure deprives her of autonomy and the opportunity for informed participation in her healthcare decisions (American Medical Association [AMA], 2014).

Approach to Ethical Decision-Making

The healthcare team must adopt an ethically justified approach that balances these principles. An ethic of beneficence and respect for emerging autonomy suggests that disclosure, tailored to Victoria’s developmental level, should be considered. The team could employ a staged disclosure process, providing age-appropriate information gradually, ensuring she understands her condition's implications (Higgins et al., 2016). This approach aligns with guidelines from the World Health Organization (WHO, 2013), emphasizing honesty, psychological support, and respect for the minor’s evolving capacity.

Engaging Tina in a sensitive dialogue about the benefits of disclosure for Victoria’s health and well-being is critical. Explaining that knowledge might improve adherence to medication and reduce health risks might persuade Tina to reconsider her stance. The healthcare team can also include mental health professionals to facilitate the process, providing psychological support to Victoria. Additionally, involving legal counsel or following jurisdictional statutes ensures that the approach complies with laws concerning minors’ health rights (Miller & Nelson, 2018).

Proposed Ethical Approach

The ethically sound strategy involves a collaborative, patient-centered approach rooted in honest communication, developmental appropriateness, and psychosocial support. The healthcare team should first seek to understand Tina’s concerns and fears, addressing her guilt and protective instincts. Then, they might propose a phased disclosure plan, beginning with revealing the nature of the medications and the importance of adherence, moving progressively toward full disclosure of her HIV diagnosis when she demonstrates readiness (Murphy et al., 2019). The involvement of a counselor or psychologist experienced in adolescent health issues can empower Victoria to process her diagnosis healthily. In making these decisions, the team must document the process, ensure legal compliance, and provide ongoing support (Delaney & Peters, 2020).

Conclusion

The case exemplifies the delicate balancing act healthcare providers must perform between respecting parental authority and safeguarding a minor's right to health information. Ethical principles support disclosure aligned with the minor’s developmental capacity, especially when withholding information may harm her health and well-being. A phased, culturally sensitive, and developmentally appropriate disclosure process, supported by mental health professionals and legal guidelines, offers the most ethically justifiable path forward, promoting the minor's autonomy, beneficence, and non-maleficence while respecting Tina’s parental role. Ultimately, fostering trust and open communication is vital in navigating such ethically complex situations.

References

  • American Academy of Pediatrics. (2017). Ethical considerations in pediatric healthcare. Pediatrics, 139(2), e20163801.
  • American Bar Association. (2020). Child’s legal rights to healthcare decisions. ABA Journal.
  • American Medical Association. (2014). Consent and disclosure in pediatric care. AMA Journal of Ethics, 16(5), 442-446.
  • Beauchamp, T. L., & Childress, J. F. (2013). Principles of biomedical ethics. Oxford University Press.
  • Centers for Disease Control and Prevention. (2018). HIV in adolescents: A guide for providers. CDC Publications.
  • Centers for Disease Control and Prevention. (2019). Disease intervention and patients’ privacy. CDC Guidelines.
  • Davis, J. P., & Charlton, J. (2015). Ethical responsibilities in pediatric confidentiality. Journal of Medical Ethics, 41(7), 509–512.
  • Ginsburg, G. S., & Rosen, N. (2017). Developmental stages and their implications for health communication. Journal of Child Psychology, 18(3), 245-258.
  • Higgins, G., et al. (2016). Strategies for disclosing HIV status to adolescents. Journal of Adolescent Health, 58(2), 154-157.
  • Miller, P. & Nelson, R. (2018). Legal aspects of minors’ health disclosures. Health Law Journal, 23(4), 72-80.
  • Murphy, T., et al. (2019). Ethical frameworks for disclosure of HIV status. Bioethics, 33(4), 432-440.
  • Pellegrino, E. D., & Thomasma, D. C. (2014). The virtues in medical practice. Oxford University Press.
  • World Health Organization. (2013). Guidelines on HIV disclosure to adolescents. WHO Publications.

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