Confidentiality as Basically a Common Ethical Dilemma in Professional Psychology - Essay Example

Name Institution Tutor Date Introduction Confidentiality is basically a common ethical dilemma in professional psychology. As a professional ethical principle, confidentiality is grounded on the view point that a psychologist should maintain or uphold the anonymity of the client. This is because the disclosure of the patients condition or name is not useful for the patients well being. The notion of confidentiality has therefore instigated a great deal of predicament when it comes to making ethical decisions. This particular paper seeks to provide an example of an ethical dilemma that is related to confidentiality. In addition, the paper will utilize the fourteen steps in ethical decision making in order to come up with a more valid and ethical decision to solve the dilemma. Description of an Ethical dilemma I have recently been employed as a Collage physiologist. My first patient is Jeremy a twenty year old student whose records indicate that he has frequently been involved in violent incidences against fellow students. Jeremy has disclosed to me that he was involved in a recent attack of a fellow classmate who is currently hospitalized. After studying Jeremy’s history and evaluating his condition, I have discovered that my client is suffering from paranoia, a severe mental condition which is mostly characterized by violence and aggression which can be a serious threat to other people. After engaging Jeremy in a three hour conversation about his condition, Jeremy pleads with me to not inform the collage management and the police about what he had done and about how serious his condition was. Application of the 14 steps in the Ethical Decision Making Step I: Identification of the situation that requires ethical consideration and decision making This particular case raises the ethical dilemma of whether I am obligated to protect my client by not reporting his condition to the University’s administration and the police. In such a circumstance, it is the role of the psychologist to inform the responsible authorities about the probable danger that can be posed by a client with an unstable mental health. However choosing to do so may violate the norm of anonymity and confidentiality. As a result a valid way of explain the situation is that disclosing the patients condition to the administration is professionally wrong, on the other hand based on the fact that the client has put the lives of others in danger, his action is also ethically wrong . The situation can be explained in the sense that failure to report Jeremy’s condition to the University administration and the police may be termed as illegal. Corley and Schneider, (p57) highlight that ethical dilemma’s do arise due legal jurisdiction. Failure to report the situation to the police may therefore make the psychologist an accomplice of the crime, incase more serious crimes are committed by the client. Step 2: Who will be affected by the decision The ethical decision regarding this particular case is bound to affect not only Jeremy but also other individuals. Jeremy is having a mental condition which has greatly contributed to his violent behavior. For instance, Jeremy’s violent attack on a classmate is actually unethical and illegal. In addition the continued existence of Jeremy in the institution may pose serious danger to other students in the future. What is evident is that his condition is bound to affect and has affected a variety of people. Step 3: Who is the client In this particular context, there is conflict concerning the client. This is because there is the therapist client relationship; as a result loyalty is divided. The implication is that this conflict can affect my judgment. Step 4: Relevant Areas of competence I am effectively prepared for this particular situation. The steps I would undertake in order to effectively handle this situation is to undertake sufficient research on the issue of confidentiality. I believe that I can do the job effectively as a result; I will not consult someone better to solve the situation. Step 5: Review of relevant formal ethical standards Ethical standards are directly related to this particular situation. According to the APA regulations (2010) in the process of making ethical decisions concerning professional behaviour, a psychologist has to put into considerations codes of ethics. However, one contradictory aspect is grounded on the fact that when applying ethical standards in decision making, there is need to make decisions according to the code of conduct of the profession. On the other hand what the psychologist does should be in line with the existing provisions of the law. However in the context of this particular situation, the ethical code of conduct requires lack of disclosure by the psychologist, on the other hand the law demands that every crime has to be disclosed. Ethical standards therefore seem to be misdirected when applied to this particular situation. Step 6: Relevant legal standards Applicable to the situation Legislations are directly related to this particular situation .One of the regulations is the 1984 Insanity Defence Act which highlights that if a defendant is proven to have a sever mental disorder , with clear evidence from an expert witness or specialist , then they can be proven as not guilty(Dattilio& Freeman,p37). The Act/ regulation speaks to this particular situation based on the fact that the client has a mental disorder; which has influenced him to commit the crime. Consequently the client can undergo trial however he can be proven not guilty based on my evidence as a psychologist. Consulting an Attorney would therefore be essential in order to gain more insight concerning the regulation. Step 7: Review of Relevant Research and Theory The Unicellular model or what is also referred to as the Interpersonal Explanations of Violence, is an emerging theory that has been utilized by criminologists to explain the causes of violence and how they can be resolved. The theory can be useful in understanding this particular situation. According to DeKeseredy and Perry, (2006) the interpersonal explanations of Violence propagates that violence is a factor that is influenced either internally or externally. The internal influence or motivation to violence is based on the analogy that human beings are actually naturally violent. On the other hand the external motivation to violence is influenced by the process of socialization and structural-functionalism. The continued interaction of an individual with his/ her environment explains the origin of violence and aggression that exists in their behaviour. As a result violent attitudes and behaviour is learned through a combination of situational and contextual factors. This theory can be useful to me as a psychologist because it would assist me in understanding my clients problem more, as a result I will find more approaches that can assist me in solving the dilemma of confidentiality. Step 8: How my personal feelings, biases, or self-interest might affect my ethical judgment and reasoning The situation makes me sad especially for my client Jeremy who does not want his condition to be disclosed to the institution due to expulsion. However I am not eager to please any individual or the institution I work for. Avoiding conflict is something I want to do nevertheless I believe that I must do what is ethical. Doing what is ethical may get me into trouble and it may make Jeremy, other workmates and my client mad. However I believe that I should do the right thing even though it may cost me. Step 9: Other considerations Affecting Ethical Responses Religion can bring about an impact on ethical response. More frequently religion advocates for forgiveness, compassion and understanding. In the context of this particular case when religious principles are applied, the decision made may to some level be unethical. Gallup (2010) argues that honesty is one of the most essential ethical values required in any particular profession. As a result in this case if religious principles such as; forgiveness is applied in the situation the response may not be ethical. Step 10: Consideration of consultation I consider consultation on the matter useful. Although the option of not consulting would be valid in order to maintain the ethical principle of confidentiality. Based on the fact that disclosing my client’s condition to another person whether they are experts in the area or not may actually be a breach of the confidentiality code of conduct for psychologists. However, because my client is experiencing a mental illness condition, I would consult a mental illness specialist. Step 11: Alternative courses of action An alternative action in resolving this particular scenario is by involving the client’s parents in the matter. The approach of introducing the parents into the problem may be a useful strategy of communicating to the client together with people he trusts. Step 12: Evaluation of the alternative courses of action One cause of action is to not report Jeremy to the administration and the police. This cause of action is purely grounded on confidentiality. However under this cause of action the best outcome is that Jeremy may gain confidence in me as a psychologist. The worst possible outcome is when Jeremy’s violent behaviour continuous and leads to adverse effects such as the death of other students. Another cause of action is to report my client to the police and the collage administration. Under the best outcome this cause of action would assist my client because he would be taken to trial after which if proven not guilty due to mental illness, he would be given professional help that would assist in eradicating the condition in the long-term. The worst possible outcome would occur if Jeremy is in disagreement with the decision to report the matter, which may influence the decision of him trying to hurt himself. Step 13: Adopting the perspective of each person who will be affected The most ethical response to this particular situation after putting my self in the shoes of those who will be affected by my decision is to present the matter before the administration; the administration should then inform the client’s parents and the police. Step 14: The final Decision Communicating to my client about my decision and informing the administration. The importance of ethical decision making in professional psychology One of the importance of ethical decision making is that it establishes integrity in the profession. When integrity is upheld by one professional the confidence of the public is enhanced. This is because the public will believe that psychologists are well trained and that they can effectively follow codes of ethics. As a result the integrity of the profession is protected. (APA, 2002). Making ethical decisions are also useful to the clients. APA (2002), highlights that ethical decisions in most cases seek to enhance the best interest of the client, although the client may perceive an ethical decision as harmful in the short run, however in the long run the decision may actually work for the betterment of the client. In conclusion from the above presentation what is evident is that professional dilemmas can resolved with correct application of ethical decision making procedures. Works Cited American Psychological Association. Ethical Principles of Psychologists and Code of Conduct 2010 Amendments. 2010. American Psychological Association Ethical Principles of Psychologists and Code Of Conduct. American Psychologist ,2002. Corley, M and Schneider, P. Disclosing secrets: When, to whom, and how much to reveal. Wickenburg; Gentle Path. P56-57, 2002. Dattilio, F and Freeman, A. Cognitive-Behavioral Strategies in Crisis Intervention . New York: The Guilford Press.p36-37, 2007. DeKeseredy, Walter Perry, Barbara. A Critical Perspective on Violence . Advancing Critical Criminology: Theory and Application .Lexington Books, 2006. Retrived From Gallup Research . Honesty and Ethics Professional ethics. 2010. Read More

Step 2: Who will be affected by the decision The ethical decision regarding this particular case is bound to affect not only Jeremy but also other individuals. Jeremy is having a mental condition which has greatly contributed to his violent behavior. For instance, Jeremy’s violent attack on a classmate is actually unethical and illegal. In addition the continued existence of Jeremy in the institution may pose serious danger to other students in the future. What is evident is that his condition is bound to affect and has affected a variety of people.

Step 3: Who is the client In this particular context, there is conflict concerning the client. This is because there is the therapist client relationship; as a result loyalty is divided. The implication is that this conflict can affect my judgment. Step 4: Relevant Areas of competence I am effectively prepared for this particular situation. The steps I would undertake in order to effectively handle this situation is to undertake sufficient research on the issue of confidentiality. I believe that I can do the job effectively as a result; I will not consult someone better to solve the situation.

Step 5: Review of relevant formal ethical standards Ethical standards are directly related to this particular situation. According to the APA regulations (2010) in the process of making ethical decisions concerning professional behaviour, a psychologist has to put into considerations codes of ethics. However, one contradictory aspect is grounded on the fact that when applying ethical standards in decision making, there is need to make decisions according to the code of conduct of the profession.

On the other hand what the psychologist does should be in line with the existing provisions of the law. However in the context of this particular situation, the ethical code of conduct requires lack of disclosure by the psychologist, on the other hand the law demands that every crime has to be disclosed. Ethical standards therefore seem to be misdirected when applied to this particular situation. Step 6: Relevant legal standards Applicable to the situation Legislations are directly related to this particular situation .

One of the regulations is the 1984 Insanity Defence Act which highlights that if a defendant is proven to have a sever mental disorder , with clear evidence from an expert witness or specialist , then they can be proven as not guilty(Dattilio& Freeman,p37). The Act/ regulation speaks to this particular situation based on the fact that the client has a mental disorder; which has influenced him to commit the crime. Consequently the client can undergo trial however he can be proven not guilty based on my evidence as a psychologist.

Consulting an Attorney would therefore be essential in order to gain more insight concerning the regulation. Step 7: Review of Relevant Research and Theory The Unicellular model or what is also referred to as the Interpersonal Explanations of Violence, is an emerging theory that has been utilized by criminologists to explain the causes of violence and how they can be resolved. The theory can be useful in understanding this particular situation. According to DeKeseredy and Perry, (2006) the interpersonal explanations of Violence propagates that violence is a factor that is influenced either internally or externally.

The internal influence or motivation to violence is based on the analogy that human beings are actually naturally violent. On the other hand the external motivation to violence is influenced by the process of socialization and structural-functionalism. The continued interaction of an individual with his/ her environment explains the origin of violence and aggression that exists in their behaviour. As a result violent attitudes and behaviour is learned through a combination of situational and contextual factors.

This theory can be useful to me as a psychologist because it would assist me in understanding my clients problem more, as a result I will find more approaches that can assist me in solving the dilemma of confidentiality.

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