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Discussion of the ethical dilemma case
A brief description of the case: Academic Dishonesty
Simon is a high school counselor. Ginger, one of the students in the school, comes to him for assistance. The student tells Simon that she collaborated with other students to cheat on the final chemistry exams. However, Ginger requests Simon not to report her to the school’s authorities and maintain confidentiality. Her reason for asking Simon to remain, mum, is because she had been failing previous chemistry exams, but she had to pass the current exam in a bid to graduate from high school. Simon decides to remain silent. In this paper, I discuss Ginger’s case, accompanied by an appraisal of my moral and ethical framework.
Discussions
When clients seek therapists’ assistance, they often get into an individual relationship with the therapists. In the process, they discuss specific issues that may demand confidentiality, as in the case of Simon and Ginger. Therapists are compelled to remain mum on matters that the client considers confidential (Knapp & VandeCreek, 2003). This oath of secrecy seeks to enhance the clients’ trust towards the therapists/counselors and reveal everything that torments them, as well as ease the delivery of other therapists’ services. Therapists should let their clients feel that they have the liberty to share everything without the fear that their testimonies will be shared with another individual outside the room.
However, the duties of a therapist are not constrained to his or her client. Therapists have an onus to protect their clients, agency, profession, as well as members of the community. In essence, a therapist’s decision concerning a single problem may affect the community as a whole. Ethical dilemmas involving privacy evolve when there is a variance of responsibilities. Therefore, therapists should adhere to the ethical principles and policies of their professional institution before making wise discretion that does not surpass the strictures of their practice. Moreover, therapists ought to refer to certain specific ethical issues, build individual professional ethics, and base their thoughts on particular overt state laws to make a profound judgment (Fisher, 2009).
If a client discloses something that a therapist may consider insidious to society, he or she is expected to react in a way that will protect society as a whole. The therapist may react by reporting the case to the police and/or cautioning potential victims. If the therapist fails to report atrocious confession, then he or she is considered liable for subsequent negative impact. However, in the case of school authorities, there should be rules and regulations that define the limits of confidentiality and give a counselor the consent to breach the oath of secrecy (Corey, Corey & Callanan, 2011). Similarly, in the case of Ginger and Simon, the latter must respond to certain ethical questions before making an ultimate decision. These issues include:
- Does opting to conceal Ginger’s conduct from the school authorities cause any negative effect on the school? How would disclosing the testimony have affected Ginger, her fellow students, as well as the school administration? By breaching the oath of secrecy, does a therapist create a danger to others by demoralizing clients from seeking assistance?
- Does the task to inform another party (school authority) require the therapist to breach the ethical responsibility to uphold his or her client’s privacy? Between the two responsibilities, which is essential?
- Can school rules and regulations be incorporated as one explains the restraints that he or she has in remaining silent on issues that affect the school and its integrity?
Privacy is an ethical issue. The essential purpose is to secure a patient’s right to confidentiality by concealing the issues revealed to the therapists but can only be shared with a third party with the consent of the client (Fisher, 2009). Confidentiality enhances communication. Nevertheless, it is not a conditional right, especially when the patient in question is a minor. Some of the omissions are affected by ethical concern, while some involve legitimacies. Despite being a client’s right as well as an ethical obligation, there are instances where a professional may opt to maintain privacy, but be prevented by law or ethics; for instance, in situations where patients’ confessions are meant to harm themselves or others.
Consequently, legislation and ethical policies encourage therapists to contradict the oath of secrecy and inform the pertinent public authorities, but only if there is apparent harm to the individual or public. Moreover, ethical regulations used by most school counselors encourage them to caution the school authorities of situations when testimony made by students is likely to promote scenarios that will eventually hurt the school. In essence, the counselor is advised to conceal the name of the patient, but to report the matter to the relevant accountable authority. Nevertheless, the decision to choose which instance is likely to cause a negative impact and may deserve the attention of school authorities (Fisher, 2009).
In the U.S., physicians/therapists are permitted to divulge only if they have tangible reasons to consider the client’s testimony to be of harm to not only him/herself but also a third party. The American Psychological Association Ethical Principles of Psychologists and Code of Conduct describe the exception that permits clinicians to breach the oath of secrecy under Standard 4.05a and b (Knapp & VandeCreek, 2003). The guideline states that a clinician can divulge the private information without seeking the permission of a client to caution the vulnerable victim of the looming danger. Nonetheless, the recipients of this information are restricted to appropriate authorities and the potential victim (Corey, Corey & Callanan, 2011).
A clinician is advised to inform minors before the therapy situations that may lead to the breach of the promise of confidentiality. However, since teenagers may feel devastated by the fact that their confessions might reach a third party, their permission may be under duress. Therefore, clinicians ought to lessen the impact by ensuring that they encourage the juvenile that all he/she is doing is meant to assist him/her out of the predicament (Jenkins & Polat, 2006). The Legal and Professional Practice Issues that should be underscored in this Academic Dishonesty Case includes:
- When a clinician/counselor concludes that a client’s behavior or confession has an insidious impact on the student, and the school as a whole, the clinician is compelled to take relevant steps that can protect the students from the imminent danger. This obligation may involve warning the authorities of student’s behavior and other relevant authorities. However, this aspect depends on the magnitude of the insidious effect, which is solely determined by the therapist.
- The core of these reflections on whether to breach or observe the oath of secrecy is the ability to forecast. Theoretically, clinicians have a responsibility to take care of everyone likely to be affected in the future by his or her actions.
- When the prevention of the projected danger demands the clinician to regulate the behavior of another individual or caution such behavior, the common law has customarily compelled responsibility if the physician or counselor is uniquely related to the insidious individual or the targeted victim (Fisher, 2009).
- Soon after using applicable professional principles to determine that the conduct of the client is dangerous or might negatively affect other students, he or she has a responsibility to apply rational exercise to secure the conduct of other students and the image of the school. In other words, the clinician must help the potential victim to circumvent the projected harm (Jenkins & Polat, 2006). The psychologist’s responsibility is not limited to his or her patient; he or she has a legal onus to protect the potential victims of the client.
The Ethical Decision Making Steps I Would Apply to Arrive at a Resolution for Ginger’s Case
Identification of the predicament
First, it is crucial to contemplate if a circumstance is an ethical issue and to identify the characteristic of a predicament. One should collect all information related to the circumstance. Afterward, one ought to elucidate if the dispute is moral, lawful, medical, professional, or ethical- or if it is a merger of all these (Corey, Corey & Callanan, 2011).
Determination of the potential issues involved
After gathering information and determining the nature of the dilemma, a therapist should identify and exemplify the essential issues as well as abandon those that are immaterial. The clinician should analyze the privileges, duties, and interests of everyone that is affected by the predicament, either directly or indirectly. Moreover, the cultural setting of the problem, the client’s social background, and other pertinent cultural aspects of the client’s problems should be examined (Corey, Corey & Callanan, 2011).
Examination of applicable ethics policies
After understanding the potential issues about the client’s situation, the therapist is then advised to evaluate the existing regulations that could be used to resolve the client’s situation. The clinician should inquire whether the rules and regulations of his or her professional institution provide a feasible solution to the predicament. If the ethical principles that are applicable to the given situation, he or she should determine if the ethics are relevant or divergent with pertinent codes (Fisher, 2009).
Understand the applicable rules and regulations
In a bid to make sound discretion, a clinician needs to have contemporary information of applicable state as well as federal policies that can be used concerning the ethical dilemma. Moreover, he or she should be up to date with the existing laws and regulations in the institution (school) that provide limitations of concealing privacy.
Seeking advice from relevant professionals
After observing all steps, therapists need to seek the opinions of responsible professionals in a bid to have more ideas to contemplate on controversial areas before making the ultimate decision. In the process of consulting other colleagues, people should not constrain themselves to only those who support their perspective. Furthermore, if the counselor realizes some lawful questions ought to be answered, he or she should seek legal advice (Corey, Corey & Callanan, 2011).
Determine the potential and feasible courses of action
As at this point, the counselor has collected adequate information and advice, and thus s/he should concentrate on thinking about the variety of actions that he or she can resort to in making a decision. He or she must think broadly, develop various approaches to dealing with the ethical dilemma, and examine each of the potential solutions by considering their ethical and legal effects. The generation of multiple ideas helps therapists to come up with an eccentric but constructive solution (Fisher, 2009).
Analyze the consequences of multiple decisions
The clinician should analyze the effect of the listed approaches to the client, the society, as well as to him/herself as a counselor. During the analysis, one should consider the possible threats and advantages of each of the outlined approaches. After discreetly analyzing the possible dangers and benefits, the counselor can proceed to pick the best choice of action. However, one should make sure that he or she refers to all the resources collected in previous stages. The more apparent a predicament appears the more lucid the solution and the more delicate a dilemma is, the more complex the choice of action. After concluding, it important for the clinician not to doubt his/her decision (Jenkins & Polat, 2006).
An ethical discretion process aims to assist one to consider all pertinent facts, utilize all the accessible resources, and think through the predicament in a manner that leads to making the best possible decision. In the case of Ginger and his academic cheating practice, the counselor opted to uphold confidentiality rather than report the conduct to the school administration. Simon could have reported the case to the school administration without revealing the identity of Ginger in the spirit of discouraging the negative effect of academic dishonesty in the school. The constraint of privacy is a vital worry for physicians because the bond between the clinician and the patient is entirely based on trust and is the foundation of therapeutic development (Fisher, 2009). If the clients have no confidence that the therapists will honor their agreement of confidentiality, they may feel restrained to disclose some of the most depressing and personal issues that need utmost concern (Corey, Corey & Callanan, 2011).
Personal life experiences related to the case
The case of Ginger’s academic dishonesty raises several questions concerning the field of psychology. Can a client have confidence that his/her clinician will conceal the information that he or she confessed to him/her? What criteria does one use to contradict the principle of confidentiality? Conversely, other people raise questions contrary to the latter questions. For instance, how can a doctor/counselor remain silent when he/she knows the sources of negative culture in a school or the potential danger that one is exposed to in the process? Can a counselor be held liable for imminent academic dishonesty in the school?
The field of psychologists has persistently encouraged practitioners that their clients should reveal everything knowing that the therapist will honor their promise maintaining confidentiality. Despite this belief, patients should be informed as they start the therapy that whatever they disclose in the therapy room could be shared with other individuals if the information is seen to be of potential danger to a particular individual or might hurt the school and its community. However, if clients are aware of this fact, they may be reluctant to share issues that are most troublesome and thus could be significant in helping the clinician to provide appropriate treatment (Corey, Corey & Callanan, 2011). Consequently, the issue of confidentiality creates a huge setback in the field of psychology. It leaves clinicians with a dilemma on how to balance morality, ethical codes, as well as state and federal laws.
Moreover, this problem does haunt not only counselors, therapists, and all practitioners in the profession of psychology, but also medical practitioners. If there is a recognized third party that ought to be cautioned of the imminent harm caused by a client, then physicians must not remain mum on the issue. In essence, this move prevents a medical professional from effectively assisting a patient who conceals some important information.
Academic dishonesty can never be right, irrespective of the circumstance that leads to it. States have disparate policies for handling candidates who are found cheating, but all those laws are punitive. One of the consequences of cheating would be failing. If caught cheating, most states will seldom allow a candidate to retake an exam, but instead, they will fail him or her. Another possible consequence would be revocation, which also includes license rebuff and suspension. Where one is dishonest in an exam for license application, the state is likely to deny the suspect a license. One can even get criminal charges just because of cheating. For instance, copying another candidate’s work could be deduced as a type of theft, and one can be prosecuted in court according to the state laws. If a counselor is aware of students who are cheating in exams, why would he/she conceal the information and let such a heinous behavior go unpunished?
Psychologists are humans. Even if ethical principles may demand that they respect the oath of secrecy, their conscience may not permit them to remain silent if they know that there are people in danger. Therefore, they must be authorized to come with an effective solution to save the lives that are under threat as testified by their patient. In the case of school authorities, there should be rules and regulations that permit the disclosure of information related to academic dishonesty even if a student requests for confidentiality (Jenkins & Polat, 2006). The discretion in Ginger’s case creates an opportunity that promotes negative behavior in an institution simply because the right to privacy enslaves him or her. If the counselor divulged the information, he would have liberated himself from the guilt of second-guessing when the problem persists. His discretion does not provide clinicians with a leeway of assisting affected parties. The counselor thinks that by sticking to the rule of privacy, he would have made a perfect ethical decision, but in essence, he has simply promoted an atrocious crime in the school.
The discretion by Simon confirms the popular assertion that some psychologists misconstrue the law and feel that they should not caution third parties even in situations that they should. Some resort to this choice of action in fear of losing their relationship with the clients. This assertion is a poignant comprehension of ethical principles. It is important that when clinicians make decisions, they ought to show that their judgment is not only correct but also reflects their advanced experience in the profession (Fisher, 2009). However, if physicians fail to utilize basic skills to distinguish where the right of privacy needs to be applied and where it should be disregarded, then the entire discretion is considered a failure. Hence, Simon’s judgment could be termed as void.
Counselors can tackle the case of Ginger in several ways. Therapists can notify their clients that they have the intention to divulge information to school administration if they realize that any of the confession could harm other students or has a negative effect in the school as a whole and seek the clients’ consent on that request (Younggren & Harris, 2008). In effect, this aspect would reduce the attenuation of the right to confidentiality by positioning the choice of admission on the side of the client. Although this approach has merits, clinicians could dangerously find themselves. However, many psychologists still apply the approach used in Ginger’s case that common sense, proper medical practice, discreet documentation, as well as legitimate care for clients are enough for executing legal duties (Corey, Corey & Callanan, 2011).
Simon’s judgment generates various questions about the traditional meaning of the privilege of confidentiality in upholding the bond between a physician and his/her client. The discretion should have applied the principle that confidentiality ends when the information shared poses a potential danger to the public (Knapp & VandeCreek, 2003). The main challenge that physicians are left with is the burden of saving a life or curbing the spread of negative behaviors. This legal duty has created an obligation to avert the occurrence of dangerous or mischievous act using proper clinical discretion. If the counselor is not discreet in making a judgment, then the outcome of his/her discretion is blamed on him/her (Fisher, 2009).
Although various lessons can be drawn from this case, it does not essentially discourage clients from visiting therapists. Students have continued to visit counselors with knowledge of the limits of privacy about psychotherapy (Younggren & Harris, 2008). The relationship between a client and a therapist is not founded on absolute confidentiality immediately. The clinician exemplifies the restraints of the right to privacy. Despite confidentiality being a crucial component in therapy, clients do understand the legal as well as the ethical onus of therapists to society. The core foundation of psychology/counseling is trust, but not absolute confidentiality. Divulging a client’s confession without his/her permission in itself contravenes the core foundation of psychotherapy, viz. trust. Nonetheless, enforcing the law where there is the failure of self-drive does not contravene trust.
Ginger’s case largely challenges conventional knowledge. It suggests that one should uphold the privacy, even if doing so is likely to hurt a minor and the integrity of an institution. A method is created using fundamental professional principles, the characteristic of professions, as well as the validation for different professional onuses. Even though counselors may be compelled to observe confidentiality, they have a professional duty to avert potential danger or negative effect (Jenkins & Polat, 2006).
Conclusion
This case presents a challenge to counselors, students, and the school authorities. Simon failed to merely divulge because the issue had no harm to other people’s lives, and there were probably no stringent laws and regulations compelling him to breach confidentiality. Therefore, schools’ authorities should ensure that they have rules that define the limits of confidentiality between a student and a counselor. In case counselors receive any information that could promote negative behavior in the school, they should report it to the school administration after inquiring from the student. In essence, therapists should not limit their duties to their patients, but they should also consider the lives of third parties.
Reference List
Corey, G., Corey, M., & Callanan, P. (2011). Issues and ethics in the helping professions (8th ed.). Belmont, CA: Thomson Brooks/Cole.
Fisher, B. (2009). Decoding the ethics code: A practical guide for psychologists (2nd ed.). Thousand Oaks, CA: Sage Publications.
Jenkins, P., & Polat, F. (2006). The Children Act 2004 and Implications for Counseling In Schools in England and Wales. Pastoral Care in Education, 24(2), 7-14.
Knapp, S., & VandeCreek, L. (2003). An overview of the major changes in the 2002 APA Ethics Code. Professional Psychology, Research and Practice, 34(3), 301-308.
Younggren, N., & Harris, A. (2008). Can you keep a secret? Confidentiality in psychotherapy. Journal of Clinical Psychology, 64(5), 589-600.
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