Medicine: Privacy and Harm Prevention

NB: We do not resell your papers. Upon ordering, we do an original paper exclusively for you.

NB: All your data is kept safe from the public.

Table of Contents

Introduction
A Comparison and Contrast of the Court Decisions
Similarities and Differences
Influence on Confidentiality
Impact on Clinical Work
Conclusion
References

Introduction

Although confidentiality is a fundamental ethical principle in counseling, other considerations may require breaching it. The case of Tarasoff v. Regents of the University of California (1976) established the need to prevent harm to non-patients as one such consideration. Together with subsequent rulings like Estates of Morgan v. Fairfield Family Counseling Center (1997), the Tarasoff decision has altered counselors’ understanding of confidentiality. This paper compares those rulings and assesses their influence on counseling.

A Comparison and Contrast of the Court Decisions

Despite differing substantially in many details and emphases, Tarasoff and Morgan’s cases are both concerned with the same central legal issue. Specifically, they revolve around the understanding that health care providers must protect members of the public from any danger posed by their patients (Younggren & Gottlieb, 2016). Those rulings demonstrate the diversity of situations in which issues of confidentiality and prevention of harm manifest.

Tarasoff v. Regents of California (1976)

The Tarasoff case was occasioned by the failure of the University of California to warn Tatiana Tarasoff about another student’s intention to kill her, which was known to a university psychologist. The court ruled that preventing danger took priority over confidentiality (Tarasoff v. Regents of the University of California, 1976). This decision established the prevention of harm to non-patients as a healthcare provider duty.

Estates of Morgan v. Fairfield Family Counseling Center (1997)

In the Morgan case, the court found the Fairfield Family Counseling Center to be liable for a discharged patient’s murder of his parents. The center had discontinued the patient’s medication prematurely and dismissed his family’s concerns about his violent tendencies (Estates of Morgan v. Fairfield Family Counseling Center, 1997). The court decided that the relationship between mental healthcare providers and patients placed a special responsibility on the former.

Similarities and Differences

While both rulings affirmed the healthcare provider’s duty to prevent harm to non-patients, they approached it from different angles. Whereas the Tarasoff case established this duty as a principle, the Morgan case elaborated its rationale as a special relationship. Also, the Tarasoff ruling concentrated on the “duty to warn” (Adi & Mathbout, 2018, p. 6). The Morgan decision dealt with a broader set of responsibilities for minimizing danger. Nevertheless, confidentiality was cited in both cases as a countervailing public interest. Both courts agreed that protecting non-patients from violence was a higher priority.

Influence on Confidentiality

The two rulings have contributed to the emergence of a more restricted concept of confidentiality in counseling. The Tarasoff case set an influential precedent for requiring a breach of confidence to prevent harm (Gladding, 2018). The need to explain the limitations of confidentiality to patients is acknowledged in the American Counseling Association’s Code of Ethics (2014). However, different states understood and implemented this duty in different ways (Adi & Mathbout, 2018). For example, not all states have made the duty to warn mandatory. Such differences arise naturally from the need to balance confidentiality and harm prevention. Those local differences must also be adequately explained to clients (International Association of Marriage and Family Counselors, 2017). Above all, counselors must be transparent about their understanding of confidentiality and its limits.

Impact on Clinical Work

The complexity of duty to protect makes it difficult to assess the influence of the rulings on clinical work. While breaching confidentiality is a drastic measure, it can be necessary to secure the well-being of patients and others. Clinicians need to take into account the local legislation regarding confidentiality (Gladding, 2018). It is also necessary to understand the codes of their associations. However, normative documents of that type can only offer broad guidelines. Whether a client is dangerous enough to justify a breach of confidence is often ambiguous. No truly reliable risk-assessment tools exist to help with this task (Adi & Mathbout, 2018). As a result, the counselor must rely on their professional judgment and that of their colleagues.

Conclusion

The Tarasoff and Morgan rulings have established that healthcare providers must protect others from their patients due to their special relationship. However, implementing this duty has proven complicated due to jurisdictional differences and the ambiguity inherent in trying to determine whether a patient is dangerous. Counselors must weigh each case carefully to avoid needlessly undermining confidentiality while still intervening to prevent harm to their patients and others.

References

Adi, A., & Mathbout, M. (2018). The duty to protect: Four decades after Tarasoff. American Journal of Psychiatry Residents’ Journal, 13(4), 6-8.

American Counseling Association. (2014). 2014 ACA code of ethics [PDF document].

Estates of Morgan v. Fairfield Family Counseling Center, 673 N.E.2d 1311 (Ohio 1997).

Gladding, T. S. (2018). Counseling: A comprehensive profession (8^th ed.). Pearson.

International Association of Marriage and Family Counselors. (2017). IAMFC code of ethics [PDF document].

Tarasoff v. Regents of the University of California, 131 Cal. Rptr. 14 (Cal. 1976).

Younggren, J., & Gottlieb, M. (2016). Mandated multiple relationships and ethical decision making. In O. Zur (Ed.), Multiple relationships in psychotherapy and counseling (pp. 42-56). Routledge.

Click Here To Order Now!