Ramic 2
Ethical Dilemma in Clinical Practice
Fiki Ramic
Professor Farr
PY440
08/25/2023
Ethical Dilemma in Clinical Practice
Introduction
Clinicians, such as psychologists and counselors, are essential in diagnosing, treating, and promoting mental health in individuals. Their work is done in various places, including offices, clinics, schools, and hospitals. The major component of their work is identifying whether a person’s behavior is odddistressing/impairing and if it might have unfavorable outcomes for their health. While executing the clinical practice, clinicians may experience differences between them and the patients as each party tries to justify what is right and wrong. Poor patient and clinician communication may yield an ethical dilemma (Mueller et al., 2017). Ethical dilemmas often occur among clinicians in their practice and lead to moral distress as there are no available measures for clinicians to resolve them (Rainer et al., 2018). This paper will examine an ethical dilemma that a clinician may face, examine the relevant section of the APA Code of Ethics, evaluate its guidance, and offer recommendations for handling the situation.
Ethical Dilemma
One example of an ethical dilemma would involve a scenario of a clinician working as a counselor in a school setting. The clinician must attend to a 15-year-old boy showing signs of depression and social anxiety. However, the parents of the boy, the client, approach the clinician and plead that the results of the diagnosis should not be disclosed to the boy. The parents claim that they strongly influence the client’s life and are deeply concerned that the boy’s mental health and academic performance would be adversely affected. They request that the clinician provide a diagnosis and treatment plan for their child without involving the student in decision-making. They argue that involving the student might cause further distress and resistance to treatment. The parents believe that knowing the severity of the condition might worsen their child’s mental state. However, the clinician understands the importance of informed consent and involving the client in their treatment decisions. This situation creates an ethical dilemma between respecting the parents’ wishes and upholding the client’s autonomy and well-being.
APA Code of Ethics Involvement
Several relevant sections of the APA Code of Ethics may apply to the dilemma. First is the principle of Beneficence and Nonmaleficence, which emphasizes the psychologist’s role to operate in a way that is helpful to the client and avoids harm. The principle emphasizes how crucial it is to maximize benefits while limiting potential harm among the clients. The principle postulates that clinicians, like counselors, are responsible for evaluating the potential harm that could arise from their professional activities and working towards minimizing it. Secondly is the principle of justice that emphasizes treating all individuals fairly and equally and ensuring appropriate care (Varkey, 2021). The clinician has to ensure that the client and the parents are treated fairly and strive to address their grievances.
Third is the principle of truth-telling. Truth-telling in professional work refers to honesty, correctness, and sincerity. The principle deals with accurately representing assessment results and avoiding deception. Truth is crucial in the interaction between a physician and the patient since without it, the patient won’t have confidence in the physician. A patient has both the right and the option of receiving information about their diagnosis and treatment. The clinician must understand which of these two options the patient favors (Varkey, 2021). The fourth principle is the respect for human rights. The principle explains the significance of upholding people’s rights and recognizing their autonomy and dignity.
The Adequacy of APA Code of Ethics
I believe the APA Code of Ethics offers a strong framework for ethical judgment and instructions on respecting client autonomy and acting in their best interests. The complexity of real-world situations can, however, occasionally exceed the bounds of the code, necessitating careful consideration of competing concepts. While the code encourages Beneficence and autonomy in the said ethical dilemma, the code does not specifically address the difficulties in managing parental involvement in the care of minor clients. The code does not provide specific guidance on dealing with parents who request to exclude their children from the decision-making process.
Recommendations
Educating the parents would be one of the recommendations that I would make to the clinician. The counselor should inform the parents of the value of the student’s active role in their mental health care. The counselor must inform the parent of the possible negative effects of excluding the student, such as treatment resistance or a lack of comprehension of their illness. The second recommendation is informed consent (Varkey, 2021). The clinician and the parents should go through a thorough informed consent procedure. During the procedure, the counselor should clarify to the student the advantages of participating in their own care decisions, the risks of being left out, and the ethical and legal requirements for maintaining confidentiality.
In conclusion, clinicians often experience ethical dilemmas in their work and require guidance toward robust ethical decision-making. The APA Code of Ethics provides valuable guidance anchored in various principles, including Beneficence, nonmaleficence, and justice. However, more careful judgment would be needed in real-life situations like the ethical dilemma presented. For instance, the clinician must carefully balance the client’s autonomy by following parental preferences while maintaining the client’s well-being as the top priority. Clinicians can deal with such ethical problems in a way that is consistent with their obligations as practitioners and as moral beings by fostering informed consent and offering education to the parents on the need to involve all parties for successful treatment.
References
Mueller, P. S., Hook, C. C., & Fleming, K. C. (2017). Ethical issues in geriatrics: a guide for clinicians.
The Elderly, pp. 91–99.
Rainer, J., Schneider, J. K., & Lorenz, R. A. (2018). Ethical dilemmas in nursing: An integrative review.
Journal of Clinical Nursing,
27(19-20), 3446-3461.
Varkey, B. (2021). Principles of clinical ethics and their application to practice.
Medical Principles and Practice,
30(1), 17–28.
Your originality report was 7% and acceptable upon review. Overall, you generally answered the general requirements of the assignment. However, you focused on the aspirational principles instead of the standards of conduct. The Code of Ethics states, “This section consists of General Principles. General Principles, as opposed to Ethical Standards (which can be sanctioned and lead to loss of a professional license), are aspirational in nature. Their intent is to guide and inspire psychologists toward the very highest ethical ideals of the profession. General Principles, in contrast to Ethical Standards, do not represent obligations and should not form the basis for imposing sanctions. Relying upon General Principles for either of these reasons distorts both their meaning and purpose” (p.3, APA, 2017). It is important in considering how to operate in clinical practice to apply the standards with the hope that overall you are applying the principles.
It is still unclear by your paper how you would respond to this situation. Regarding APA Style, the title goes on the first line of the second page. You did a great job with citations. Please see the rubric for point distribution.
