sample case study counselling bachelor degree
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Sample Case Study Counselling Bachelor DegreeTRANSCRIPT
1. Introduction
It is undisputable that counselling, as a discipline, is built upon the foundation of
ethics. One of the purviews of ethics in the counselling discipline is the (ethical) requirement
on the counsellor to keep whatever transpires between the counsellor and his/her client
remains confidential. In seeking counselling treatment, a client has the valid right to expect
that he/she will be safe in disclosing his/her innermost feeling and darkest secrets to their
counsellor. In other words counselling is a safe harbour where the client can pour out his/her
heart content to the counsellor or tell him secrets that the client will not reveal to other
people.
According to Bond (2010, p.155), one of the etymological origin of the word
confidentiality is the Latin word “con-fidere” which mean ‘strong trust’. This is reflective of
the high level of trust that are necessary in order for a counsellor-client relationship to work,
in other words, high level of trust emanating from the client to the counsellor is a prerequisite
for creating a conducive therapeutic counselling environment in which the client may open
up without reservation and therefore enables the counsellor to address the issues that are
causing the client concern. According to Bond (p.155) further, it is for this reason that the
safeguarding of confidential information revealed by the client becomes a high ethical
priority in the counselling profession and the profession jealously guards any attempt to
breach the same.
The American Counselling Association (ACA) Code of Ethics (2005) embodies this
ideal in Section B of the Code. Titled “Confidentiality, Privileged Communication and
Privacy”, the introduction to the Section reaffirm the counselling profession mantra that trust
is the basis upon which counselling relationship between the counselling professionals and
the client is built. In fact, the Section introductory section treats it as an ethical aspiration of
every practitioners to earn the trust of clients by “creating an ongoing partnership,
establishing and upholding appropriate boundaries and maintaining confidentiality”.
This paper will discuss a few issues regarding confidentiality by way of case study of
two main fictional characters, Jonathan and Ms. Jane Doe.
2. Discussion
2.1 Case study on confidentiality and privileged communication
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Ms. Jane Doe, an unmarried woman in her thirties and the only child in a family,
sought counselling from Jonathan, a registered and licensed counsellor in Kuala Lumpur
running his own practice. The therapy centered on Ms. Jane Doe’s dilemma because of her
past, in particular, the abortion of an out-of-wedlock foetus that had been carried out by Ms.
Jane Doe when she was in her teen and an out-of-wedlock child that she has with her UK
boyfriend (the child has since been in the custody of the boyfriend’s family). Since her teen,
Ms. Jane Doe was sent to an upscale boarding school in the UK where she abused her new
found freedom. Due to her sexually active lifestyle in her teen when she was overseas, she
was contracted with herpes simplex, a sexually transmitted disease. All of these she managed
to hide from her parents, who worked as lecturers in two renown universities in Malaysia and
were both sought-after experts in their fields.
Ms. Jane Doe, after completing her tertiary education overseas, on the other hand, had
started a new leaf in her live, and had become a certified public accountant with a reputable
accounting firm in Kuala Lumpur. Mr. John Doe, a partner in another reputable accounting
firm, fell in love with Ms. Jane Doe, the feeling was mutual and Ms. Jane Doe was equally
madly in love with Mr. John Doe. When the two decided to get serious and started discussing
about marriage, Ms. Jane Doe’s past haunted her again since she had kept her past as secret
from Mr. John Doe, a religiously devoted person. She is also afraid of her sexually
transmitted disease history, since according to doctor, there is no cure for it and once
infected, the herpes virus remains in the body for the entire life. According to the doctor
further, the herpes infection may be recurring from time to time especially during times when
the body immune system is impaired e.g. when the person contracts cold or HIV. In the
course of the counselling session, Ms. Jane Doe went for HIV screening and a few weeks
after that the result shows that she was HIV-positive. She was devastated but nevertheless
told Jonathan that she will go on marrying Mr. John Doe, who did not know about her
condition.
The burden of carrying those secret had taken its toll on not only Ms. Jane Doe’s
physical health but her mental health as well. That is the reason why she sought counselling
from Jonathan in the first place. The counselling sessions had been going on for almost one
year when suddenly Ms. Jane Doe stopped seeing Jonathan for no apparent reason, leaving
behind tonnes of unpaid bills. After Jonathan’s attempts to contact her over the phones were
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unsuccessful and after two reminder letters to settle the unpaid bills sent to her home remain
unheeded, one of Jonathan staff suggested that they send the letter to Ms. Jane Doe’s office.
Jonathan was still considering his staff suggestion when they receive a letter from Ms.
Jane Doe’s office asking for invoice of Ms. Jane Doe counselling session. When Jonathan
staff called Ms. Jane Doe’s office further, one of the staff there informed them that Ms. Jane
Doe had been transferred overseas on short notice and the bill for counselling session will be
footed by the firm. In return, Ms. Jane Doe’s employer requested Jonathan to provide them
with a complete report of the session together with assessment of her psychological
condition. Jonathan was never informed by Ms. Jane Doe of any arrangement of payment
from third party.
Several weeks after that, Jonathan was informed by Ms. Jane Doe’s parent that she
had died in an accident overseas. It was after her death that her parents came to know about
the counselling session and they demanded to know from Jonathan everything about why
their daughter sought treatment from Jonathan, insisting that as the parents to Ms. Jane Doe,
they had the right to know everything.
After the above, event Jonathan’s was called by the police to assist them in the
investigation on the cause of accident that took Ms. Jane Doe’s life as investigation shows
that Mr. John Doe may have something to do with her death as a few weeks before the
accident, Mr. John Doe had bought life insurance in the value of millions of ringgit for Ms.
Jane Doe, and after her death, Mr. John Doe was the sole beneficiary named in the insurance.
The police believe that information revealed by Ms. Jane Doe during the counselling session
might assist them in their investigation.
Jonathan had not revealed any of the information shared by the late Ms. Jane Doe to
any of the party above, as yet. But he is in a dilemma since all the parties above keep on
pressing him, while the police investigating officer warned him that the police will obtain a
subpoena and call him as witness when Mr. John Doe is charged in the court for murder of
Ms. Jane Doe.
What are the ethical implications associated with the scenarios in the case study
above? What should Jonathan do?
2.2 Analysis of the case study and discussion of literature review based on the ethical
issues found in the case study and identification of the ethical principles in the American
Counselling Association (ACA) Code of Ethics relevant to the ethical issues in the case study
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Ethical dilemmas are staple occurrences in day-to-day work of a counsellor. The
counsellor’s ability to recognize an ethical dilemma when he is faced with one is crucial in
determining whether he will decide on the dilemma ethically. In this regard, several studies
(Fleck-Henderson, 1995; Neukrug, Milliken, & Walden, 2001; Welfel, 2010) show results
which point to the fact that this critical ability is lacking in many counsellors (Constable,
Kreider, Smith and Taylor, 2011, p.2). This part will explore the case of Jonathan, a
registered and licensed counsellor in Kuala Lumpur running his own practice as given in the
case study above.
After reading through the case, this part propose to further analysed the following
central issues identified in the case as below :
1) the degree of confidentiality a counsellor owes his client when the safety of
other people is at stake (i.e. Jane Doe confidential information that she has
HIV and whether Jonathan should tell Mr. John Doe); and
2) responsibility of the counsellor to parents of the client; and
3) counsellor’s obligations to third party payers; and
4) whether there exist legal obligation to reveal confidential information to assist
police in their investigation.
5) Post-mortem confidentiality
In analysing Jonathan case above, this part will also incorporate review of literature
on the principle of confidentiality and privileged information in the counselling profession. In
the above case study, Jonathan is faced with complex situations where the principle of
confidentiality and privileged information between a professional (in this case, a counsellor)
and his client is tested to the extreme. It is in situation like this that the American
Counselling Association (ACA) urges counsellors concerned to consult decision-making
models which are widely accepted in the profession and utilize the model most appropriate to
their situation (Kocet, 2006, cited in Constable, Kreider, Smith and Taylor, 2011, p.2). Based
upon recommendation by Constable, Kreider, Smith and Taylor (2011, p.2) above, this paper
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has chosen to utilize the ethical decision-making model by Welfel (2010) - this paper
however refer to the latest work of Welfel (2012) - because that model integrate the standards
and ethical principle of the counselling profession, endorse analysis that is aligned with the
accepted moral vision of the profession and stress the importance of counsellor responsible
and dutiful thought in arriving at a particular decision. Welfel (2012, pp. 29-57) presented
counselling professionals with a ten-step model of arriving at an ethical decision when faced
with an ethical dilemma. Actually, it is a nine-step model since the final step is an ex post
facto step i.e. reflection after decision is made and made known. The ten steps are presented
below (the headings are reproduced ad verbatim from Welfel (2012, pp. 29 – 57) and will
directly be applied to Jonathan case above.
Step One : Becoming Sensitive to the Moral Dimension of Practice
Meta-analysis by Welfel (2012, p. 32) on previous studies carried out to assess
practitioners sensitivity to moral dimension of the counselling practice revealed a shocking
result – all studies analyzed show a discouraging pattern of moral and ethical insensitivity
among students and practitioners alike in social work and psychology fields. Based on other
studies, Welfel (2012, p.32) suggests three intervention measures to curb this malady of
insensitivity to moral/ethical dimension of practice namely : 1) development of a professional
ethical identity which is achieved through formal education and involvement in graduate
program that sow the seed of culture of commitment to the ethical values of the profession; 2)
self-assessment to ensure that personal motives of becoming a counsellor/entering a
profession in mental health field is in alignment and not in clash with the moral vision of the
profession itself and finally 3) paradigm shift in practitioners’ mental set about ethics, namely
: 1) ethics must no longer be regarded by practitioners as secondary concern in their practice
i.e. secondary concern after clinical practice concern, instead they must regard ethics as the
crux of their practice; finally 2) practitioners must not take ethical issues lightly i.e. regarding
them as highly visible to practitioners when they occur and can be swiftly dealt with, instead
practitioners must be constantly on guard for ethical principle violations and must set up
procedures to ensure that no ethical principle violations will occur.
The current case study shows that Jonathan is sensitive to the ethical dimension of the
profession and the practice, in particular the requirement of confidentiality and privileged
communication between counsellor and client, even a deceased former client. In the last two
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paragraph of the case study, clearly Jonathan has become aware that he is facing an ethical
dilemma, and he will be embarking on an ethical decision making process to settle the
dilemma.
The American Counselling Association’s Code of Ethics (2005) is clear on this.
Standard B.1.c. of the Code titled “Respect for Confidentiality” states that “Counsellors do
not share confidential information without client consent or without sound legal or ethical
justification”.
Step Two : Identify the Relevant Facts, Socio-cultural Context, and Stakeholders
Once Jonathan realizes that a situation involving ethical consideration exists, he or she needs
to organize relevant case information, including the cultural and social context in which the
situation occurs (Welfel, 2012, p. 34).
For relevant facts, Jonathan must realize that currently his client is dead, and he, as
the person who hold his client’s secrets, has become the central figure in several settings i.e.
the employers who wants to know about their employee, the parents who want to know about
their daughter, the police who wants to investigate his client’s death and the secret that only
Jonathan and his dead client know – the HIV positive status of Ms. Jane Doe.
Stakeholder is defined as a person or a group of people who are connected to the
client who may be helped or harmed by a counsellor’s actions (Garcia et al., 2003; Treppa,
1998 cited in Constable, Kreider, Smith and Taylor, 2011, p.3). In the above scenario the
people that will be impacted by Jonathan will be Jonathan himself, the late Ms. Jane Doe (i.e.
her reputation), Ms. Jane Doe’s parents, Mr. John Doe, Ms. Jane Doe’s employer and the
police.
On the socio-cultural context, Jonathan must realize that in the eastern society, the
revealed secret can sometimes become a stigma to the entire family. On the other hand,
Jonathan must also realized that in the eastern society, parents still sway authority over their
unmarried children, hence the insistence on Ms. Jane Doe’s parents to know about her
secrets.
Step Three : Define the Central Issues in the Dilemma and the Available Options
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Step three involves attempts by the counsellor to classify the fundamental ethical issues or the
type of ethical problem involved (Welfel, 2012, p. 35). In this case the main issues have
already been listed above and will be reproduce below :
1) the degree of confidentiality a counsellor owes his client when the safety of
other people is at stake (i.e. Jane Doe confidential information that she has
HIV and whether Jonathan should tell Mr. John Doe); and
2) responsibility of the counsellor to parents of the client; and
3) counsellor’s obligations to third party payers; and
4) whether there exist legal obligation to reveal confidential information to assist
police in their investigation.
5) Post-mortem confidentiality
When the above central issues has been identified, the next step for Jonathan is to
brainstorm the available course of action that he can think of without any filtering/censorship.
Thereafter, they must evaluate and eliminate the unlikely options. Evaluating can be done by
asking “what else might be ethical” and eliminate options that does not fulfil ethical
requirements (Welfel, 2012, p.36). An example of the above would be that for ethical
solution Jonathan might ask the parents of Ms. Jane Doe to wait until Jonathan reveal them in
court when he is required to do so by the court – and thus does not violate any ethical
principle.
Step Four : Refer to Professional Ethical Standards and Relevant Laws and Regulations
Once the counsellor identifies an ethical issues and the available options, the next step
is to refer to professional ethical standard to determine whether the available options is in line
with the Standards, Laws and Regulation in its application. For example, in Jonathan case
above, the ACA indicates that confidentiality is the default fiduciary duty owes by a
practitioner to his client as stated by Standard B.1.c. which provided that “Counsellors do not
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share confidential information without client consent or without sound legal or ethical
justification”. However, there is several exception to this as provided by the Code. Standard
B.2 of the Code list down the exceptions, namely, (1) when disclosure is required to protect
clients or identified others from serious and foreseeable harm or when legal requirements
demand that confidential information must be revealed ; (2) When clients disclose that they
have a disease commonly known to be both communicable and life threatening, counselors
may be justified in disclosing information to identifiable third parties, if they are known to be
at demonstrable and high risk of contracting the disease; (3) When subpoenaed to release
confidential or privileged information without a client’s permission, counsellors, obtain
written, informed consent from the client or take steps to prohibit the disclosure or have it
limited as narrowly as possible due to potential harm to the client or counselling relationship.
The above ethical standards, law and regulation shall be the benchmarks for Jonathan
list of possible options for solutions.
Step Five : Search Out the Relevant Ethics Literature
This step involves consulting professional literature that explores the thinking of other
scholars and practitioners who have faced the same ethical dilemma before and draw
inspirations and obtain new perspective from such literature on how the dilemma can be
settled ethically (Welfel, 2012, p. 41). It is submitted that in the internet era nowadays, this
task will be easy for Jonathan.
Step Six : Apply Fundamental Ethical Principles and Theories to The Situation
Kitchener (1984 cited in Welfel, 2012, p. 43) identified five primary ethical principles
governing human service professions including counselling. In step six, Jonathan should
apply this fundamental ethical principles in reaching his ethical decision. These principles are
:1) respect for autonomy, 2) non-maleficence, 3) beneficence, 4) justice and 4) fidelity
provide counselling professional with a guideline/framework for examining their work with
their clients. Respect for autonomy means respect for a client’s choice, freedom, and dignity;
non-maleficence is the duty to do no harm to clients; beneficence is the responsibility to do
good as a counselor; justice demands fair treatment to the client; and fidelity is the
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counselor’s faithfulness to commitments, honesty, and loyalty (Welfel, 2010 cited in
Constable, Kreider, Smith and Taylor, 2011, p.6 ).
In this regard, Jonathan must ascertain from records and his recollection of what were
his late client’s request regarding the secret i.e. should them secret be secret forever or can be
revealed to selected person after she died. In deciding whether to reveal or not whether it will
harm his late client’s reputation. Justice principle requires Jonathan decision to be fair to all
parties involved and he has to ask himself whether it would be fair, for example, not to reveal
the information to the police when such information is crucial to bring justice to his late
client.
Step Seven : Consult with Supervisors and Respected Colleagues to obtain Alternative
Perspectives
Standard C.2.e. of the ACA Code, entitled “Consultation on Ethical Obligations”
provides that “Counselors (must) take reasonable steps to consult with other counsellors or
related professionals when they have questions regarding their ethical obligations or
professional practice”. Consultation with supervisors and respected colleague gives the
counsellors concerned an objective perspective (Constable, Kreider, Smith and Taylor, 2011,
p.7). As such. Jonathan should confer with his respected fellow counsellors and ask their
opinion on how best to ethically settle his dilemma.
Step Eight : Deliberation and Decision Making
In this step, after carefully following through Welfel (2012) model, the counsellor
concerned must make decision that is ethical. Recommendation as to what Jonathan shall do
is provided in part 2.3 below.
Step Nine : Inform Appropriate People and Implement the Decision
When Jonathan has firm up his decision, he must then implement and document the
decision, as well as inform his supervisor and client of his decision. A counsellor, such as
Jonathan, must have ethical courage to follow through with his decision even when faced
with resistance. After completing this task, Jonathan will have to document his decision, the
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way the decision was implemented and his rationale for arriving at his decision. This are for
record purposes since his decision may be open to challenge later and he has to defend
himself (Welfel, 2010 cited in Constable, Kreider, Smith and Taylor, 2011, p.8).
Step Ten : Reflect on the Actions Taken
Step 10 is done after the decision is made, implemented and recorded. It is a period
for reflection on the part of the counsellor that allows him to identify ways in which the
process could be improved when the next similar dilemma occurs (Welfel, 2012, p.
55).Confidentiality is one of the basic ethical obligations a counsellor owes his client. A
counsellor, like other professionals such as accountants and doctors need a significant degree
of honesty in revealing information on the part of the clients/patients who seeks their services
in order for them to help such clients/patients effectively. Reciprocally, such clients/patients
request some reassurance that the confidentiality of their personal information will be
safeguarded from unauthorised disclosure to a third party. As societies developed, they have
formulated ethical and legal frameworks governing confidentiality for different profession
and in the counselling profession, the one of the oft-referred one is the ACA Code of Ethics,
2005.
As has been stated above, the ethical guidelines to the principle of confidentiality and
privileged communication are provided for in the ACA Code of Ethics, 2005. The highlights
of the Code has been written by Ponton and Duba (2009) . According to Ponton and Duba
(2009, p. 119), professional ethics can be seen as the implicit and explicit understanding of
the relationship between the profession and society. The relationship can best be understood
as a covenant (contract) between the profession (and its members) and the society (Miller,
1990, cited in Ponton and Duba, 2009,p.119). According to Ponton and Duba (2009, p.119),
The ACA Code of Ethics (ACA, 2005) reflects the counselling profession’s understanding of
the responsibilities inherent in the covenantal relationship between the profession and the
society. Code of ethics has been adopted by various modern professions with the objective of
ensuring common standard and minimize personal strife (Baker, 1999 cited in Ponton and
Duba, 2009, p.119) and guide professionals through the most common pitfalls in practice
(Welfel, 2002 cited in Ponton and Duba, 2009, p.119). The Introduction to each of the eight
sections of the ACA Code of Ethics (ACA, 2005) shows the understanding shared by
professional counsellors of their covenantal relationship and the specific manner in which
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they fulfil the counselling needs of the contemporary society (Ponton and Duba, 2009,
p.119). Specifically, Section B of the ACA Code of Ethics (ACA, 2005) laid down the
common belief that counsellors recognize that “trust is a cornerstone” of their covenantal
relationship with society and that they affirm their responsibility to promote that covenantal
trust through their respect for each client’s personality, culture, and history. The guiding
principles of the Code are clear throughout the section, Whether the issue is related to
confidentiality and boundaries with minors or sharing information with insurance companies,
or even sharing information after a clients death (Ponton and Duba, 2009, p.119).
Counsellors are in constant communication with clients throughout their professional
relationship. The most common privileged given to counselors are dealing with privacy and
confidentiality of information shared by clients. In reference to Section B of ACA Code of
Ethic, counsellor must respect the privacy rights of a client in which the soliciting of client’s
information should be done provided it may beneficial to the counseling process. Meanwhile,
the confidentiality right of a client restricts the counsellor’s privilege to share the client’s
information without his consent and if required, the counselor’s action must be justified
ethically and legally. However, by virtue of ACA Code of Ethic, there are three
circumstances where the confidentiality right is lift-up namely legal requirement, dealing
with fatal and contagious disease and by court order. Despite this guidelines, practitioners
must tread this ground carefully since good and ethical deeds sometimes is not the same as a
legally acceptable deed.
The first ethical issue is regarding whether Jonathan shall maintain confidentiality
when the safety of other people is at stake (i.e. Jane Doe confidential information that she has
HIV and whether Jonathan should tell Mr. John Doe). In dealing with fatal and contagious
disease, according to Corey, Corey and Callanan (2012, p. 261), Standard B.2.b of the ACA
Code of Ethics lay down the guidelines on ethical responsibilities of practitioners who might
deal with HIV positive clients who are unwilling to share their HIV status with their partner.
According to the Standard :
“B.2.b. Contagious, Life-Threatening Diseases
When clients disclose that they have a disease commonly known to be both communicable
and life threatening, counselors may be justified in disclosing information to identifiable third
parties, if they are known to be at demonstrable and high risk of contracting the disease. Prior
to making a disclosure, counselors confirm that there is such a diagnosis and assess the intent
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of clients to inform the third parties about their disease or to engage in any behaviors that
may be harmful to an identifiable third party.”
The second ethical dilemma of Jonathan involves the extent of responsibilities of the
counsellor (Jonathan) to parents of the client. The ACA Code’s guidelines on responsibility
of counsellor towards parents of their clients (Standards B.5) only cover the situations where
their clients are minors or adults who lack the capacity to give voluntary consent to release
the confidential information. This paper submits that in case of adult clients who have the
capacity to give voluntary consent, the parents of such clients have no better rights to know
the confidential information than other third parties outside the privileged relationship of
counsellor-client.
With regard to third-party payers right to confidential information of the payee who is
the counsellor’s client, Standards B.3.d of the ACA Code is very clear on this : Counselors
disclose information to third-party payers only when clients have authorized such disclosure.
With regards to whether there exist legal obligation to reveal confidential information
to assist police in their investigation, there are evidence that in practice, the ethical
requirement of confidentiality means total confidentiality even if by doing so the counsellor
are in violation of law. According to Bond (2010, p.155), counselling professionals have
traditionally taken a strict view of confidentiality and protection of clients’ privacy.
According to him some psychoanalysts have even been threatened with imprisonment (for
which they have prepared themselves) for their refusal to reveal their clients’ confidential
information even after the legal requirements for disclosure have been met. He cited the case
of Anne Hayman, a psychoanalysts who refused to give evidence consisting of confidential
information of her client. Hayman presented her reason for not abiding by the court request
and the court agree with her. According to Hayman (1965, cited in Bond, 2010, p. 155-156) :
“Patients attend us on the implicit understanding that anything they reveal is subject
to a special protection. Unless we explicitly state that this is not so, we are parties to a
tacit agreement, and any betrayal of it only dishonours us. That the agreement may
not be explicit is no excuse”
Even the Standard in ACA Code governing this issue gives not complying with the law’s
request as one ethical option for the professionals. According to Standard B.2.c, titled “Court-
Ordered Disclosure”, when a counsellor is subpoenaed to release confidential or privileged
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information without a client’s permission, the counsellor must obtain written, informed
consent from the client or take steps to prohibit the disclosure or have it limited as narrowly
as possible due to potential harm to the client or counselling relationship (emphasis added).
Another issue in Jonathan case above is post-mortem confidentiality i.e. should the
confidentiality requirement remains even after the death of Jonathan’s client? There is no
guidelines in the ACA for post-mortem confidentiality, but according to Bradley, Hendricks
and Kabell (2011), confidentiality should survive the death of the patient. The writers cited
the case of the psychiatrist, Martin Orne who after the death of his celebrity client, released
the tapes of their sessions to the client’s estate who in turn released the tapes to the deceased
client’s biographer who write the biography based on the tapes. This case caused an uproar
from the profession. For example, Dr. Gaylin, psychiatry professor at Columbia University
and an expert on medical ethics, concluded that Dr. Orne, by his action, has betrayed both his
patient and profession. Dr. Jeremy Lazarus (chair of the Ethics Committee of APA), in
reference to this case stated that ‘‘A patient’s right to confidentiality survives death. Our view
is that only the patient can give consent to the release of records. What the patient’s family
wants does not matter a whit’’ (Stanley, 1991 cited in Bradley, Hendricks and Kabell
(2011)). Despite the various criticisms, Dr. Orne maintained that he had acted with the
permission of Anne Sexton’s estate executor.
2.3 Identification of the most ethical course of action in solving the ethical dilemma
presented in the case study and the rational for the same
After we synthesize the issues faced by Jonathan, they all boil down to the following
issues : whether he should release the confidential information to the party who request them
and in case of Mr. John Doe, whether Jonathan should tell him that Ms. Jane Doe was HIV-
positive during her lifetime. After going through the analysis and the Standards in the Code
of Ethics as well as the literature review, this paper is of the opinion that the most ethical
ways for Jonathan is to NOT divulge any of his client’s (Ms. Jane Doe) secret to any of the
party above. He may ask all the parties concerned to start a legal proceeding against him to
obtain the confidential information that they want. Based on literature, duty to keep
confidential information released by the client survived the client’s death. Standard B.2.c.
titled “Court-Ordered Disclosure” maintained that “when subpoenaed to release confidential
or privileged information without a client’s permission, counsellors obtain written, informed
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consent from the client or take steps to prohibit the disclosure or have it limited as narrowly
as possible due to potential harm to the client or counselling relationship”. In Jonathan’s case
above his client’s has already died, perhaps the only option for him is to have it (i.e. the
disclosure) to be limited as narrowly as possible due to potential harm to the client reputation
after her death in the event Jonathan is subpoenaed by the court.
Regarding Ms. Jane Doe HIV status, based on Corey, Corey and Callanan (2012, p.
261) above, Jonathan is not obligated to reveal that to Mr. John Doe. Furthermore, it is not
stated whether he himself sees the HIV screening test result. According to Corey, Corey and
Callanan (2012, p. 261), Standard B.2.b of the ACA Codes places the responsibility on the
counsellor for examining a number of issues before arriving at the best ethical decision in a
given case. The Standard holds that counsellors may be justified in disclosing information to
a third party who is at risk, however counsellors are not obligated to take this course of
action. According to Corey, Corey and Callanan (2012, p. 261) this is an example of what is
ethically appropriate may have been legally unacceptable – practitioners may act in ways
they deem to be ethical only to find that they have broken legal standards. As such to protect
himself and to honour his agreement with Ms. Jane Doe, the only option available in this
regard to Jonathan is to keep the confidential information as confidential – even after his
client’s death.
3. Conclusion
As a conclusion, the duty of a counsellor to keep his client’s information confidential
is a sacred duty which continues even after the client’s death. This duty provide
confidentiality even against the client’s family members.Though the Code of Ethics provides
some guidelines in dealing with how a counsellor should dispense this duty, the guidelines is
not exhaustive. As such, reference must be had to professional literature and fellow
counsellors on how to best ethically deal with dilemma such as this. Literature which
provides methodological model to arrive at ethical decision are many, one of them is the ten-
step process by Welfel (2012). Despite the existence of the Code and literature, counsellors
must be careful in discharging this duty of confidentiality since at times, what is ethically
laudable might not be legally permissible. More often than not, the ethical integrity of
counselling professionals are tested when the confidential information in their possession
become the subject of clamouring requests by third parties not privy to the counsellor-client
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relationship. In such an instance, this paper submit that counsellors must be reminded why
the clients reveal confidential to them – because of their (the counsellors) willingness to keep
them as confidential no matter what it takes.
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REFERENCES
Bradley, L.J., Hendricks, B. & Kabell, D.R. (2011). Postmortem Confidentiality: An Ethical
Issue. The Family Journal: Counseling and Therapy for Couples and Families.
Retrieved from www.educ.ttu.edu/...and.../Postmortem%20Confidentiality.pdf
Bond, T. (2010). Standards and Ethics for Counselling in Action. London : SAGE
Publications Ltd.
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