Ethics

Ethical Considerations
** It is critical that counselors consider their ethical obligations for every case they encounter. There are several ethical codes that could be applied to Jason’s case. Section A.9 refers to the quality of care given to terminally ill clients. A.9. a. states that counselors strive to take measures that enable clients: ** ** Jason’s counselor needs to make sure all of his physical needs are being met. His physical needs may include medications, which he wants to stop. His emotional needs may need to be met with continued counseling, which he is also thinking of ceasing. He doesn’t seem to have a lot of friends or a significant support group, so his social needs may be lacking. The counselor would need to determine his spiritual needs to assess if they are being met. Jason could be lacking some of these basic end-of-life needs so the counselor would enpower him to get them met. In order for Jason to be given every opportunity to make informed decisions about his life, he may need some education on the ramifications of ceasing his medication and terminating his counseling relationship. The counselor should also assess his ability to make rational decisions. **
 * 1) **To obtain high quality end of life care for their physical, emotional, social and spiritual needs; **
 * 2) **To exercise the highest degree of self-determination possible; **
 * 3) **To be given every opportunity to engage in informed decision making regarding their end-of-life care; and **
 * 4) **To receive complete and adequate assessment regarding their ability to make competent rational decisions on their own behalf from a mental health professional who is experienced in end-of-life care practice. **
 * A.9.c. addresses confidentiality in counseling those with end-of-life-decisions. Counselors who provide services to terminally ill individuals who are considering hastening their own deaths have the option of breaking or not breaking confidentiality, depending on applicable laws and the specific circumstances of the situation and circumstances of the situation and from appropriate professional and legal parties. This code could apply to Jason’s case if the counselor thought Jason planned to harm himself. Counselors are obligated to make their decisions based on the ACA codes of ethics. Clients who plan to commit suicide are indicating that they are putting themselves in imminent danger and according to the standard, counselors have to take appropriate action to preserve the client’s life. However, this ethical parameter applies to a physically healthy person, not a terminally ill person. Jason has not stated that he is going to commit suicide, but his death is imminent if he discontinues his HIV medications. He also is going to die from his disease even with medications; this is also something to consider. **


 * C.2.e. states that counselors take reasonable steps to consult with other counselors or related professionals when they have questions regarding their ethical obligations or professional practice. This code implies that the counselor faced with Jason’s case should seek consultation from his/her counseling peers or supervisors. The counselor should carefully consider this code when counseling a client with end-of-life decision. If they determine that they are not competent to deal with Jason’s case, they should not take his case and refer him to an appropriate source. ACA code of ethics A.9.b. addresses counselor competence, choice and referral. It is important that the counselor helping those with end-of-life decisions have the competency and experience necessary to practice. Counselors may choose to work or not to work with clients who wish to explore their end-of-life options. If the counselor is uncomfortable with his or her own competence, the ethical path to take would be to provide the client with a referral. In Jason’s case, he reports that he may or may not be coming back for any additional sessions, due to travel and possible effects from stopping his medication. If he decides not to come back, the counselor unfortunately may not have the chance to consult with someone. **

** A.2.a is also relevant to Jason’s case. It states that clients have the freedom to choose whether to enter into or remain in a counseling relationship and need adequate information about the counseling process and the counselor. Counselors have an obligation to review in writing and verbally with clients the rights and responsibilities of both the counselor and the client. Informed consent is an ongoing part of the counseling process, and counselors appropriately document discussions of informed consent throughout the counseling relationship. Jason has the right to refuse treatment and leave the counseling relationship at any point. He also has the right to stop taking his medications, for they are a form of treatment. ** ** Several ACA codes of ethics could apply to Jason’s case. Counselors have an obligation to consider any ethical implications their cases may present. Consulting with other counseling peers and supervisors is always a good idea. In order to provide beneficial counseling, counselors must be educated and aware of all the ACA code of ethics. **  []