Ethical+Decision-Making+Model

Case Study | Ethical Considerations | Legal Issues | Counselor Recommendation | Review of the Literature | Ethical Decision-Making Model

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Step #1: Identify the Problem
The first step in the ACA Ethical Decison-Making Model is to Identify the Problem. In this particular case, the problem is that Mark has been subpoenaed by Debbie's attorney to release confidential counseling records. Paul does not want any of his information disclose media type="youtube" key="rhbyCwJbaB8" height="377" width="504" align="left"d, especially information pertaining to his extra-marital affair and marijuana use. Mark has the ethical responsibility to honor Paul's wishes and the legal responsibility to respond to the subpoena if it is valid.

It is also important when reviewing any case to separate the facts out from the assumptions. Below is a quick chart that reveals what the facts are.

__**Mind Maps **__

Step #2: Apply the ACA Code of Ethics
There are many ACA Code of Ethics that are pertinent to this case.

Counselors do not share confidential information without client consent or without sound legal or ethical justification.
 * B.1.c Respect for Confidentiality
 * 1) It is Mark's responsibility to ensure that Paul's records are kept confidential.

At initiation and throughout the counseling process, counselors inform clients of the limitations of confidentiality and seek to identify foreseeable situations in which confidentiality must be breached.
 * B.1.d Explanations of Limitations
 * 1) Throughout the counseling process, Mark should inform Paul of the limitations of confidentiality. Mark should also discuss with Paul the potential complications that may arise, like a subpoena for records.


 * B.2.c Court-Ordered Disclosure

When subpoenaed to release confidential or privileged information without a client’s permission, counselors 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 counseling relationship.
 * 1) Mark must obtain a written release form before disclosing Paul's confidential information. Mark must ensure that only the amount of information that is sufficient to fulfill his legal obligation is revealed.


 * <span style="font-family: Verdana,Geneva,sans-serif; font-size: 120%;">H.1.b. Conflicts Between Ethics and Laws

<span style="font-family: Verdana,Geneva,sans-serif; font-size: 120%; vertical-align: baseline;">If ethical responsibilities conflict with law, regulations, or other governing legal authority, counselors make known their commitment to the ACA Code of Ethics and take steps to resolve the conflict. If the conflict cannot be resolved by such means, counselors may adhere to the requirements of law, regulations, or other governing legal authority.
 * 1) <span style="font-family: Verdana,Geneva,sans-serif; line-height: 23px;">As the counselor, Mark should follow the guidelines of the ACA when making decisions concerning this case. It is important that he attempt to resolve the matter in a professional and ethical way.

Step #3: Determine the Nature and Dimensions of the Dilemma
<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 120%; text-align: justify; text-decoration: none; vertical-align: baseline;">Our main moral principle is fidelity, which is loyalty to our clients and honoring our commitments to them. Mark has made the commitment to Paul to keep their counseling sessions private, according to the informed consent form that was signed. As long as the information was covered, Paul understands the limitations of this confidentiality. If there’s a court order for the disclosure of his records and there is no other option since Mark has followed the ACA guidelines, the law takes precedence. Mark, however, would only release portions of Paul’s records, which are directly necessary to comply with the court order. A subpoena is insufficient cause to release information regarding a client; A court order or a specific release is needed.

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 120%; text-align: justify; text-decoration: none; vertical-align: baseline;">The current thinking concerning this type of dilemma, according to the literature, is to always consult with one’s own attorney. In order to protect the client, the counselor can arrange agreement with the opposing attorney for a partial release of information. The request for information can be changed from full disclosure to partial disclosure, such as an affidavit from the counselor summarizing the records. The literature does also suggest that the counselor speak with the judge concerning partial disclosure to the judge only (“in camera”). Also, the counselor could discuss with the opposing attorney the release of general/partial information instead.

<span style="background-color: transparent; color: #000000; display: block; font-family: Arial; font-size: 120%; text-align: justify; text-decoration: none; vertical-align: baseline;">There are state and national organizations that work to assist professional counselors in taking the appropriate legal and ethical steps. The American Counseling Association provides free confidential professional/ethical consultations to members of the ACA. If a counselor is seeking this advice, they can contact the ACA Ethics and Professional Standards Department to set up appointments. Counselors can also contact their state LPCA to receive information regarding the proper protocol for certain cases.

Step #4: Generate Potential Courses of Action
<span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">There are many potential paths Mark could take regarding this case.
 * <span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">Mark could ignore the subpoena and wait for a court order. If the subpoena is not valid, then Mark may wait for the proper legal documents before responding.
 * <span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">Mark could release full records, including information the client does not wish to disclose (pot use, affair).
 * <span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;"> Mark could release partial records, excluding pot use and affair to the court.
 * <span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">Mark could contact Debbie's lawyer to see what information they are wanting regarding Paul’s files. Once Mark knows what specific information the opposing side is seeking, he could then discuss this with Paul to find out if he agrees to release the data or not.
 * <span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">Mark could contact the ACA and LPCA for legal and ethical advice regarding this case.
 * <span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">Mark could consult with another counselor/colleague to determine the best course of action to take.

Step #5: Consider the Potential Consequences of all Options & Determine a Course of Action
As a counselor, it is vital that Mark explores all potential consequences so that he can make a well-informed decision.


 * <span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">If the subpoena was ignored, then Debbie’s attorney could get a court order from a judge and then the records would have to be released. All of them. This includes everything from test records, general records, to psychotherapy notes taken by Mark. With this happening, potentially harmful information could get out about Paul that would be detrimental to his chances of getting custody of his children and potentially ruining his therapeutic alliance with his counselor. This sensitive knowledge could possibly affect his relationship with Monica and Jeffrey. This course of action does not seem to be in the best interest of Paul, therefore this option should be eliminated.


 * <span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">Releasing full records without Paul’s consent, could potentially have the same harmful effects as a court order for the records, but it is important to note that the trust in the counselor-client relationship will have been broken. Paul could have feelings of betrayal from his counselor and therefore not trust him in the future. The counseling relationship might not survive this breach of confidentiality and growth could be halted. This is also an ethical violation that could potentially lead to a lawsuit by Paul. Mark could be faced with the possibility of having his license revoked for his unethical behavior. His professional reputation and competence could be in question from this decision. This course of action does not seem to be in the best interest of Paul, therefore this option should also be eliminated.


 * <span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">Releasing partial records is a viable option for the counselor. If Mark has a discussion with the opposing attorney regarding what specific information they are requesting, then they may agree to a summary of the counselor’s case notes instead of full disclosure. Mark could then speak with Paul about what information is acceptable to be released and what should be kept confidential. Only the pertinent facts that Paul is comfortable releasing would be included in the court case, and the rest would be omitted. This is a more viable option for Paul and should be considered further.


 * <span style="background-color: transparent; color: #222222; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">Consulting with other professionals is very important for this case. By discussing with other counselors/colleagues, Mark may gain better insight as to how past cases have been handled and how to move forward. Contacting national and state professional organizations is a way for Mark to insure that he has taken every precaution necessary to choose the best ethical/legal decision. This course of action, along with the previous option, seems better suited for Mark and Paul and should be explored in depth.

Step #6: Evaluate the Selected Course of Action
<span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">After reviewing all possible courses of actions and consequences, the most beneficial option seems to be a combination of consulting other professionals, along with requesting a partial release of client records. Upon examination of the selected option, no new ethical considerations have been uncovered. After applying the three tests suggested by Stadler, the results are as follows:


 * <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">__**Justice:**__ In this scenario, Mark appears to be acting in a fair manner towards Paul. Choosing to consult when faced with a difficult dilemma would be applied to every situation and client, not just in this case. Client advocacy is a crucial responsibility for all counselors and by asking for partial records, Mark is providing this service to Paul.
 * <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">__**Publicity:**__ In the public eye, Mark is not only acting ethically but is also abiding by the legal standards for counselors. By seeking professional opinion, Mark is taking the proper steps to cover all of his bases and ensure that his actions are thorough.
 * <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">**__Universality:__** The course of action that Mark has chosen (consulting and request for partial disclosure), would be a good recommendation for other counselors/professionals in a similar situation.

<span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">Upon completing these three tests, this decision appears to be the appropriate course of action and is now ready to be implemented.

Step #7: Implement the Course of Action
<span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;">There are certain steps that Mark must take to implement this course of action. <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 120%; text-decoration: none; vertical-align: baseline;"> First, Mark should ensure that the subpoena is in fact valid. If the subpoena is legitimate, then the counselor should contact professional organizations/colleagues to determine what would be the best ethical and legal route. From here, Mark should contact the opposing attorney to determine what information is being requested. If needed, the counselor should present the idea of a partial release of records or a general statement about Paul’s treatment. This information should only be shared with the judge, since Paul does not want his counseling sessions disclosed to the court. At this point, Mark should have the confidence needed to fulfill his course of action because of the extensive legwork to ensure that this decision is in the best interest of the client. After the court case is over, Mark should review his actions to determine if they were indeed appropriate for the situation.