Scenario
At the Metropolitan Counseling Center, receptionist Amy relays a message from Jim Jones, who claims to be the client’s husband. Jim asks Amy to inform his wife that he has a work emergency and needs her to pick up the children from soccer practice. When the client arrives, Amy passes on the message, causing the client to become distressed. She reveals that she and her husband are divorcing and she fears that such information could negatively impact her parental suitability during the custody hearing.
Problem Identification
The problem in the discussed scenario is connected with violating the nonmaleficence rules by the receptionist who wanted to be helpful. She did not aim to break the client’s privacy, who was consulting with the counselor at that moment. The receptionist did not check whether the client’s husband had the right to take the child, taking this situation for granted. In reality, the client was divorced from her former husband, and he had no legal permission to take his daughter without asking her mother about it.
Therefore, the receptionist unwillingly violated the client’s right to confidentiality and betrayed her trust. The receptionist harmed the counselor’s client, which clearly broke the nonmaleficence principle. The problem has an ethical character and is complex because the counselor is responsible for the employees’ actions, including the receptionist, but it is difficult to control these actions.
Application of the ACA Code of Ethics
According to the Practitioner’s Guide to Ethical Decision-Making, there are several critical steps that the receptionist should consider before letting children go with their father. The main point is that the professional should ensure that their actions do not harm the client, corresponding to the nonmaleficence rule. Section B.1.c. in the ACA Code of Ethics (2014) supposes that the counselor can dispose of the client’s information carefully and articulate it to others only if this action is ethically or legally justified.
As stated in H.2.b. part, the counselor has the right to give access to the client’s personal information to the employees who are authorized to possess this information (ACA code of ethics, 2014). The receptionist is among these employees, even though they are directly subordinate to the counselor. These standards are connected with the discussed scenario because they show that the receptionist possesses private information of the client, but her decision to give it to the third party is ethically wrong.
Applicable State Codes/Laws and Federal Mental Health Laws
The clear guidelines for privacy are described in part 4757 of the Ohio Administrative Code, entitled “Counselor, Social Worker, and Marriage and Family Therapist Board” (Ohio administrative code, 2022). Section 4757-5-02 of the 33 Ohio Revised Code (2020) sets the code of ethics and privacy. Ohio law mandates that a counselor or licensee maintain confidentiality unless doing so would result in a violation of another law or with the client’s express permission (Ohio revised code, 2020). On the federal level, the Health Insurance Portability and Accountability Act regulates patient information confidentiality (HIPAA, 1996). These standards apply to providing counseling services, which are understood to include counseling practices and personnel.
The Nature and Dimensions of the Dilemma
It is vital to remember that counseling supposes the highest level of confidentiality, and the client’s information should not be disclosed under any circumstances. The trustworthiness of the counselor is the most critical aspect of this practice due to the client’s mental health issues that make them feel vulnerable (Hall-Clifford & Cook-Deegan, 2019). The critical detail is that the counselor is responsible for the employees that work in the office, including the receptionist (Remley & Herlihy, 2020).
The actions described in the case study scenario correspond to the problem of breaching the client’s confidentiality rights and inability to act according to the nonmaleficence principle. The professional counselors who abide to the ACA Code of Ethics are school counselors and counselors who work in mental health facilities (Simons & Cuadrado, 2018). They work with the populations that have high level of psychological vulnerability, which makes their pursuit of the ethical principles obligatory. School and healthcare institutions are the organizations where their work is essential.
Potential Courses of Action
It is possible to address the problem from the scenario in several ways to ensure that the client’s information remains confidential and that the principle of nonmaleficence is preserved. First, the counselor should instruct the employees working in the office that private information about the client should not be disclosed to anyone without the direct permission of the individual. It does not matter whether the person asking for the disclosure of information calls themselves the relative and has an emergency (Remley & Herlihy, 2020). In this case, the receptionist should go to the counselor, interrupt the session, and ask the client for permission to let the child go with their father.
The second variant of actions that I propose is to ask the man who calls himself the client’s husband to wait in the hall until the session is over. As a receptionist, I can offer him some tea or coffee, but I should keep the child from going with him. The third potential course of action includes calling the counselor and asking them to warn the client about the man searching for her daughter. This situation might endanger the child’s well-being, which is unacceptable from an ethical point of view (Hall-Clifford & Cook-Deegan, 2019).
All three approaches to the situation correspond to the principle of nonmaleficence because they protect the client’s private information and do not allow the minor to go with the adult person when her mother asks to look after her daughter. In addition, it allows the receptionist to protect the trustworthiness of the counselor, which is professional behavior (Dixon & Quirke, 2018). In this case, the counselor’s role is to instruct the receptionist about the peculiarities mentioned above for a clear understanding of the topic. Thus, the proposed solutions are optimal and ethical because they are based on professional ethical rules.
References
American Counseling Association. (2014). ACA code of ethics. Web.
Dixon, S., & Quirke, L. (2018). What’s the harm? The coverage of ethics and harm avoidance in research methods textbooks. Teaching Sociology, 46(1), 12–24. Web.
Hall-Clifford, R., & Cook-Deegan, R. (2019). Ethically managing risks in global health fieldwork: Human rights ideals confront real world challenges. Health and Human Rights, 21(1), 7–18.
Health insurance portability and accountability Act. Pub. L. No. 104-191, § 264, 110 Stat. (1996). HIPAA Privacy Rule and Sharing Information Related to Mental Health. Web.
Ohio administrative code. (2022). Justia. Web.
Ohio revised code. (2020). Justia. Web.
Remley, T. P., & Herlihy, B. (2020). Ethical, legal, and professional issues in counseling. Pearson.
Simons, J., & Cuadrado, M. (2018). Narratives of school counselors regarding advocacy for LGBTQ students. Professional School Counseling, 22(1), 1–9. Web.