The Duty Of A Person Hospitalized

According to the AMHCA Code of Ethics, 2010, Section III.9, Commitment to Students, Supervisees and Employee Relationships, "the primary obligation of supervisors is to monitor services provided by supervisees to ensure client welfare." (p. 16) According to the AMHCA Code of Ethics, 2010, Section I.A.1.a, “the primary responsibility of mental health counselors is to respect client dignity and promote client welfare.” (p.2) Both codes of ethics have parallel stances when it comes to acting ethically in the benefit of the client’s interest. Supervisory roles are crucial in the development of counselors and ensuring the welfare of clients.

However, it is not always that simple and there may be some instances when it is not possible to maintain total confidentiality and the counsellor my have to pass on certain information that was revealed. For example, if a crime has been committed or if there is a risk of harm to another person. In this case the counsellor must be clear with the client what information they may have to pass on and to whom.

This paper is a response to a video discussing the issues of confidentiality, privilege, reporting, and duty to warn. This paper looks at these issues and their explanations in the American Counseling Association Code of Ethics as well as the Georgia State Board of Professional Counselor’s ethical guidelines and provides a commentary on the laws. It was found that these issues are not always black and white, but there is some debate on these issues. Confidentiality is both an ethical and a legal responsibility yet there are often times when the ethical demands clash with the legal demands. This paper explores some of those crashes and explains what I have learned from the video and the professional and stage guidelines concerning confidentiality and its implications and how I will apply what I have learned into future practice.

I selected the article “Duty to Warn and Protect: Not in Texas” for review, as it applies to the state in which I reside. The article cites Texas Health and Safety Codes, based on a 1999 Texas Supreme Court ruling that states counselors do not have a duty to warn or protect. Having a duty to warn and protect is defined as protecting clients or others from perceived harm (Jackson-Cherry & Erford, 2014). An example would be that a client tells their counselor in a confidential session that he is considering stabbing his ex-girlfriend. The duty to warn would mean the counselor should notify authorities and the ex-girlfriend thus breaking confidentiality. The duty to protect would be to admit client to a facility for the client to be assessed for a propensity for violence towards the ex-girlfriend. This became important after a 1969 incident where a counselor, had a client expressed harm towards a girl and the counselor contacted the authorities, yet never contacted the girl, who was subsequently killed by the client a few months later, known as the Tarasoff v. Regents of the University of California case (Jackson-Cherry & Erford, 2014).

There are several ethical dilemmas that the mental health professionals that are working as a team will face including “ensuring that the client has given informed consent, maintaining client confidentiality, and involving professionals, paraprofessionals, and family in appropriate coordinated processes that benefit the client” (Paproski & Haverkamp, 2000, p.96).

The duty to warn refers to a psychologist notifying a potential third party or governing authorities of the danger that might be inevitable. The duty to warn goes together with the duty to protect a third party whose life might be in danger. The therapist has a legal role to play by protecting a third party from danger through hospitalization and outpatient therapy while still observing confidentiality. However, the duty to warn might require the confidentiality to be overlooked. Duty to warn refers to warning an individual but not the public. When a person threatens the public, they should not be notified even if the danger gets noted. A psychologist has a role to play in every client’s life.

The state of North Carolin, which I reside in at the present does not require the "duty to warn", for the clinician/client professional relationship. “It is noted that the clinician, may do so in the best interest of the client having permission to warn. Also, the clinician shall provide the ‘best medical practice’ standards when involved in a therapist/ client professional relationship ethically or legally in light of a dilemma “(Cape Fear Psychological, 2014). The clinician must take precautions from an ethical and legal standpoint but, with regards for the safety of the client and/or any individual affected in serious harm or danger.

The Ohio Nurse Practice Act seems to have outlined particular instances where the nurse must advocate for the safe care of their patients. In particular, a section specifically deals with an occurrence when executing an order that may potentially be harmful to the patient. According to the Ohio Board of Nursing (2013), the nurse must clarify the order with the prescriber if there is any question about its safety.

The Tarasoff v. Regents of the University of California case on confidentiality are legal and ethics-related implications derived from the case where the psychologist failed to inform the victim or the parents of the victim of death threats, thus failing to carry out the duty to protect or warn. Three general categories of states include: those that mandate some duty to warn or protect (and that often specify whether law enforcement, the victim, or a combination should be “warned”); those that allow therapists to warn by protecting them from liability for breach of confidentiality if they do so, but do not require them to issue a warning; and those that offer no statutory or case law guidance (Johnson, Persad & Sisti, 2014).

Analyzing the journey of a hospitalized patient is imperative in nursing practice in order to produce holistic, strengths based care (Gottlieb, 2014). When examining the patient and his or her journey, it is crucial for the nurse to explore many factors including the patient’s personal history leading up to admission, the unique and individualized care plan, impacting strengths and gaps within the healthcare system, as well as the factors affecting discharge care and planning. For the purpose of this paper, a patient by the name of Anna will be explored in order to highlight essential aspects associated with providing holistic care.

Holahan & Cook (2005) stated that the Census Bureau released data showing that the number of uninsured Americans had increased by 850,000, to 45.8 million, between 2003 and 2004. Furthermore, the poverty rate between thsoe years increased from 12.5 percent to 12.7 percent with declination in household income (Holahan & Cook). One must understand the meaning of commodity and moral obligation before implynig it our health care system. As commodity may be viewed as what a person can afford to be bought for profit or benifit for a person. On the other hand, a moral obligation is a sense of righteous duty that one must perform in order to benifit a majority. A government is established to govern a welfare of it’s people one essential part of the

In Texas, the therapist owes no duty to warn individuals who are under possible threat, but I strongly believe that there are terrible consequences if under the Texas Constitutions denies the duty to warn. In my personal opinion, the Tarasoff’s Law should be applied to all states because if a patient clearly presents behavioral intentions to hurt an individual, the therapist must inform the possible victim and the law enforcement. I believe that when an individual seeks for help, the therapist might detect signs of threat against others and like the Tarasoff’s case or the Peck case, the individuals states his intentions to damage a person, property or even to third party individuals. The therapist must be allow to “break the patient-client

Research has shown that functional decline is considered to be one of the complications of hospitalization in older adults. One third of older adults develop functional decline following hospitalization. The effect of the acute illness and reconditioning associated with bed rest can be major reasons for functional decline and this can be avoidable (Boyer, 2011). Therefore, providers must have adequate understanding of the common causes, complications, and treatment of this condition in order to be able to initiate prompt detection, evaluation, and treatment of functional decline in the elders.

When a patient is admitted to the hospital, the nurse needs to be aware of the frequent hospital acquired problems such as the development of pressure injuries and moisture acquired dermatitis which could cause poorer patient outcomes and an increase to expenses for the hospital. There are a wide variety of assessment tools nurses can use to group patients based on their risks for skin breakdown or the development of pressure injuries such as the Braden Scale, which includes but is not limited to how frequent the patient is wet which would potentiate skin breakdown. What that scale does not take into account is the number of layers of linens on the average hospital bed. Many nurses may never have considered that folding a regular top sheet

Exception to Autonomy – If a counselor becomes aware that an individual is planning on infringing on the rights of others, by causing harm or depriving them of their autonomy, the counselor is held to the “Duty to Warn” and must