Applying Ethical Principles

Health professionals deal with complicated ethical issues and must navigate professional values and principles. One of the core ethical principles for health professionals is confidentiality, especially in mental health, as things revealed by patients are usually private, personal information. This principle will help establish a basic level of trust between the patient and the providers, thereby encouraging open communication between the patient and the provider. Indeed, this is indispensable in establishing good therapeutic relationships. However, confidentiality can conflict with the health professional’s duty to prevent harm when there are disclosures that suggest danger to others. Such an ethical dilemma faces Dr. Laura Simmons, a clinical psychologist treating Mr. Alex Turner, who has just confessed to recurrent thoughts and plans of an attack on a colleague. This paper uses ethical principles and an ethical decision-making model to analyze the arising ethical issues, evaluate effective communication strategies, and offer a solution that upholds Dr. Simmons’ professional responsibilities to her patients and the community.

Overview of the Case Study

Dr. Laura Simmons has been treating Alex Turner, a 35-year-old software engineer, for six months now for symptoms of depression and anxiety. Their sessions had, over time, developed into a safe place for Alex to share even his deepest fears and frustrations. During one of the sessions, Alex confides in recurrent thoughts about killing a colleague, which is the result of an old professional rivalry that recently worsened due to some personal conflicts. Alex goes as far as to describe concrete plans, talking about an icy intention of carrying these thoughts into action. The disclosure puts Dr. Simmons into an enormously difficult situation: to choose between one of the foundational elements of her profession, confidentiality, and a breach of privacy in order to save a potential victim.

The key stakeholders that have to be considered in the decision-making process by Dr. Simmons are Alex, whose trust and therapeutic progress will be lost if confidentiality is broken; her colleague, who could be in life-threatening danger if the intervention by Dr. Simmons does not occur; and lastly, Dr. Simmons herself, who has to weigh her legal and ethical obligations toward the conflicting decision that conveys a choice consistent with both her health care and moral commitments.

Analysis of Ethical Issues in the Case Study

The ethical dilemma in this case study is the balance between confidentiality and the healthcare provider’s duty to protect others from harm. The principal ethical rule regarding confidentiality in psychology creates an enabling environment for patients to discuss issues without fear of disclosure, judgment, or retaliation (Tariq & Hackert, 2023). This is the basis of the therapeutic alliance, a relationship important in mental health treatment that makes people honest, trustworthy, and thus open to their thoughts and feelings. However, Dr. Simmons is also constrained by the principles of beneficence and non-maleficence, where she is supposed to act in a manner that is constructive and not damaging.

Notably, Alex’s specific plans to cause harm to another person put Dr. Simmons in an ethical dilemma where her duties to maintain confidentiality and prevent harm are at odds. If she sticks to keeping the conversation private, she will potentially allow Alex to move forward with his injurious thoughts unabated, which means another person could suffer physically. On the other hand, breaking confidentiality might damage the therapeutic process and thus hurt Alex. Literature in the field of mental health ethics substantiates that professionals facing such dilemmas must carefully evaluate the seriousness of the threat and consult legal guidance, if necessary, to make an ethically informed decision (Avasthi et al., 2022).

Using the Ethical Decision-Making Model to Analyze the Case Study

The ethical decision-making model, which includes moral awareness, moral judgment, and ethical behaviour, provides a framework to analyze this dilemma.

Moral Awareness

Dr. Simmons first identifies the existence of a serious ethical dilemma. She clearly realizes that she must keep confidence in Alex, a core aspect of her profession as a psychologist. At the same time, she knows that Alex’s mention of an intention to carry out a violent act gives rise to moral and legal duties to take steps to prevent harm to a third party.

Moral Judgment

At this stage, Dr. Simmons weighs possible actions in light of ethical principles. Beneficence—the obligation to work for the best interests of all parties involved—calls for Dr. Simmons to take action, if possible, to prevent harm. Non-maleficence—the commitment not to harm—requires that she proceed with caution regarding Alex and the potential target. Fidelity to Alex’s trust underscores the need for confidentiality. To choose a suitable course of action that upholds her moral and professional obligations, Dr. Simmons should speak with legal or ethical counsel.

Ethical Behavior

The course of action that Dr. Simmons has to entertain should transform her awareness and judgment into moral behavior. For instance, she may want to weigh the risk of disclosure against maintaining Alex’s trust. Suppose she believes the risk of harm is significant. In that case, she might consult with an ethics advisor or supervisor regarding necessary steps she could take without unilaterally violating confidentiality so that her response would be ethically and legally appropriate.

Effectiveness of Communication Approaches in the Case Study

Effective communication is an important component when dealing with ethical dilemmas—situations that are sensitive since confidentiality might be broached (Ewuoso et al., 2021). How Dr. Simmons communicates with Alex has built a safe, open therapeutic environment. She made Alex feel secure enough to begin opening up about his most disturbing thoughts based on her excellent listening skills and non-judgmental attitude. This open communication style not only helps Alex in his healing process but also enables Dr. Simmons to realize how serious he is with his intention.

Consequently, some strategies that Dr. Simmons might use in communication could worsen things. If Dr. Simmons were to confront or judge Alex about the implications of these thoughts, Alex would become defensive, which could lead to him abandoning the therapy. On the other hand, good communication incorporates empathic listening and an open, non-threatening environment in which Alex can understand his feelings and, in turn, can de-escalate his intentions of carrying through with these thoughts. By gaining trust, Dr. Simmons may be able to gain more information, which could guide her in relation to the ethical dilemma at hand.

Resolving the Ethical Dilemma by Applying Ethical Principles

The balanced and ethically sound solution for Dr. Simmons is to do an adequate risk assessment and consult with legal or ethical advisors. This approach combines the principles of beneficence, non-maleficence, and fidelity with consideration for autonomy and legal obligations. In so doing, by weighing the gravity of Alex’s intent, Dr. Simmons will be able to determine if the disclosure is warranted and legally justifiable to protect the intended victim. This compromise protects secrecy so far as is practicable but allows any decision to disclose to rest on ethical need.

Beneficence and Non-maleficence

Dr. Simmons should take steps to prevent any harm to Alex’s colleague while doing her best to minimize damage to her therapeutic relationship with Alex (Varkey, 2021). A risk assessment would clarify the potential threat, and consulting with an advisor would make sure that Dr. Simmons’ actions are well-aligned with her ethical duties.

Fidelity and Autonomy

This approach respects Alex’s right to confidentiality unless disclosure becomes necessary for safety (Varkey, 2021). Consultation with other professionals reflects interdisciplinary collaboration, which is invaluable in dealing with complex ethical dilemmas.

This approach not only informs Dr. Simmons’s immediate actions but also collaborates across disciplines and reinforces a shared commitment to patient safety and ethical practice within her organization. Having this team approach, Dr. Simmons would not have to face the dilemma in isolation, perhaps minimizing damage to her therapeutic alliance with Alex.

Conclusion

The ethical dilemma facing Dr. Simmons may represent the complexity required in balancing confidentiality against the duty to prevent harm. Using an ethical decision-making model that includes principles such as beneficence, non-maleficence, fidelity, and autonomy, she might make reflective and moral decisions about her duties. In addition, risk assessment and consultation with interdisciplinary support give her steps that ensure safety without trampling on confidentiality. This further underlines the need for a systematic ethical framework, effective communication, and mutual support in approaching such complex moral issues within healthcare.

References

Avasthi, A., Grover, S., & Nischal, A. (2022). Ethical and legal issues in psychotherapy. Indian Journal of Psychiatry, 64(7), 47–61. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_50_21

Ewuoso, C., Hall, S., & Dierickx, K. (2021). How do healthcare professionals respond to ethical challenges regarding information management? A review of empirical studies. Global Bioethics, 32(1), 67–84. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8023626/

Tariq, R. A., & Hackert, P. B. (2023, January 23). Patient confidentiality. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519540/

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119

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Develop a solution to a specific ethical dilemma faced by a health care professional.

Develop a solution to a specific ethical dilemma faced by a health care professional by applying ethical principles. Describe the issues and a possible solution in a paper of 3-5 pages.

Introduction
Whether you are a nurse, a public health professional, a health care administrator, or in another role in the health care field, you must base your decisions on a set of ethical principles and values. Your decisions must be fair, equitable, and defensible. Each discipline has established a professional code of ethics to guide ethical behavior. In this assessment, you will practice working through an ethical dilemma as described in a case study. Your practice will help you develop a method for formulating ethical decisions.

Instructions
Note: The requirements outlined below correspond to the grading criteria in the scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance-level descriptions for each criterion to see how your work will be assessed.

For this assessment, develop a solution to a specific ethical dilemma faced by a health care professional. In your assessment:

• Select one of the case studies presented in the Assessment 03 Supplement: Applying Ethical Principles [PDF] resource. (Case Study: Confidentiality and Mental Health)
  • Note: The case study may not supply all of the information you need. In such cases, you should consider a variety of possibilities and infer potential conclusions. However, please be sure to identify any assumptions or speculations you make.
• Summarize the facts in the selected case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
  • Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
  • Identify who is involved or affected by the ethical problem or issue.
  • Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
    • Apply the three components outlined in the Ethical Decision-Making Model media.
  • Analyze the factors that contributed to the ethical problem or issue identified in the case study.
    • Describe the factors that contributed to the problem or issue and explain how they contributed.
• Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
  • In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references. You will select at least one current scholarly or academic peer-reviewed journal articles published during the past 3–5 years that relate to your topic.
    • Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
    • Review the Think Critically About Source Quality resource.
      • Assess the credibility of the information source.
      • Assess the relevance of the information source.
• Discuss the effectiveness of the communication approaches present in a case study.
  • Describe how the health care professional in the case study communicated with others.
  • Assess instances where the professional communicated effectively or ineffectively.
  • Explain which communication approaches should be used and which ones should be avoided.
  • Describe the consequences of using effective and non-effective communication approaches.
• Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
  • Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
  • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
  • Discuss the key lessons this case provides for health care professionals.
• Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
  • Describe the proposed solution.
  • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
  • Discuss how likely it is the proposed solution will foster professional collaboration.
• Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  • Apply the principles of effective composition.
  • Determine the proper application of the rules of grammar and mechanics.
• Write using APA style for in-text citations, quotes, and references.
  • Determine the proper application of APA formatting requirements and scholarly writing standards.
  • Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.
    

    Applying Ethical Principles

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• Assessment 3 Example [PDF] 

Additional Requirements
Your assessment should also meet the following requirements:

• Length: 3–5 typed, double-spaced pages, not including the title page and reference page.
• Font and font size: Times New Roman, 12 point.
• APA tutorial: Use the APA Style Paper Tutorial [DOCX] for guidance.
• Written communication: Use correct spelling, grammar, and punctuation.
• References: Integrate information from outside sources to include at least two references (the case study and an academic peer-reviewed journal article) and three in-text citations within the paper.
• APA format: Follow current APA guidelines for in-text citation of outside sources in the body of your paper and also on the reference page.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• Competency 1: Apply information literacy and library research skills to obtain scholarly information in the field of health care.
  • Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
• Competency 3: Apply ethical principles and academic standards to the study of health care.
  • Summarize the facts in a case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
  • Discuss effective communication approaches the provider can use to address the issue in the case study.
  • Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
• Competency 4: Write for a specific audience, in appropriate tone and style, in accordance with Capella’s writing standards.
  • Discuss the effectiveness of the communication approaches present in a case study.
  • Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
  • Write following APA style for in-text citations, quotes, and references.