Applying Ethical Principles

Applying Ethical Principles

Healthcare providers, especially mental health practitioners, are presented with cases that create complex ethical dilemmas. Mental healthcare providers are expected to apply the ethical decision-making model in their daily practice in order to navigate the complex ethical environment in their practice. This article provides an overview of a case study depicting an ethical dilemma in mental health practice, the ethical issues in the case study, the effectiveness of the communication approaches present in the case study, and the application of the ethical decision-making model and ethical principles to solve the ethical issues presented in the case study.

Overview of the Case Study

Case Study: Confidentiality and Mental Health

The selected case study explores the issue of confidentiality in mental health. The case study involves Dr. Laura Simmons, a licensed clinical psychologist, and her patient, Mr. Alex Turner, a 35- year-old software engineer. For the last six months, Dr. Laura Simmons has been helping Mr. Alex Turner manage his severe depression and anxiety (Capella University, n.d.). Dr. Laura and Mr. Alex have been able to establish a strong therapeutic relationship, as in each session, their communication is usually open and trustful. Mr. Alex usually shares his deepest fears and concerns with Dr. Laura.

In one particularly intense session, Alex openly revealed to Dr. Simmons the recurring thoughts he had been having of harming a colleague due to a longstanding professional rivalry and recent personal conflicts (Capella University, n.d.). Alex describes in detail the plans he has developed to harm his colleague and expresses a genuine intent to act on these thoughts. This revelation by Alex creates an ethical dilemma for Dr. Simmons. She values the principle of confidentiality, as it has created the foundation for the therapeutic relationship with Alex. Alex has always trusted her with his innermost thoughts. As Alex’s mental healthcare provider, Dr. Simmons understands that reporting Alex’s plans would break his trust in her and could potentially harm their current therapeutic relationship. At the same time, Dr. Simmons knows she is bound by the principles of beneficence and non-maleficence. Beneficence compels her to act in the best interest of her patient and those around him, while non-maleficence emphasizes the importance of “doing no harm.”

Ethical Issues in the Case Study

The ethical issue in the case study arises from the conflict between patient confidentiality and the ethical principles of beneficence and non-maleficence. In the case study, Dr. Simmons understands the importance of maintaining her client’s confidentiality. Care providers are ethically and legally required to keep private and safeguard the conversations they have with their clients as well as the information the clients entrust to them (Varkey, 2021). In this case, Dr. Simmons, despite her knowledge of Alex’s plan to harm his colleague, must ensure she maintains her client’s trust. At the same time, she has a duty and a legal obligation to report the information about Alex’s intentions to harm another individual to the relevant authorities. The law requires therapists to report cases to the right law enforcement authorities in which their clients might hurt themselves or someone else (Geiderman & Marco, 2020). Therefore, Dr. Simons must decide whether to safeguard confidentiality with Alex and maintain their good therapeutic relationship or adhere to her ethical and legal obligation, report Alex’s intentions, and protect both Alex and his colleague.

Effectiveness of the Communication Approaches Present in the Case Study

The communication between Dr. Simmons and Alex in the case study is characterized by trust and openness. Alex is comfortable sharing his deepest fears and concerns with Dr. Simmons, while Dr. Simons guarantees the confidentiality of all information shared during all sessions. Open and trustful communication is the first step towards the creation of a safe and open therapeutic environment, as well as a strong therapeutic relationship. Good communication is a big facilitator to the provision of patient-centered care (Kwame & Petrucka, 2021). However, the ethical dilemma Dr. Simmons faces after Alex tells her about his plans to harm his work colleague may indicate that there were gaps in their communication. In addition, this may mean that Dr. Simmons may have focused on communication that only focuses on creating a safe space for sharing but avoided telling Alex about the limits of their communication and confidentiality. Due to this failure to communicate effectively, she now risks either her client’s confidentiality or failure to adhere to her ethical and legal obligation to do no harm and duty to report.

Relating Dr. Simmons Approach to the Ethical Decision-Making Model

The three components of the ethical decision-making model are moral awareness, moral judgment, and moral action (Khursheed et al., 2019). In the case study, Dr. Simmons displays her moral awareness as she appreciates the existence of an ethical problem when Alex, her client, tells her about his plans to harm a colleague at work. On the other hand, her moral judgment is shown in how she considers the various ethical approaches and outcomes when choosing to report or not to report the case based on the information she has from Alex. She weighs between maintaining her patient confidentiality and deciding based on the principles of beneficence and maleficence. She does not display any moral action, as that would have been possible had she chosen a clear course of action. This will depend on the decision Dr. Simmons makes in her professional capacity.

Applying Ethical Principles to Provide a Solution to the Ethical Dilemma

Dr. Simmons openly shows that she adheres to the principle of confidentiality and understands her obligations to the safety of her patient and the people around him. The ethical dilemma in the case can be resolved by focusing on the provisions of the ethical principles as well as legal obligations. Notably, the ethical dilemma arises from the conflict between the principle of confidentiality and those of beneficence and non-maleficence. To resolve this dilemma, Dr. Simmons must weigh what is more beneficial. In this case, she must go by the principles of beneficence and non-maleficence, as it will be beneficial to Alex by protecting him from the legal consequences of harming a colleague and protecting the colleague from getting harmed.

Conclusion

In conclusion, ethical dilemmas, as observed from the case study on confidentiality and mental health, develop from the conflicts between the ethical principles of autonomy, beneficence, non-maleficence, and justice. The case study also highlights the complexity of ethical dilemmas in mental healthcare. It clearly shows the limits of confidentiality and how considerations of the weight of benefits of other ethical principles can help resolve complex ethical dilemmas in mental healthcare.

References

Capella University. (n.d.). Case study: Confidentiality and mental health. Capella.

Geiderman, J. M., & Marco, C. A. (2020). Mandatory and permissive reporting laws: obligations, challenges, moral dilemmas, and opportunities. Journal of the American College of Emergency Physicians Open, 1(1), 38–45. https://doi.org/10.1002/EMP2.12011

Khursheed, U., Sehar, S., & Afzal, M. (2019). Importance of ethical decision making; Application of James Rest Model. Saudi Journal of Nursing and Health Care. https://doi.org/10.36348/sjnhc.2019.v02i12.007

Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing, 20(1), 1–10. https://doi.org/10.1186/S12912-021-00684-2/FIGURES/1

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 healthcare professional by applying ethical principles. Describe the issues and a possible solution in a paper of 3-5 pages.

-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.

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, a solution to a specific ethical dilemma faced by a healthcare professional must be developed. In your assessment:

1. Select one of the case studies presented in Assessment 03 Supplement: Applying Ethical Principles [PDF]. Download Assessment 03 Supplement: Applying Ethical Principles [PDF]
   • 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.
2. 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 Modelmedia 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.

3. 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.
     • 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
       • Assess the credibility of the information source.
       • Assess the relevance of the information source.

4. Discuss the effectiveness of the communication approaches present in a case study.
   • Describe how the healthcare 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.
5. 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 healthcare professionals.
6. 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.
7. 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.
8. 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.