Problem 1
As a psychologist, Mr. J should concern whether he should release or keep the client’s privacy and confidential to the deceased client’s brother-in-law, due to relationship quite closely with a client while who is an author and Mr. J cannot refer permission from the deceased client.
There is a potential ethical issue relevant to this vignette is privacy and confidential (APA, 2010).
As a psychologist has the right and responsibility to protect client’s confidential and welfare to achieve the client’s interest. While the client has the right to freely disclose the personal information by himself or appointed a legal representative to release the privacy and confidential mandated by federal law (McConnell & Larson, n.d.). The third party such as the deceased client’s family member should follow the mandated by law with relevant ethical code and decision making from the psychologist and judicial section (McConnell & Larson, n.d.).
There is two ethical code can be relevant in this vignette which is Standard 4.01 Maintaining Confidentiality and Standard 4.05 Disclosures (APA, 2010). Ethical Standard 4.01 (APA, 2010) permits psychologist should take responsibility to keep confidentiality and acknowledge the limitation of confidentiality followed by the relevant law to the people they served. On the other hand, a psychologist can disclose the confidentiality to people who are legally authorized by law (APA, 2010, Standard 4.05).
The psychologist will maintain the privacy and confidential done by the client and follow the relevant law (APA, 2010, Standard 4.01), if the client had made the legally authorized person, the psychologist may disclose to the person according permitted by law, (APA, 2010, Standard 4.05).
However, there is some issue should consider by a psychologist before he takes any action. A psychologist may reflect back the reason of the client come to seek him, but why not disclose to the family member? This can be the reason the client want to maintain his privacy and confidential protect by the law and if psychologist wants to release confidential from him, the psychologist needs to get permission for him accordingly state law (Grossman & Koocher, 2010). For example, HIPPA takes care the client’s confidential with well managed by only allow the patient alone or legal authorize a person to review the relevant medical records, it can enhance the sense of security client to received treatment from a psychologist (Mir, 2011).
Furthermore, in this case, the client’s legal authorize person can obtain the confidentiality of client by state law. But the psychologist may reject to disclose the relevant information to the deceased client to the legal authorize person due to take care the benefits of the client by followed the relevant judicial (Grossman & Koocher, 2010). For example, the psychologist should evaluate release the confidential of the client will bring more harmful or benefits to the client if the author release client’s privacy and confidential in the book.
A psychologist may evaluate the cost of effect to decide to continue to keep confidential of a deceased client if it will more bring benefits to the deceased client. Although the family member to seek the psychologist to obtain more information from the deceased client, a psychologist not necessary to tell family member information of client but at the same time can communicate with them and comfort them for emotional support (Leslie, 2008; Grossman & Koocher, 2010). Apart from that, if released the confidential of a deceased client to the author, although he is client’s family member but it also hinder the potential risks to the deceased client due to publish a book is not only involved with the family member society but involved with outside of the boundaries of the family relationship. If the author misinterprets the information given by a psychologist, maybe the deceased client’s reputation will be affected (McConnell & Larson, n.d.). Hence, the death of client cannot argue and this may create more conflict between the family members and psychologist also need to face legal issue due to make an improper judgment and decision making.
On the other hand, if the family member still needs to obtain the confidentiality of deceased client, a psychologist may refer whether the death of client has appointed the legal representative by permitted by law. Besides these, psychology also needs to know about the ethical standard code and the federal law or state law to make a decision whether suitable to release the privacy and confidential of a deceased client. It is very differently from the different federal law and state law permitted by different areas. If this condition is permitted by law and can breach the confidentiality of deceased client, before breach the confidential, psychologist also need to evaluate the potential risks and benefits can bring to the consequences of the individual, family, and society although the client already dead.
A psychologist can obtain the information from deceased client’s family members ask about his family members’ opinions and communicate with the death of client’s brother-in-law about the book he wanted to publish relevant to the deceased client is a what kind of content and how details he wanted to know about from his past history. The psychologist should consideration the former client’s reputation and best interest and avoid any unpleasant issue relate to release confidentiality of deceased client between the family members. If every family members agree and allow the author use the deceased client’s information in the book, every family members should sign the informed consent to show their commitment agree and have the obligation to take the responsibility together in any circumstances they had promised before the authorized person can obtain the confidentiality of former client by legally. This is also a way that the psychologist can avoid any conflict when anything happens, the family members sued the psychologist, and psychologist cannot control the family members how to use the client’s privacy and confidential, it is a way can avoid any unfavorable consequences.
Maintaining confidentiality is a good practice for a psychologist to respect the human’s right and it is well-organized to ensure the privacy and confidential of the deceased client can continue, and it is protected by law and organization to avoid people to misuse the resource to create the personal conflict and interest.
Breach the confidentiality can create a lot of family members unethical issues, such as the author can use this confidential information of the deceased client for the personal purpose to earn money by selling the book, it can create exploitative the deceased client’s information and to fulfill personal interest rather than the deceased client interest. After breach the confidential information, there will create more issue and conflict situation rather than maintain confidentiality,
Based on current situation in vignette, the best course of action is maintaining confidentiality because from this vignette, that shown the author want to use the confidentiality of deceased client from personal purpose and without informing the deceased client previously, and it has potential to harm other family members and can create more conflict situation and it is unfair to deceased client. Maintaining confidentiality can avoid any issue happen and show respect to deceased client’s right.
Problem 2
As a psychologist, Mr. L faced the problem to collect the therapy sessions fees of the deceased client by considerate who can help death of client to clear outstanding of the fees and should he collect the therapy sessions fees from the deceased client’s brother-in-law and he is an author.
Mr. L faced the ethical dilemma, is it appropriate to collect the therapy sessions fees from deceased client’s brother-in-law due to he knew the former client had sought psychologist for therapy sessions and at the same time, who also want the ask for more information of the deceased client, as an author. Furthermore, if the psychologist does not disclose the detailed information of the deceased client, will he still can collect the outstanding fees from the family members?
In this vignette, there has a potential ethical issue is record keeping and fee (APA, 2010).
Ethical Standard 6.04 Fees and Financial Arrangements (APA,2010) permits psychologist should make the agreement relevant to issue of fees and financial arrangement between client before begin the therapy session.
As a psychologist, has the right to collect the outstanding therapy fees of deceased client which is permitted by law and allow to appoint the agencies of legal procedures to collect the fees, if the deceased client’s family members failed to pay and psychologist must inform the family members before allow third party to collect the outstanding fees and stated to the family members the procedures of involved third party will release the information of deceased client but it is only related to the basic information of deceased client (APA, 2010, Standard 6.04; Who pays when a patient dies?, 2009 ) .
Whereas the deceased client had promised to pay the therapy fees in the informed consent and agreement, can be the responsibility of deceased client need to take responsibility to pay the unpaid therapy fees and if he failed to do so, he also had appointed the contact person to need to contact if emergency happens or legal representative to take behalf the responsibility in the informed consent with the psychologist.
The deceased client’s legal representative need to take the responsibility follow the informed consent had made by the deceased client as mandated by law. Otherwise, the deceased client’s wife need to take the responsibilities to help client clear the unpaid fees accordingly the marital property laws permitted by the state or federal. (Who pays when a patient dies?, 2009). If not above of the parties take the responsibility to paid the fees, the family members such as the brother-in-law can be considered to ask for paid since he knew the client attend the therapy session from the psychologist.
In this situation, a psychologist can contact the deceased client’s legal representative to collect the unfinished payment make by deceased client accordingly the agreement has made. If the legal representative failed to pay the payment, the psychologist may give the grace period to the client to clear the payment or give the discount to the person to encourage them to make the payment as promised by the deceased client. If still cannot settle the payment maybe the psychologist should ask the deceased client’s wife to paid or his brother-in-law to paid. Since his brother-in-law knew the deceased client had sought the therapy sessions and cannot denial it, but at the moment, psychologist should also keep confidential of deceased client and if the author wants to pay the payment the psychologist just released relevant information with the payment but not mention which types of therapy provider to deceased client. If all family members refused to pay the payment, psychologist just appoints the agency or take legal procedures to collect the unfinished payment by deceased client had made mandated by law (Who pays when a patient dies?, 2009).
This is involved that all parties family members of deceased of client and psychologist should cooperate to achieve the best interest of the deceased client and through the compromise between family members.
The best course action is to collect the unfinished made by the deceased client according to his promised can finish his wish and take his reputation by not exploited his right and achieve his best interest by not violate any ethical code and mandated by law.
References
America Psychological Association. (2010). Ethical principles of psychologists and code of conduct with the 2010 amendments. Retrieved from http://www.apa.org/ethics/code/
Grossman, L. R., & Koocher, G. P. (2010). Privacy, confidentiality, and privileges of health records and psychotherapy notes in custody cases. American Journal of Family Law, 24(1), 41-50.
Leslie, R. S. (2008, November). Confidentiality/Privilege – Death of the patient. Retrieved from CPH and Associates: http://www.cphins.com/legalresources/bulletin/confidentiality
McConnell, A. L., & Larson, S. (n.d.). Protecting your privacy: Understanding confidentiality. Retrieved from American Psychological Association: http://www.apa.org/helpcenter/confidentiality.aspx
Mir, S. S. (2011). HIPAA privacy rule: Maintaining the confidentiality of medical records, part I. Journal of Health Care Compliance, 13(2), 5-14.
Who pays when a patient dies? (2009, June). Health care collector: The monthly newsletter for health care collectors., 23(1), p. 7.