Ethical and legal

Question 1

Where in COE does confidentiality come under

Answer 1

Principle 1 Respect for the Dignity of Persons and Peoples

1.6 privacy and confidentiality

Question 2

What acts (legally) associated with confidentiality

Answer 2

Privacy Act and Health Information privacy Code

Question 3

What is confidentiality

Answer 3

• Promote a persons right to privacy
• Do not disclose personal information without informed consent
• Only collect info that is needed
• Inform what will do with info
• Store, discard to keep privacy

Question 4

Limits to confidentiality + where in COE

Answer 4

COE Principle 1.6

• Warn others
• Abuse of child
• Public safety
• Harm to self or others
• Court orders
• Supervision/ Team setting

Question 5

Descretion to warn vs duty to warn

Answer 5

• DISCRETION to warn (not DUTY to warn)
• will still be held accountable for professional negligence so still a duty
• Protected against legal action by the client if we warn from serious threat by rule 11

Question 6

importance of children

Child abuse: what act, section numbers and what COE -

Answer 6

• Principle 1.5 – Principle 2.5
• Advocate for the young person
• Welfare for young person takes precedence
• Oranga Tamariki Act 1
• Section 14: Risk = serious harm, suffering or likely to suffer, neglect – unable to care for child, child behaving in harming (even mental or emotional) to others, or child committed series offence
• Section 15: report to = chief executive or police
• Section 16: immunity from consequences for reporting

Question 7

What is the purpose of COE

Answer 7

• Unify practices of all professions
• Helps in decision making
• For public to know what to expect

Question 8

What is informed consent + where in COE

Answer 8

COE Principle 1.6 / mental health act (right to make informed choice)
* Aware of assessment, intervention, results, duration, purpose, benefits, risks
* Consent is given voluntarily
* The client has the capacity to consent
* Evidence for consent
* Opportunity to clarify

Question 9

What about a child and informed consent?

Answer 9

• Same as above +
• language they will understand
• environment they feel comfortable
• Ample opportunities for questions

Question 10

Who can consent

What is consent-based off

Answer 10

Who can consent
* No age of consent
* Competent – all deemed competent unless incompetence established

What is consent-based off
* Ability to consent = age, maturity, complexity of service, alcohol intake, pain, distress, brain injury, interest level of child, language memory attention (ability of neuropsychic tests to establish competence remains unclear),
* Court says: comprehend and retain important info about treatment, can believe it, can weigh the risk and need and arrive at a choice, can communicate a decision

Question 11

What if child cant consent

Answer 11

• Guardian of the child consents (no legal requirement to have both consents)
• Both guardians should consent if one doesn’t the other can make an appeal to the court – not a legal guideline for the psychologist to gain consent from both guardians but good practice to discuss consent with both parents

Question 12

What if Refusing treatment + where in COE

Answer 12

• Right to refuse treatment
• Often courts find a child incompetent to refuse treatment and give it any way…even if child and parent disagrees
• E.g.; Teenagers with anorexia refuse treatment - The judge held that although she had sufficient understanding to make an informed decision, the judge had the inherent power under his or her parents patriae jurisdiction to order the treatment be given

Question 13

How are records shared + what principle in COE

Record keeping + what principle in COE

Answer 13

How are records stored and shared – principle 2
- Parents don’t have the right to child’s medical health records
- If other health providers want info then ask the client

Record keeping – Principle 3
- Can’t carry identifying records unless pandemic EQ etc then need extra caution

Question 14

Conflict of interest + what prinicple in COE

Answer 14

Principle 3.4

• recognise that conflicts of interest are a threat to the integrity of relationships.
• seek to avoid relationships that might present a conflict of interest.
• Where unavoidable, psychologists identify any real or potential conflicts of interest and take all reasonable steps to address the issue in the best interests of the parties.

Question 15

What is professional misconduct

Answer 15

Professional misconduct
- Abusing clients
- Having a personal relationship with clients – this obviously includes sex but would also include dating, etc
- Practising under influence of drugs or alcohol
- Failing to provide adequate information on a procedure
- Poor record keeping
- Breaches of confidentiality: unless public interest duty over-rides confidentiality contract
- Practicing outside of one’s area of competency
- Not adhering to the scientific literature on empirically validated treatments
- Exploiting work relationships to further own personal or business interests
- Calling yourself a psychologist if not registered
- Releasing test questions of psychological assessment tools

Question 16

Maintain appropriate boundaries - where in COE

Answer 16

– Principle 3.3

Question 17

How to protect against professional misconduct

Answer 17

• Supervision
• Reflective practice
• Transference / countertransference
• Competency

Question 18

Competence + COE

Competence informed through + COE

Cultural competence + COE

Ones values stress etc + COE

Answer 18

Competency – Principle 2.2
- attain and maintain knowledge and skills
- Recognise limits – only provide service where competent
- Can justify decisions in light of current psychological knowledge and standard practice

informed through - Principle 4.1
- relevant reading, peer consultation, and continuing education

Continual cultural competency – 4.2
- seek appropriate training regarding customs and culture of the group with whom they are working.

how ones stress values etc influence - Principle 3

Question 19

Regular supervision COE

Answer 19

Principle 2.2

Question 20

Aware of how individual factors (stresses, values, beliefs) influence work - COE

Answer 20

– Principle 2.2 + 3.2

Question 21

Accountability + COE

Answer 21

4.4

Question 22

Principle 1

MOSES/ PAUL

Answer 22

Respect for the Dignity of Persons and Peoples
1.1: General Respect
1.2: Non-Discrimination
1.3: Relationships between Maori and non Maori
1.4: Sensitivity to Diversity
1.5: Children/Young Persons -
1.6: Privacy and Confidentiality-
1.7: Informed Consent

Question 23

Principle 2

DANIEL

Answer 23

Principle 2 Responsible caring
2.1: Promotion of Wellbeing- do no harm (sexual rela with clients and supervisees not permissible)
2.2: Competence- recognise limits to own competency, rely on scientific knowledge/evidence, maintain up to date skills, reflect on own biases/values and how they influence work with client
- Common law eg if therapist didn’t show duty of care and client is harmed - Negligence
2.3: Active Participation
2.4: Vulnerability
2.5: Children/Young Persons- take account of the developmental level of children/young persons and do not exploit them in any way
2.6: Well-Being of Human Research Participants
2.7: Animals

Question 24

Principle 3

JOSEPH

Answer 24

Principle 3 Integrity in relationships
3.1: Honesty
3.2: Personal Values
3.3: Structure of Relationships- maintain appropriate boundaries with those with whom they work
3.4: Conflicts of Interest- conflicts of interest are a threat to the integrity of relationships (inc sexual rela), seek to avoid dual relationships & do not exploit any work relationship to further their own personal or business interests and consider power differential

Question 25

Principle 4

NATHAN/ELIJAH

Answer 25

4.1: Welfare of Society - up to date with society, speak out in a manner consistent with the four principles of this Code, when they possess expert knowledge that bears on important societal issues
4.2: Respect for Society
4.3: Benefit to Society - protect psych knowledge and skills from being misused my incompetent others
4.4: Accountability, Standards and Ethical Practice

Question 26

1.5: Children/Young Persons

Answer 26

1.5: Children/Young Persons - best interest of child
- Children Young Persons and their Families Act (1989) allows reporting of any suspicion of maltreatment/neglect/abuse of child under 17 to OT or police, gives protection to reporter, reporting is not mandatory

Question 27

1.6: Privacy and Confidentiality-

Answer 27

1.6: Privacy and Confidentiality- inc who info shared with, notes, and limits eg supervision, team setting, diminished capacity (eg child), urgent need (risk self or others), legal requirements
- Privacy Act: the use, disclosure, and storage of personal info, and access to personal info (consider telehealth)
- Health Practitioners Competency Assurance Act: If psych is being investigated need access to their files
- Legal eg notes/reports being subpoenaed
- Breach confid: eg Tarasoff Case - set precedent that psychs have to disclose imminent harm (duty to warn in US), but in NZ (Discretion to warn) not required by law to disclose, but protected if we do by Information Privacy Code (but if we don’t and harm arises we may be considered negligent)
- Amendment to Privacy Act- If you know the likelihood, severity of consequences and time it which threat may be realised - disclose
- Privilege (owned by client not psych, client can override): when some info (confidentiality) is allowed to be maintained in court (Wigmores principles eg benefit of releasing the info does not outweigh risks/negatives of sharing privileged info)

Question 28

1.7: Informed Consent-

Answer 28

1.7: Informed Consent- right to withdraw, consent to provide or obtain info from others, & competent to consent - Gillicks competence inc ability to comprehend, believe it, weigh up info & communicate decision (no age). Exceptions- diminished capacity (ID, psychosis, AOD, meds, age etc), urgent need, legal requirements
- Code of Health and Disability Services Consumer Rights: Right to be fully informed (explanation of condition, risks, costs and benefits of options, results of tests, and any info participation in research)
- NZ Bill of Rights - everyone has the right to refuse treatment (but competency is assumed - need check they are competent to refuse treatment - criteria is under Health and Disability Services Code)
- Court Gillick case (determine who is competent)
- Care of Children Act 2004: No age of consent
- If not competent to consent- aim get informed assent and consent from other eg parent, appointed welfare guardian or enduring power of attorney, if emergency and no-one to consent can provide services if meet criteria eg best interest and think consistent with choice they would make if they were competent

Question 29

2.2: Competence-

Answer 29

2.2: Competence- recognise limits to own competency, rely on scientific knowledge/evidence, maintain up to date skills, reflect on own biases/values and how they influence work with client
- Common law eg if therapist didn’t show duty of care and client is harmed - Negligence

Question 30

3.4: Conflicts of Interest-

Answer 30

3.4: Conflicts of Interest- conflicts of interest are a threat to the integrity of relationships (inc sexual rela), seek to avoid dual relationships & do not exploit any work relationship to further their own personal or business interests and consider power differential

Question 31

2.1: Promotion of Wellbeing-

Answer 31

2.1: Promotion of Wellbeing- do no harm (sexual rela with clients and supervisees not permissible)

Question 32

3.3: Structure of Relationships

Answer 32

3.3: Structure of Relationships- maintain appropriate boundaries with those with whom they work

Question 33

ACT/BILL

right to refuse tx

override right to refuse tx

informed consent

Answer 33

Bill of Rights Act 1990 – Everyone has the right to refuse medical treatment

Mental Health Act 2004 – Can refuse BUT can be overridden

Code of Health and Disability Services Consumers Rights 1996 – Right to be fully informed, no age required. Competence assumed unless reasonable grounds for believing they’re not.