Ethics

Question 1

When do you report?

Answer 1

○ If you have a professional/privileged relationship you do not have to report (it is your client)
○ Oregon law-child abuse is required to be reported
Ethical code (may) require reporting for welfare

Question 2

Worldviews

Answer 2

Like sand in a picnic– it gets everywhere

Question 3

U.S. Legal System (order)

Answer 3

1. Federal (U.S. law, HIPAA)
2. States (ORS, OARS, state statutes)
3. Adjunction (Ethical codes, administrative rules)

Question 4

HIPAA

Answer 4

Applies to "anyone who provides health care and does electronic transmission of health care information". 
Domains:
-Application
-Compliance
-Enforcement
-History

Question 5

Consent

Answer 5

Good for 6 years, should include need to report

Question 6

Oregon Board of Psychological Examiners

Answer 6

An agency of the Oregon state government, goal is to “protect the public”. Advocates change, creates/enforces rules, receives complaints

Question 7

Ethical Standards (According to APA)

Answer 7

• Resolving ethical issues
• Competence
• Human relations
• Privacy and confidentiality
• Advertising and other public statements
• Record keeping and fees
• Education and training
• Research and publication
• Assessment
• Therapy

Question 8

Tarsoff duties

Answer 8

“The protective privilege ends where the public peril begins”

Question 9

Confidentiality with children

Answer 9

• Parental consent required
• Involve child in plan and treatment
• Work with child to determine what problems are disclosed with parents

Question 10

Multiple relationships

Answer 10

Not all are unethical; prohibited if it impairs objectivity, competence or effectiveness

Question 11

Therapeutic Contract

Answer 11

“It may get worse before it gets better,” Should discuss: problems, goals, methods, length/frequency, costs, risks, limits of confidentiality, cancellation provisions

Question 12

Malpractice

Answer 12

“the failure to fulfill the requisite standard of care: whether by omission or commission”, involves: duty, damage, deviaion, or direct link

Question 13

Privacy

Answer 13

Keep it to yourself

Question 14

Confidentiality

Answer 14

Limited sharing

Question 15

Privileged

Answer 15

Not shared in court

Question 16

General Principles

Answer 16

• Beneficience and non-maleficience
• Fidelity and responsibility
• Integrity
• Justice
• Respect for people’s rights and dignity

Question 17

Record keeping requirements

Answer 17

• Rx monitoring
• start/stop times
• type of therapy
• frequency, # of sessions
• results of clinical tests
• Summary of Dx, functional status, treatment plans, symptoms, prognosis, & progress to date.

Question 18

Abuse reporting

Answer 18

Mandatory for public officials with “reasonable cause” to a law enforcement agency; exception- do not have to report if information is privileged

Question 19

Risk Management Formula

Answer 19

Clinical risk= ((patient risk) x (context) x (disciplinary consequences))/ (therapist factors)

Question 20

Why is Oregon reporting different?

Answer 20

For a licensed psychologist working in Oregon, it is up to the discretion of the psychologist what would be best for the client’s well-being

Question 21

“Red Flag”

Answer 21

A rule that applies to “creditors” to signal risks of identity theft

Question 22

Implementing the “Red Flag” rule

Answer 22

• verify pt identity
• be alert for conflicting info
• have a plan to respond if red flag is detected
• manage service providers
• annually review program’s effectiveness

Question 23

Enforcement of the “Red Flag” rule

Answer 23

◊Civil fine of $100/ea up to $25,000/yr
◊ Criminal fines up to $250,000 up to 10yrs imprisonment for each violation
There is a move to more vigorous enforcement now

Question 24

What actions qualify as an abuse report

Answer 24

Professional misconduct
Child Abuse
Elder Abuse
Abuse of mentally ill and developmentally disabled

Question 25

Child Abuse Reporting

Answer 25

-Public or private official with reasonable cause to believe abuse has occurred and..

• -has contact with child or abuser
• -there is a mandatory report (unless it is privileged)
• reporting without permission is a breach of confidentiality

Question 26

False reporting

Answer 26

• Possible $1000 fine

- Class a violation

Question 27

Therapist’s legal aspects after reporting

Answer 27

• Get immunity from liability for good faith reporting

- Providers are required to cooperate with investigations

Question 28

What is professional misconduct?

Answer 28

• Conduct unbecoming a licensee
• is detrimental to the best interests of the public
• contrary to recognized standards of ethics of the licensee’s profession
• that endangers the health, safety or welfare of a patient or client

Question 29

Reporting Elder Abuse and Mentally Ill or Disabled Persons

Answer 29

• Require mandatory reports
• Privileged communications are exempt
• Welfare concerns may require reporting (elderly abuse)

Question 30

Disclosing client information

Answer 30

• Do not do it because of HIPAA/confidentiality
• Except:
• -with client permission
• -To personal representative, guardian, healthcare representative, personal representative
• -Within and among health care service organizations and with DHS, Corrections or OR Health
• -With consent for TPO

Question 31

TPO

Answer 31

Treatment, Payment and Healthcare operation