Module 4 - Confidentiality and Diverse populations Flashcards
What standard does documentary material need to meet in regard to consent
Must reflect conditional nature
What are the basic principles of consent?
- Informed
- Voluntary
- Rational
What do you do when client lacks competence
Fully inform clients regardless of competence (A.3.)
When is limited competence excepted?
- explicit waiver in advance;
* when not reasonable e.g. small children (A.3.1)
What is a mature minor?
ability to understand the nature of the proposed services;
their level of cognitive development, including:
o their perceived capacity to comprehend the reasonably foreseeable consequences of accepting or refusing the service being offered; and
o the benefits and risks associated with the service;
and whether they have a Medicare card in their own name.
What should you do when a client is impaired?
assent to provide service should be secured (A.3.7).
Can obtain consent from someone else with legal authority (A.3.6)
What is the client’s right to know according to Pomerantz and Handelsman?
- psychologist’s professional orientation;
- background and experience as a psychologist;
- alternative professional orientations;
- arrangements regarding appointments;
- limits of confidentiality;
- fees and charges; and
- insurance arrangements and rebates.
What info does Pryor recommend providing to client?
• the nature and extent of the professional services to be provided;
o including the preparation and provision of reports;
o exactly who will be providing the services;
o the professional qualifications and affiliations of service providers;
o the purpose and rationale for the service and criteria for evaluating service outcomes;
• the provider’s expectations of clients, including homework and other preparation required for consultation sessions;
• the likely costs of the service;
• the client’s right to withhold information and to question the relevance of procedures used in service delivery;
• what will happen to any personal, assessment or evaluative information gathered in the course of service delivery;
• the limits of confidentiality, including conditions under which information may be made available to other appropriately qualified professionals; and
• appropriate means of complaint or redress if the client is dissatisfied with service delivery or outcomes.
What are the two components of privacy?
- The right to be left alone
2. The right to control personal information
What does the CoE say in relation to privacy?
- Collect information only related to agreed upon service (A.4)
- Obtain consent from associated (A.7)
- Use info for primary purpose it was collected (B.5.5)
- Clients can waive to use info for secondary purpose (A.5.5(a))
- Duty to protect clients’ privacy during disclosure (A.5.4)
- De-identified client data to researchers (A.5.5.(b))
- Adequate client records (B.2)
- Correct inadequate records (B.2.4)
- Do not refuse reasonable requests from clients for information (A.6)
What does confidentiality refer to?
Keeping secrets
What does the CoE say in relation to confidentiality?
- Information must be handled in a way that it is protected (A.5.1.(a))
- Duty continues until after termination of services and death of client (Jifkins, 2009)
- Take reasonable steps to protect clients after ceasing services (e.g. retiring or own death) (A.5.1(b))
What superscedes the requirement to maintain confidentiality?
legal requirements to disclose (A.5.2(a))
Is there a legal duty to report suspected child abuse/criminal activity/suicide
In most jurisdictions, yes
When does the moral duty to disclose to avert immediate and specific risk of harm to identifiable persons arise?
- It arises in situations where clients are at immediate, specific risk of harming themselves (Australian Psychological Society, 2008b);
- the psychologist or others (Australian Psychological Society, 2008c);
- It applies in jurisdictions where reporting suspected child abuse and neglect or other injurious criminal activity is not mandated (Australian Psychological Society, 2008a).
What is Ross’ prima facie duty?
• “It might be said that besides the duty of fulfilling the promises I have and recognise a duty of relieving distress, and when it is right to do the latter at the cost of not doing the former, it is not because I think I shall produce more good thereby but because I think it [relieving distress] is the duty which is in the circumstances more of a duty.”
When must you disclose?
- With the consent of the relevant client or a person with legal authority to act on client’s behalf.
- Where there is a legal obligation to do so.
- If there is an immediate and specific risk of harm to identifiable person/people that can be averted only by disclosure.
- Or when consulting with colleagues in the course of supervision/training where identities are concealed or the client consents.
What factors should you consider in breaching confidentiality?
- Circumstances
- Level or risk or harm
- Who to inform
- How much to disclose
- Is info de-identified
What factors identify a risk of violence?
- Active symptoms of serious mental illness (particularly command hallucinations)
- Impulsivity
- Lack of insight and/or disconnection from reality
- Lack of empathy or remorse
- Poor response to treatments such as anxiolytics.
What categories of suicide risk exist?
- Those who are chronically ill, in chronic pain, seriously disabled, or in extreme poverty; where the common factor is hopelessness
- Those who have suffered severe trauma and may be in a state of chronic depression
- Those who exhibit suicidality as a ‘last resort’ to express their pain.
What are alternatives to disclosure?
- Intensify treatment
- Recommend inpatient treatment
- Direct control
What are levels of culture?
- Personal
- Interpersonal
- National
- Universal
What is the four step model for reflective writing (Baker, 1996)?
Identification
Description
Significance
Implications
What general principle governs informed consent
A - Respect
What general principle governs confidentiality
C - Integrity
What does Brock suggest instead of informed consent?
Shared decision making
What is the individual right to exercise their role in decision-making
Autonomy
What right to autonomy do psychologists have?
protection from undue harm that might results from client’s actions