privilege & confidentiality cont. and ethical fallacies and pitfalls Flashcards
what is a fallacy
Logically invalid argument; appears logical and feels logical, but there is a lot of errors in reasoning; the brain is a powerful thing (brains try and help us make sense of a situation that makes no sense); same idea of PTSD
some example of cutting ethical corners
-Reading the law and going by the law
-Going with someone of a higher status
-Not considering alternatives
-Doing what requires less of you
-Tired, fatigued, stressed
what is bias and how does it impact ethical judgment
Something that impacts your judgment
How does bias impact ethical judgment
-Dictates what we think is important vs. unimportant
how to handle ethical fallacies
-Have to stop, pause and think before you begin to address question
-Easy to fall into, automatic is so powerful
cognitive commitments
-Committed to the way we are thinking, not considering other alternatives
-Confirmation bias: looking for evidence that confirms what we are thinking
-Cognitive dissonance also plays out: uncomfortable in ethics because there is a value in it; we want a good grade and we have clients that we care about; uncomfortable to be wrong and want to avoid the feeling
authorities
Automatically go with what supervisor says
groups
Groupthink
-Have to learn to challenge the group consensus
hindsight bias
After you already know the outcomes, saying that you would have been able to make the best predictions
correspondence bias
Fundamental attribution error
-Attribute something more to person than the environment
false consensus
Tendency to believe that people think like we do, when in reality there might be another way of thinking
status quo bias
Not wanting to make decisions that lead to change
optimistic bias
Tendency to believe that our decisions have less weight than they actually do, “it’ll be fine”
narrative bias
Leads us to construct or believe narratives that explain why events happen by oversimplifying and overinterpreting
equality bias
We are socialized to believe that the right thing to do is to make decisions based on the principle of equality; but equality is insufficient and assumes an equal playing field
PA ethics code two provisions to disclosure/confidentiality
1) Psychologist may not disclose confidential information to a third party without the consent of patient
2) Psychologists can discuss clinical information with other persons clearly concerned with case if reasonable efforts are made to avoid undue invasions of privacy
-Psychologist can utilize clinical material in classroom teaching and writing when information is deidentified
-APA code mentions this as well
-Consultation/ group supervision
-When you are working with folks under the same laws as you, you can discuss but de-identified
what are some of the things you have to do to be HIPAA compliant
Must provide information to patients about their privacy rights (notice of privacy practices)
Permit patient access to records
-Allowed to see everything, but you are not required to hand everything over; does not mean you need to give everything over, but you just have to let them see it
-Process notes are not a part of the record, unless someone subpoenas you; have to have a system of shredding them so you are not caught with them
Obtain patient authorization for use and disclosures to others
Implement clear privacy procedures for electronic transmission and data storage
Designate privacy officer
Implement security procedures
Train employees in compliance
Reasonable ensure that business associates etc. comply with privacy transition rules
Correction of potential violations (privacy officers role)
what is useful to include in an ROI
Required by HIPAA and Pas mental health procedures act
-Name of patient
-Name of agency or individual releasing information
-Name and title of individual or agency receiving information
-Expiration date or condition under which release expires
-best practice to have an expiration date
-You will not know someone later; what would you do if someone comes to you with information and you are not actively seeing them, call client and see about releasing information?
-Discharges do not always indicate release
-Rule is around releasing information, not taking information
-Identification of information to be released
-Signature of patient and date (parents and sign for children under 14 and personal representative or guardians for adults who are declared incapacitated around healthcare)
-Other mandated language
-Other discretionary information (e.g. two signatures if patient is physically unable to sign, limitations to release)
Would be helpful to also include how information will be shared
ROI for assessment reports
-Depends who your client is, if it is a forensic case you are not giving it to the person you are assessing
-Do not give raw scores
laws included in HIPAA surrounding releases
-Patient may have right to obtain copy of records
-Institutions or treating practitioner may own the physical records themselves
-Debate around complete access to records and raw data due to potential harm
-Requires access to PHI but does not require access to psychotherapy notes
APA ethics code and releases
Does not explicitly state that patients have rights to their records
PA law and releases
Mental health procedures act
-Drug and alcohol settings: patients have right to inspect entire record
-Institutional setting: project director may remove portions of record prior to inspection if the director believes information may harm patient
-Patients can appeal decisions to limit information
Inpatient and publicly funded licensed outpatient mental health centers
-Right to inspect records unless director believes
-Disclosure of specific information concerning treatment will constitute substantial detriment to the patient’s treatment
-When disclosure of specific information will reveal the identity of persons or breach the trust or confidentiality of persons who have provided information upon an agreement to maintain their confidentiality
-E.g. family or couples cases
-Patients can always appeal
how to handle HIPAA in group practices
All staff are formally trained in HIPAA regulations
Staff must sign an employee confidentiality form
Emails and fax coversheets communicating PHI must indicate “confidential”
Fax policy posted by fax machine
-Have to have confidential on the top or first page of the fax
All vendors must sign contract with practice
Officer manage who oversees HIPAA authorizations, completion, and maintenance of records, receives complaints and applies sanctions
Information can be shared internally without consent
PA ethics codes does not have rules around independent practice
things to consider about confidentiality
HIPAA privacy and security rule
PA ethics code principle 5
APA ethics code standard 4
PA state laws
Also need to consider
-Psychologist’s role
-Purpose of the psychological activity
-Legal status of the person with whom the psychologist is working
-Institutional and organizational policies
electronic media and confidentiality
Being knowledgeable about and obtain technical assistance in employing appropriate methods for protecting confidential records
Recording audio, video, or digital images
-Store recordings in safe locations, passwords to protect access
-Distort voice or mask faces when possible
-Proper measures to destroy recordings when no longer needed
-Reformatting flash drives
-Eraser for PCs
-File Vault 2 for Mac
