Professional, Ethical, and Legal Responsibilities Flashcards
Joseph Juran’s Quality Improvement Process (Four-Step Method of Change)
- Defining the project and organizing.
- Diagnosing (analyzing problems, formulating theories, etc.)
- Remediating (consider alternative solutions while addressing institutional resistance to change).
- Holding (evaluating performance and monitoring the control system.)
Title II, Controlled Substances Act of 1970
DEA aggressively monitors substances with the highest potential for abuse. Schedule 1 is highest abuse potential, Schedule 5 is the lowest abuse potential.
Federal Analogue Act of 1986
Enacted to treat substance analogues, or any substance with chemical structures substantially similar to controlled substances, as Schedule I or II, provided the substances are intended for human consumption.
Synthetic Drug Abuse Prevention Act of 2012
Classified certain synthetic, or designer drugs as Schedule 1.
Schedule I
Drugs with highest abuse potential, can cause severe dependence, and have no medical use (heroin, LSD, marijuana, ecstasy).
Schedule II
Higher abuse potential than Schedule III and lower abuse potential than Schedule I (cocaine, meth, oxycodone, fentanyl.)
Schedule III
Moderate to low abuse potential (anabolic steroids, codeine, ketamine, testosterone.)
Schedule IV
Low potential for dependency (Xanax, Ativan, Ambien, Valium, Tramadol).
Schedule V
Lowest potential for abuse or dependency (Robitussin, lomotil, Lyrica, Parepectolin.)
Omnibus Transportation Employee Testing Act
1991, mandatory drug and alcohol testing for employees in safety-sensitive job positions (truck drivers, ferry operators, airplane pilots, bus drivers, etc.)
Duties of a DOT SAP (Substance Abuse Professional)
-Assessment
-Clinical evaluations and tx recommendations
-Outside referrals when warranted
-Tx goals and objectives
-Face-to-face follow up evaluation
-Review progress
-Determine employee’s overall compliance
Informed Consent
The process of fully informing clients about the inherent risks, limitations, and benefits of treatment, including the rationale for selecting specific treatment, other treatment options, and cost.
Can consent be revoked at any time?
Yes, for court-ordered and mandated clients as well.
If clients are mandated to receive treatment, is informed consent to disclose confidential info needed?
Yes
Rights and responsibilities of provider and client
- Receive respectful tx
- Ask questions
- Terminate counseling at anytime.
Subpoena
Confidentiality can be broken, provider can consult with attorney.
Safety and Welfare of Client
Counselors are legally mandated to protect this. When a counselor suspects a client is a danger to themselves or others, elder abuse or child abuse, counselors must report suspicions to authorities.
Medical emergency
Counselors may disclose confidential info.
Commit a crime
If a client poses a serious threat to public safety, confidentiality must be breached.
Charges against counselor
If a client brings charges against a counselor, the client waives privilege and protection of confidential info.
Title 42 of the Code of Federal Regulations (CFR), Part II
Requires written consent to disclose protected health information.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
Protects personal and identifiable health information and confidential records.
Virtual private network
Protects private data sent through public platforms with two-factor identification methods.
Encrypted Platforms
Data is converted into encrypted code to keep info secure and protected.
Media Sanitation
Disposal of client information (permanently destroyed through an irreversible process.)
Autonomy
The freedom of a person to control the direction of their life without force or coercion; each individual has the right to make decisions for themselves.
Obedience
The obligation to follow legal and ethical directives and mandates, including federal and state laws and the regulations of the counseling profession.
Conscientious Refusal
The obligation to refuse illegal and unethical directives; to act in a manner that prevents the maltreatment of oneself and others.
Beneficence
The desire to help others by promoting the well-being of those served; to act in the best interest of others.
Gratitude
The need to show appreciation by passing along the good that was freely received from others; the duty to give back.
Competence
The requirement to practice in a manner that reflects an understanding and application of the current treatment modalities, theories, and key addiction treatment philosophies.
Justice
The obligation to treat others in fairness, to show equitable treatment by supporting equal access to services.
Stewardship
The responsibility to appropriately, effectively, and judicially allocate available resources to those in need of help.
Fidelity
Honor promises.
Diligence
Obligation to provide service that are efficient, prompt, and thorough.
Nonmaleficence
Do no harm.
Restitution
Make amends when necessary.
Organizational Ethics
Helps providers determine acceptable practices, ensure universal accountability, and monitor compliance with identified standards of care. May not always conform to governmental or regulatory laws.
Professional Ethics
Provide rules of conduct designed to protect the general public, create accountability, enhance tx practices, mitigate risk, and minimize internal discord.
Principle ethics
Rational, intuitive, objective, fair and impartial
Virtue Ethics
Defined by one’s character, internal motivations, and intentions.
Mandatory ethics
Dictated by minimal standards of conduct and guided by regulatory laws and practices (confidentiality, privacy, and mandated reporting.)
Aspirational Ethics
Am I using the highest quality of care available at this time, in this circumstance, with this particular client?
Positive ethics
Guides practitioner’s in going above and beyond the call of duty to maximize client benefits and minimize client risk. “How can I be the best support or resource for this client?”
Value ethics
Guided by one’s morals, core beliefs, and actions. “What do I personally believe to be the best option in this situation?”
Code of Ethics Principle 1, 1-9
- Treat clients with respect and dignity.
- Never condone discrimination.
- Right to privacy.
- Informed consent/confidentiality
- Mandated clients/ROI
- Relationship not moved beyond standard parameter.
- Consultation and Supervision
- Need for termination.
- Refrain from abandonment.
When should an AP disclose payment fees?
Before the client’s initial session.
Can AP’s withhold records or reports for nonpayment of services?
No.
When can an AP engage in bartering?
- If client requests it.
- When it does not cause harm or exploitation.
- If it does not compromise counseling relationship.
- If state and federal law allows it.
- If a written contract is provided that stipulates fair market value of the items/# of sessions provided.
What situations are disallowed for personal profit?
- Self-referrals
- Commissions
- Enterprises
- Gifts
Communication
AP’s must communicate in a culturally and developmentally appropriate manner. Any cultural concerns related to the client’s related to the client’s ability to grant informed consent must be documented.
Treatment Planning
AP’s must collaborate with clients. TX plans must be updated and revised at regular intervals to ensure successful provision of services.
Level of Care
AP’s must make every effort to provide clients with effective and appropriate treatment interventions.
10-Step Ethical Decision Making Model (NAADAC)
- Identify the problem.
- Apply the code of ethics and laws.
- Consult with supervisors.
- Generate potential and reasonable course of action.
- Evaluate each option.
- Implement course of action.
- Document each step of decision-making process.
- Analyze.
- Reflect on the outcome.
- Reassess.
Ethical Relativism
No fixed principles of right and wrong, decision-making considers context and consequences and varies from person to person.
Ethical Absolutism
There are fixed moral and ethical standards. Ethical codes are to be taken literally.
Clinical Pragmatism
Considers the practical and moral consequences of decision-making and establishes such grounding thru interpersonal assessment rather than absolute truths.
Humanistic Ethics
Uses critical thinking skills and evidence to resolve ethical dilemmas and help individuals reach their highest potential.
Situational Ethics
No universal doctrines for what is right and wrong, solutions are reached by evaluating each situation on a case-by-case basis.
Religious Ethics
Moral principles based on religious teachings.
Van Hoose and Paradise Conditions for Ethical Behavior
- maintain professional honesty
- best interest of client
- w/o malice or personal gain
- justify actions based on current state of profession.
Foundational Principles of Ethics
Autonomy, justice, fidelity, beneficence, and non malfeasance.
3 Key Attributes of Ethical Decision-Making: Commitment
Remain steadfast in the process of ethical decision-making and remain absolute in this purpose no matter the personal cost.
3 Key Attributes of Ethical Decision-Making: Competency
Have the capacity to gather relevant information, generate alternative solutions, understand risks, and choose an appropriate course of action.
3 Key Attributes of Ethical Decision-Making: Consciousness
Approach ethical dilemmas with intentionality and mindfulness and apply moral principles to ethically responsive actions.
6 Components of Ethical Maturity
- Moral character and watchfulness
- Match an ethically oriented action with internalized ethical principles.
- Courage
- Avoidance of wrongdoing and defend actions.
- Be at peace w/decisions.
- Self-reflection
When should an AP review mandatory disclosures?
Before initiating service.
How should an AP present informed consent to a client?
In written document and thru verbal review, in clear language.
When should an AP review confidentiality with a client?
Before initiating treatment and on an ongoing basis.
Privilege
Protecting confidential info in legal proceedings.
SOAP Documentation
Subjective, objective, assessment, and plan
DART Documentation
Description, assessment, response, and treatment plan.
Principle III
Client’s right to competent treatment, including having a provider who is loyal, respectful, and free from discrimination and bias.
Professional impairment
Loss of functioning that would cause harm to the client or others.
How can AP’s engage in advocacy efforts?
Legislative processes, public forums, and academic settings.
Cultural Competency
Seek knowledge and understanding of diverse cultural beliefs, attitudes, norms, traditions and behaviors.
Cultural Humility
Other-oriented and accepting. Remain teachable, open, self-critical, and receptive to new and challenging ideas and perspectives.
Cultural Sensitivity
Adapt communication and behavior in a manner that is accommodating and accepting of each client’s cultural heritage, customs, norms, and values.
Microaggressions
Form of covert discrimination and racisms that evolve from underlying biases.
Principle V in NAADAC Code of Ethics
- Instrument (tool used for assessment)
- Usability (level of ease)
- Validity (instrument’s accuracy.)
- Reliability (Consistently measure what it intends to measure.
Synchronous Services
Take place in real time and involve interactive communication. (texting, IM, online chatting, RT video-based services, land-line, mobile phone)
Asynchronous Services
Do not take place in real time, instead, they involve alternative modes of distance counseling. (Emailing, faxing, texting IM, intranet services, discussion forums.)(
Technology Assisted Care (TAC)
Offers delivery options through the continuum, beginning with intake thru termination.
Direct liability
Results from the supervisor neglecting their role in the decision-making process as evidenced by not making a reasonable effort to supervise.
Vicarious Liability
Results from the supervisee’s dereliction of duty. Supervisors must remain vigilant for any potential acts of violence by each supervisee’s clients and understand the duty to warn process.
