|Type of paper:||Essay|
|Categories:||Religion Ethical dilemma Sexual assault|
Irina’s case is an ethical dilemma because she together with her family refused medical evaluations for rape. Dr. Janet Mathews is in an ethical dilemma because of his role as a clinical psychologist who specializes in adolescent trauma, she is tasked with ensuring that she understands Irina’s condition and formulates a plan of treatment. However, in this case, Mathews will be unable to comprehend what actually happened in regard to a sexual assault because both Irina and her parents refuse a medical evaluation. Not to mention, Irina is from an Arabic culture, which further enhances the ethical dilemma, because of faith-based beliefs.
Some of the APA ethical principles that help to frame the nature of the dilemma include justice and respect for people’s rights and dignity. Fisher (2012) asserted that the principle of justice has the corresponding virtue of fairness. More so, regarding the ethical principle of respecting people’s rights and dignity, the author affirmed that its corresponding values are respect and consideration. Dr. Mathews is in an ethical dilemma because even though his work is to ensure adolescents overcome trauma, it will be difficult in this case because neither Irina nor her parents want her to undergo a medical evaluation for sexual assault.
State Laws on Treatment of Minors
Irina’s age and parent’s involvement in the referral can affect the way Dr. Mathews resolves the dilemma. Irina is only 13 years old, which makes her incapable of making decisions based on her health. Her parent’s involvement to refuse a medical evaluation for a sexual assault further complicates the case because Irina will be unable to get treatment if indeed a sexual assault happened.
State laws can affect the treatment of minors on the access of guardians to a minor’s health care record and influence Dr. Mathews's decisions. American Psychological Association (2007) articulated that state laws encourage psychologists to comprehend the consequences of gender socialization on factors such as race and their impact on mental health. Dr. Mathews needs to understand that the state laws constrain her to treat Irina because of gender-sensitive concerns. Furthermore, the HIPPA rule does not require the release of a patient’s records when the information is compiled because in the anticipation of a criminal proceeding (Fisher, 2012). In this case, Dr. Mathews could probe deeper into Irina’s sexual assault and not release her health records to her parents. Then the doctor could use her clinical expertise to ensure Irina heals from her ordeal.
Relevant APA Ethical Standards to the Case
Standard 2.01a requires psychologists to provide services based on their areas of competence (Fisher, 2012). 2.01b requires psychologists to understand factors such as age, gender, ethnicity, and religion while 2.01c tasks psychologists to have relevant information about their client’s population (Fisher, 2012). Arredondo and Toporek (2004) asserted that psychologists should be competent on cultural values and biases during interaction with clients. In the scenario, Dr. Mathews is a clinical psychologist who focuses on adolescent trauma. Looking at the circumstances, Irina faced trauma because of the trauma.
Standard 2.04 bases on scientific and professional judgments (Fisher, 2012). The author indicated that the standard applies to psychologists who issue public advice via platforms such as the Internet, media, television, and radio. In this case, the standard constricts Dr. Mathews from publishing Irina’s health information on media outlets.
Standard 3.04 deals with the way psychologists should avoid harm and take reasonable steps to minimize harm to their clients from diverse populations. American Psychological Association (2003) issues guidelines on multicultural education and organizational change. In the scenario, Dr. Mathews should be aware of Irina’s Arabic culture, and their concerns about a girl’s sexual purity and stigma associated with sexual assault. Zerr and Pina (2014) indicated that health beliefs are usually difficult to conceptualize because of factors such as stigma. Furthermore, standard 3.06 requires psychologists to refrain from having a professional role where personal relationships exist (Fisher, 2012). In this case, there is no conflict of interest because Dr. Mathews does not have a personal relationship with Irina or her family.
Standard 4.01 and 4.02 tasks psychologists with maintaining patient confidentiality and discussing the limits of confidentiality respectively (Fisher 2012). The standards limit psychologists from discussing patients’ information with other people who are incapable of providing informed consent. Furthermore, standard 10.10a requires psychologists to terminate therapy when the client is denying their services. Since Irina and her family deny medical evaluation for sexual assault, Dr. Mathews has the obligation to end the therapy.
Other standards that may apply is standard 3.10, which requires informed consent before treatment, and 4.03, which prohibits psychologists from recording their conversation with clients (Fisher, 2012).
Alternatives for Resolving the Dilemma
Dr. Mathews has alternatives for resolving the dilemma. Gallardo, Parham, Johnson, and Carter (2009) call for the need of integrating culturally responsive practices. The authors talked about negotiating a decision-making process to manage to treat the patient. Dr. Mathews could call both Irina and her parents and negotiate with them on the need for a sexual assault evaluation. This alternative, however, might be challenging because of informed consent. Vasquez (2012) affirmed that patients should not use clients for their needs and gratifications. Even though Dr. Mathews would like to help Irina achieve mental health, she will have to avoid probing into the sexual assault case because both her family and her did not provide informed consent. The alternative that best reflects the ethics code is to terminate treatment. The alternative reflects standard 10.10a, which requires psychologists to end therapy if the client does not provide consent for treatment. The best alternative, however, would be to negotiate with Irina and her parents about the need for treatment.
Steps to Ethically Implement and Monitor the Decision
The steps that Dr. Mathews should take to implement her decision ethically would be to have a meeting with both Irina and her family on the benefits of a sexual assault evaluation. The benefits that Dr. Mathews might mention include helping Irina to get justice and help identify any complications if a sexual assault occurred. Besides, Dr. Mathews should ensure that all health preparations are in place to provide Irina and her parents with sensitive information on the issue of diversity. The doctor should monitor the effects of her decision by first collecting information on the assault, then analyzing information on the assault and identifying patterns.
American Psychological Association. (2003). Guidelines on multicultural education, training, research, practice, and organizational change for psychologists. American Psychologist, 58, 377–402.
American Psychological Association. (2007). Guidelines for psychological practice with girls and women. American Psychologist, 62, 949–979.
Arredondo, P., & Toporek, R. (2004). Multicultural counseling competencies = ethical practice. Journal of Mental Health Counseling, 26(1), 44–55.
Fisher, C. B. (2013). Decoding the ethics code: A practical guide for psychologists. Thousand Oaks, CA: Sage.
Gallardo, M. E., Johnson, J., Parham, T. A., & Carter, J. A. (2009). Ethics and multiculturalism: Advancing cultural and clinical responsiveness. Professional Psychology: Research and Practice, 40, 425–435.
Vasquez, M. (2012). Social justice and civic virtue. In S. Knapp, M. Gottlieb, M.Handelsman, & L. VandeCreek (Eds.), Handbook of ethics in psychology (Vol. 1, pp. 75–98). Washington, DC: American Psychological Association.
Zerr, A., & Pina, A. (2014). Predictors of initial engagement in child anxiety mental health specialty services. Child & Youth Care Forum, 2, 151–164.
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