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INFORMED CONSENT Before a person becomes a client, he or she must consent to treatment. Obtaining consent precedes any treatment and recordkeeping. In order to consent to treatment, the client must first be made aware of what he or she is agreeing to become a participant in. Minimally, the client should be made aware of the who, what, when, and how. The qualifications of the professional counselor who will be treating the client should be clearly acknowledged. The particular goals of counseling must be identified, as well as the risks and benefits associated with counseling. When results, if any, may be expected and how financial considerations are arranged should be specified. A client’s consent to treatment can occur only after certain requirements are met, defined as the elements of informed consent (Bray, Shepard, & Hays, 1985; Schwitzgebel & Schwitzgebel, 1980). The elements of informed consent are competence, voluntariness, full information, and comprehension. Competence is the client’s ability to make a rational decision with regard to participation in treatment. Voluntariness means that the client is free to make the decision to participate or not to participate in treatment. Full information is provided to the client regarding the probable risks and the potential rewards of participation in treatment. Comprehension means that all information provided is expressed in simple language the average person would be expected to easily understand. controversy. Professional judgment must be used when seeking a balance between the client’s desires and right to make an informed decision about treatment and the potential therapeutic compromise resulting from overdisclosure. CONFIDENTIALITY The obligation of practitioners to maintain the confidentiality of their relationships with their clients is a cornerstone of the therapeutic process and an essential prerequisite for the therapeutic relationship. Confidentiality, according to Siegel (1979), involves professional ethics rather than legalism and expresses a promise or contract to reveal nothing about an individual except under certain conditions agreed to by the client. Confidentiality may also be based in statute or case law (Swoboda et al., 1978). Confidentiality is thought of as being similar to, but not interchangeable with, privileged communication and privacy because they have different meanings. Distinguishing between confidentiality, privilege, and privacy is critical in understanding a variety of legal/ethical problems. Confidentiality, as defined by Shah (1969), relates to matters of professional ethics. Confidentiality protects the client from unauthorized disclosures of any sort by the practitioner without informed consent of the client. Confidentiality, however, is not absolute. State and federal regulations and court decisions have mandated the disclosure of information in certain situations, even if it means breaking confidentiality. Understanding the concepts of privilege and pr.
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Resources for Week 2 HLTH440 from: M.U.S.E. My Unique Student Experience Registered Trademark CEC 2013. All Rights Reserved. The Basis for Health Care Ethics What is Ethics?Ethics is what you believe is right or wrong. It is a moral philosophy that seeks to help the individual distinguish between good and bad as defined by one's culture. Ethics guides individuals and groups in their decisions about health care and other matters. Ethics helps the individual and group set boundaries. Health care ethics is based on the law, professional codes of ethics, standards of care, and institutional policies and practices (corporate law). Codes of EthicsCodes of ethics or codes of conduct are lists of standards or guides that provide an ethical framework for practice within a profession. Physicians are bound by the Hippocratic oath, but nursing has its own code of ethics. All health professions have a code of ethics. It is axiomatic that the practice of health care presents moral and ethical dilemmas, because it deals with human beings and life-altering circumstances. Health care financing presents broader moral dilemmas in the allocation of scarce resources. The conflict exists between the inherent values, duties, and obligations in caring for patients and the availability of resources to treat them. The depth or content of a code of ethics is dependent on the type of contact that the health care professional has with a patient. Ethical Theories A number of ethical frameworks or theories are used to make decisions in health care and, in general, to set boundaries for expected behavior. The theories are used to determine what is fair or unfair. The following are several ethical frameworks: Normative ethics: The ethical theory that describes how things ought to be. Teleological theory: Also known as consequentialist theory, which believes that the best action in any situation is the one that promotes the greatest happiness for the largest number of people. In health care financing, this would fall under the rubric of cost containment by calculating the net benefits verses the consequences. Utilitarianism: This is Mill’s definition of morality, which is the practical ethics of judgment: What is the greatest good that will benefit the greatest number of people? Medicare falls under this rubric. Deontological theory: What one should or must do based on the obligations and duties of one’s life. This theory focuses on means, whereas teleological theory focuses on ends. Virtue ethics: This is the ethics of care as a part of virtue ethics; virtue ethics is a form of normative ethics, which emphasizes the character of the interaction between the health care provider and the patient. This is the opposite of the emphasis on rules or consequences in other moral theories. Health care virtues include compassion, conscientiousness, cooperativeness, discernment, honesty, trustworthiness, truth telling, integrity, kindness, respect, and commitment. Situational ...
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