An Ethical and Legal Consideration of Confidentiality Requirements

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NORTHCENTRAL UNIVERSITY

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Student:  Michelle A. Brown                                                

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An Ethical and Legal Consideration of Confidentiality Requirements

Michelle A. Brown

Northcentral University

An Ethical and Legal Consideration of Confidentiality Requirements

Introduction

        Americans place a priority on being able to make decisions for themselves independent of others, including government officials (Brooks, 1999). They have had the right to personal freedom insured in the Constitution, federal, state, and local law. A similar respect for persons and their rights exist in the ethical code for psychologists. There are legal and ethical limits, however, that must be considered when treating patients. Age for consent and threats of violence are two particularly vexing issues.

        This paper will briefly explore these ethical dilemmas, within the context of a practicing psychologist in the Kansas City, Missouri area. Kansas City has the unique experience of existing within the boundaries of three different counties: Jackson, Platte, and Clay. Kansas City, Missouri is a distinct legal jurisdiction from Kansas City, Kansas. Residents frequently travel between the two with little or not thought to the state line that divide the two. As a psychologist here, it is important to make sure that patients are aware that each state has its own laws and regulations which could impact their care and under which set the provider is practicing.

Consent, Disclosure of Information, and Sexual Consent

        In the state of Missouri, the age of consent for treatment is generally considered to be eighteen years of age or older (Missouri Revised Statutes, ch. 431). Exceptions are for minors who are lawfully married or a minor parent of a child. Any minor may make treatment decisions for himself or herself in case of pregnancy, with the exclusion of abortion; seeking treatment for sexually transmitted disease; or for drug or substance abuse treatment.

        Confidentiality requirements follow in the same vein. Persons licensed as psychologists in Missouri are not to disclose information acquired in the course of their professional relationship with a client without written consent unless the client is under eighteen years of age and the information indicates that the minor individual is the victim of a crime (Missouri Revised Statutes, ch. 337).

        The age of consent for sexual intercourse is a bit less straightforward. On the state level, statute dictates that if the initiator of sexual contact is between eighteen and twenty one years of age, the age of consent is fourteen. If the initiator of the sexual contact is over twenty one years of age, the age of consent is seventeen (Age of Consent, n.d.). On the county level, however, there are some differences. Jackson County has defined the age of consent as fourteen years of age (Juvenile Delinquency, n.d.). Clay and Platte Counties do not define a specific age on their own. Neither does the city of Kansas City.

        In Ethics for Psychologists: a Casebook Approach, Tien, Davis, Arnold and Benjamin (2012), describe a situation in which a young patient is being seen by a psychologist. The patient is twelve years old, and her mother feels she is suffering from depression. The mother states that she does not want to be involved in her daughter’s treatment. Instead, she takes on the role of transportation provider. After a few weeks of treatment, the patient informs the treating psychologist that she pregnant and, after being advised to discuss this with her fundamentalist parents, quits treatment. The psychologist follows up; advising all parties against termination. The patient subsequently terminates anyway, with parental consent. The parents then insist on access to the patient’s records.

The American Psychological Association, or APA, has an ethics code that mandates confidentiality (Tein et. al., 2012). The situation may provide some ambiguity for the psychologist in the example, because adolescents do not have the same legal status as adults (Brooks, 1999). The example is unclear as to whether the treating psychologist had obtained permission from the client to discuss the pregnancy during the follow up call. If permission was not obtained from the client to disclose the pregnancy and discuss termination, the call goes against both the legal and ethical standards.