Patient Confidentiality: Changing the Rules for Modern Duty to Warn

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Patient Confidentiality
Changing the Rules for Modern Duty to Warn

Mark O 'Brien
Professional and Ethical Issues
Instructor
Dr. Alina Perez
Florida Institute of Technology
October 8, 2012

Every first year psychology student is taught that maintaining the confidentiality of the client is a prime concern in the development of a counseling relationship. As a practicing psychologist, members of the American Psychological Association are subject to guidelines for ethical behavior and sanctions for not maintaining patient confidentiality. However, the decision to protect a patient 's divulgences or even the fact that a person is a client can become a quagmire of ethical complications that few psychology students address in depth before they step into the counseling world. When does the duty to maintain a patient 's confidentiality cease and where does it begin? From the legal guidelines of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to the ethical guidelines of the APA, the practicing psychologist is faced with a multitude of situations in which the maintenance of client confidentiality becomes difficult or even potentially illegal. In this paper the writer will attempt to address some of the situations which can cause ethical dilemmas for the psychologist and some of the potential answers that are available.

Perhaps even more than the APA, HIPAA concerns regarding confidentiality are of primary importance to the practicing psychologist. In 1996, Congress adopted a law aimed at protecting patient privacy that has resulted in annual privacy notices to patients and new paperwork to prove that medical providers are ensuring the privacy of their patients. In theory, it also protects patient confidentiality. According to the United Stated Department of Health and Human Services, which oversees the law, " A covered entity must disclose protected health information in only two situations: (a) to individuals (or their



References: American Psychological Association (2012) Ethical Principles of Psychologists and Code of Conduct. Retrieved Oct. 4, 2012, from http://www.apa.org/ethics/code/index.aspx?item=3 Bartol, C.R Friedman, E. (2009, Aug. 19) Va. Tech Shooter Seung-Hui Cho 's Mental Health Records Released, ABCNews. Retrieved Oct. 4, 2012, from http://abcnews.go.com/US/seung-hui-chos-mental-health-records-released/story?id=8278195 Gabriel, P Khan, A. (2011, Jan. 20) "Are the mentally ill more violent?" Los Angeles Times. Retrieved Oct, 4, 2012, from http://articles.latimes.com/2011/jan/20/health/la-he-mentally-ill-violent-20110116 Knaus, B U.S. Department of Health and Human Services (2012) Health Information Privacy. Retrieved Oct. 4, 2012, from http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index.html Vendantam, S Zur, O. and Gonzalez, S. (2002) "Multiple Relationships in Military Psychology," Retrieved Oct. 5, 2012, from http://www.zurinstitute.com/dualmilitary.html.

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