Ethics Case Study: The Vignette

The vignette described a woman who comes in for a session in an agitated state. The psychologist has worked with her for a few weeks and she was not overtly suicidal or homicidal. On this visit, the psychologist decided to refer her to an inpatient due to her becoming unreliable and taking 17mg of Xanax in 30 hours instead of 2.5mg prior to her appointment.The decision making process for this vignette is very important because of the dilemma involved. The ethical decisions-making process I am going to engage in will be the Canadian Code of Ethics for Psychologist and the decision- making process that accompanies it.

My first decision will be to identify the key players in this vignette. The individuals and groups are the female patient

There are a lot of ethical standard that can be apply to this scenario, the most and most important one avoiding harm (Standard 3.04). The psychologist should take a reasonable step to avoid harming the patient especially when it is foreseeable. Before referral, the psychologist has known that the patient was abusing Xanax, she had taken 17 mg in the 30 hours when she should have only taken 2.5 mg, her behavior is very unreliable and she was not overtly suicidal or homicidal but the tendancies were there. Practicing within the boundaries of competent (Standard 2.01), the psychologist was knowledgeable enough to know that the client was in danger of harming herself or others. The psychologist took the necessary precautions to avoid harm by referring her to an inpatient facility. The psychologist cooperated with another professional (Standard 3.09) when it was needed which was in the best interest of the client. The psychologist should be aware of HIPPA rules when cooperating with the other professional. The patients written authorization on release of PHI should be communicated to the other professional. This brings us to the pressing issue for the psychologist right now; the psychologist wants to check on the status of the client, but the facility will neither confirm nor deny her stay there. The psychologist can fax the release form but, with the condition that it should be communicated to the inpatient clinic as confidential on the fax cover. The mistake the psychologist made was not getting a full release from the client, this should have been discussed during informed consent (Standard 3.10). This should also have been done as early as feasible before services and the psychologist had ample time since the client has been coming for several weeks. Even though this patient might be in a heightened emotional state due to her unreliable state before