Legal and Ethical Issues in Human Service
As from the case study, Samantha is a case manager ad deals with mentally disabled persons. She assists them in planning, controlling and assessing their medical services to ensure quality and effectiveness of the health care services provided to them. Ian is one of her clients and has a moderate IQ of 55. Although he is fairly self-sufficient, he at times requires help from his sister Kate who takes him for his appointments. Ian has been facing challenges with his memory lately and he even tells Samantha during one of his visits. Kate is worried about her brother’s well-being and tries to communicate with Samantha so that she can get useful information concerning her brother. Some of the main legal issues related with working with intellectually disabled clients include, guardianship, decisional capacity, express and informed consent and confidentiality.
Regarding Ian’s situation, the legal issues raised are confidentiality, decisional capacity and express consent. Confidentiality refers to the protection of individual information shared with a therapist, doctor or generally any consultant. In the case study, Ian and Samantha have private sessions whereby Ian shares information about his health and well-being. This information is not supposed to be revealed to a third-party. Decisional capacity refers to the capability of an individual to comprehend information he is told and make reasonable decisions independently. Ian has an IQ of 55 which is relatively low as compared to the normal IQ range. He may therefore lack the capacity to process information and make decisions that will benefit him. Express consent refers to the permit given to a consultant to disclose any information or records regarding their health or well-being. In Ian’s case, his information is subject to confidentiality but may be disclosed to his sister if the information is crucial and Samantha does not see the need to deny access to the information.
Samantha is in a dilemma whether to reveal the information to Kate or keep it confidential. Ian is an adult and although he is mentally disabled he has a certain capacity to make his own decisions. However, Kate is a sister and a close relative to Ian. Therefore, revealing some of the information to her may be for the benefit of Ian. Since Ian has been having problems with his memory lately, it may be important for Kate to know his state. Samantha should reveal some of the information to Kate without Ian’s knowledge. This will assist her to devise ways of preventing his brother from endangering his life. However, Samantha should not reveal everything and should not give full access to all of Ian’s records without his consent. Disclosing the information to Kate may have serious implications on Samantha. If she breaches the confidentiality, Ian might lose trust in her and this will directly impact her reputation. Furthermore, Ian may decide not to be a client anymore and this a loss for her business. Contrastingly, disclosing the information may have positive implications too. Kate may find ways to safeguard his brother’s well-being who is exposed to numerous dangers considering his condition and recent memory lapses.
Informed consent plays a significant role in this scenario. Ian’s mental disability is mild and he has some extent of decisive capacity. Informing him before disclosing information to his sister may be appropriate and shows a respect for his boundaries and right to privacy. However, Samantha should judge from the seriousness of the situation before making a decision. From the scenario, Ian’s memory lapses recently caused him to forget to switch off his stove before leaving his house. Such an issue could cause serious health complication or even worse, death. If Samantha consulted Ian for his consent before sharing information, he may decline because he does not want to see Kate panic about his condition. However, going forth and revealing such information to Ian’s sister without his consent may save His life in the long run.
Other implications of the case study include the possible termination of Samantha’s certificate to serve. If Samantha signed a confidentiality agreement and breaches it, she risks the penalty of losing her certification. However, the termination is not restricted to employees who have signed the contract. Samantha may also be subject to a law suit. Ian may decide to sue her for malpractice because sharing sensitive information is an invasion of his privacy. Some of the National Organization for Human Services (NOHS) standards that may apply in this scenario are like the duty for human professionals to safeguard their client’s right to privacy and confidentiality. This standard only exempts cases where maintaining the confidentiality results in severe damage to the client. Another standard is the requirement for human professionals to act promptly and with integrity in case they suspect that their client is exposed to danger. Acting promptly helps to prevent the client from harm. The human professional may seek for advice, request for supervision or breach the confidentiality of their relationship.
To minimize the occurrence of such legal issues, human professionals should put across certain strategies. Before dealing with a client, they should find a suitable balance between the client’s right to discretion of sensitive information and the necessity to disclose records in a bid to promote their safety and well-being. Besides they should have a confidentiality policy which states the terms of privacy and circumstances in which confidentiality and their informed consent is suspended. Client’s should read and understand the policy in advance to avoid future disagreements and misunderstandings.
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