Question

For the following testing scenario, identify specific ethical considerations or potential violations committed by Dr. Jefferson as discussed in your textbook and course manual. From an ethical perspective, please consider what Dr. Jefferson has done well and what she could have done differently. If there is a violation of the Canadian Psychological Ethical Guidelines for Psychologists, provide recommendations for a more ethical practice (i.e., what advice would you give to Dr. Jefferson?) Dr. Jefferson lives and practices psychology in a rural area. She has been a registered psychologist for 5 years (Ph.D. in Child Psychology) and her area of specialization is anxiety disorders and depression. She began to provide psychotherapy to Mr. Giles, a 42-year-old, who was dealing with depression. After three sessions, Mr. Giles suffered a significant head injury while at work. His impairment is noticeable by Dr. Jefferson without any type of testing, although she administers the Halstead-Reitan Neuropsychological Battery, just in case. Mr. Giles’s co-worker, Cynthia, helped him find an attorney so that his rights are protected, especially since the incident occurred at work. Dr. Jefferson had Mr. Giles sign a release to talk with the attorney as well as Cynthia. From a phone call with the attorney, WSIB (Workers Compensation) wants to work out a settlement, but the attorney has little understanding regarding Mr. Giles’ level of impairment. Mr. Giles demonstrates a variety of cognitive deficits. He needs assistance and monitoring with daily tasks, such as home care, shopping, transportation, understanding the settlement process, reading his mail, and paying his bills. He will likely need to go into an assisted living facility. His family lives three provinces away and provides minimal help, both emotionally and financially. Mr. Giles doesn't appear to understand his legal rights or the settlement process. Prior to providing extra-therapy support, Dr. Jefferson had Mr. Giles sign a document explaining her fees for the additional services. She is not sure that he completely understands what is happening or her version of informed consent for the additional services. The psychologist has been doing much of the case management work on her own, such as locating a long-time friend who is willing to help him at home, engaging in lengthy discussions with his primary care physician and neurologist, participating in multiple conversations with the attorney, and trying to find a guardian or power of attorney. Over dinner and beers, she has also spoken at length to her partner, a neuropsychologist, about how best to serve her client.

Answer 1

According to the Canadian Psychological Ethical Guidelines for Psychologists, informed consent of the subject includes his full understanding of the matter and agreeing to do it. In the above case, Mr. Giles suffers from cognitive impairment due to which his understanding of the nature of a problem is questionable. Dr. Jefferson had Mr. Giles sign a document explaining her fees for the additional services. She is not sure if he completely understands her version of informed consent for the additional services. However, Dr. Jefferson goes ahead and manages most of Mr. Giles case management. As a psychologist, who is registered for five years, she violated two major ethical guidelines. First, informed consent must be mutual and understood by both the parties. Here, the subject was unaware of what was happening to him, there is no informed consent. On a humanitarian level, the psychologist wanted to help Mr. Giles, however, she should have made sure that understands her version of informed consent. The second guideline violated is, confidentiality. A psychologist is not allowed to disclose details about her subject to any other person until it is not an emergency with regard to the subject's mental health. Dr, Jefferson should have not discussed Mr. Giles personal life and details with her partner. Dr. Jefferson is Mr. Giles therapist and she must abide by the guidelines provided.