Case 2. Cultural Values and Competent
Mental Health Services to Minors
Irina, a 13-year-old girl of Arabic cultural
heritage living in Boston, Massachusetts, was brought by her parents to a
hospital emergency room after an assault by a stranger. Based on her injuries,
the hospital staff suspected that the attacker had also sexually assaulted the
girl, but she and her parents refused medical evaluations for rape. The family
received a referral to see Janet Matthews, a clinical psychologist specializing
in adolescent trauma. During their initial meeting with Dr. Matthews, the
parents asked the psychologist not to discuss any sexual aspects of the assault
with their daughter but to treat the psychological trauma from the assault in
general.
They told the psychologist that admitting a rape had
taken place would cast a
stigma on their daughter and make her ineligible to
be married to men in their
closely knit ethnic community. When asked in
private, the girl also requested that
sexual issues not be discussed for the same reason.
Ethical Dilemma
Dr. Matthews does not know if she should agree to
the parents’ and child’s request.
FOR THE USE OF UNIVERSITY OF PHOENIX STUDENTS AND
FACULTY ONLY.
NOT FOR DISTRIBUTION, SALE, OR REPRINTING.
ANY AND ALL UNAUTHORIZED USE IS STRICTLY PROHIBITED.
Copyright © 2013 by SAGE Publications, Inc.
Appendix B——357
Discussion Questions
1. Why is this an ethical dilemma? Which APA Ethical
Principles help frame the
nature of the dilemma?
2. Who are the stakeholders and how will they be affected
by how Dr. Matthews
resolves this dilemma?
3. How might Irina’s age and parents’ involvement in
the referral affect how
Dr. Matthews can resolve this dilemma? How might
state law on treatment
of minors and HIPAA rules on access of guardians to
a minor’s health care
records influence Dr. Matthew’s decision? (See
sections on “A Word About
HIPAA” in the Preface of this book, on parental
rights under Standards 3.10b,
Informed Consent, in Chapter 6, and the Hot Topic at
the end of Chapter 7
“Confidentiality and Involvement of Parents in
Mental Health Services for
Children and Adolescents.”)
4. What attitudes, knowledge, and skills are
required to develop a culturally
competent treatment plan for Irina (see the Hot
Topic for Chapter 5
“Multicultural Ethical Competence”)?
5. Is Irina likely to benefit from the treatment if
the possibility of sexual aspects
to the trauma is not explored?
6. How are APA Ethical Standards 2.01a, b, and c;
2.04; 3.04; 3.06; 4.01; 4.02;
and 10.10a relevant to this case? Which other
standards might apply?
7. What are Dr. Matthews’s ethical alternatives for
resolving this dilemma?
Which alternative best reflects the Ethics Code
aspirational principles and
enforceable standards, legal standards, and Dr.
Matthews’s obligations to
stakeholders? Can you identify the ethical theory
(presented in Chapter 3)
guiding your decision?
8. What steps should Dr. Matthews take to ethically
implement her decision
and monitor its effect?
0 comments:
Post a Comment