13 hours ago Doctors in hospital emergency departments are frequently confronted with intoxicated patients who may be uncooperative, aggressive and refuse to undergo diagnosis and treatment. In the chaotic environment of the emergency department, the doctor must decide whether to override the patient's refusal a … >> Go To The Portal
The obligation to report incompetent or unethical conduct that may put patients at risk is recognized in both the ethical standards of the profession and in law and physicians should be able to report such conduct without fear or loss of favor.
Therapist Code of Ethics on Reporting a Crime 1 Considerations. Psychologists (and other therapists, such as social workers and counselors) obviously take the trust of their patients very seriously. 2 Features. ... 3 Misconceptions. ... 4 Exceptions. ... 5 Uncertain Cases. ...
A therapist may be forced to report information disclosed by the patient if a patient reveals their intent to harm someone else. However, this is not as simple as a patient saying simply they “would like to kill someone,” according to Jessica Nicolosi, a clinical psychologist in Rockland County, New York.
So, if they follow their professional obligation to report patients (pursuant to detailed guidelines [14]), doctors may face civil and criminal liability for unauthorized disclosure under some state laws [15].
Healthcare workers have a legal and ethical responsibility to protect the patients they care for. When these responsibilities are ignored, patients suffer. Additionally, healthcare workers can be held responsible for these behaviors. Ethical behavior or responsibility is doing the right thing for the patient. Many healthcare professions have codes of ethics to which practitioners are expected to adhere. For example, the nursing Code of Ethics is a lengthy document that covers ethical expectations in detail. Some examples of unethical behaviors include fraud and neglect. Let's discuss court cases that illustrate the negative impact of unethical practices.
Healthcare Fraud. Physicians have a legal and ethical responsibility to provide healthcare that is appropriate for the patient. Healthcare fraud is a major issue within healthcare that negatively impacts customers.
They are expected to do what is best for the patient or consumer and make the right choices when providing care. Unethical behaviors or illegal practices can lead to poor patient outcomes and loss of trust.
Unethical behavior can have negative physical impacts on patients. When healthcare workers do not provide necessary treatments or interventions, the patient can't be expected to get better. For example, Sabit didn't implant hardware into his patients' backs to improve their pain or mobility, but said that he had.
Ethical behavior or responsibility is doing the right thing for the patient. Many healthcare professions have codes of ethics to which practitioners are expected to adhere. For example, the nursing Code of Ethics is a lengthy document that covers ethical expectations in detail.
The emergency medical technicians instructed the nurse to attempt to resuscitate the man, but she refused because she was scared. The patient had not provided orders or instructions not to resuscitate him in the event of an emergency, but the nurse failed to do so.
Caring for others is a unique profession, and part of that caring is protecting patients from harm. Patients are harmed when healthcare workers do not provide necessary care. Healthcare workers can also be held responsible for not performing as they should. To unlock this lesson you must be a Study.com Member.
Laws Concerning Disclosure of Impaired Drivers. Many states have enacted laws to address the problem of impaired drivers. Some of these laws mandate disclosure to motor vehicle authorities, while, in others, disclosure is voluntary. Some states require reporting for specific conditions but not for others [4].
Sometimes drivers act voluntarily in ways that make them unsafe, such as driving while intoxicated or exhausted. In these circumstances, we rightfully hold them responsible for injury or damage caused by their choices.
Whether they mandate reporting, prohibit it, or make it voluntary, the laws have much room for improvement. Ethically and professionally physicians’ duties do not stop with existing laws; they are encouraged to “work with their state medical societies to create statutes that uphold the best interests of patients and community and that safeguard physicians from liability when reporting in good faith” [14].
Although a number of states mandate or permit physician reporting of diseases or illness that may impair driving abilities, those that don ’t address the physicians’ role in reporting put physicians in a peculiar position. On the one hand, the American Medical Association’s Code of Medical Ethics explicitly acknowledges that physicians have a responsibility “to recognize impairments in patients’ driving ability that pose a strong threat to public safety and which ultimately may need to be reported to the Department of Motor Vehicles” [14]. On the other hand, the law may prohibit physicians from disclosing confidential information without an explicit exception. In other words, if informing driver’s licensing agencies (i.e., the Department of Motor Vehicles) about potentially dangerous drivers is not a legally sanctioned reason for breaching confidentiality, physicians may be unable to disclose. So, if they follow their professional obligation to report patients (pursuant to detailed guidelines [14]), doctors may face civil and criminal liability for unauthorized disclosure under some state laws [15].
Physicians should be aware of their professional responsibilities and the legal requirements of the states in which they practice. When determining whether to report a patient’s medical condition that may impair driving, physicians may have to weigh conflicting guidelines: a professional obligation to report and a legal requirement to maintain confidentiality, even in the face of danger to the public.
Oregon, for example, has broad regulations. Its laws require physicians ( especially primary care physicians) to report conditions that impair sensory, motor, and cognitive functioning to state authorities [5], and they provide comprehensive standards for determining when a driver is impaired.
Where obligated to report, physicians must do so. When reporting is voluntary, they should also consider their professional obligations before deciding on a course of action. Certainly, limited criminal and civil liability protections that place the physician at legal risk should be a factor in cases where reporting is not mandated.
Reporting a colleague who is incompetent or who engages in unethical behavior is intended not only to protect patients , but also to help ensure that colleagues receive appropriate assistance from a physician health program or other service to be able to practice safely and ethically.
Medicine has a long tradition of self-regulation, based on physicians’ enduring commitment to safeguard the welfare of patients and the trust of the public. The obligation to report incompetent or unethical conduct that may put patients at risk is recognized in both the ethical standards of the profession and in law and physicians should be able ...
The clinician who diagnoses a patient as intoxicated but fails to warn the patient of the dangers of driving may face liability not only for common negligence (if the intoxicated patient injures someone else) but also for medical malpractice.
Theoretically, it is the patient's responsibility to arrange alternative transportation, but the impaired individual may fail to do so. Practically, then, the clinician needs to assist the patient in arranging to get home by some means other than driving. The alternatives include a friend or relative of the patient (who is not intoxicated) or a taxi. If all else fails, call the police and inform them of the situation. If you don't take these precautions, you could be sued, not only by the patient, but by anyone he or she injures.
If you document that you warned the patient not to drive and made reasonable efforts to arrange alternative transportation for the patient, you will have met the standard of care, for both common negligence and medical malpractice.
Medical malpractice has 4 elements: (1) a duty of care (to the patient); (2) a breach of the standard of care; (3) an injury; and (4) proximal cause (that the breach of the standard of care caused the injury).
In that case a physician in Massachusetts, Dr. Florio, had prescribed oxycodone, metolazone, prednisone, tamsulosin, potassium, paroxetine, oxazepam, and furosemide to a man in his seventies who had advanced metastatic lung cancer.
The legal aspects of patient care are determined by country-specific regulations, which in turn are governed by medical ethics. For instance, when an Indian psychiatrist is alleged of “wrongdoing,” it is determined whether he acted contrary to “medical ethics,”[6] or to the pertaining laws in the country.[1] .
ETHICAL ISSUES. Ethic is defined as “a set of moral principles, especially ones relating to or affirming a specified group, field, or form of conduct.” [5] Technically, ethics talk about morality and desirable way of behaving but may not be binding on an individual.
Diagnosis is of paramount importance to manage psychiatric patients effectively which rests on adequate history from significant others, as psychiatrists cannot rely solely on mental status examination. When individuals are admitted involuntarily through Honorable courts and prisons into tertiary level public hospitals, there is a lack of adequate history. This is more common with those referred from prisons. Attempts are made to discuss with the prison medical officer and caregivers. The caregivers are either untraceable or unwilling to discuss. Also, because of unawareness regarding mental disorders, the only history obtained from the medical officer is of the patient being irritable or displaying suicidal threats. This is not enough to arrive at a diagnosis. Thus, the lack of adequate history is a major problem in a forensic psychiatric setting. The management of such patients, thus, is mostly based on inpatient observation. In recent times, in India, there is an increased focus on training of judiciary and prison medical officers which is a welcome step. There is also a dire need to have a judicial policy that mandates caregiver's and/or family member's presence while referring such individuals to psychiatry hospitals.
Absconding behavior in patients with mental illness. When PWMI abscond from psychiatric hospitals, especially closed wards, it places an enormous burden on the hospital staff in terms of the legal implications. The absconders may not take care of self and may be at risk of harm to self, others, and property.
17. The Indian Express. In 5 years, 420 patients have ‘disappeared’ from state-run IHBAS. [Last cited on 2019 Jan 27]. Available from: https://indianexpress.com/article/cities/delhi/in-5-years-420-patients-have-disappeared-from-state-run-ihbas/
Also, because of unawareness regarding mental disorders, the only history obtained from the medical officer is of the patient being irritable or displaying suicidal threats. This is not enough to arrive at a diagnosis. Thus, the lack of adequate history is a major problem in a forensic psychiatric setting.
The 18 (17.65%) cases out of a total of 102 cases were acquitted on the grounds of mental illness. The Honorable High Courts’ judgment was mostly in line with the judgment of the lower Court and heavily relied on the documentary evidence of mental illness.
Therapists are held to very high ethical standards by their governing state board and a violation of those ethics could result in fines, loss of licensure, or even jail time , said Walwyn-Duqesnay. While each state has its own set of guidelines and regulations on what its mental health professionals are required to report, there are common themes that transcend across the country.
“If a therapist fails to take reasonable steps to protect the intended victim from harm, he or she may be liable to the intended victim or his family if the patient acts on the threat ,” Reischer said.
Therapy is where you can share your deepest, darkest secrets, fears and vulnerabilities with the expectation that you won’t be judged and what you say won’t be shared. In fact, that’s the whole point of the whole process.
In the case of suspected child abuse, therapists must file a report if they have “reasonable suspicion” about child abuse.
Cinéas said a therapist may have to step in and report a situation when vulnerable people are threatened, which could include children, elderly individuals and those living with a disability.
A therapist may be forced to report information disclosed by the patient if a patient reveals their intent to harm someone else. However, this is not as simple as a patient saying simply they “would like to kill someone,” according to Jessica Nicolosi, a clinical psychologist in Rockland County, New York. There has to be intent plus a specific identifiable party who may be threatened.
Most situations will stay under wraps. For instance, Reed noted that even if a wife is cheating on her husband and they are going through a divorce, the therapist has no legal obligation whatsoever to disclose that information in court.
According to the APA, if a therapist is unsure of whether a discussion with a client should be reported to law enforcement or not, she should consult with other professionals in the mental health field or appeal to state or national mental health professional associations for advice on the matter. The code of conduct states that therapists are expected to reach out to others in the field whenever they are not clear about whether a client discussion goes beyond the protection of patient-therapist confidentiality.
The information shared between a patient and therapist, in almost all cases, is meant to be kept confidential in order to build a trusting relationship. However, there are exceptions to this rule, as outlined by the American Psychological Association's Code of Ethics.
The code of conduct states that therapists are expected to reach out to others in the field whenever they are not clear about whether a client discussion goes beyond the protection of patient-therapist confidentiality. References.
According to the American Psychological Association's Code of Ethics, therapists should let their clients know that in the event the client discusses inflicting or being the victim of child abuse, inflicting or being the victim of elderly abuse, or posing a serious danger to themselves or to others, and the therapist believes these threats or allegations of violence to be valid, the therapist will have to report such discussions to law enforcement officials. Also, therapists may be asked to release confidential information shared by their clients during therapy to the judicial system if served with a court order, though they are bound to only reveal information that is absolutely mandated by the judge in the case and nothing more.
Though some people may think that anything goes in a therapy session, confessing or discussing plans for violent crimes cannot necessarily be kept confidential by therapists. As stated in their code of ethics, they have a duty to protect their clients from hurting themselves or others. However, it is also important to note that any misconceptions someone being treated might have about this should be cleared up at the beginning of therapy when the therapist discusses with the client the exceptions to their confidentiality privilege.
It is crucial for psychologists to do whatever they can to keep any information shared between themselves and their patients during therapy sessions confidential. However, psychologists must also protect the health and well-being of their patients, which means protecting them from hurting themselves, inflicting injury upon others, or being hurt by someone else.
The waiver states that under certain circumstances, such as the discussion of military law violations, discussions between a soldier/veteran and his therapist may not remain confidential.