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Health Information Portability and Accountability Act (HIPAA)
The privacy law is a federal guideline which establishes the minimum practices regarding the disclosure of patient information to third parties. The Act indicates the circumstances under which data belonging to a patient can be released, the nature of consent required, when consent is not necessary, and the acceptable scope of patient information. It is held that the Act has led to the expansion of health rights on the issue of patient data. The law also grants healthcare recipients rights. For instance, patients have the right to be notified about requests for the disclosure of their details, a right to access individual health information and amend their records. However, the privacy rule does not override state laws on the issue. Thus, the compliance of HIPAA demands that one also observes the Federal laws on privacy.
Popularly known as the privacy rule, the Health Information Portability and Accountability Act (HIPAA), it was introduced with the main purpose of enhancing the privacy of individuals seeking healthcare assistance. Under the provisions of the Act, recognition is given to the idea that given mental health information must be protected compared to other types of patient data. Under the law, psychotherapists are not expected to publicize any notes or information taken from clients regarding their health status. In effect, the emergence of the HIPAA is an issue that strikes cognizance with the historical psychology aspect of “process notes” Thus, the primary rule of concern for psychologists is the use of process notes.
Under the law, psychotherapy notes are those taken using any medium by mental/ psychological health experts in documenting and analyzing contents in conversations when holding private sessions to counsel patients. In practice, the notes capture the impression that psychologists muster concerning individuals seeking care. For that reason, a possibility exists that the notes can contain data that is inappropriate for public consumption.
The law stipulates that when disclosing such information, the acquisition of consent and authorization from the patient must be obtained. Thus, specific permission must be acquired before psychotherapy notes are disclosed. In the past, insurance firms have requested the entire patient information to decide on covers. However, with the new law, health plans cannot be reimbursed in case a patient declines to the release of sensitive information based on the provision on psychotherapy notes. As already indicated, in the past, if a patient objected to the release of the information, their health covers would be withdrawn. The effect of the Act is that insurance companies cannot conduct their activities relying on psychotherapy notes.
The other important guideline that emanates from the HIPAA borders on the right that health professionals possess. Psychologists have the right to decide on releasing the psychotherapy notes to care recipients unless state law allows them to acquire such data. Although healthcare seekers do not have the right to inspect their records, the case differs regarding the process notes. In particular, under HIPAA, care recipients do not have the right to access or obtain copies of the information. It is further interesting given that when a psychologist denies the patient access or a copy of the notes, such a decision is not subject to a review process. It is also noted that other parties do not assess the notes taken by the professionals.
Under the law, it is stated that the psychotherapy notes are distinct from the normal patient records. Thus, the data is kept separate from the medical records of an individual. Such rules have an implication on the profession of healthcare. In essence, the primary objective is to protect patients from intrusion. These rules apply irrespective of the orientation of care provision: whether private or public.
Ethics is becoming an increasingly important aspect in organizational activities. As a term, ethics borders on acceptable codes of conduct in entities or societies. Thus, the issue of morality is critical. For a firm to operate ethically, deciding on its values, beliefs and culture is a primary consideration. It is observed that an entity needs to establish what it stands for, and how its activities will be carried out in the pursuit of set objectives. In order to enhance the chances of ethical conduct, organizations need to list the aforementioned attributes and share them with all stakeholders. In other words, businesses need to set clear codes of conduct. It is also established that ethical conduct accounts for societal expectations. In effect, operating by laws of states forms another fundamental basis for acting ethically.
With the progress witnessed in the electronic media systems, communication has become easier although it has many risks. In particular, unexpected parties such as hackers can intercept the advanced systems of connection. Thus, the issue of client confidence must e addressed.
Practitioners are at risk because email communication can be hijacked if criminals compromise passwords or if a sender transmits an email to a wrong email address. When the message involved contains confidential information, a major risk arises. The fact that any form of communication can be intercepted by unintended recipients calls upon those involved to devise measures to reduce the chances of such events from taking place. In order to enhance ethical conduct, it is necessary that professionals comply with protective measures that are given. Even though stringent measures are taken, the fact that system administrators can access electronic communication is a major concern. This explains why the Electronic Communications Privacy Act criminalizes the interception of communications, such as e-mail. Whether enough precautions are taken to protect client information remains a contentious issue. Nevertheless, professionals have the responsibility of protecting confidential data.
In the current times, the use of social media has expanded exponentially. Although the platform was meant to accord users an opportunity to share socially, the media is extending beyond the objective to serve other unanticipated roles. Given that professionals are a part of the society, they also use the media. Sometimes, the experts use media for organizational purposes such as marketing their services and enhancing reputation. However, professionals also use the media for private functions. It is noted that a professional does not cease from being one just because he is posting as a private person. Thus, whenever an expert posts items, he/ she needs to observe professionalism. However, this applies to issues touching on the profession. For instance, observing the principles of ethics and responsibility is significant.
Many social media instruments are available to professionals in the field of healthcare. Such tools include blogs, social networking sites, micro blogs, media-sharing sites, wikis, and gaming environments. The platforms can be applied to improve professional networking, education, patient care, organizational enhancement, patient care extension, and across public health programs. Nevertheless, the tools present many risks regarding quality of information, danger posed to professional outlooks, breach of patient privacy, licensing and violation of professional boundaries. In order to overcome such risks, many organizations provide guidelines which must be followed.
Malpractices capture actions or conduct that falls outside the parameters of accepted behavior. For individuals to avoid malpractices, they need to understand procedural standards, legal requirements and social conduct. For psychotherapists, it is important to be careful when handling duties. In particular, psychologists encounter conflicting sources while executing their day-to-day mandates.
In order to lower the chances of being involved in malpractices, psychologists should submit to formal standards that are given to guide conduct (Grindrod, et al. 2014). They also need to pay attention to the changing legal landscape in order to understand their legal obligations. In addition, respecting the guidelines by professional associations such as those provided by the American Psychological Association (APA) Committee on Professional Standards is instrumental towards staying away from malpractices.
At one time, when psychologists were required to work with physicians to deliver care, it would have been a malpractice for the latter professionals to extend services in the absence of the latter experts. However, the requirement has since been lifted, and psychologists have the freedom to work on their own in the delivery of care. Von Muhlen and Ohno-Machado also noted that professional guidelines demand that health practitioners maintain privacy expectations. If a psychologist fails to honor such obligations, then he/ she might have committed a malpractice. In essence, engaging in any conduct that does not meet the standards set to guide psychologist would constitute a malpractice.
Malpractices encompass professional negligence, and other torts that provide grounds for complaints. Within the field of psychology, the Ethical Principles of Psychologists and Code of Conduct prepared by the APA guides the understanding of malpractices. Violations of the provisions in the guidelines and breaking of state laws comprise malpractices.
One of the most plausible approaches that psychologists can employ to overcome malpractices is to observe and abide by ethics principles. Thus, the health practitioners need to be informed about tenets such as beneficence, autonomy, informed consent, non-discrimination, honesty, confidentiality, among others. The attribute of autonomy rests on treating each person with respect based on humanity grounds. Regarding beneficence, the major talking point is doing right so that no person suffers harm out of the activities carried out. Psychologists can avoid malpractices by following laid down procedures, maintaining competence, and paying attention to developments in the field. Observing such a conduct allows practitioners to avoid committing malpractices in their duties.
Given that psychotherapy is a powerful instrument, it has a potential to harm, or benefit some of the parties involved in healthcare delivery. Through an understanding of the stipulated guidelines, psychologists are at a good position to avoid the challenge. It is also held that observing the principle of justice would be critical in a psychologist’s bid to avoid malpractices. In this regard, practitioners are expected to cooperate with other professionals, review committees, avoid discrimination and observe appropriate record keeping trends.
It is significant to note that violations of ethics expose practitioners to liability as well as professional discipline. In some cases, a possibility exists that an individual is held criminally responsible for an action. Many states have incorporated the codes of conduct into their rules. The implication is that once someone violates the law, the professional bodies can institute investigations and take disciplinary measures against those involved. Thus, remaining updated on requirements as outlined by professional bodies and state laws is critical for psychologists harboring ambitions to stay free of misconduct. It is apparent that knowledge of the law is significant in any field of operation.
In practice, if the Board of Psychology determines that negligence, abuse of procedure or any form of malpractice has been committed, it has the capacity to dole severe penalties such as suspension or cancellation of one’s practicing license. Other measures include community service, probation, and other punitive measures that the board considers appropriate. Consequently, psychologists need to pay attention to guidelines to avoid malpractices.
Hypothetical Ethical Case
The following case relates to my colleague (Joshua) who is a psychologist. While going about his daily duties, a client visited his office seeking an opinion on the most appropriate approach to handling a terminally ill patient. Apparently, the patient had no chances of living having suffered extensive damage to some of the most vital body organs.
Based on the diagnosis, the victim suffered from hypoxic encephalopathy, which is a euphemism for brain injury that results from oxygen starvation. The doctors confirmed that the patient (Peter) would not recover from the vegetative state. After deliberating on the issue, Joshua was convinced that the best case scenario would be the termination of the life of the client’s patient. Consequently, he recommended that the life of the patient be ended given that he stood no chance of recovering.
Whenever an issue pertaining to end-of-life arises, ethical concerns arise. In particular, the question about the decision to terminate life is contentious. Simply put, the contention rests on whether any person has the powers/ right to decide that it is time to end the life of another. Drawing from the wider literature on ethics does not help the matter. For instance, the deontological school of ethics differs markedly from the teleological orientation. In particular, the deontological school of thought supports the idea that individuals are bound by the duty to do what is right. Based on this line of thinking, right is absolute. The implication is that an actor or an activity s either right or wrong.
Referring to the issue at hand, the school would perceive the case as being based on ending or preserving life. In brief, sympathizers of the school would argue that taking away life is amoral irrespective of the circumstances. The argument rests on the idea that there are two options to life: either preserving or ending it. The former is right while the latter is wrong. In this regard, adherents of the deontological school of thought would observe that Joshua’s decision to recommend ending of the patient’s life is unethical. On the other hand, the case of teleological ethics concentrates on the consequences of an action/ decision. Under the ethical framework, adherents are interested in the effect of an action. In particular, decisions or actions that derive the maximum benefit are preferred. In the current case, it is held that the caregivers, the patient, family, and the care facility are involved. Hence, a decision to end life is preferred given that many of the involved stakeholders would benefit from such. In particular, the family would incur reduced suffering, fewer costs, and peace of mind. For care facilities, such a decision would allow for freeing of space to cater for other patients. It is also held that at the current state the patient is half-dead. Consequently, it would be logical to end such a person’s life. It is held that based on the teleological approach, ending the patient’s life would be the most appropriate move. Consequently, reliance on the framework indicates that the decision suggested by Joshua is ethical.
I would argue that I was impressed by the manner in which my friend handled the case. One of the most notable cases that strike similarity is that of 2005 involving a terminally ill patient known as Terri Schiavo. When arriving at the decision, many aspects come into play. In the first place, getting information about the case at hand is important. After understanding the issue, referring to ethical principles is paramount. Upon such consultation, a decision is made regarding the best approach to resolve the issue. Laws vary from state to state on the issue of end-of-life. For instance, California does not support maintaining terminally ill patients on life support while New Jersey does.
Wise, Hersh and Gibson opens with the observation that occupational health hazards have become endemic in the field of psychology. The authors indicate the pressure that surround the work of present-day psychologists predispose them to ethical dilemmas. In particular, health practitioners have concerns in their attempts to meet competency expectations. Professionals in the field need to flourish and demonstrate ‘intentionality, awareness and routine’ in their activities for the three authors, intentionally engaging in various practices and encouraging patients to employ them would help in furthering the field of healthcare with specific reference to self-care. The writers also suggest that the incorporation of certain practices into the learning curriculum of psychologists would help improve the quality of self-care. The enhancement of the client-psychologist relationship is also integral to the bid to improve the quality of care. As Wise et al. observe, sustainability in psychologist self-care is dependent on the acknowledgment of humanity. Psychologists must recognize that the separation between them and their clients is thin. Thus, self-care is more than just an ethical imperative as it is also a humanist requirement.
Positive emotion, mindfulness, mindful awareness, and/ or personal robustness are incorporated and sustained in self-care, positive results are obtainable. Although sustained self-care and advanced wellness are not free, they enhance the quality of life.
According to the Family Caregiver Alliance, self-care is at the heart of healthcare services. For the entity, the need for health services continues rising, and putting a strain on individuals assigned the responsibility of delivering services to patients. The alliance acknowledges that at times, attitudes and beliefs are an obstacle in the extension of care. This is more pronounced when individuals are required to administer self-care. However, persons involved in the delivery of healthcare within family set-ups need to consider the potential benefits derived from self-care. In particular, the Family Caregiver Alliance observes that family-based caregivers are at an increased risk of becoming sick and suffering from conditions such as stress, depression and trauma. Thus, individuals who are extending care are required to be cognizant to the fact that taking a negative approach to the exercise is counterproductive. In addition, are givers must overcome misconceptions which enhance levels of stress.
For Barnet, self-care is justifiable because of the need to overcome distress, trauma, impaired professional competence and burnout. Distress is the subjective emotional reaction experienced by individuals to a number of challenges such as illness concerns. For the author, burnout is the terminal stage encountered by stress therapists. Such a state leads to emotional exhaustion, a feeling of poor accomplishment and depersonalization. Caregivers also stand a chance of suffering from vicarious traumatization which is secondary level stress characterized by co-victimization and compassion fatigue. To overcome the above problems, psychologists require appropriate knowledge, skills, the right attitude and values necessary to prevailing order to overcome impaired professional competence, put stress levels under check is the most useful approach.
For Wise et al., self-care is critical in the pursuit of improving the quality of life. The authors recognize the need to administer care in a manner that fosters life rather than creating a sense of survival. In order to enhance practice, taking an ethical and a humanistic approach to self-care would be significant. Based on the exposition by the Family Caregiver Alliance, overcoming problems related to self-care, such as stress, trauma, negate attitudes and beliefs is critical towards the improvement of the delivery of healthcare. Thus, psychologists can improve practice by exploring mechanisms to eliminate such setbacks. Based on the article by Barnet (n.d), the identification of the problems involved in the practice would be important in improving self-care.