Reply to Michelle Medina Week 5 Discussion Post Consultation Implications Context
RESOURCES: 1
PSY 699 Week 5 Discussion Guided Response: (PLEASE SEE MICHELLE’S POST BELOW) (PleConsultatio Implications in Context
Was the suggested course of action presented ethically sound based on the APA Ethical Principles and Code of Conduct? If so, how? If not, why not? Did your colleague consider the legal ramifications of the course of action he or she suggested? Were the arguments for the suggested course of action supported by appropriate evidence-based psychological concepts and theories? What other resources might you suggest to your colleague that would inform the response to this case? Was your colleague’s recommendation culturally sensitive? What developmental issues did your colleague consider? What other issues might you suggest for further review in this case?
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Michelle Medina PSY Week 5 Post Consultation Implications Context
When this case was first reviewed, Victoria was only 12 years old, and her mother Tina did not want the status of Victoria’s HIV diagnosis disclosed to the child. The staff complied with this request. Now that four years have passed, and Victoria is now older the topic of disclosure is more of an issue. Despite Tina’s assurance that her daughter would remain abstinent until marriage, Victoria is now sexually active and has not been practicing safe sex with her boyfriend. With this new knowledge, the APA ethical principles and code of conduct can be used to defend why the staff is obligated to disclose this information to Victoria. According to the APA code of ethics 4.05b, the psychologist may disclose confidential information without the consent of an individual if it is to protect the client/patient or others from harm (American Psychological Association, 2010). Now that Victoria’s behaviors and Tina’s nondisclosure are putting others, it is becoming more unethical not to advise Victoria of her diagnosis.
Should the staff encourage the daughter to inform her mother that she is sexually active?
At this point, it is incredibly important that the staff encourages Victoria to inform her mother that she is sexually active. Not only is it necessary to prevent the spread of the virus, but also there are other issues associated with being sexually active that Vitoria may need support on like pregnancy and emotional issues that can come from being sexually active at a young age. By educating Victoria about the risks associated with being sexually active and the risk of sexually transmitted diseases may motivate her to speak more openly with her mother. Having more open conversations bout HIV and sexually transmitted diseases will help remove the stigma that makes it hard for disclosure (Leonard et al., 2010).
Would knowledge regarding her daughter’s sexual activity influence the mother’s stance regarding disclosure?
Knowing her daughter’s sexual activity could increase the chances that the mother will disclosure the diagnosis to her daughter. According to research, most people, around 65% of individuals believe that it is unethical to have unprotected sex with a partner without disclosure of HIV status. Since most people do not want others infected this information would likely motivate a change in Tina’s stance on disclosure (Horvath et al., 2011).
Should the staff break confidentiality and inform the mother that her daughter is sexually active?
Since Victoria is still a minor, Tina has the right to know this information. AS the legal guardian of the child, Tina is responsible for Victoria’s actions and needs to take precautions to ensure that her daughter is protected as well as has the obligation to protect others. There are now punitive laws in place as an effective prevention strategy against HIV and places like Canada have had laws in place since 2012 (Patterson et al, 2020).
Should the staff encourage the mother to inform the daughter of both her and her daughter’s HIV status?
Although Tina doesn’t need to inform her daughter of her diagnosis, it would be useful to provide Victoria with the knowledge that her mother understands the situation and could bring the two of them closer together. It is imperative now that Tina tell her daughter about her diagnosis. Since young age transmission of HIV occurs through unprotected sex and injection drug use, by not telling Victoria other people are now at risk of becoming infected (Leonard et al, 2010).
Does the daughter’s boyfriend have any rights in this situation? If so, what are they?
Many places now have HIV-specific laws in place for HIV exposure and if convicted of not disclosing information to partners a person can be convicted of up to 30 years of imprisonment (Horvath et al, 2011). Not only does the boyfriend have any rights, but Victoria will also have a legal obligation to inform him of the risk of exposure.
Based on the daughter’s age, does the mother have a right to not disclose the diagnosis to her daughter?
Considering Victoria is now 16 and in many places is of age for legal consent, the mother no longer has the right to withhold this information from her daughter. Because of this, it is necessary for the staff to fully educate Tina of the potential ramifications of her choices if she chooses to continue with the secrecy. Not only has Tina now allowed her daughter to put herself and others at risk, but she is also to the point where her relationship with Victoria may be negatively impacted by the nondisclosure. Disclosure is vital in the management and care of HIV and typically a person who is related to the child is the one who does the disclosure (Dlamini & Matlakala, 2020).
Does the mother have a right to privacy regarding her diagnosis, which could be threatened if her daughter learns of her status?
The mother does have a right to her privacy, but at this point, it will be difficult for her not to share this information when her daughter inquires about how she became infected. Having more open conversations about HIV will help remove the stigma and discrimination. It will also help Victoria with the disclosure of her diagnosis to future partners (Obermeyer et al, 2011).
Are there other approaches the staff can take? If so, what are they?
The staff could speak to Victoria directly about her sexual activity and educate her fully on the risks associated with unprotected sex. Since Victoria has mentioned that she has already engaged in unprotected sex, the staff can encourage her to get tested for sexually transmitted diseases. By doing this, Victoria can learn about her diagnosis without her mother disclosing this information to her. Unfortunately, this method could destroy the trust she has in her mother and could ultimately create more secrecy in the family if Victoria is now unwilling to speak to her mother about what she learned. The staff could educate Tina about the facts that despite behavioral interventions and education many young people will still engage in risky behaviors, and it is necessary to do everything she can to protect her daughter from not only the emotional trauma that is to come from the late disclosure but the potential legal risks that can be associated with the nondisclosure.
Is further information required in order for you to create an ethically sound suggested course of action?
There is no further information required to make an ethically sound suggested course of action. Many routes can be taken in this situation but at this point, it is a much larger risk to not disclose this information.
Resources
American Psychological Association. (2010). Ethical principles of psychologists and code of conduct: Including 2010 amendments (Links to an external site.). http://www.apa.org/ethics/code/index.aspx (Links to an external site.)
Dlamini, C. P., & Matlakala, M. C. (2020). Disclosure of human immunodeficiency virus status to children: Pattern followed by parents and caregivers. African Journal of Primary Health Care & Family Medicine, 12(1), 1–6. https://doi-org.proxy-library.ashford.edu/10.4102/phcfm.v12i1.2230 (Links to an external site.)
Horvath, K. J., Weinmeyer, R., & Rosser, S. (2011). Should it be illegal for HIV-positive persons to have unprotected sex without disclosure? An examination of attitudes among US men who have sex with men and the impact of state law. AIDS Care, 22(10), 1221-1228. Retrieved from http://www.tandfonline.com/toc/caic20/current (Links to an external site.)
Leonard, A. D., Markham, C. M., Bui, T., Shegog, R., & Paul, M. E. (2010). Lowering the risk of secondary HIV transmission: Insights from HIV-positive youth and health care providers. Perspectives on Sexual and Reproductive Health, 42(2),110-116. doi: 10.1363/4211010
Obermeyer, C. M., Baijal, P., & Pegurri, E. (2011). Facilitating HIV disclosure across diverse settings: A review. American Journal of Public Health, 101(6), 1011–1023. doi: 10.2105/ajph.2010.300102
Patterson, S., Nicholson, V., Milloy, M.-J., Ogilvie, G., Hogg, R. S., Carter, A., Li, T., Ding, E., Sereda, P., Greene, S., de Pokomandy, A., Loutfy, M., & Kaida, A. (2020). Awareness and Understanding of HIV Non-disclosure Case Law and the Role of Healthcare Providers in Discussions About the Criminalization of HIV Non-disclosure Among Women Living with HIV in Canada. AIDS & Behavior, 24(1), 95–113. https://doi-org.proxy-library.ashford.edu/10.1007/s10461-019-02463-2 (Links to an external site.)
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