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The Ethical Standards set out by the American Psychological Association (APA) assist the psychologist in reaching a course of action in their practice (American Psychological Association, 2010). Most of these actions involve making decisions concerning an ethical situation that arises between the patient and the psychologist, and the legal ground concerning such situations. One of the most common decisions involves the continuation or discontinuation of care of a patient who is a minor, as the decision has to take into account the guardian’s position as the legal consent giver (American Psychological Association, 2010). This paper aims to analyze critically an ethical situation involving disclosure of the health status of a minor when the parent is against it.
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Victoria, who is 12 years old, is infected with HIV which she contracted from her mother during childbirth. Her mother Tina is aged 36 years, and she is also infected from a former relationship. Although they are both under medication, Tina has never disclosed to her daughter about her true health status and only tells her the medication is a treatment for a blood problem. As a result, Victoria has started showing displeasure in taking the medication an occurrence that is of concern to the clinical staff as she occasionally misses her dosage. From the clinic therapist argument, disclosing her health status would be the only way that Victoria would appreciate the purpose of the medication and show adherence to it. However, failure to understand the reason for the medication, her health would continue deteriorating as she would continue missing her doses. On the other hand, her mother feels that Victoria is a minor and believes that she has a responsibility to protect her from emotional devastation that would result from disclosing such information. As her mother, she believes her daughter is not ready to know the truth about her health status.
Victoria as a patient has a right to know her HIV status and diagnosis. Despite being a minor, it is believable that Victoria is missing her doses as a result of the regimen medication due to lack of a clear understanding of the purpose of her medication. In this regard, a client has a right to information in order to give informed consent to treatment.
On the other hand, Tina as a mother has a right to decide on whether her child is ready to take such sensitive information as her HIV status. Parents have the authority and responsibility to make health and medical decisions concerning their children on their behalf. Due to the vulnerability of children, parents are believed to understand them better and have the moral authority to choose on the best course of action regarding their children (Heeren, 2011). In this sense, Tina has a right not to disclose the HIV diagnosis to her daughter. However, the decision should adhere to the best interest of the daughter.
Regarding Tina’s right to privacy, she is an independent patient, and her health status and right to privacy cannot be threatened if the daughter learns of her own status, because Tina is an patient autonomous from her daughter. The staff should, therefore, tell Victoria of her status, if her mother fails, if only it promotes her health condition, as it is the responsibility of the clinic staff to strive to benefit the patient with no harm by safeguarding their health in accordance to the principle of beneficence and non-maleficence (Edwards, Reis, & Weber, 2013). Similarly, the principle of integrity insists on truthfulness, honesty, and accuracy to maximize benefits.
The clinic staff must restrict the disclosure of Victoria’s health status to the professional aspect alone. In this sense, information regarding how she contracted the disease should not be disclosed as it would threaten her mother’s privacy. This would be against the principle of respect of dignity and rights of other people (Bird, Fingerhut, & McKirnan, 2011). The staff can as well consider convincing Tina to look at the positive side of disclosing the information to the daughter which would collectively be in the best interest of promoting her health by adhering to the medication. This is supported by the principle of justice, which provides for exercising reasonable judgment and providing equal quality of service, procedure and process are upheld. It also promotes justice and fairness which would benefit both of them.
Conclusively, further information is important in making ethically sound decision regarding the mode of disclosure that should be used to Victoria. It is important to note that most of Tina’s fears are based on perception which might have resulted from her background. Understanding the cause of her fears is critical in taking the right course of action (Aultman & Borges, 2011). Similarly, considering Victoria is a minor it is also good to find out how much she knows about HIV so as to make the right decision concerning her diagnosis and disclosure.
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- American Psychological Association. (2010). Ethical principles of psychologists and code of conduct: Including 2010 amendments.
- Aultman, J. M., & Borges, N. J. (2011). The ethics of HIV testing and disclosure for healthcare professionals: What do our future doctors think? Medical Teacher, 33(1), e50-56.
- Bird, J. D. P., Fingerhut, D. D., & McKirnan, D. J. (2011). Ethnic differences in HIV-disclosure and sexual risk. AIDS Care, 23(4), 444-448.
- Edwards, L. L., Reis, J. S., & Weber, K. M. (2013). Facilitators and barriers to discussing HIV prevention with adolescents: Perspectives of HIV-infected parents. American Journal of Public Health, 103(8), 1468-1475.
- Heeren, G. A. (2011). Changing methods of disclosure: Literature review of disclosure to children with terminal illnesses, including HIV. Innovation – The European Journal of Social Science Research, 24(1-2), 199-208.