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Duty to Warn

January 12, 2010
by Dr. Anne
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At a treatment center working with drug court clients, several clients report having engaged in sextasy (taking Viagra with ecstasy and cocaine or methamphetamine combinations) The clients reported that the combined drugs made sex "the best ever". One of these clients, Jake is HIV positive and reports having unprotected sex with his "number one lady" as well as having sexual contact with two acquaintances who are really into the music shows at a local theater. Sandra, the counselor has met the "number one lady" and knows how to contact her. She reported what the client said to her supervisor. The supervisor thinks that there is no need to take any action because the most important consideration is confidentiality. Sandra talked to her client about the importance of telling the persons with whom he is sexually involved of his status. Jake became upset and said that Sandra is interfering with his personal life; he thinks her role is limited to supporting his recovery and sending positive reports to drug court. Sandra consulted the NAADAC Code of Ethics and found no support for exercising duty to warn in this situation.

Several mental health professional groups have added an ethical standard that supports members in exercising a duty to warn the partner of a client who has a life threatening illness and reports having unprotected sex with an identified partner. During this calendar year, our code of ethics will be reviewed and standards rewritten or added to meet the current needs of our profession. What action is appropriate for Sandra is the situation described? Do we need a standard that provides guidance on this issue?

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Dr. Anne

Anne S. Hatcher, EdD, CAC III, NCAC II, is Co-Director of the Center for Addiction Studies at...