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Sharing Ethical Issues and Concerns

May 11, 2009
by Dr. Anne
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William White in the introduction to his book, Critical Incidents noted that ethical issues have long been considered to be an individual issue. Such issues “fester in silence until they detonate into humiliating exposes” of our personal and agency shortcomings. Even when counselors think that they are following all the guidelines learned in a legal and ethical issues class, they might later think about something done and realize that it could be considered unethical by someone else. At other times, counselors just don’t stop to think about the implications of what they are dong. There is a need to develop a process in agencies and within our profession for ethical problem solving. Thus, a discussion of ethical concerns is beginning on the Addiction Professional blog. The goal is to provide an opportunity for addiction professionals to discuss situations and to consider ethical concerns from various viewpoints. Some questions and scenarios will be posted as starting points for discussion. An issue for consideration and response is being posted separately. Anne Hatcher

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Is it the standard of ethical care to disclose PERSONAL identification data such as name, d/o/b, SSN WITHOUT written/informed consent of the patient to a state agency for the purpose of a state registry for those receiving voluntary treatment for addiction?

Absolutely NOT! Why do they need their SSN, DOB for voluntary treatment? I would be uncomfortable even asking the patient to give such information and I would certainly offer a disclaimer stating it was not mandatory! Now in support of evidenced based outcomes I would fully support giving the state any statistical information they wanted but no individual identifiers.

Thank you for the response. Working with both clients and students, there are mixed responses to the question of requiring disclosure of identifying information. A court case a number of years back found that the importance of the information to the state was more important than privacy of the client. Research related to how many times a person seeks treatment requires some type of identifying information in order to track individuals in treatment. We again have the conflict of privacy versus the research documentation. Either side can be argued and more often than not the research side is supported.

Yet another related issue is gathering information about sexual behavior that might lead to HIV exposure. Clients who know that the questionnaire includes identifying information will lie about their sexual behaviors so research based on those documents is flawed.

Other comments of this topic are encouraged. Exchanging ideas provides an opportunity to explore various viewpoints and some times leads to new insight.

Anne Hatcher

Dr. Anne

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