Legal, ethical, and public policy issues

Krajeski, James P.

doi:10.1002/yd.23319904810

New Directions for Mental Health Services

1990

DOI: 10.1002/yd.23319904810

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Legal, ethical, and public policy issues

James P. Krajeski

Abstract: HIV infection forces mental health professionals to confront difficult legal and ethical issues. Problem solving requires the delicate balancing of diverse interests and a thoughtful approach that rationally weighs the benefits and disadvantages of traditional as well as new solutions.

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Cited by 3 publications

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“…The literature addressing the issue of protecting client confidentiality and the legal duty to warn is of two principal types: Theoretical discussion of the issues involved in duty to warn and research examining particular reasons for professional ethical decisions. First, there is ample theoretical discussion of the issues involved in duty to warn (Erickson, 1990;Krajeski, 1990;McGuire, Nieri, Abbott, Sheridan, & Fisher, 1995;Oppenheimer & Swanson, 1990;Schlossberger & Hecker, 1996;Totten, et al, 1990). These general discussions, though helpful in sorting through issues, lack specificity as to the actual decision-making processes concerned in making an ethical decision.…”

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confidence: 99%

Family Therapists' Ethical Decision‐making Processes in Two Duty‐to‐warn Situations

Burkemper

2002

J Marital Family Therapy

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This quantitative study investigated the ethical decision-making process of 177 Missouri members of the American Association for Marriage and Family Therapy using two in-session duty-to-warn scenarios of child abuse and HIV transmission. The components of the critical-evaluative level of ethical decision making include the lower-level decision components of personal/therapeutic response, professional ethics, and legal considerations/laws of the State, and the components of the higher-level decision base, the meta-ethical principles, which are nonmaleficence, autonomy, beneficence, fidelity, and justice. Statistical results indicated that in the child abuse scenario, professional ethics and legal considerations/laws of the State were considered most important, whereas in the HIV scenario, professional ethics were the preferred lower-level decision base. Across scenarios, the preferred higher-level decision base was nonmaleficence. There were differences across the child abuse and HIV scenarios in the perceived significance of the remaining lower-level decision base items as well as differences in perceived significance and ordering of the remaining meta-ethical principles. Limitations are discussed.

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confidence: 99%

Family Therapists' Ethical Decision‐making Processes in Two Duty‐to‐warn Situations

Burkemper

2002

J Marital Family Therapy

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HIV antibody testing and client retention in the therapeutic community

Gonzalez

Rosenthal

Bigler

et al. 1994

Journal of Substance Abuse Treatment

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Exploring the Ethics of Observational Research: The Case of an HIV Study in Tanzania

Norris

Jackson

Khoshnood

2012

AJOB Primary Research

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Background Observational studies have generally been viewed as incurring minimal risk to participants, resulting in fewer ethical obligations for investigators than intervention studies. In 2004, the lead author (AN) carried out an observational study measuring sexual behavior and the prevalence of HIV, syphilis, and herpes simplex virus type 2 (HSV-2), among Tanzanian agricultural plantation residents (results reported elsewhere). This article uses an ethical lens to consider the consequences of the observational study and explore what, if any, effects it had on participants and their community. Methods Using a case study approach, we critically examine three core principles of research ethics—respect for persons/autonomy; beneficence/nonmaleficence; and distributive justice—as manifested in the 2004 observational study. We base our findings on three sources: discussions with plantation residents following presentations of observational research findings; in-depth interviews with key informants; and researcher observations. Results The observational research team was found to have ensured confidentiality and noncoercive recruitment. Ironically, maintenance of confidentiality and voluntary participation led some participants to doubt study results. Receiving HIV test results was important for participants and contributed to changing community norms about HIV testing. Conclusions Observational studies may act like de facto intervention studies and thus incur obligations similar to those of intervention studies. We found that ensuring respect for persons may have compromised the principles of beneficence and distributive justice. While in theory these three ethical principles have equal moral force, in practice, researchers may have to prioritize one over the others. Careful community engagement is necessary to promote well-considered ethical decisions.

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Legal, ethical, and public policy issues

Abstract: HIV infection forces mental health professionals to confront difficult legal and ethical issues. Problem solving requires the delicate balancing of diverse interests and a thoughtful approach that rationally weighs the benefits and disadvantages of traditional as well as new solutions.

Cited by 3 publications

References 29 publications

Family Therapists' Ethical Decision‐making Processes in Two Duty‐to‐warn Situations

Family Therapists' Ethical Decision‐making Processes in Two Duty‐to‐warn Situations

HIV antibody testing and client retention in the therapeutic community

Exploring the Ethics of Observational Research: The Case of an HIV Study in Tanzania

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