CM PRACTICE EXERCISE - Ethically What Went Wrong?

1. Jim is doing an intake with a man who claims he is depressed. He tells Jim that ever since his wife left he has had trouble concentrating and waking up in the morning. He talks about how lonely it is at home, how much he misses his children, how he is tempted to drink in the evenings, and how little he has to look forward to. Jim nods. He understands. "Yes, my wife left last month, too," Jim tells the man. "I know just what you mean. I get to feeling like, well, like there isn't as much meaning. I never knew the kids were so important to me, but I guess they were. On Saturdays I used to do things with my son and I still get him every other weekend, but it's not quite the same thing, is it?" "No," the man responds, "I was thinking ..." Jim interrupts the man to say, "Well, I do a lot of thinking, too. I think about what I could have done differently and if it was my fault. Don't you think these women would see that it's hard, too hard I think, to raise kids alone?" The conversation continues in this vein until the end of the interview.
2. Carmen is supposed to see her small caseload of persistently mentally ill individuals at least twice a week. Lately with school and her mother's death, she has not really seen the clients that often. She has checked in with them on the phone, but she also has used time when she was out seeing clients to do errands at the library and to empty her mother's home. Now one of her clients is in court after committing a crime. The client and the lawyer agree that the client might be able to use his mental health status as a reason for committing the crime, and they ask to introduce the case record as evidence in the court proceedings. Fearing that it will be discovered how little supervision and attention she has given her client, and knowing that ultimately she could be blamed for the fact that her client committed the crime while under her somewhat irresponsible care, Carmen invokes the concept of privileged communication to avoid having to give the file to the court.
3. Ted is in a clinic with his elderly client for a routine blood workup, which they do every other month. He notices the client is bruised on the face and arms. For a while he makes small talk with her, and then he asks her about the bruises. She is somewhat evasive but indicates, "They weren't the result of no fall!" Without explicitly blaming her daughter and son-in-law, with whom she lives, she makes it quite clear that the bruises are not the result of an accident. After the blood test, during which neither the doctor, who sees her briefly, nor the technician make any mention of the bruises, Ted takes his client home. He toys with the idea of reporting the bruises to the protective services at the county Office of Aging but decides not to. He bases his decision on the fact that the law does not specifically require him to do so, that it would be hard and take a lot of time to have to place this client in another living arrangement, and that the daughter seems like a very nice person whom Ted does not feel like stirring up over an uncomfortable situation.