Ethical Decision-Making Process Report Case: Pennsylvania Supreme Court Decision, Emerich V. Philadelphia Center for Human Development, Inc. (Watson, 2005)

1. Identify the Problem

Overview: In Emerich v. Philadelphia Center for Human Development, Inc., the Pennsylvania Supreme Court addressed whether a mental health professional has a duty to warn a third party of potential harm posed by a client. Key Issue: Whether the therapist had an obligation to warn a potential victim about threats made by the client.

2. Apply the ACA Code of Ethics

Relevant Codes: ACA Code A.1.a (Primary Responsibility): Counselors' primary responsibility is to respect the dignity and promote the welfare of clients. ACA Code B.2.a (Serious and Foreseeable Harm and Legal Requirements): Counselors must disclose information when there is a serious and foreseeable threat to an identifiable person or group. ACA Code B.1.c (Respect for Confidentiality): Counselors protect the confidential information of prospective and current clients.

3. Determine the Nature and Dimensions of the Dilemma

Confidentiality vs. Duty to Warn: The therapist must balance the ethical duty to maintain client confidentiality with the duty to protect potential victims from harm. Legal Precedents: The court in this case drew upon the Tarasoff v. Regents of the University of California decision, which established a therapist's duty to warn identifiable victims of threats.

4. Generate Potential Courses of Action

Course of Action 1: Maintain client confidentiality without warning the potential victim. Course of Action 2: Warn the identified potential victim and breach client confidentiality. Course of Action 3: Seek supervision or consultation while maintaining confidentiality to determine the best course of action.

5. Consider the Potential Consequences of All Options

Course of Action 1: Potential victim remains unaware of the threat and could be harmed. Therapist maintains client confidentiality but may face legal repercussions for failing to warn. Course of Action 2: Potential victim is warned and can take precautions. Client confidentiality is breached, potentially damaging the therapeutic relationship and client trust. Course of Action 3: Provides an opportunity for guidance from a supervisor, but may delay necessary action.

6. Evaluate the Selected Course of Action

**Preferred Option: Course of Action 2 (Warn the Potential Victim )** - Ethical Justification: Given the serious and foreseeable harm to an identifiable person, the ethical obligation to protect the potential victim outweighs the duty to maintain client confidentiality. - Legal Compliance: This action aligns with the legal precedent set by Tarasoff and supports the Pennsylvania Supreme Court's decision in Emerich v. Philadelphia Center for Human Development, Inc. - Professional Responsibility: This action upholds the primary responsibility of promoting client welfare and respecting the dignity of all individuals involved.

7. Implement the Course of Action

Steps to Take: Clearly document the client's threat and the decision-making process. Inform the potential victim about the threat in a manner that is clear and actionable. Notify appropriate authorities if necessary to ensure the potential victim's safety. Continue to provide support and therapeutic services to the client, addressing the issue that led to the threat.

8. Consider Diversity, Inclusion, and Cultural Considerations

Counselor Considerations: As a mental health professional, it is important to be aware of one's own cultural background, values, and potential biases. I identify as a counselor who values diversity and strives for cultural competence. My decision-making process must be free from biases that could affect my judgment regarding the client's behavior and the potential victim. Client Considerations: The client's cultural background, values, and circumstances should be considered to understand the context of the threat. It's crucial to approach the situation with sensitivity to the client's cultural and personal identity to maintain a therapeutic alliance while addressing the risk.

9. Document the Decision-Making Process

Documentation Should Include: A detailed record of the client's statements and behavior that led to the identification of a threat. Notes on the consultation with a supervisor or legal counsel. The rationale for breaching confidentiality, citing relevant ethical codes and legal precedents. The steps taken to warn the potential victim and any follow-up actions.

10. Review and Reflect

Post-Action Review: Reflect on the effectiveness of the action taken and any impact on the therapeutic relationship. Evaluate the outcome to improve future decision-making processes in similar situations. Engage in ongoing professional development to enhance understanding of ethical dilemmas and legal responsibilities.

Conclusion

The decision to warn a potential victim in the Emerich v. Philadelphia Center for Human Development, Inc. case demonstrates the application of ethical principles, legal precedents, and cultural considerations in clinical practice. By following a structured ethical decision-making process, mental health professionals can navigate complex situations effectively while prioritizing the safety and welfare of all individuals involved.

References

Watson, D. (2005). Emerich v. Philadelphia Center for Human Development, Inc. Pennsylvania Supreme Court Decision. American Counseling Association (ACA) Code of Ethics. Relevant State and Federal Laws.

Step-by-step explanation

Approach to Solving the Question: 1. Understand the Case Context:

Familiarize yourself with the Pennsylvania Supreme Court Decision, Emerich v. Philadelphia Center for Human Development, Inc., to understand the specifics of the duty to warn situation. 2. Review Ethical Guidelines:

Examine A Practitioner's Guide to Ethical Decision Making. Identify relevant ACA (American Counseling Association) ethical codes, and other relevant professional guidelines such as ASCA (American School Counselor Association) or IAMFC (International Association of Marriage and Family Counselors). 3. Structure the Report:

Use a formal outline format with clear headings and subheadings to document each step of the ethical decision-making process. 4. Incorporate Diversity and Inclusion Considerations:

Reflect on how cultural, personal values, and identities of both the counselor and the client affect the ethical decision-making process. 5. Legal Considerations:

Identify and cite appropriate federal and state laws that influence the decision-making process.

Detailed Explanation:

1. Identify the Problem:

Case Overview: Summarize the key facts of the Emerich case, focusing on the central issue of whether the therapist had a duty to warn a third party of potential harm. Ethical Dilemma: Clearly articulate the ethical conflict between maintaining client confidentiality and the duty to warn a potential victim. 2. Apply the ACA Code of Ethics:

Relevant Ethical Codes: Identify specific ACA ethical codes that apply to the situation. For instance, ACA Code B.2.a (Serious and Foreseeable Harm and Legal Requirements) emphasizes the need to disclose information when there is a serious and foreseeable threat. 3. Determine the Nature and Dimensions of the Dilemma:

Analyze the Conflict: Discuss the conflict between ethical principles (e.g., confidentiality vs. duty to protect) and how they apply to the case. Legal Precedents: Reference the Tarasoff case and other relevant legal precedents that establish the duty to warn. 4. Generate Potential Courses of Action:

Identify Options: List all possible actions the counselor could take, considering both ethical and legal implications. 5. Consider the Potential Consequences of All Options:

Evaluate Outcomes: Discuss the potential consequences of each course of action for the client, the potential victim, and the counselor. 6. Evaluate the Selected Course of Action:

Preferred Action: Choose the best course of action based on ethical guidelines, legal requirements, and potential outcomes. Justification: Provide a thorough justification for the selected action, referencing ethical codes and legal precedents. 7. Implement the Course of Action:

Action Steps: Detail the steps necessary to implement the chosen course of action, ensuring compliance with ethical and legal standards. 8. Consider Diversity, Inclusion, and Cultural Considerations:

Counselor Considerations: Reflect on the counselor's own cultural background and biases that might influence decision-making. Client Considerations: Address the client's cultural background, values, and how these might impact the situation and the counselor's approach. 9. Document the Decision-Making Process:

Record Keeping: Emphasize the importance of thoroughly documenting the decision-making process, including consultations, decisions, and actions taken. 10. Review and Reflect:

Post-Action Review: Discuss the importance of reviewing the outcome of the action taken and reflecting on the decision-making process to improve future practice.

Examples:

Example of Identifying the Problem:

In the Emerich case, the therapist faced a situation where the client made specific threats against an identifiable individual. The ethical dilemma was whether to breach confidentiality to warn the potential victim. Example of Applying Ethical Codes:

ACA Code B.2.a emphasizes that counselors must disclose information to prevent serious and foreseeable harm. In this case, the threat made by the client was deemed serious and specific, triggering the duty to warn. Example of Considering Diversity:

If the counselor comes from a background that highly values client autonomy and confidentiality, this might influence their initial hesitation to breach confidentiality. Conversely, if the client belongs to a community that has historically mistrusted mental health professionals, this might affect the counselor's approach to communicating the necessity of the breach.

Key References:

ACA Code of Ethics:

American Counseling Association (ACA). (2014). ACA Code of Ethics. Retrieved from ACA website A Practitioner's Guide to Ethical Decision Making:

Forester-Miller, H., & Davis, T. E. (1996). A Practitioner's Guide to Ethical Decision Making. Retrieved from ACA website Legal Precedents:

Tarasoff v. Regents of the University of California (1976).

List 1 diversity consideration (e.g., power, privilege, oppression, discrimination, communication, value conflicts, skills, etc.) from your (the counselor's) perspective. Each bullet should be 1-2 complete sentences. List 1 way you (the counselor) can advocate for diversity considerations considering the first two bullets. Each bullet should be 1-2 complete sentences. . Generate a Potential Course of Action and Consider Consequences Provide one course of action (solution) possible that will be clinically appropriate and supported by ethical and legal requirements. Select the course of action (which could include more than one step or action) that best fits as a solution to your dilemma and provide a rationale for this course of action. This bullet should be 3-4 complete sentences. Do not worry about judging and eliminating solutions, you will evaluate these in the next step. Each bullet should be 1-2 complete sentences. Identify how your course of action will help you resolve your dilemma. This bullet should be 2-3 complete sentences. Consider the consequences of implementing the solution outlined above. Each bullet should be 1-2 complete sentences.

References Cite relevant professional ethical code Cite your state laws or statutes Cite relevant counseling principles and other relevant materials