A care provider has a legal obligation to take the necessary measures when he or she knows of a patient’s intention to commit suicide. However, the legal system does not specify the steps that the provider should take although it proposes that such an intervention must parallel the standards of the community. Consequently, the provider is faced with the issue of confidentiality. They are also faced with the choice of whether to disclose the client’s decision to their colleagues or superiors. This undoubtedly emerges as a breach of contract. Breaching confidentiality requires sufficient justification as it amounts to breaking an implicit pledge to the client to preserve the integrity of the therapeutic relationship. Thus, although the legal structure upholds the intervention of the provider, it leaves him or her to decide on its nature.
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In the case study provided, the client discusses her suicidal intentions with the provider and offers a rational basis for desiring to relieve the family members of the burden of care. Nevertheless, based on Werth (2002), the provider should not engage in any debate regarding the rationality of suicide. From a therapist’s context, the situation charges the provider with an ethical obligation to mediate and avert the actual suicide from occurring. Werth (2002) underscores the need for the provider to observe ethical codes about such a situation. The ethical requirement of the situation does not obligate the therapist to always intervene to prevent suicide but the counselor’s obligation is to assess and not prevent death from occurring.
Another ethical dilemma that emerges under this situation relates to the principle of client autonomy regarding decision-making. Although a client has the right to decide what he wants, the provider has to decide between allowing the client to accomplish her intent and advocating for the safety of the client. These two situations contradict as the decision is not from a third party. Here, the provider must determine which position transcends client safety and autonomy. With regards to assessing justice, a therapist should take into consideration if they are letting subjective prejudices including racism, classism, sexism, ageism, or ableism affect clinical decision-making and the proposed intervention against those that are ruled out (Werth, 2002).
The moral dilemma presented by this case relates to selecting a consultant. According to Werth (2002), consulting with a specialist can aid in decision-making a great by large and protect the therapist against any allegations of negligence. Nonetheless, the consultations ought to be in writing and filed. It is worthy of note that if the recommendations of the consultant are ignored, an adverse outcome is imminent. Therefore, since palliative cases can compromise the moral concerns and values of consultants, it is advisable to select a consultant who has an understanding of his or her expertise, skill, and approaches before a complex clinical situation occurs.
Long-term Therapies versus Crisis Interventions
These treatment approaches are very distinct in a number of perspectives. The context of crisis intervention differs from that of long-term therapies. The goal of crisis intervention, according to Benveniste (2007) involves helping patients cope with the new situation, and restoring the original functionality state. These goals are accomplished through mobilizing the patient to discuss his or her experiences, gain some understanding of the occurrence, resolve the related emotions, and design ways to resolve his or her problems. Long-term therapies, on the other hand, refer to treatment regimens that go over many months or even years or a lifetime.
Benveniste, D. (2007). Crisis Intervention After Major Disaster.
Werth, J. L. (2002). Legal and Ethical Considerations for Mental Health Professionals Related to End-of-life Care and Decision Making. American Behavioral Scientist , 46, 373.
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