Introduction
The case of Hannah and Adara entails an ethical dilemma related to the appropriateness of a therapist’s breach of privacy and confidentiality when deciding the client’s best interest. In this case, the counselor will work with a student from a diverse cultural background who prefers her issues handled with a lot of privacy and confidentiality. Adara is a young Muslim girl who feels excluded from her school community due to her cultural and religious background. Given the complexity of the case and its representation of larger multicultural concerns that negatively impact the client’s psychological well-being, this case analysis offers a solution that prioritizes the counselor’s problem with the student’s cultural values, religious and customs, beliefs, and political preferences. A school counselor should demonstrate and maintain the highest level of integrity to protect the rights of Adara, who represents the Muslim community. Therefore, Hannah must ensure that the young Muslim student is treated fairly and appropriately. In this case, her professional standards and other resources will allow for enhancing Adara’s feeling of belongingness and relief of her psychological concerns.
The issue involving Hannah and Adara is not an isolated case in contemporary society and relates to larger societal problems. Indeed, according to Chin et al. (2020), ethnic and racial discrimination in general and social rejection, in particular, constitute a common reason for depression, anxiety, and stress in marginalized groups. Adara’s case mirrors social phenomena where most people have found themselves at the crossroads of multiculturalism because of different races, ethnic groups, religions, and cultural affiliations with the people they interact with. Many people have had suicidal thoughts because of belonging to cultural or religious groups that they felt were not dominant in their areas (Chin et al., 2020). For example, Adara tells Hannah that she wishes she was dead, which illustrates her frustration with the social rejection she experiences daily. Nonetheless, despite her willingness to obtain help from a professional, she prefers Hannah to handle her issues confidentially.
Applied Ethical Principles and Standards
When dealing with ethical dilemmas in a practice setting, counselors must follow standards of care and basic principles of professional conduct. According to the American Psychological Association’s (2017) ethical principles, psychologists must comply with beneficence and nonmaleficence, fidelity and responsibility, integrity, justice, and respect for people’s rights and dignity. A counselor should be committed to enhancing professional and scientific knowledge of human behavior and interactions.
Since privacy and confidentiality are basic human rights, Hannah must respect them. In other words, the therapist in the case study must not disclose private information about her client to third parties. In this case, the Muslim girl was unhappy because Hannah did not respect confidentiality issues requiring personal information not to be leaked (Petrini et al., 2017). As a psychologist, Hannah should protect the rights of the Muslim girl with religious and cultural particularities that make her a vulnerable member of society, given her minority status. Confidentiality is critical, so the girl can communicate openly and sincerely when sharing her concerns. If the psychologist keeps sharing Adara’s information in sessions, it will jeopardize the client’s trust and safety.
Moreover, responsibility and integrity should be the fundamental principles when dealing with Adara. Indeed, Hannah must strive to be objective and establish a relationship of trust with Adara since the client does not seem to trust the psychologist due to the breach of confidentiality manifested through the disclosure of private matters to third parties (Petrini et al., 2017). Presently, Adara seems to be having issues with trust and requires a trustworthy person beside her. It is relevant for Hannah to know her scientific and professional responsibilities before the Muslim community, particularly Adara. Living in the USA is a challenging experience for the girl due to the problems in cultural fit and socialization. As a psychologist, Hannah should uphold professional conduct and standards to ensure justice and integrity prevail when dealing with the Muslim girl. For example, psychologists must promote truthfulness, honesty, and accuracy when dealing with issues around their clients.
The principle of nonmaleficence might be controversial in this case due to the understanding of harm to the client. In particular, Adara experienced some problems, particularly when she discovered that her perceived confidential information was leaked to her parents (Abuhammad et al., 2020). Therefore, the counselor must ensure that the Muslim girl does not experience psychological harm during the sessions. Thus, everything she conveys should not be leaked to third parties to ensure she trusts the people she shares information with. In this case, Hannah must ask whether her actions harm Adara in one way or another, whether by commission or omission. The practices and actions of a healthcare provider should always be correct and in the patient’s best interest to avoid adverse consequences (American Psychological Association, 2017). Hannah is more responsible for coordinating care correctly to ensure Adara receives the best attention to her problem.
Alternative Solutions
Several alternative solutions might be considered, namely the adherence to culturally sensitive therapeutic measures, engaging in professional cooperation with other counselors, and negotiating family therapy options with the client. Firstly, culturally sensitive therapy might empower the client to handle her marginalized status as her strength (Chin et al., 2020). Possible ramifications of this solution might be the integration of Adara’s cultural heritage as an empowering element, which will ultimately reduce her suicidal intentions. Secondly, the engagement of other counselors will allow for a multitude of opinions on the dilemma and help Hannah find a relevant approach to the problem (Petrini et al., 2017). A possible ramification for this solution might be the emergence of a multifaceted individual approach to the client with the following improvements in her well-being.
Thirdly, integrating family therapy for a minor might be a relevant solution for gaining support for Adara. Since a decision to include parents in sessions would be consensual, this solution would comply with the principles of care and benefit the client in the long term (American Psychological Association, 2017). In such a manner, to address the ethical dilemma, a counselor should strictly comply with the principles and standards of ethical conduct and incorporate cultural sensitivity, multi-professional teamwork, and family therapy.
The issue involving Adara requires a course of action, and Hannah should handle it with compassion and understanding and avoid the ethical dilemma of privacy, trust, and confidentiality. Therefore, Hannah must understand that Adara is going through a challenging time because of having to face the challenges of multiculturalism and religion (Chen et al., 2020). Therefore, Adara’s behavior might be unpredictable and require the therapist to understand (Abuhammad et al., 2020). There is no need to breach privacy and confidentiality involving the Muslim-American girl. Being compassionate will also help because it will assist the girl in recovering from the depression that she is presently experiencing (Tegegne et al., 2022). Hannah should encourage the client to do things that will help to overcome the problem confidentially.
Since the client has expressed a desire to die, which is suicidal in some way, there is no need for the psychologist to panic about the issue. Therefore, the psychologist should know that the girl is at risk of dying because of her problems. However, there is no cause for alarm as the psychologist should address the issue with a lot of calm to ensure that Adara benefits as much as possible. Being suicidal is very common in contemporary society, and nothing is new (Tegegne et al., 2022). Therefore, not panicking will help Hannah to come up with the best solution possible. Hannah should ensure that Adara knows she is dealing with a professional psychologist who will handle the issue to the best of their ability (American Psychological Association, 2017). Confidence is vital in this case as it will assure the Muslim-American that all is well even when faced with many challenges.
Research
Multiple research studies have been conducted to investigate ethical issues in counseling and might be used to support the proposed solutions and course of action. A survey by Abuhammad et al. (2020) conducted among nursing professionals found that patients’ rights are fundamental and should not be violated by disclosing sensitive or private information to third parties. Therefore, respecting personal life and privacy is essential in providing care. This research study was based on a cross-sectional design involving an online survey in June 2020. The study involved 800 nursing professionals who agreed to participate in the survey (Abuhammad et al., 2020). The outcome demonstrates that there is a need for professional nurses to learn a confidentiality and privacy course before they start working in the healthcare environment. When applied to the analyzed case, the appropriateness of this research is manifested through the emphasis on human rights prevalence over other conflicting considerations arising in care practice.
Privacy breach dilemmas are also commonly addressed in academic literature. Indeed, in the study by Tegegne et al. (2022) involving health personnel, it was found that respecting patients’ privacy is critical. This research methodology was an institutional cross-sectional study involving 410 health professionals (Tegegne et al., 2022). This study showed that healthcare personnel have a limited attitude toward patient confidentiality and privacy but have essential knowledge about it. Respecting the privacy and confidentiality of a patient is relevant to any health professional. The knowledge and practice of privacy and data sharing among patients are critical in the modern healthcare system. In this case, Hannah’s decision-making might be explained by her limited favorable attitude toward her client’s confidentiality and privacy and insufficient knowledge about these principles. Every professional must observe a patient’s confidentiality and privacy are legal and ethical responsibilities. Respect for privacy and confidentiality is the foundation of care excellence.
Conclusion
In conclusion, the analyzed case study demonstrates the ethical challenges experienced in healthcare. Hannah is a psychologist tasked with providing professional therapy to patients like Adara. Therefore, understanding biomedical ethics is critical when dealing with Muslim Americans. The young girl feels unsafe and excluded at school when she discovers that the confidential information she shared in therapy was deliberately reported to her parents without authorization or approval. Although the girl has suicidal thoughts, she does not wish such information to get to third parties. Therefore, Hannah needs only to offer professional advice and desist from informing third parties about what a patient like Adara is experiencing to safeguard privacy.
References
Abuhammad, S., Alzoubi, K. H., Al-Azzam, S. I., & Karasneh, R. A. (2020). Knowledge and practice of patients’ data sharing and confidentiality among nurses in Jordan. Journal of Multidisciplinary Healthcare, 13, 935–942.
American Psychological Association. (2017). Ethical principles of psychologists and code of conduct.
Chin, D., Loeb, T. B., Zhang, M., Liu, H., Cooley-Strickland, M., & Wyatt, G. E. (2020). Racial/ethnic discrimination: Dimensions and relation to mental health symptoms in a marginalized urban American population. American Journal of Orthopsychiatry, 90(5), 614-622.
Petrini, C., Gainotti, S., Morresi, A., & Nanni Costa, A. (2017). Ethical issues in uterine transplantation: Psychological implications and informed consent. Transplantation Proceedings, 49(4), 707–710.
Tegegne, M. D., Melaku, M. S., Shimie, A. W., Hunegnaw, D. D., Legese, M. G., Ejigu, T. A., Mengestie, N. D., Zemene, W., Zeleke, T., & Chanie, A. F. (2022). A cross-sectional study of health professionals’ knowledge and attitude towards patient confidentiality and associated factors in a resource-limited setting. BMC Medical Ethics, 23(1), 1-10.