APPENDIX A
Examples of Ethical Dilemmas - Question #15 and #16
Confidentiality/Release of Information Issues
• Acquaintance rape of 17 year old and decision of whether or not to notify a parent. Upon
student’s request, decided NOT to notify parent.
• What to do with third party reports in a clinical file when client requested copy of file. In this
case third parties were fearful of being harmed by client.
• A student who was both homicidal and suicidal sought services at a local agency with no 24-
hour backup. The agency requested information and we only had a limited release.
• Request for records of student applying for a license to be an attorney in Texas. Student had
received counseling for alcohol abuse.
• Client requested to review file. No procedure existed within the center. Sped to adapt form
from another center (with permission) and have it approved by university lawyer prior to
student returning to enact the request.
•
Issues about deciding how at risk a suicidal or homicidal person is and when to inform others.
• How to comply with Campus Security Act of 1990 without compromising client confidentiality.
We determined that we in counseling cannot 'verify' crimes.
•
The question of whether to release information to the parents of a student who took his life.
The file contained an old release (now expired) giving permission to consult with parents. To
help the parents with closure, a summary of the file was prepared and reviewed with the
parents. Questions were answered and support provided.
•
Internal conflict over confidentiality in a voluntary hospitalization. Administration notified
parents against client's will in a non-emergency. Administration failed to see legal/ethical
perspective. Sees counselor as 'making this up'. Very PR oriented.
• Several clients where we struggled with the balance between confidentiality, safety issues and
institutional responsibility. We lean toward erring in the direction of safety, but not without a
good deal of consu