Title: Balancing Confidentiality and Autonomy: Ethical Considerations in the Janet Godkin Case
Introduction:
The case of Janet Godkin, a voluntary mental patient seeking access to her records, raises important ethical issues surrounding confidentiality and autonomy in mental health treatment. This essay will explore the ethical challenges presented in this case, drawing on the ethical principles outlined in the American Psychological Association (APA) Code of Ethics (Koocher & Keith-Spiegel, 2016). Additionally, it will discuss how I, as a therapist, would respond to Godkin’s request and consider the relational ethics issues involved.
Ethical Issues:
a) Confidentiality: The refusal to grant access to Godkin’s records raises concerns about the breach of confidentiality and the potential impact on her autonomy.
b) Autonomy: Godkin’s desire to verify her experiences and write a book based on her medical records highlights the importance of respecting her autonomy to make decisions about her own life and narrative.
Ethical Challenges and Principles:
The ethical challenge in this case revolves around balancing the therapist’s duty to maintain confidentiality with the client’s right to autonomy. Drawing upon the APA Code of Ethics, the following principles are relevant:
a) Principle of Respect for Autonomy: This principle emphasizes the importance of honoring clients’ right to make informed decisions about their lives. Godkin’s request to access her records aligns with this principle as she seeks to exercise autonomy over her own narrative.
b) Principle of Confidentiality: This principle underscores the therapist’s obligation to protect the client’s privacy and maintain confidentiality. However, it is not absolute and can be overridden by considerations of client welfare or legal requirements.
Response as a Therapist:
a) In responding to Godkin’s request, I would carefully consider the ethical principles and relevant factors to determine the best course of action.
b) Factors Considered:
i) Client Welfare: I would assess the potential benefits and risks associated with granting Godkin access to her records. If there is no foreseeable harm and it supports her therapeutic goals, I would lean towards supporting her request.
ii) Legal Obligations: I would review the applicable laws regarding access to medical records and ensure compliance with any legal requirements or restrictions.
iii) Organizational Policies: I would consider any policies or guidelines set by the hospital or mental health institution regarding record access and release.
iv) Therapeutic Relationship: I would reflect on the impact of my decision on the therapeutic relationship, ensuring that open communication and trust are maintained. Engaging in a collaborative discussion with Godkin about the potential implications of accessing her records would be crucial.
v) Personal Values: I would reflect on my personal values and biases that may influence my decision-making process and ensure that they do not compromise the client’s autonomy or well-being.
Relational Ethics Issues:
The primary relational ethics issue in this case is power imbalance. As the therapist, I hold significant power over Godkin’s access to her records. To address this issue, I would engage in open dialogue with Godkin, ensuring transparency about the implications and potential risks involved in accessing her records. Collaborative decision-making would allow for shared power and respect for her autonomy while maintaining professional boundaries.
Conclusion:
The Janet Godkin case highlights the ethical challenges faced by therapists when balancing confidentiality and autonomy. By considering relevant ethical principles, assessing various factors, and engaging in open communication with the client, therapists can navigate these challenges while upholding both their professional obligations and respecting clients’ rights to autonomy and privacy.
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