a at least 700 word paper in which you examine the legal aspects of recordkeeping and providing expert testimony. As part of your examination, address the following items:
- Analyze the ethical issues related to documenting informed consent and ethical issues related to release of treatment and assessment records. Patricia
- Which enforceable standards are relevant to the release of treatment-related materials and disclosure of information arising out of treatment? Patricia
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wk 4 Legal Psychology assignment.
Running head: LEGAL AND ETHICAL ASPECT OF PROFESSIONAL PSYCHOLOGY Legal and Ethical Aspect of Professional Psychology Rebecca Monell, Terri Norwood, Victoria Rose, Synquetta Walker & Yolanda Wimbush PSYCH 660 University of Phoenix Legal and Ethical Aspect of Professional Psychology Professional psychology can described in a numbers of ways. However, there is one code of conduct with many standards that all psychologist have to follow. This is the Ethical Principles of Psychologist and Code of Conduct. The laws are in place to protect the psychologists, as well as the client. Professional ethics help psychologists maintain their competence by paying close attention to revision and regulation that may change. This paper will examine the aspects of recordkeeping and providing expert testimony. Ethical issues related to documenting informed consent and ethical release of treatment and assessment records will be analyzed. The enforceable standards that are relevant to the release of treatment-related materials and disclosure of information arising out of treatment will be listed. Specific examples of what each enforceable standard requires or prohibits will also be listed. A rationale for proposed actions will provided. Most of all, the legal issues associated with assessment, testing and diagnosis documentation in professional psychology will evaluated. Ethical Issues Related to Documenting Informed Consent and Release of Assessment Records Practicing psychologists are required to inform their patient/client as well as their legal guardian about the information that will be shared among the legal guardians and others if needed based on the information provided. Some information that is disclosed during the assessment may need to be disclosed to others under the regulations of law and the psychologist’s policies. The reasons for discloser of confidential information needs to be discussed with the patient/client (Fisher, 2013). The release of treatment and assessment records may cause ethical issues to arise. Standard 4.05 permits that psychologists are to release confidential information if the appropriate consent had been obtained. There should be a signed release form indicating that the information can be released from HIPAA authorization. The documents should indicate specifically the persons or organization that the confidential information can be released from. If the information falls under HIPAA guidelines, the psychologist must obtain written valid authorization from the individual or representative prior to releasing the information. However, there are specific instances that require the psychologist to release the information without the consent of the client or patient. This information includes “those initiated to provide needed professional services; obtain appropriate professional consultation; protect the client/patient, psychologist, or others from harm; or obtain payment for services.”(Fisher, 2013). Enforceable Standards Relevant to the Release of Treatment-Related Materials and Disclosure of Information There are several Ethical Standards that are relevant to the release of treatment-related materials and the disclosure of information. According to Fisher (2013) Standard Principle E: Respect for People’s Rights and Dignity refers to the psychologist’s responsibility to protect the confidential information that is obtained from the client/patient. Standard 4.01 of the American Psychological Association Ethic’s Code requires that all psychologists have to take reasonable precautions to protect the confidential information. However, no information cannot be disclosed without the consent of the client/patient. Under the Ethical Code 3.10 informed consent can only be given by the client/patient or the legal guardian if the person is a minor or is unable to give consent based on medical needs. Specific Examples of What Each Enforceable Standard Requires or Prohibits According to the APA code of ethics (2015), informed consent is covered under standard 3.10. According to this standard, a psychologist needs consent by the patient to assess and treat the psychologist is to obtain written informed consent for the transfer of all patient’s information. A written release of information is required to be filled out and signed by the patient. This release according to Fisher (2013), needs to be precise in stating who shall receive the information, and what information should be received. According to APA Ethical Code (2015), no confidential information can be released without patient consent. If the patient is unable to consent or is a minor, Standard 3.10b states that informed consent may be given instead by a legal guardian, or legal representative of the patient (APA Code of Ethics, 2015). Standard 3.10 does not allow for psychologists to discuss confidential information with any individual without a written release. This standard is also present under the HIPAA law, which requires a written release for medical information (Fisher, 2013). It is also unethical for psychologists to proceed when consent is needed, but not obtained. Documenting all written consent falls under ethical standard 6.01. According to Fisher (2013), APA ethical standard 6.01 includes the requirement of keeping all records for “7 years” (p.181). Maintaining organized records ensures that the psychologist has a file containing all assessments, treatment schedules, personal notes, and all documentation on decisions as well as patient consent papers. This information is important in the event that it is needed for another professional to access or the courts to access. This standard does not allow for psychologists to have incomplete records, falsified records, or unorganized records. A psychologist following this guideline will be able to access any patient record, and find any information that might be required. If the courts need documentation of a defendants assessment results, a psychologist would be able to access the information easily. Along with standard 6.01 comes standard 6.02. According to APA ethics code (2015), Standard 6.01 involves confidentiality in both the maintenance and disposal of all patient records. According to Fisher (2013), computer records should be protected by passwords and firewalls. In the event that information needs to be transferred to another professional, this standard also requires that all psychologists to send data in an encrypted form, and to distort all audio or visual recordings of patients in an attempt to protect their identities. According to Fisher (2013), psychologists could also “use code numbers to identify patients” (Fisher, 2013, p.186). Standard 6.02 does not allow for a psychologist to allow anyone to look at patient files, nor does it allow a psychologist to store patient files in an unsecure area with open access to the public. This standard also do not allow a psychologist to release information about a patient, their treatments, or any other information pertaining to the patient that could harm the patient. Along with the standards requiring informed consent and maintaining confidential records, there is standard 5.01 which requires all psychologists to the “avoidance of false statements, or deceptive statements” (Fisher, 2013, p.162). Psychologists need to ensure that all information that they maintain and release about their patients is both factual and in representation of the clients themselves. Standard 5.01 does not allow for psychologists to falsify any documentation, consent papers, or assessments that they obtain from their patients. This standard also is effective when giving expert testimony about a patient or client. Rationale for Proposed Actions and Their Consistency with Ethical Guidelines Ensuring that all psychologists maintain accurate and confidential records is enforceable by the APA code of ethics. Failure to follow these standards can lead to legal action against the psychologist. To ensure that all psychologists maintain accurate records, Fisher (2013) identified that psychologists have the option of “gaining technical assistance” (p.136) to gain support in setting up a secure server, password protected areas and to set up a firewall. These actions will allow psychologists to ensure that their records that are saved on a computer are safe and secure. It is also imperative that psychologists limit access of patient information to themselves and selected individuals that the patient allows. The transfer of confidential documentation is enforced under standard 6.02. Plans to ensure that standard 6.02 is followed would include sending information that is encrypted, or altered in a way that would reveal no confidential information about the patient. Files should be sent in a manner that ensures their confidentiality, and a release of information should accompany the documents. When maintaining or transferring audio or video recordings, Fisher (2013) also mentioned that a psychologist should “distort voices and smear the faces of patients” (p.136), to ensure patient confidentiality. Ensuring that psychologists maintain accurate documentation of informed consent is also under standard 6.01 and 6.02. Informed consent should be included in the patient files, and stored in a way that is easily accessible should it be needed. A psychologist should obtain consent for all assessments, treatments, release of information and the like. Ensuring that they are maintaining organized files, ensures that the patient’s information could be accessed by those who need it in an appropriate manner. Evaluate the Legal Issues Associated with Assessment, Testing and Diagnosis Legal issues in psychology can arise at any given time. Professionals offer many services to different individuals over a period of time. Tests and assessments are used in educational and vocational settings. Individual are assessed for a number of reasons. However there is sometimes a question where the assessment, test and diagnosis is valid and reliable. This is where ethical and legal issues may become a problem. Psychologist professional’s validity is very important. “Validity is the overarching technical requirement for assessments, however, additional professional and social criteria have been considered in evaluating assessments, such as: (1) how useful the test is overall, (2) how fair the test is overall, and (3) how well the test meets practical constraints” (Cole & Willingham, 1997). Most importantly, validity play a major role in the diagnosis of the client. The misdiagnosis of clients can cause major legal issues because the assessments are used for crimes, psychological diagnosis, education purposes, and other life changing situations. A misdiagnosis may cause criminals to go free or on the other hand innocent or mentally disable people may be punished unfairly. In an educational setting, a student may not receive the help needed to perform effectively in school. Standard 9.02b states that “Psychologists use assessment instruments whose validity and reliability have been established for use with members of the population tested. When such validity or reliability has not been established, psychologists describe the strengths and limitations of test results and interpretation” (American Psychological Association, 2010). Therefore, it is imperative that professionals follow standards that are in place to avoid legal issues. Specific Legal Issues that Can Arise In Documenting Assessment, Testing, and Diagnosis Psychologist have been conducting research, assessment, testing and diagnosing patients for years. When a Psychologist commits these thoughts to paper, it then becomes a legal issue. These issues become very real and can create concerns for the patients, the medical professionals and health care workers. These issues can range anywhere from putting private information of patients on paper, identity theft, breaking HIPPA violations and exposing patients to harsh conditions like losing their jobs, embarrassment from family and friends and alienation from social groups. Psychologists are educators of the public and it is their duty to not only help patients but cause no harm to them. “Educators must take the initiative and the time now to analyze any existing or potential problems, whether real or imagined, and try to solve them while they are able to do so under non-adversarial conditions in a court of law.” (Collis, 1990, p. 574). Some legal issues that can arise is informed consent. Informed consent was a huge violation of patient’s rights because the doctors didn’t ask the patients for their permission, they just took it upon themselves to do what they felt was necessary and right. This is the result of a Supreme Court ruling, Schloendorff v. Society of New York Hospital (1914). Informed consent also means informed refusal. This decision led to the concept of informed consent that allows adults capable of making an informed decision the right to decide if they want to receive medical treatment (Whitstone, 2004). Along with informed consent, can informed refusal, (Sabatino, 2012). This means the patient has the right to refuse medical treatment, test and doctors. If the doctor determines that the patient is not capable of making an informed decision about his or her treatment, whoever is authorized to make medical decisions will be responsible to do so (Sabatino, 2012). Other issues that arise with assessment, testing and diagnosis, deals with race, ethnicity and gender. So that no one is violated because of one of these items, it is best to review the American Psychological Association (APA) Code of Ethics. Standard 9 of the APA’s Code of Conduct (2010) addresses issues related to assessments. It states that “Psychologists administer, adapt, score, interpret or use assessment techniques, interviews, tests or instruments in a manner and for purposes that are appropriate in light of the research on or evidence of the usefulness and proper application of the techniques” (pg. 12). Another legal issue, is breaking patients’ confidentiality. Confidentiality can only be broken with the permission of the client, or their medical proxy as long as doing so does not break any laws or it can be disclosed if it is required by law under certain conditions. Those conditions include if it is needed to provide required services, obtain a consultation, protect someone from harm, or to get paid for provided services (American Psychological Association, 2010). According to the American Psychological Association (2010) in Standard 4: Privacy and Confidentiality, under section 4.01 Maintaining Confidentiality, it states: “psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship” (pg.7). In section 4.02 Discussing the Limits of Confidentiality it goes on to say that “Psychologists discuss with persons…and organizations with whom they establish a scientific or professional relationship…the relevant limits of confidentiality and…the foreseeable uses of the information generated through their psychological activities” (pg.7). This is a part of the informed consent process, discussed earlier. This is the result ending in the Privacy Rule known by its official name The Health Insurance Portability and Accountability Act of 1996 (HIPPA). All of the assessments, testing and diagnosing relies on the proper credentials of the Psychologist. The board of Association of State and Provincial Psychology Boards (ASPPB) are licensing boards for the United States and Canada. Thus helping develop the Examination for Professional Practice in Psychology (EPPP). These boards are all in conjunction to ensure the Psychologist have the proper training and required skills to asses a patient and keep up with the necessary code of ethics that require the Psychologist not to break the law. Rationale for Proposed Actions The overall concept is to protect the client not only physical but emotionally and mentally. The results from evaluations and testing’s can be harmful in the sense that someone’s bias may affect the way they treat a person. Informed consent protects that no one who is not in right sound or mind can receive any information without permission. This also allows a record of the individuals who have access to the information, as if an issue arises there is paper trail of all those involved or aware. Standard 4.05 Disclosures state that Psychologists disclose confidential information without the consent of the individual only as mandated by law, or where permitted by law for a valid purpose such as to (1) provide needed professional services; (2) obtain appropriate professional consultations; (3) protect the client/patient, psychologist, or others from harm; (APA, 2010) The rationale is that the patient should always be respected and protected. These standards are established to protect that no wrongdoing is possible with a patients information and that they patient has control of their treatment as well as the individuals who are involved or have input in their treatment. In conclusion it is important to have the patient centered in their treatment that they are educated on what their situation maybe what methods are being used and how such an experience may affect them. Every individual should receive the same levels of respect due to human rights, despite what others may consider to be a disability or anything differing from what some may identify as norms. Putting the patient first indicates that they feel supported and can see their growth. Having a “paper trail” allows not only the psychologist to see what has and has not been successful but the client as well. There is evidence of what has been successful and what may failed. Records also protect that there will not be any falsified information released that can cause harm, the general principle of psychology set the tone that psychologist utilize as a foundation and Legal and ethical aspect establishes fairness and equal rights. Reference Ethics. 2015. Retrieved from http://www.apa.org/ethics/code/ American Psychological Association. (2010). Ethical principles for psychologists and code of conduct. Retrieved from http://www.apa.org/ethics/code/principles.pdf Cole, N., & Willingham, W. (1997). Gender and fair assessment. Hillsdale, NJ: Erlbaum. Collis, J. (1990). Educational malpractice: Liability of educators, school administrators and school officials. Charlottesville, VA: The Michie Company Law Publishers. Fisher, C.B. (2013). Decoding the ethics code: A practical guide for psychologists (3rd ed.). Thousand Oaks, CA: Sage Sabatino, C. (2012). Informed Consent. Retrieved from http://www.merckmanuals.com/home/fundamentals/legal_and_ethical_issues/informed_cconsent.html Whitstone, B. N. (2004). Medical Decision Making: Informed Consent in Pediatrics and Pediatric Research. Retrieved from http://tchin.org/resource_room/c_art_18.htm
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