Ethical Dilemma Working with Hiv Positive Client
Reconstruction of scenario for case No. 4: Assuming that I am a registered counsellor working in a hospital in Malaysia. The client has been referred by doctor in order for him to go through counselling. Recently he came to hospital to carry yearly medical check-up for various tests including HIV test. Results showed all tests carried out are in good condition except the HIV test result is positive. From the counselling intake session, I also know that he is sexually active and has not told any of his partners about this. Isn’t it my ethical responsibility to inform someone that he is, in effect, dangerous to others?
Selected Ethical Decision Making Model – Forester-Miller and Davis (1996)
Step 1: Identify the Problem - (1) client may possible of transmitting contagious disease (HIV) to third parties through sexual encounter, if demonstrating in high risk behaviour (2) uncertain of client’s intention to protect others (3) uncertain if client has knowledge on the need for partner notification/counselling (4) uncertain on client’s knowledge of modes of transmission of HIV to others (5) Client personal issues such as relationship with others, control, revenge, insecurity etc.
Step 2: Apply the ACA code of Ethics - (A.1.a) The counselling relationship - Primary Responsibility; (B.1.c) Confidentiality – Respect for Confidentiality; (B.2.b) Confidentiality – Contagious, Life-Threatening Diseases – Exceptions; (B.2.d) Confidentiality- Minimal Disclosure; (B.3.b) Information shared with others – treatment teams; (B.3.c) Information shared with others – confidential settings; (C.1) Professional Responsibility- knowledge of standards; (C.2.a) Professional competence – Boundaries of competence.
Step 3: Determine the Nature and Dimensions of the Dilemma
• My primary responsibility is to promote welfare for my client but the safety of the partners should be protected too.
• HIV is contagious and to find way for not putting other into high risk of contracting the
Selected Ethical Decision Making Model – Forester-Miller and Davis (1996)
Step 1: Identify the Problem - (1) client may possible of transmitting contagious disease (HIV) to third parties through sexual encounter, if demonstrating in high risk behaviour (2) uncertain of client’s intention to protect others (3) uncertain if client has knowledge on the need for partner notification/counselling (4) uncertain on client’s knowledge of modes of transmission of HIV to others (5) Client personal issues such as relationship with others, control, revenge, insecurity etc.
Step 2: Apply the ACA code of Ethics - (A.1.a) The counselling relationship - Primary Responsibility; (B.1.c) Confidentiality – Respect for Confidentiality; (B.2.b) Confidentiality – Contagious, Life-Threatening Diseases – Exceptions; (B.2.d) Confidentiality- Minimal Disclosure; (B.3.b) Information shared with others – treatment teams; (B.3.c) Information shared with others – confidential settings; (C.1) Professional Responsibility- knowledge of standards; (C.2.a) Professional competence – Boundaries of competence.
Step 3: Determine the Nature and Dimensions of the Dilemma
• My primary responsibility is to promote welfare for my client but the safety of the partners should be protected too.
• HIV is contagious and to find way for not putting other into high risk of contracting the