ACTIVITIES:
- Follow up on recieving medical records on patient K
- Discuss with Floy the ethical issues present at Larue Carter
INTEGRATION QUESTION: Values & Ethics/micro or macro: Describe an ethical issue, concern or dilemma you experienced in the field. How was it resolved?
I have skipped my "reflection" section this week, due to the detail in which I would like to answer this week's integration question. It is almost too difficult to only pick one ethical dilemma I have experienced in the field. It seems that I am noticing them more and more as time goes on. Some are dealt with appropriately, and others are just tossed around until someone forgets about them.
First, I noticed with one patient in particular, the way he was being treated for mental illness could, in some eyes, be viewed as an ethical issue. The boy is actually 22, making him a young adult. He has no legal guardian, and therefore, should be "the boss" when it comes to decisions about his treatment- or one would think, if he were being treated at any other hospital. However, there are a lot of grey areas when working with mental health. This boy was showing signs of severe depression, paranoia, borderline personality disorder, and has some schizo-typical tendancies... However, I argue, that he should STILL be in control of his care.
He has been hospitalized (at Larue) for over 2 years. Before Larue Carter, he was in and out of various other mental health centers, since around the age of 13. Doctors and treatment teams have had quite a difficult time looking for the roots of his problems, and successfully treating him. It is a very difficult case to follow.
One day, this patient asked me to recieve medical records for him from his previous medical providers (please keep in mind that this is a high functioning 22 year old). His mother confirmed the names and addresses he had given me. I took two different consent forms (one for each mental health center) to the unit for him to sign. He signs the legal consent forms saying he would like information to be passed from "Mental Health Center A" to Larue Carter, saying he would like to have a copy of whatever I can find. He thought it might help fill in gaps in his memory as to why he's been in the hospital for so long. He also wanted a copy to go to his doctor at Larue Carter.
As soon as the fax arrived from "Mental Health Center A" I took a copy to the doctor. I explained to the doctor that Kyle would like to have a copy, and the doctor said, "No! No! NO!" I was shocked. His quick and stern reply made me feel pretty stupid. He explained to me that due to confidentiality, this information was coming from one doctor at "Mental Health Center A" to one doctor (him) at Larue Carter. Absolutely no one else was to see what I had been faxed. However, what I recieved were merely progress notes, MUCH like the ones we already had in his chart (available to nursing staff, social workers, and other team members) from his other previous hospitals.
I find my ethical dilemma here. The patient is an adult. He signed the consent form for information to come to the hospital (not just the doctor). If he asks to see it- why would he not be allowed to see his own chart? Afterall, it is information about HIM. That just kind of confuses me. I am researching this now, and would like to see what the NASW code of ethics has to say about it...
What do you think?
Please feel free to comment with any ideas....
WEEKLY HOURS: 21.5
HOURS TO DATE: 205
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