The Case Study of an Ethical Dilemma

Introduction

An ethical dilemma refers to a problem in deciding the existence of two possible moral imperatives and where none of them is acceptable or preferred. The difficulty in determining certain complicated situations comes from the situational conflicts where, when one is obeyed there is a possibility of lapsing another. They are sometimes known as ethical paradoxes in morals that occur philosophically, the dilemma in ethics is mostly invoked to discredit a system of ethics or moral codes or to make an improvement which will help resolve the paradox. There is a need to have an ethical decision-making model because there is a need to protect the clients or patients because of the increased cases of violating the ethical standards as well as laws (Sommers, 2017). This mostly happens because the counselors do not in most cases identify the major ethical issues, especially in clinical situations.

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Thesis Statement

The main scope of the case study is to show the ethical dilemma counselors experience in situations where clients are involved. In this situation, the counselor is expected to make a decision based on a case involving her client who lied about using the drug intravenously. The rules of the rehabilitation center were clear that they were only recruiting patients with the problem of intravenously. The client has benefited from the treatment given his history with drugs. However, the right steps have to be taken to avoid future incidents from happening. Therefore, the case study involves the steps in decision making where an ethical dilemma exists.

The Problem/Dilemma and the Potential Issues

Rights, Relevant Issues, Responsibilities, and Welfares of Individuals Involved

The family of the patient under treatment is concerned since they have the rights to know what treatment their relative is receiving and should have consent for it. The situation dramatically impacts them because the rehabilitation center has to question the close family members if they are aware the patient was not using the drug intravenously. When the patient is discharged after Susie Q find out about the lie, they have a right to know the main reason for any decision made. The family has a responsibility of talking to their patient about the situation in order make them aware that what he did was not right. However, the welfare of the client has to be considered to ensure he received the help he needed despite the situation. The issue of social, economic status may impact the case significantly because the family may not be stable in terms of finances to provide better care to the patient in other facilities and this might lead the patient to go back to drugs because of lack of better care he needs.

In this situation, the difficulty occurs where the counselor discovers that her patient has been lying about using intravenously. The patient begs the counselor not to report the matter because he has been benefiting from the treatment given that he has been using drugs. The ethical dilemma here is whether the counselor should notify the client about the intravenous drugs case to the relevant authorities or not because she has to make a choice when she chooses to report, the patient will stop receiving treatment from the treatment center, and his life might be ruined. Also, if she decides to be silent about the matter, she will be going against ethical codes of the health facility where it has been made clear that only patients who have been using intravenously will receive treatment.

Therefore, she is required to decide on the right step to take in that situation, in this context the conflict is both clinical and professional because the interests of the clinician do not align with those of their patients. A professional conflict occurs when there is an opposition between what is considered as private interests and the official duties or responsibilities of an individual. The person's involved individual is mostly in the position of power, trust or has authority. Therefore, there is a need for such a situation to occur so that a potential judgment can be provided or compromised. The counselor undergoes a professional conflict because she might be willing to help the patient, but the position she holds does not allow her to act in favor of him because she has responsibilities of doing what is right and following the ethics (Corey, 2015).

The Critical Fundamental Moral Principles

The essential fundamental principles of ethical codes include honesty, fidelity, autonomy, beneficence, non-maleficence, and justice. According to (Corey, 2015) each of these principles critically describes how an ethical dilemma can be solved; they provide a solution to various problems facing professionals during their work. Veracity refers to honesty especially with clients or vice versa, in this situation, there is a need for the counselor, to be frank with her patient of the consequences of lying about using intravenously. The substance abuse treatment center is clear about the kinds of patients that are required and there nurse is expected to act rationally given the rules of the center. She is not likely to support the act of lying for personal benefits from the patient, and therefore there is a need to report the situation to the relevant authorities for appropriate measures to be taken.

Another fundamental principle is fidelity where the counselor is expected to remain faithful, loyal, can fulfill commitments, be time conscious and also have the ability to keep appointments. Susie Q should be devoted in her work in that she is faithful to the rules and guidelines of her place of work and in case of any problem, she is expected to act rationally and with honesty. She is also required to be loyal and not support or cover the mistakes made by the client because she is obliged to the treatment center. She is also expected to meet her commitments and finish her responsibilities on time as well as keep appointments with the other clients who need similar help or assistance. Autonomy refers to respecting the right of the client to making their own decisions; the counselors should have the patients consent before treating or counseling them. The counselor should not make any decisions for the client before consulting them because the clients know what they want or what treatment or counseling they want since they are the ones who need assistance.

The counselor must be fully aware that at times a client might bring up specific topics that tend to annoy them or even push their personal "buttons". Therefore, it is essential for the counselor to know how to deal with such situations when they arise with a lot of wisdom. Some counselors tend to have extreme emotional reactions when the clients have behaviors that tend to conflict with the values or ethics, and some of them end up overreacting, and at that moment they are not able to set aside the values they believe in or know. The counselor is also encouraged to examine what is the core of their value-based conflict; they can identify the main issues underlying to identify the significant barriers that prevent the counselor from delivering the required services to their clients.

Beneficence means that the client should benefit from the counseling or treatment they receive in the substance abuse treatment center and the counselor is expected to do what is best for the patient. If the counselor has not enough experience to assist the client, there is a need for her to quit because she might do what is not required or go against the client's wishes or wants. The counselor should practice justice when handling the client by ensuring he is treated equally with other clients that are receiving treatment in the center.

Lastly, the counselor is expected to be non-maleficence where she is supposed to act responsibly by avoiding exploitation of the patients. She should also avoid any form of intervention not approved, and that can cause harm to the patient in any way, the counselor should also prevent any emotional, sexual or financial exploitation and avoid any form of malpractice or incompetence. The counselor should provide services when fitting to offer better services to their clients and bring satisfaction (Remley, 2014).

Ethical and Legal Standards The counselors are in most cases faced with dilemmas which can be moral or otherwise; Susie Q works with her clients to deal with many issues that the clients bring in the consultation room. The counselor has to consider this dilemma and give them thoughtful consideration, and at the same time, the ethical dilemma requires her to make reasonable decisions not only because of the consequences that might occur but also due to the result of the therapeutic relationship. The moral codes of NAADAC include the counseling relationship, evaluating, assessing and interpreting the client's data, confidentiality especially in communication and privacy, and professional responsibility.

Relevant Ethical Codes or Principles of NAADAC

In the counseling relationship, the counselor has the burden of protecting the integrity of the counseling relationship by ensuring that the client is well provided with the most beneficial services. In this case, the patient using drugs has the right to receive adequate treatment and any other kind of referral by considering his legal, educational and financial resources that are required. The counselor should also identify her responsibility to the society as a whole and any other specific responsibility that may in particular circumstances or occasions need loyalty to other people in need. In the process of counseling, Susie Q might find the client to be exploitable and vulnerable when such incidents occur; she should look for ways provide support and nurture the relationships for the client to develop and have good advantages with others.

Evaluating, interpreting and assessing the client's data involves the counselors using the appropriate assessment instruments to counsel or treat a client by considering their personal or cultural background. The process of evaluation and interpretation ensures the well-being of the specific clients or groups of clients; the counselors should only base their reports or recommend the clients by following the right procedures and using the proper instruments. These instruments are expected to be reliable and should also be verified by the researchers as being efficient. This applies in this situation where the counselor is required to have a scope of competency, the client under treatment in the local drug and substance center is responding therapy despite him having lied about the use of the drug intravenously. However, the counselor is required to use appropriate instruments that have been approved and are easy to interpret to administer treatment or assist the client in need.

Confidentiality, especially in communication and privacy, applies where the counselors are required to provide information to their clients with regards to the level of privacy and any other purposes for releasing information by following the laws of privacy. When the counselors are providing services to groups of individuals such as families or couples, there is a need for them to review the limits or any possible exceptions to confidentiality and a written document containing the terms and conditions provided to each (Corey, 2015). The counselor in this circumstance should only disclose the client's information when she has full consent from the client. She should put effort by ensuring that the confidential information of the client is protected except in individual cases or situations.

Professional responsibility expects the counselor to espouse objectivity and integrity while in the process ensuring that high...