1 Making Difficult Decisions with Patients and Families The IEP event I attended was held on March 4, 2023, concerning making difficult decisions with patients and families. The session focused on the concept of ethical decision- making. The case study discussed in the session was based on a critical ethical, and legal issue faced by a medical professional. In the case study, Dr. Jeya receives a request from the patient's mother, Mrs. Bertha Khoo, to covertly test for drug use by the patient, Annie. The request takes place over the phone after three months following Annie's first follow-up appointment. The proposal from Mrs. Khoo seems to concern the safety and Annie's ability to care for her son. While the patient does disclose her challenges with past drug addiction and recovery with Dr. Jeya in their first session, the request from the patient's mother creates a barrier for Dr. Jeya.
2 Some ethical questions addressed in the session's small group discussion were: Should the Dr. perform a drug test without the patient's consent? If the Dr. does the test, can he disclose a patient's health information to another person without informed consent? Should child protective services get involved? Would this convey the message that the Dr. expects this patient will not be truthful despite being partially aware of the patient's past drug history? Would doing the test violate the respect and rights of the patient? All questions were discussed based on patient privacy, the confidentiality of health information, and the Dr-patient relationship. To come to an ethical conclusion, we followed two steps. The first step was to identify if the situation is an ethical dilemma. The second step was making an ethical argument for the course of action after analyzing facts and values, balancing principles and intuitions, as well as comparing our decision to other similar situations. Based on the steps, we concluded that the Dr. should professionally handle this situation by not doing the drug test without the patient's consent. He should not speak with Mrs. Khoo unless Annie is present to maintain confidentiality. At the same time, Dr. should not disregard Mrs. Khoo's concerns by referring Annie to a social worker at the hospital after addressing the question of current drug use. The Dr. should also advise Mrs. Khoo to contact child protective services if required, since Dr. does not have background information concerning possible child neglect by Annie. He should not discuss the issue of possible child neglect with Annie out of respect and to maintain a trustworthy relationship. The greatest learning experience from this event was learning to identify an ethical dilemma and address the issue appropriately. The steps to making ethical decisions are essential in social work practice because, as professionals, we must be guided by the code of ethics. These ethical principles and standards are core values on which social work's mission is based. They
3 further guide decision-making and conduct when ethical issues arise. From this event, I learned how easily an ethical dilemma might arise. Despite good intentions, a professional in the field of working with clients should always work towards maintaining professionalism.
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