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Patient Confidentiality and its Implications

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You are a bachelor level human services professional working as a therapeutic aide (mental health technician) in a community mental health center where you have a client who is 17. He reveals that he has a baby on the way with his current girlfriend; he asks you not to tell his parents about this. He lives with his parents and the girl lives with her parents - she has already told her parents and is receiving pre-natal care through her doctor, but she has refused to name the father. What factors would you need to know/consider to assist the client and address confidentiality issues? Would you consider breaking his confidentiality to his parents? To his girlfriend's parents?

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In a case like this, confidentiality laws would still apply. However, when dealing with individuals, especially minors who have engaged in behaviors that can affect other individuals/their parents, the best approach to use ...

Solution Summary

Patient confidentiality can be complex when dealing with underage adults. This solution discusses these implications.

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Tarasoff Case: Exploring, Understanding, and Implications

A number of states have adopted "duty to warn" or "duty to protect" laws following the landmark court case Tarasoff v. Regents of University of California (1976). In addition, there are other mandated exceptions to maintaining client confidentiality such as reporting child or elder abuse, or the reckless transmission of HIV or other sexually transmitted diseases. Most statutes protect mandatory reporters from liability claims, including those based on a breach of confidentiality. Counselors need to remain apprised of their state's statutes related to confidentiality and "duty to warn," and understand how these statutes apply to their own practice. In addition, as you review the Tarasoff case and related readings, be mindful of the issue of vicarious liability, which extends "duty to warn" liability to a counselor's supervisor.

Reference: Tarasoff v. Regents of University of California, 17Cal.3d425, 131Cal.Rptr.14, 551P.2d334 (1976).

1. Give a brief description of the State of Maryland case law and statutes related to the Tarasoff decision. Then, analyze how a professional counselor would resolve "duty to warn" and/or "duty to protect" dilemmas, noting relevant ethical codes and decision-making models. Be specific, referencing specific case law and statutes.

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