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Ethical Issues & Mental Health: Right to Treatment, Informed Consent & Confidentiality

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  • 0:05 Rights of Patients
  • 1:20 Confidentiality
  • 2:27 Right to Treatment
  • 4:22 Informed Consent
  • 6:03 Lesson Summary
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Lesson Transcript
Instructor: Natalie Boyd

Natalie is a teacher and holds an MA in English Education and is in progress on her PhD in psychology.

When someone goes to see a mental health professional, they have legal and ethical rights that are meant to protect them. In this lesson, we'll explore three major rights of patients: confidentiality, the right to treatment, and informed consent.

Rights of Patients

Imagine that you are a psychologist, and Kat comes to see you. She struggles with bipolar disorder. For a while, she'll be very energized and optimistic. Everything seems to fall into place for her, and she can go several days without sleeping. But then, it's like a light switches off inside of her. She becomes despondent and listless. She's exhausted all the time and isn't interested in doing any of the things that she normally finds fun.

For years, Kat has been struggling with these swings in her mood and energy levels. But recently, things have gotten worse. She's starting to think and talk about hurting herself. Her friends and family are concerned and have forced her to come to see you, a psychologist.

Whether Kat comes on her own or is forced to come to you by friends and family or through a court order, she has certain rights, and you have certain responsibilities that apply to her and anyone else who seeks or is ordered into therapy. Let's look closer at three patient rights within the world of psychology: confidentiality, the right to treatment and informed consent.

Confidentiality

So you're a psychologist, and Kat is under your care for bipolar disorder. One day, as you're working out in the park, you find out that one of your workout buddies is a colleague of Kat's at the company where she works. Kat's coworker says he's concerned about her. He's seen that she sometimes acts depressed, and he doesn't want her to hurt herself. You tell him that she'll be okay; she's got bipolar disorder, and you're working with her on overcoming her issues.

It might seem like you've just done a good thing, reassuring Kat's friend that she'll be okay. But, what if he goes to their boss and tells him that Kat has bipolar disorder? What if she gets fired because her boss doesn't want to deal with someone who has a psychological disorder?

You've broken one of the main ethical (and legal) obligations of a psychologist: that of confidentiality. Psychological patients, like medical patients, have the right to talk to their therapist in almost complete confidence. Only under a very few circumstances can a psychologist reveal anything about their patients.

Right to Treatment

Confidentiality isn't the only right that patients have. According to a famous article by Morton Birnbaum, psychological patients have ''a constitutional right to receive such individual treatment as will give them a realistic opportunity to be cured or to improve his or her mental condition.'' Essentially, Birnbaum argued that psychologists have a duty to provide treatment that will help the patient.

What does this mean in practice? Remember that Kat is seeing you because she has bipolar disorder. As her psychologist, your job is to provide her with good treatment. There are essentially two ways that you can violate the right to treatment:

1. You do not provide treatment.

If Kat comes to you, and you have her sit in your office, but never talk to her or try to help her in any way, you are not providing treatment. This might seem like an extreme example, and it is. But, imagine that instead of your office, Kat is admitted to a psychiatric ward of a hospital. There, she gets her basic needs taken care of (food, water, shelter), but people are so busy that they don't take the time to try to help improve Kat. This is another example of how a patient might not receive treatment.

2. The other way that you can violate the right to treatment is if you provide her with treatment that does not offer 'a realistic opportunity' to help the patient.

Imagine that Kat comes to see you, and you talk to her. You know that she has bipolar disorder and that most patients with bipolar disorder respond well to medication and therapy. But, instead of giving her medication and therapy, you decide that the best treatment for Kat is to be locked in a dark closet for hours at a time. With no evidence that this could cure her, you are not providing her with good treatment.

Informed Consent

But, let's say that you are Kat's psychologist, and you want to provide her with the best treatment possible. You know that medication is likely going to be part of that treatment, but as with many medications, the mood stabilizers used for bipolar patients come with side effects. What do you do? Do you just hand over the pills and say, 'Here. Take these?'

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