In any professional field, maintaining the highest level of ethics is essential. Speech-language audiologists and pathologists are not an exception. In general, clinicians dealing with different types of patients should ensure that they withhold information regarding the medical status of their patients at all costs. Principle of Ethics I of the ASHA Code of Ethics (2016) requires individuals to conduct their professional responsibilities while maintaining the welfare of the individuals they serve. Specifically, rule 1-P of the principle requires speech-language audiologists and pathologists to maintain confidentiality of any personal or professional information about clients served professionally or involved in scholarly activities and research (American Speech-Language-Hearing Association [ASHA], 2016). However, the information may be revealed when done to safeguard the welfare of the individual or is legally required by law. Clinicians may experience ethical dilemmas with confidentiality, as explored in the hypothetical scenario below.
Jane is a student clinician in a hospital. One morning, she received Client M, a 16-year-old female with hearing and language problems. Client M was seeking assistance from Jane to improve her speech and language. While the client had attended the clinic in the company of her mother, the client expressed the wish for her mother to leave the room so that she could have some privacy. During the therapy session, the client revealed unprompted personal life information, including being pregnant. The client said that she was experiencing numerous symptoms, including severe vomiting in combination with feelings of nausea, a condition that has been recurrent over the past week. She had discovered that she was two months pregnant after having been sexually active over the past three months. The client further revealed that her sex partner is a close neighbor and classmate who is also 16 years old. Jane assisted the client with their speech and language problems and scheduled her for another interview. Once the session ended, Client M’s mother raised concerns that she had noted changes in her child’s behavior in recent weeks but could not identify the problem. She asked whether the client had revealed any personal information that could explain the recent behavior change. The mother insisted that she paid for the session and had the right to know.
Speech-language pathologists and pathologists must maintain the highest level of confidentiality regarding the patient’s condition to ensure conformity with ASHA ethical principles. From the above example, if Jane decides to disclose Client M’s pregnancy status to her mother without the latter’s approval, this amounts to a breach of the confidentiality rule provided by ASHA and the ethics resources policies, which require safeguarding information revealed by the client (ASHA, 2016). Information should not be shared unless the client has allowed the professional to do so. The client has the right to uphold the information until such a time when they feel that they can share details of the pregnancy or any other health condition with family or friends (ASHA, 2016). Therefore, telling the mother would expose the client’s state, making them feel uncomfortable, which can lead to other adverse psychological consequences such as stress.
In my opinion, the above case could have been handled better by the clinician consulting the patient before revealing their pregnancy status to the mother. Although she is underage and informing the mother may be in her best interest, it is not fair or ethical to leave the girl out of this process since she might not be psychologically ready to face her mother about her prevailing condition. Further, the mother might also need more time to be ready to receive such information. Telling her abruptly may promote a negative reaction. Despite the client explicitly stating the information should be kept private, the student clinician should know that all information shared must be kept private unless there is a legal necessity. In this case, the father is also a minor, and the sexual activity was consensual; therefore, no laws were violated. Instead, the clinician should encourage the mother to talk to the daughter and raise her concerns.
In conclusion, maintaining patient information confidentiality is crucial at every stage of the treatment process. It is unethical to reveal patient information to a third party, whether they are parents or otherwise. Since the sexual activity was with a fellow minor and consensual, there is no legal requirement to violate confidentiality. Therefore, the clinician should not reveal personal information to the client’s mother.
References
American Speech-Language-Hearing Association. (2016). Code of Ethics (2016). https://www.asha.org/policy/code-of-ethics-2016/#:~:text=The%20ASHA%20Code%20of%20Ethics,making%20related%20to%20professional%20conduct
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