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Duty to Warn and HIV clients

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Samantha Strachoff

on 1 May 2014

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Transcript of Duty to Warn and HIV clients

What is HIV
• According to the Center for Disease Control and Prevention (CDC) HIV is a virus spread through body fluids that affects specific cells of the immune system, called CD4 cells, or T cells. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. When this happens, HIV infection leads to AIDS.
Duty to Warn
Brian is a 24-year old married bisexual man entering counseling to deal with grief and depression associate with a recent diagnosis of HIV infection. During the course of counseling, Brian discloses that he continues to be sexually active with his wife and also occasionally with anonymous male partners. Brian has not disclosed his diagnosis to anyone and maintains that it is necessary to do so because he practices "safe sex".
Duty to Warn and HIV clients
What are we exploring?
Should Duty to Warn apply to psychologists who learn that one of their patients is HIV positive and engaging in unprotected sex with an identified person who is at risk for getting HIV but doesn’t know it?
Prevalence
The Tarasoff Decision
Tarasoff mandated three conditions sufficient to impose a duty to warn:
(1) a special relationship
(2) a reasonable prediction of conduct that constituted danger
(3) a foreseeable victim
Ethical Concerns
1) Preventing harm to third-parties
2) Issues of confidentiality and duty to warn
3) Counselor application of ethical principles
a) Autonomy
b) Nonmaleficence
c) Beneficence

Example:
Permitted Disclosure
1) Refusal of a client to warn sexual partners
2) Therapist identifies high-risk situation involving partner
Counselor Decision
1) Decreasing risk
2) Present model of risk assessment
a) no risk
b) negligible risk
c) high risk
So what is a therapist to do !?
References
About HIV/AIDS. (2014, February 12). Centers for Disease Control and Prevention. Retrieved April 29, 2014, from http://www.cdc.gov/hiv/basics/whatishiv.html

Gehring, D. D. (1982). The counselor's 'duty to warn.'. Personnel & Guidance Journal, 61(4), 208-210. doi:10.1002/j.2164-4918.1982.tb00314.x

Hazler, R. Legal and Ethical implications of HIV and Duty to Warn For Counselors: DoesApply?. Journal of Counseling & Development, 397-400.

Kain, C. (1988). To breach or not to breach: Is that the question? A response to Gray and Harding. Journal of Counseling and Development, 66, 224-225.

Kitchner, K. (1984). Intuition, critical evaluation and ethical principles: The foundation for ethical decisions in counseling psychology. The Counseling Psychologist, 12(3), 43-55.

Melchert, T. P., & Patterson, M. M. (1999). Duty to warn and intervention with HIV-positive clients. Professional Psychology: Research And Practice, 30(2), 180-186. doi:10.1037/0735-7028.30.2.180

Simone, S. J., & Fulero, S. M. (2001). Psychologists' perceptions of their duty to protect uninformed sex partners of HIV-positive clients. Behavioral Sciences & The Law, 19(3), 423-436. doi:10.1002/bsl.450
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