HSP Medical Ethics & Patient Rights 2 — Questions and Answers
Question 1: A patient discloses during therapy that they are in an abusive relationship but explicitly refuses help and instructs the psychologist not to contact anyone. What ethical principle is MOST in conflict with mandatory reporting obligations here?
- Beneficence
- Autonomy (Correct answer)
- Justice
- Fidelity
Correct answer: Autonomy
Autonomy—the patient's right to self-determination—is most directly in tension with the psychologist's duty to report or intervene in abuse situations.
Question 2: Under HIPAA, which of the following is NOT considered protected health information (PHI)?
- A patient's diagnosis documented in a medical record
- De-identified data that cannot reasonably identify an individual (Correct answer)
- A patient's appointment schedule stored electronically
- Insurance billing information linked to a patient name
Correct answer: De-identified data that cannot reasonably identify an individual
De-identified data that meets HIPAA's Safe Harbor or Expert Determination standards is excluded from PHI protections.
Question 3: A psychologist is asked by a court to release therapy records for a patient involved in a custody dispute. The patient objects. What should the psychologist do first?
- Release the records immediately to comply with the court order
- Inform the patient and, if appropriate, seek a qualified protective order (Correct answer)
- Refuse the court order on grounds of confidentiality
- Destroy the records to protect the patient
Correct answer: Inform the patient and, if appropriate, seek a qualified protective order
APA Ethics Code 4.05 instructs psychologists to inform the client and, if appropriate, take steps such as seeking a protective order before releasing records compelled by court order.
Question 4: Which ethical standard most directly governs a psychologist's obligation to avoid exploiting clients for personal gain?
- Integrity
- Nonmaleficence
- Avoiding Exploitation (multiple relationships) (Correct answer)
- Competence
Correct answer: Avoiding Exploitation (multiple relationships)
APA's standards on multiple relationships and exploitation specifically prohibit psychologists from misusing their influential position for personal, financial, or sexual gain.
Question 5: A patient who was previously involuntarily committed now presents voluntarily for outpatient care. Which right is RESTORED upon voluntary outpatient status?
- The right to refuse all treatment
- The right to leave treatment at any time (Correct answer)
- The right to choose any therapist regardless of license
- The right to access other patients' records
Correct answer: The right to leave treatment at any time
Voluntary outpatient patients retain the right to discontinue treatment and leave at any time, unlike individuals subject to involuntary commitment orders.
Question 6: The Tarasoff decision established that psychologists have a duty to protect identifiable third parties from a patient's serious, credible threats. Which of the following scenarios would MOST clearly trigger this duty?
- A patient expresses vague frustration that 'the world would be better without my boss'
- A patient states a specific plan to stab a named coworker after work tomorrow (Correct answer)
- A patient has a history of past violence but denies current intent
- A patient describes a dream in which they harm a family member
Correct answer: A patient states a specific plan to stab a named coworker after work tomorrow
Tarasoff duty is triggered by a specific, credible, and imminent threat against an identifiable victim, which the second option clearly satisfies.
Question 7: A psychologist discovers that a colleague is impaired by substance use and this is affecting client care. According to APA ethics, what is the FIRST recommended course of action?
- Immediately report the colleague to the state licensing board
- Attempt to address the concern directly with the colleague if feasible (Correct answer)
- Notify all of the colleague's clients about the impairment
- Terminate clinical contact with the colleague without discussion
Correct answer: Attempt to address the concern directly with the colleague if feasible
APA Ethics Code 1.04 encourages informal resolution by raising the concern directly with the colleague before escalating to formal reporting, when doing so does not compromise client welfare.
HSP Medical Ethics & Patient Rights 2
A patient discloses during therapy that they are in an abusive relationship but explicitly refuses help and instructs the psychologist not to contact anyone.
What ethical principle is MOST in conflict with mandatory reporting obligations here?