MAC Ethical Practice 2 — Questions and Answers
Question 1: A client in a methadone maintenance program tells their counselor they are driving a school bus while impaired. What is the counselor's PRIMARY ethical obligation?
- Immediately report to the client's employer
- Warn identifiable third parties who are at risk of serious harm (Correct answer)
- Maintain confidentiality because addiction is a protected disability
- Consult a supervisor and document the conversation
Correct answer: Warn identifiable third parties who are at risk of serious harm
The duty to warn overrides confidentiality when there is serious, imminent, and foreseeable danger to identifiable third parties.
Question 2: Which ethical principle requires a counselor to keep client information private and disclose it only with consent or legal authority?
- Autonomy
- Beneficence
- Confidentiality (Correct answer)
- Fidelity
Correct answer: Confidentiality
Confidentiality is the ethical obligation to protect client information from unauthorized disclosure.
Question 3: An addiction counselor is asked to provide expert testimony against a former client in a malpractice lawsuit. The MOST appropriate action is to:
- Refuse all testimony to protect former clients
- Testify only if a court order or client consent is obtained (Correct answer)
- Testify freely since the therapeutic relationship has ended
- Provide a written report but decline oral testimony
Correct answer: Testify only if a court order or client consent is obtained
Confidentiality extends beyond termination of treatment and requires a court order or written client consent before disclosure.
Question 4: A counselor discovers that a colleague is having a sexual relationship with a current client. The FIRST step should be:
- Report directly to the state licensing board
- Confront the colleague directly and document the conversation (Correct answer)
- Notify law enforcement immediately
- Ignore it to avoid workplace conflict
Correct answer: Confront the colleague directly and document the conversation
Most ethical codes recommend addressing the issue directly with the colleague first, then escalating through proper channels if unresolved.
Question 5: Under 42 CFR Part 2, a substance use disorder treatment program may disclose client records WITHOUT client consent in which situation?
- A police officer presents a valid subpoena
- A medical emergency threatens the client's life (Correct answer)
- An insurance company requests records for billing
- A family member claims to be the client's emergency contact
Correct answer: A medical emergency threatens the client's life
42 CFR Part 2 permits disclosure without consent in bona fide medical emergencies to medical personnel.
Question 6: Which scenario BEST illustrates a boundary violation rather than a boundary crossing in addiction counseling?
- Accepting a small homemade gift from a client at termination
- Attending a client's graduation ceremony at their request
- Entering a business partnership with a current client (Correct answer)
- Sharing a personal recovery story to normalize the client's experience
Correct answer: Entering a business partnership with a current client
A business partnership with a current client creates a dual relationship that exploits the counselor's position of trust and constitutes a boundary violation.
Question 7: A counselor who routinely imposes their own values about abstinence on clients who express a harm-reduction goal is violating which ethical principle?
- Nonmaleficence
- Justice
- Autonomy (Correct answer)
- Fidelity
Correct answer: Autonomy
Autonomy requires counselors to respect clients' rights to make their own decisions about their treatment goals.
MAC Ethical Practice 2
A client in a methadone maintenance program tells their counselor they are driving a school bus while impaired.
What is the counselor's PRIMARY ethical obligation?