PBC Ethical Standards & Professional Boundaries 3 — Questions and Answers
Question 1: A perinatal bereavement specialist learns that a grieving parent is also a colleague at the same hospital. Which action BEST maintains ethical boundaries?
- Provide care as normal since professional competence is unaffected
- Refer the colleague to another provider to avoid role conflict (Correct answer)
- Disclose the dual relationship to hospital administration before proceeding
- Provide care only in clinical settings, not in shared workplace areas
Correct answer: Refer the colleague to another provider to avoid role conflict
Referring a workplace colleague to another provider eliminates the dual relationship that could compromise objectivity and the therapeutic alliance.
Question 2: Which of the following is an example of 'countertransference' in perinatal bereavement care?
- A client projecting anger about her loss onto the counselor
- A counselor feeling personal grief when a client describes her stillbirth (Correct answer)
- A counselor using evidence-based techniques for complicated grief
- A client refusing to discuss her pregnancy loss in sessions
Correct answer: A counselor feeling personal grief when a client describes her stillbirth
Countertransference occurs when the clinician's own emotional responses—such as personal grief—are triggered by the client's material.
Question 3: When obtaining informed consent from a bereaved parent for bereavement support services, which element is MOST essential?
- Confirmation that the parent is emotionally stable enough to consent
- Explanation of the nature, limits, and alternatives to the proposed support (Correct answer)
- Agreement from the surviving partner before consent is finalized
- Documentation that the parent has no prior mental health history
Correct answer: Explanation of the nature, limits, and alternatives to the proposed support
Informed consent requires that the client understands the nature of services, their limits, and available alternatives so they can make an autonomous decision.
Question 4: A perinatal bereavement counselor is asked by a grieving father to write a letter supporting his custody case. The MOST ethically appropriate response is to:
- Write the letter since advocacy is part of holistic bereavement support
- Decline and explain that this role is outside the therapeutic relationship (Correct answer)
- Write a factual letter limited to attendance and participation in sessions
- Consult with the client's attorney before deciding
Correct answer: Decline and explain that this role is outside the therapeutic relationship
Writing advocacy letters creates a dual role that can compromise the therapeutic relationship and the counselor's professional neutrality.
Question 5: Which ethical standard governs a perinatal bereavement specialist's obligation to refer clients when the client's needs exceed the clinician's competence?
- Nonmaleficence (Correct answer)
- Veracity
- Justice
- Beneficence
Correct answer: Nonmaleficence
Nonmaleficence—'do no harm'—requires clinicians to recognize the limits of their competence and refer to prevent client harm.
Question 6: A perinatal bereavement nurse documents a family's care in the medical record. What is the MOST important ethical consideration regarding this documentation?
- Documentation should be detailed enough to support billing requirements
- Documentation should be accurate, objective, and limited to clinically relevant information (Correct answer)
- Documentation should capture all emotional reactions expressed by the family
- Documentation should be withheld from the medical record to protect privacy
Correct answer: Documentation should be accurate, objective, and limited to clinically relevant information
Accurate, objective, and clinically relevant documentation upholds both professional standards and the client's rights to privacy.
Question 7: A perinatal bereavement specialist notices a colleague engaging in boundary violations with bereaved families. According to professional ethics, the FIRST step is to:
- Report immediately to the state licensing board
- Confront the colleague directly and document the interaction
- Consult with a supervisor or ethics committee about the observed behavior (Correct answer)
- Inform the affected families of their rights
Correct answer: Consult with a supervisor or ethics committee about the observed behavior
Consulting with a supervisor or ethics committee is the appropriate first step, ensuring that concerns are addressed through proper professional channels.
PBC Ethical Standards & Professional Boundaries 3
A perinatal bereavement specialist learns that a grieving parent is also a colleague at the same hospital.
Which action BEST maintains ethical boundaries?