Case Study: Confidentiality, Privacy, and Privilege


In research, investigators must often collect data about very sensitive and private aspects of participants’ lives. In clinical work, psychology professionals are often privy to highly charged emotions and situations. In fact, due to the highly sensitive nature of their work, psychology professionals or those studying to be psychology professionals are often in morally ambiguous situations, or they may be working with individuals with conflicting demands, needs, or perceptions of what constitutes ethical behavior.

Concepts integral to the protection of information and individual rights include confidentiality, privacy, and privilege. These concepts often are used interchangeably, but they have distinct similarities and differences. It is imperative that psychology professionals fully understand their responsibilities related to each one. Failure to do so puts them at risk of violating trust-based relationships and may have significant ramifications.

For this Application, review the following Case Study:

You are conducting a study of resilience among families that have experienced domestic violence. You will meet with participants four times over a 1-year period, conducting numerous assessments of their psychological well-being and daily functioning in order to study patterns over time.

Maria is a 32-year-old Latina woman. She has volunteered herself and her daughter, Rosalinda (age 6) to participate in your study. Maria explains that she is separated from Rosalinda’s father, who has allegedly committed violent acts in the home. When Maria and Rosalinda came to the first data collection session, Maria read and signed an informed consent form while in the waiting room. The form was fairly standard, citing all the usual terms of and exceptions to confidentiality.

Over the course of the study, during the sessions, you begin to know both mother and daughter well. As you make your way through the daily functioning assessment interviews at the third session, Maria tells you that she has started to date again. Maria seems unusually anxious about finishing the interviews quickly. She watches the clock and interrupts you to confirm that she will be receiving the same $50 stipend that she received at the end of previous sessions. You also notice that Rosalinda’s distress symptoms appear to be getting worse. For example, she is extremely upset when Maria goes to the restroom and cannot be calmed for the rest of the session. However, you are not a clinician, so your impressions are based on your own personal experiences with children.

Shortly after Maria and Rosalinda leave, a man approaches your office and introduces himself as Maria’s husband. He appears to have followed them and wants to know what she and Rosalinda were doing in your office. He does not seem threatening in any way and seems quite civil and pleasant.

The Case Study allows you to apply ethics to real-life situations and demonstrate your understanding of the decision making needed to resolve such conflicts. It is rare for an ethical dilemma to involve only one issue, so you should take the time to reflect on the complications that present themselves in the situations described in the Case Study.

For this week’s Application, review the overview of the five ethical decision-making models that can be found in the Learning Resources section.

Koocher and Keith-Spiegel’s nine-step ethical decision-making model
Canadian Code of Ethics for Psychologists: The 10-step ethical decision-making process
Rest’s four-step ethical decision-making model
Jones’s four-step intensity-contingent ethical decision-making model
Fisher’s eight-step ethical decision-making model
For this week’s Application, submit a 3 page paper that includes the following:

An explanation of the ethical dilemmas you perceive to be involved in the Case Study.
A description of what you might do in response to the dilemma. Include the following in your explanation:
A step-by-step application of one of the decision-making models provided above.
An explanation of the possible outcomes for each individual in the Case Study.
An explanation of any benefits and limitations of the model you selected.


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