Legal and Ethical implications of HIV and Duty to Warn For Counselors: DoesTarasoffApply?

A Comparison of the Ethical Beliefs of Certified Rehabilitation Counselors and National Certified Counselors

Results of a national survey of certified rehabilitation counselors (CRCs) are compared with those obtained by Gibson and Pope (1993) from a national sample of national certified counselors (NCCs) to determine their beliefs about whether particular behaviors are ethical, and the degree of consensus or controversy about these behaviors. Commonalities and differences in the beliefs of these two groups are described. Implications for education and the field of rehabilitation counseling are discussed. The authors conclude that the high degree of similarity between beliefs of CRC and NCC respondents provides empirical support that these counselors share a fundamental set of ethical beliefs.

HIV medical care provider practices for reducing high-risk sexual behavior: results of a qualitative study

A first step in ensuring that HIV-infected persons practice the safer sexual behaviors that reduce disease transmission is to make certain that they receive accurate information about the relationship between sexual risk behaviors and HIV transmission. Health care providers can play a pivotal role in preventing secondary transmission of HIV; federal agencies and professional guidelines encourage providers to counsel HIV-infected patients about safer sex practices and transmission risks, particularly since the health care encounter may be the only time that HIV-infected persons receive information about prevention and risk reduction interventions. Yet research indicates that these opportunities are often missed. Prior to implementing a prevention demonstration project in an urban HIV and STD clinic, we conducted a qualitative investigation with providers, including physicians, nurse practitioners, physician assistants, and nurses. The purpose of this investigation was to examine the current status of prevention education and counseling efforts at the clinic, examine the barriers and facilitators to providing prevention counseling, and identify key areas where providers believed that they needed additional training.

Ethical dilemmas related to counseling clients living with HIV/AIDS

This study tested an eight-factor model of client actions/decisions in terms of the extent to which professionals counseling persons with HIV/AIDS believed that those actions/decisions presented ethical dilemmas, and the frequency with which they encountered such actions. A confirmatory factor analysis lent initial support for the hypothetical eight-factor ethical-dilemma model for the ratings regarding the extent to which the participants believed those items constituted ethical dilemmas. Similar results were obtained for the frequency ratings, but in this case a second, competing model was equally plausible. Several significant predictors of participant ratings were found and are discussed.

Family therapists' ethical decision-making processes in two duty-to-warn situations

This quantitative study investigated the ethical decision-making process of 177 Missouri members of the American Association for Marriage and Family Therapy using two in-session duty-to-warn scenarios of child abuse and HIV transmission. The components of the critical-evaluative level of ethical decision making include the lower-level decision components of personal/therapeutic response, professional ethics, and legal considerations/laws of the State, and the components of the higher-level decision base, the meta-ethical principles, which are nonmaleficence, autonomy, beneficence, fidelity, and justice. Statistical results indicated that in the child abuse scenario, professional ethics and legal considerations/laws of the State were considered most important, whereas in the HIV scenario, professional ethics were the preferred lower-level decision base. Across scenarios, the preferred higher-level decision base was nonmaleficence. There were differences across the child abuse and HIV scenarios in the perceived significance of the remaining lower-level decision base items as well as differences in perceived significance and ordering of the remaining meta-ethical principles. Limitations are discussed.

Knowledge of laws regulating issues related to HIV and AIDS: development of the HIV/AIDS and the law scale

42 middle-aged and older adults, ranging in age from 51 to 85 years, completed 10 items dealing with the assessment of knowledge regarding laws regulating issues related to HIV and AIDS. Participants also completed 40 items involving knowledge of risks for HIV infection. The Cronbach coefficient alpha and test-retest reliability coefficient on the HIV/AIDS and the Law Scale were .74 and .83, respectively. Over-all, the grand mean for correct answers was 46.9%, whereas the grand means for incorrect answers and "don't know" responses were 13.6% and 39.5%, suggesting substantial lack of knowledge of laws regulating issues related to HIV and AIDS. Women (50%) and younger participants (51 to 66 years old; 48.2%) showed more of this knowledge (50%) than men (43.0%) and older participants (46.2%). The sample reported a substantial amount of knowledge regarding HIV transmission assessed with factual (92.2% correct) and misconception (87.5% correct) items. The correlation between this knowledge and knowledge of laws regulating issues related to HIV and AIDS was .42 (p < .01). Research with this scale using adolescents and young adults as well as the utility of the scale in areas of clinical, legal, and policy development are discussed.