PS311 Unit 10 Ethical Case Analysis Example

A Mother, a Positive Test and a Child Welfare Worker's Call: A PS311 Unit 10 Ethical Case Analysis

[Student Name]

Purdue University Global

PS311: Ethical Practice in a Diverse World

Unit 10 Ethical Case Analysis

[Instructor Name]

[Date]

The client, her family, the staff and the program are composite; the laws, codes and studies cited are real, and state rules vary.

The Case

Ms. P., 29, a Navajo woman living in Tucson, entered the program six months ago after a child welfare investigation found that she had left her two-year-old alone while buying drugs, a report the program itself made at the time. Her son was placed with her sister, and reunification depends on her completing treatment. As part of her reunification plan she signed a release letting her caseworker receive her attendance record and her urine screen results. She has attended every session and tested negative for four months. Last week her test was positive for methamphetamine. She tells Elena, the case manager trainee, that she used once after learning her mother had died, begs her not to tell the caseworker and says she will lose her son.

Identifying the Problem

The conflict is between respecting Ms. P.'s wishes and protecting her trust, on one side, and the program's obligations under her consent and the child welfare process, on the other. Beneath that lies a question of her son's welfare. Corey et al. (2019) begin any ethical decision by naming the problem and everyone it affects: Ms. P., her son, her sister, the caseworker, the program and Elena herself.

Principles in Tension

Applying the principles Beauchamp and Childress (2019) describe, autonomy favors honoring Ms. P.'s choices, but her signed consent is also an exercise of autonomy, made when she entered the case plan. Beneficence favors keeping her in treatment and supporting reunification. Nonmaleficence warns against harming her through unauthorized disclosure and against harming her son through concealment. Justice asks that she be treated as other clients with the same consent would be. Fidelity, which Kitchener (1984) added for counseling, asks the program to keep its commitments to her and to the court process she agreed to join.

Her signed consent was not a rule imposed on her; it was a promise she made, and keeping it respected her too.

The Law

Records of federally assisted addiction treatment programs are protected by 42 CFR Part 2, which allows disclosure with the patient's written consent and limits use of records against the patient in legal proceedings without specific safeguards (U.S. Department of Health and Human Services, 2024). Ms. P.'s consent covers drug test results to her caseworker. It does not cover her account of her mother's death or her session content. There is no new report of child abuse or neglect: her son lives with her sister, and a single use does not by itself meet the definition of neglect. The law therefore requires the program to share the test result, because that is what she authorized, and nothing more.

Working Through a Model

Elena followed the stepwise model her program uses. She identified the problem and the relevant codes, reviewed the law above and consulted her supervisor that afternoon. They considered four options: withholding the result, which would violate the consent and the program's commitment; sharing the result without telling Ms. P., which would honor the consent but damage trust; sharing the result and the session content, which would exceed the consent; and helping Ms. P. tell the caseworker herself before the program sent the result, then sending only the result.

They chose the last option. It honored the consent, respected Ms. P.'s autonomy over how her story was told, kept session content confidential and gave her the best chance to show the caseworker the honesty and engagement that reunification depends on.

Culture

Ms. P. is Navajo, and her grief over her mother's death carried cultural dimensions that Elena did not know. Cultural humility, which Hook et al. (2013) describe as an open, curious and respectful stance, meant asking rather than assuming. Elena asked whether there were people or practices that would help her through her loss, and Ms. P. described wanting to attend her mother's funeral on the reservation and to see a traditional healer. With her consent, the program helped her arrange to attend and adjusted her schedule. Elena also noted that the federal Indian Child Welfare Act applies to custody cases involving Native American children and asked Ms. P. whether her tribe was involved in the case, so the caseworker would have accurate information.

The Conversation

Elena and her supervisor met with Ms. P. together. They explained what the program had to share and why, what it would not share and that they would support her in calling her caseworker first. Ms. P. was angry and then frightened. With Elena present, she called the caseworker, explained the relapse and her mother's death and asked what would happen next. The caseworker said a single positive test after months of negative ones, reported honestly, would not by itself change the reunification plan but would mean more frequent testing for a month.

Documentation

Elena documented the positive result, Ms. P.'s request, the consultation, the options considered, the decision and its reasons, the conversation and the release of the test result under the existing consent. The note recorded that no session content was shared.

What Each Option Would Have Cost

Looking back at the options makes the choice clearer. Withholding the result would have broken Ms. P.'s own consent, exposed the program to legal risk and, if the caseworker learned of it later from another test, could have looked like concealment that damaged her case far more than one positive result. Sending the result without warning her would have kept the law but cost the trust that kept her in treatment. Sharing her session content, including her grief, would have exceeded what she authorized and given the court private material she never agreed to release. The chosen path was the only one that kept every promise the program had made to her.

Reflection on the Decision

The decision did not give Ms. P. what she asked for, and it was still the decision that served her best. Withholding the result would have broken a promise she had made and, if discovered, could have cost her far more. The course's tools did not remove the difficulty. They made the reasoning visible to everyone involved, showed where the law drew its lines and kept the conversation centered on Ms. P. rather than on the program's protection.

References

Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.

Corey, G., Corey, M. S., & Corey, C. (2019). Issues and ethics in the helping professions (10th ed.). Cengage Learning.

Hook, J. N., Davis, D. E., Owen, J., Worthington, E. L., Jr., & Utsey, S. O. (2013). Cultural humility: Measuring openness to culturally diverse clients. Journal of Counseling Psychology, 60(3), 353-366. https://doi.org/10.1037/a0032595

Kitchener, K. S. (1984). Intuition, critical evaluation and ethical principles: The foundation for ethical decisions in counseling psychology. The Counseling Psychologist, 12(3), 43-55. https://doi.org/10.1177/0011000084123005

U.S. Department of Health and Human Services. (2024). Fact sheet 42 CFR part 2 final rule. https://www.hhs.gov/hipaa/for-professionals/regulatory-initiatives/fact-sheet-42-cfr-part-2-final-rule/index.html