March 9, 2015
Mary Ann Little
A Minor Confidentiality Issue
Working in the human service and healthcare profession, over the course of time one comes across cases that places them in ethical dilemmas. When the dilemma involves a child the decision is critical. Many different factors comes into play and when the parents aren’t together that only enhances the situation. Confidentiality is key in this expertise of profession, however, when is it important to breach that confidentiality? As we explore many options and cases certain ones are sensitive and require special consideration. You have to make sure that all the T’s are crossed and I’s dotted. Every option must be addressed in order to best assist the need of the client.
Tavion Robinson was a 6 year old little boy who was brought into the ER with a broken arm and several abrasions. When asked what happened, the boys’ father answered that he fell off the jungle gym at the park. While still at the hospital, the father didn’t seem to want to allow the staff to speak to Tavion without him present. The hospital staff was suspicious about the fathers’ story of how Tavion got his injuries, the abrasion seemed to be to clean for him to have gotten them from falling at the park. The staff finally got a chance to speak with Tavion without his father while he was getting his x-rays. Tavion confirmed what his father was saying about his injuries. The staff questioned Tavion further concerning any abuse or fear of abuse at home. Tavion denied any allegations and it was noted in his file. Once the x-rays were complete and prior to leaving Tavion’s father requested that a notice be placed so that he is to be notified before any of Tavion’s records be released and since that he and Tavion’s mother are divorced (noncustodial parent), she is not allowed access to Tavion’s records. Shortly after Tavion’s visit to the ER, his mother comes to request his records from that visit and states she suspects his father of physical abuse.
In a case such as this, the best interest of the child is what’s most important. Let’s evaluate the case: Tavion is 6 with a broken arm and abrasions. His father states that he fell of the jungle gym at the park, yet, the abrasions signify something different because they were to clean and if he had actually fallen the abrasions would have been different. There is also the fathers’ behavior, not wanting Tavion to speak with the staff alone and asking to be notified anytime someone request Tavion’s medical records, as well as not wanting his mother to have copies. Then there are her accusations of abuse by his father. The ethical issues in this case are simply, whether or not there should be a breach of confidentiality and allow the mother access to Tavion’s records and the physical evidence that could have been due to abuse.
In the state of Tennessee, at hospitals there are Social Workers on staff to handle cases like Tavion’s. Along with the evidence of the abrasions and the concern of his mother would simplify enough to get a Social Worker involved in the case and conduct further investigation. However, his father was adamant about not giving the mother any type of information and the hospital wouldn’t want to have a violation against them. Yet, when is it okay to have a breach of confidentiality? This is a sensitive case and must consider all aspects. Even with Tavion’s father instructions, his mother could easily speak to the hospitals Social Workers about her son’s visit to the ER and her concerns of abuse in the home.
There are some internal and external issues that could come from this situation. First by the hospital giving the ER visit records to Tavion’s mother could turn into a law suit for breach of confidentiality. With his mother being the non-custodial parent in some states those parents have no right according to the law. National Associate of Social Workers states that “there is some