Question
How should clinicians handle situations where an ethical code and a legal requirement appear to conflict?
Answer
When ethical standards establish a higher bar of conduct than the law technically permits, clinicians should generally follow the ethical code, since the code may protect against forms of harm that the law does not directly address. When such a conflict arises, it must be made explicit and communicated to relevant parties, such as by informing an attorney that record disclosure could produce a problematic clinical outcome and by exploring alternatives, such as providing a treatment summary rather than full documentation.
If genuine conflict cannot be resolved through discussion or compromise, clinicians should generally defer to the law, provided doing so does not require violating fundamental human rights. Throughout this process, consultation with trusted colleagues and an ethics committee is essential, along with careful documentation of these conversations. It is also worth pausing to verify that a true conflict exists at all; sometimes what initially appears to be a direct violation is actually a misunderstanding that becomes clear once additional clarifying questions are asked.
This Ask the Expert is an edited excerpt from the course, 'Ethical Integrity in Mental Health: A Framework for Proactive Decision-Making,' presented by Rachel Singer, PhD.
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