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Medical Ethics/Could my counselor breach confidentiality this way?

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Question
Well I had some things happen with my therapist and am wondering if she was allowed to breach confidentiality the way she did.

Well first off, I am 19, so am no longer a minor. I live in New York, so I am not sure if things are different there or something.

But anyways. So a bit back I was talking to my therapist and told her that I had bought some sleeping medication as a 'back up plan' I didn't tell her that I was going to kill myself on 'this day and this time' with them, just that I wanted to have a back up plan, something to keep in my back pocket.

She made me get rid of them when I got home, and had me call her once I got rid of them.

Then the next week I saw the person that prescribes me medication (she works as a team with my therapist) she is a nurse practitioner. She of coarse asked me if I had any thoughts of hurting myself/committing suicide. Me trying to be as honest as possible told her yes and she asked how I would do it. I hesitated, but told her the ways that i had thought of doing it. She told me she wanted to call my mom to ensure I was safe at home, but I was really scared so she let it slide this time.

But then when I saw my therapist the next day she told me she had chatted with my nurse practitioner and they had decided that my mom needed to be contacted and told that I have suicidal thoughts. She said that it was that or being placed in the psych ED.

She ended up calling my mom because that was her preferred course of action. She said she could breach confidentiality in this case.

Now was she allowed to force me to let her call my mom?  Is that her right? She said too many red flags were going up. But is it legal for her to have done this.

I'm just wondering. And now because of what happened I am now afraid to tell her everything that's going on with me anymore. Is there a way that you can ease my fear as well as answering my question about the legality of it all?

Answer
Katherine,

It is not a breach of confidentiality for a mental healthcare worker or medical provider to communicate with another provider.  Also, you were not forced to let your mother know of your condition since you were provided with a choice; ie: be involuntarily committed or tell your mother.  If you elected not to tell your mother, your therapist would have institutionalized you as a potential danger to yourself.  If she unilaterally contacted your mother without providing you with a choice, that would be a breach of your confidentiality if you were 18 or older at the time.

I hope this helps clarify the ethics of the situation.  I wish you the best.

Very truly yours,

Paul D. Friedman, M.A, Ph.D., J.D.

Medical Ethics

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Paul D. Friedman, M.A., Ph.D., J.D.

Expertise

In addition to my law degree, I have a master's degree in bioethics and a doctorate of philosophy involving comparative medical, legal and business ethics. I am an adjunct professor at a medical school teaching ethics to healthcare professionals and graduate students.

I can answer questions dealing with general ethics principles, including medical ethics, research ethics and bioethics. I am not a moralist and do not interject subjective values such as what is morally right and wrong. Also, I do not give legal advice over the internet.

For more information, you can view my webiste at WWW.EXPERTETHICS.COM

Experience

I have been a civil trial attorney since 1989 with a masters degree in bioethics and a doctorate of philosophy involving comparative ethics.

Organizations
State Bar of Arizona
State Bar of Colorado (inactive)
District of Columbia Bar (inactive)
Federal Bar
Licensed in the Arizona District Court
Licensed in the Ninth Circuit Court of Appeals
licensed in the United States Supreme Court
American Bar Association
American Association for Justice
Arizona Trial Lawyers Association
American Society for Bioethics and Humanities
Kennedy Institute of Ethics


Publications
A list of my copyrighted publications and presentations is contained at WWW.EXPERTETHICS.COM

Education/Credentials
Bachelor of Arts 1985
Juris Doctorate 1989
Master of Arts in Bioethics 2004
Doctorate in Philosophy 2006

Awards and Honors
Phi Beta Kappa
Multiple Who's Who
Outstanding Achievement Award in Bioethics from Midwestern University

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