Read Case Example 5.1 -- Failure to Secure Informed Consent
Read Case Example 8.1 -- "Please Help My Boyfriend"
Case
Example 5.1
Failure to Secure Informed Consent
A physician was ordered to appear before his state’s medical board to
respond to complaints the board
had received from 6 of his patients about his practice of medicine. The major
complaint was that the physician was using energy modalities in conjunction
with standard Western medical practices during treatment. He had learned these
techniques while attending several weekend continuing education courses.
The problem was that he did not explain the energy methods he was using to his patients. Consequently, the patients did not feel they received information necessary to feel comfortable or, in our words, to make an informed consent about the use of energy modalities.
Further, the physician did not have the patients sign proper documentation that they had received information to make an informed consent which further compounded the problems for the physician.
The medical board had broad powers to regulate the practice of medicine in the physician's state. Traditionally, energy modalities are not considered part of the standard of practice of medicine and fall outside the scope of practice. The physician, by not obtaining informed consent, opened up a can of worms.
In addition to the charges of not obtaining
informed consent, the board also required the physician to
answer to charges of violating ethical standards, failure to document, practicing
medicine below the standard of care and outside the scope of practice, and
obligating patients to
purchase supplements.
The physician could have avoided having to answer to the medical board if he had not violated several core psychological concepts in ethics.
One, he did not consider the patients to be partners in the decision-making process.
Secondly, he failed to give his patients a voice in the process and to obtain permission (informed consent) to proceed with using energy modalities during treatment.
Another core psychological concept in ethics
is that every action that the practitioner takes is in the service of the
client's needs and not the practitioner's desires. The facts suggest that
the physician was placing his need to use energy modalities ahead of his patients’
need to understand energy modalities
and to make an informed choice. By not considering the patient's needs and
not being in partnership with his patients, the physician misused the power
differential inherent in all therapeutic and fiduciary relationships.
In the recent past, energy modalities were considered to be non-invasive and to have no side effects other than client relaxation which may have justified the somewhat casual use of an energy modality. In today’s climate of expanded privacy laws and patients’ rights, informed consent for any intervention is essential.
Case
Example 8.1
“Please help my boyfriend”
Jenny had been Tom’s client on and off throughout the last 7 years.
She benefited from his use of energy therapies and was enthusiastic about
stimulating meridian acupoints to enhance her personal life. She brought her
new boyfriend, James, to a recent session with the request, “Please
teach him your energy therapy methods. I have shown him all I can remember,
like the tapping, and it has already helped both of us greatly.”
Tom felt deeply gratified that the client sought him out to assist with the new relationship and quickly launched into several algorithms to address the boyfriend’s blocked material. In this true example, the couple broke up several weeks later for a number of reasons unknown to the therapist. The ex-boyfriend then sued the Tom for “using experimental methods with him that embarrassed him in front of his girlfriend and resulted in alienation of affection.”
Here’s a good example of the Drama Triangle in 3 easy moves:
1) a request to assist (client perceived as a Victim) made to eager therapist (Rescuer);
2) the client’s shift to Persecutor role by suing the therapist;
3) and a switch of the therapist to Victim role of a long lawsuit that actually resulted in his giving up his license.
Whenever you feel flattered, you would do well to raise a big red flag. What considerations would you need to make before offering James innovative approaches? What do you need to explain to Jenny regarding her use of the methods as James’ girlfriend?
Before jumping into such an inviting, seemingly
innocent, request you would need to consider that James
is really a new, as yet unknown client. What safeguards to you have to insure
that a new client is appropriate to energy-oriented approaches? How do you
assess readiness, interest, and willingness?
The rules of informed consent and client choice are just as real, and more complex, when a romantic relationship is involved.
