21 Aug 2022


Ethical Dilemma In Out Patient Facility

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Ethics govern the daily functioning of individuals especially among those people who work in substance abuse treatment in the world. In most cases, people working in the substance abuse treatment field face several ethical dilemmas meaning that there is a need for establishing ways through which such ethical dilemmas can reduce. These challenges occur both at the individual and society level, but they have significant influence among the substance abuse professionals, victims, and the families of the affected individual. Working at substance abuse field exposes an individual to dilemmas related to the individual beliefs, judgments, and values. The dilemmas arise from the fact that people from different societies have differences in the manner in which they perceive an individual who is seen as drug abuse (McIntosh, 1989). As a result, cultural diversification related to addiction treatment originates from the fact that people professionals have to make decisions based on the requirements of the victim, society, and focus on adhering to professional ethics. This paper explores the application of ethical dilemmas in outpatient treatment. 

Substance abuse professionals need to make decisions related to the type of substances administered to the victim, time to start the treatment process, and when to end it (CEUSource: CEUSource , 2012). In circumstances where people visit the clinical facilities are prescribed to substance addiction, they end up experiencing treatment issues such as overdose and treatment issues. For instance, a drug user may be in need of professional intervention, but the community, individual, and family beliefs and values become inhibiting factors to search for that treatment process. An example of an outpatient treatment dilemma occurred to Julie who is a social worker in a substance abuse clinic. She once experienced anxiety and explained to substance abuse, and the doctor prescribed lorazepam as a substance to reduce the anxiety issue associated with increased level of alcohol abuse. Though Julie was incompetent in performing duties, she was later released to the society ending up overdosing the substances. Since she was an outpatient, she experienced complications such as overdose which resulted in further admission for treatment (CEUSource: CEUSource, 2012). This scenario presents some of the issues that arise from ethical dilemmas in substance treatment because professionals have challenges in determining the right time to start and end the treatment process. 

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The challenges witnessed in this case originated from the fact that Julie was involuntarily committed to inpatient treatment making it difficult for the doctor to prescribe and monitor the movements of the individual with the treatment process. The inpatient treatment program could have been an alternative approach through people would develop a sure way of ensuring that people receive the best treatment approach in that sector. In situations where substance abuse professionals experience dilemmas in deciding whether to set an inpatient treatment or not, the victims are always set to enter the family and society increasing the risks for both the victim and the people in the community. In most cases, they end up abusing the abuse treatment program which increases the vulnerability of drug (Van, 2016). Drug abuse administration in Maryland requires that the people in the society should have a law hearing before engaging in any form of treatment which makes the process to be a complicated one. 

The ethical dilemma experienced in this sector originates from the fact that the patient had an alternative to either choose for inpatient or outpatient program. Based on this information, it is evident that the doctor provided inpatient services to Julie, but she was involuntary willing to adhere to the outpatient counselor as required by professional substance abuse. The central argument, in this case, is that the freedom and requirements of the law in different countries contribute to the increased level of deaths that result from the increased use of substance abuse. If there is an establishment of global laws governing the addictions substance treatment, there will be a reduction in the rate at which patients develop complications from the outpatient treatment program. The freedom that governs the people in the substance abuse facility contributes to the increased level of complications associated with drug abuse. 

The ethical dilemma experienced in this situation occurs from the fact there are cultural differences between people from different cultures have different perceptions that people usually have when it comes to making decisions related to the treatment process. In this case, the doctor had described a professional requirement that the doctor needed to develop ways for understanding how people develop adequate skills required in the treatment process (Day ‐ Vines et al., 2007). However, the doctor did not have the sufficient skills required in making the decisions associated with the kind of treatment to be administered to the patient. The decision made has to consider the values, beliefs, and willingness of the individual as well as the needs for developing an alternative approach in addressing the needs of the people in the society. The various aspects that ought to be considered when choosing the kind of treatment administered to Julie remain the reason behind the overdose by Julie. If Julie acted by the doctor’s advice, there would not be the development of such complications. 

Decision making and confidentiality dilemma in decision-making approach is a common approach that leads to the creation of problems associated with substance addiction treatment program in a situation where counselors have to make decisions associated with the kind of treatment that an individual has to experience. For example, the doctor gave adequate information to Julie related to the kind of counseling she would need to undergo. Decision-making process requires identifying an approach for helping in the decision-making process. The doctor took an initiative of explaining the benefits and costs associated with each type of treatment exercised to the victim. Julie failed to adhere to the guidelines provided by the doctor. This information indicates that there are differences associated with confidentiality and the decision-making process required in offering substance addiction treatment. Despite the advice by the doctor about the benefits of having an outpatient counselor, the patient failed to adhere to the prescribed treatment approach. 

Freedom of choice and action that govern the operation of substance addiction professionals and interaction with clients can be seen as a contributing factor to the occurrence of the issue (Mullen et al., 2006). For example, the ethical requirements for the addiction professionals require that the therapist should take the initiative for establishing guidelines depending on the complexity of the addiction. Similarly, the professional ethical operation also requires that the interaction between the client and the therapist should operate by the willingness of the victim (Lee, 2015). The role of the doctor is limited to the explanation of the best alternatives that need to be applied in handling that particular situation. However, the final decision comes from the patient after evaluating the alternative available in addressing the issue. The doctor in the scenario had little say on the decision made by Julie because she had already provided the expected discussion on the issue. 

The role of an addiction counselor is to ensure that there is an establishment of successful ways through which they can monitor and improve the welfare of the victims. In this case, they must ensure that they provide the best alternative for the patients to promote their protection from the beginning of the treatment up to the last moment of the treatment process keeping information from the patient confidential. The ethical action of counselors also requires that there should be mechanisms for preventing harm to the patient whenever possible. For example, the doctors and the counselor for the anxiety disorder developed by Julie would have monitored the behavior and actions by Julie thus avoiding the occurrence of the complications. However, an ethical dilemma arises from the complexity of social norms experienced by addiction professionals when handling such complications. For instance, patients find it challenging to perform some actions explained by the patients because of the failure in addressing the issues associated with substance abuse. Some actions such as greeting the patient appear to be some of the best approaches that professionals need to apply. However, this becomes unacceptable to the clients because their culture and customers act against these behaviors. The desire for patients to keep their requirements for confidentiality of the information with the doctor might have been a fundamental reason behind the refusal of accepting outpatient counselor. 

Racial differences between the client and the professional therapist may also contribute to the failure of Julie to engage in the inpatient treatment thus resulting in drug overdose which helped to the increased complications experienced by Julie. Some communities such as Indian Americans find it challenging to seek interventions from professionals because most of the professionals are whites (Herlihy & Corey, 2014). In this case, they prefer exploring interventions from people within the community because they are particular about the kind of treatment they expect from those professional therapists. However, if they belong to a different racial group, there will be the existence of doubts and that people will be unwilling to seek interventions. For example, if the doctor prescribed Julie to a counselor from different backgrounds, Julie would find it difficult to accept because of the suspiciousness of the kind of fairness they are going to receive from the counselor. In most cases, professional therapists for substance addiction are mostly willing to provide adequate treatment to the patient with care and fairness, but the existence of racisms exercised across the globe makes it challenging to meet the expected needs of the victim. 

Some boundaries govern the interaction between patients and professional therapists for drug abuse. In some cases, the family and the society at large become essential elements in determining the kind of prescription that the victim ought to undergo (Monti et al., 2014). This consideration provides differing alternatives of when to start and end the treatment problem. For example, the level of anxiety that Julie develops because of exposure to substance abuse can take a prescribed period, but this depends on the willingness and ability of the family members to interact with the counselors and therapists. Despite the involvement of the community and family members, the treatment process takes different actions because the ethical operation requires that counselors and professionals should not interact with non-objective ability members thus keeping the interaction process confidential (Lee, 2015). 

Ethical dilemmas are common among therapists, and they originate from various principles and values governing the interactions with the victims. Some people find it challenging to seek synergies with patients because they believe that it is difficult to find therapists who adhere to cultural differences. Substance abuse and the intervention mechanisms differ from one state to the other, and this affects the intervention approaches that ought to be applied in deciding the best treatment process. For example, people have adequate information about the requirements for engaging in the treatment process. The freedom of choice and difference in customs also create ethical dilemmas in treating the people which make it impossible to achieve a global cultural acceptance of the addiction treatment process. These aspects apply in the case of Julie where it becomes challenging to accept inpatient treatment and also fails to accept an outpatient counselor. 


CEUSource:CEUSource (2012). Ethics for substance abuse counselors. Retrieved from http://ceusource.com/texts/ethics_text.html

Day ‐ Vines, N. L., Wood, S. M., Grothaus, T., Craigen, L., Holman, A., Dotson ‐ Blake, K., & Douglass, M. J. (2007). Broaching the subjects of race, ethnicity, and culture during the counseling process.    Journal of Counseling & Development ,    85 (4), 401-409. 

McIntosh, P. (1989). White privilege: Unpacking the invisible knapsack. http://www.library.wisc.edu/EDVRC/docs/public/pdfs/LIReadings/InvisibleKnapsack.pdf. If you choose to search online for the article, make sure it includes a discussion before and after the listing of 26 privileges. 

Monti, P. M., Colby, S. M., Mastroleo, N. R., Barnett, N. P., Gwaltney, C. J., Apodaca, T. R., ... & Biffl, W. L. (2014). Individual versus significant-other-enhanced brief motivational intervention for alcohol in emergency care.    Journal of consulting and clinical psychology ,    82 (6), 936. 

Mullen, R., Dawson, J., & Gibbs, A. (2006). Dilemmas for clinicians in use of community treatment orders.    International Journal of Law and Psychiatry ,    29 (6), 535-550. 

Herlihy, B., & Corey, G. (2014).    ACA ethical standards casebook . John Wiley & Sons. 

Lee, K Lee(2015). Embracing diversity: Treatment and care in addictions counseling. Cogella Publishing: 

Van Wormer, K., & Davis, D. R. (2016).    Addiction treatment . Cengage Learning. 

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