ethical dilemmas in counseling vignetteshow to draw 15 degree angle with set square

I will reflect on a video presentation as well as the North Carolina rules and regulation and the ACA Code of Ethics as it relates to confidentiality and ethics. Dr. Crane is questioning the pros and cons of being the therapist and the faculty advisor. As the session winds down, Mr. Drapier spontaneously asks for a second opinion about his treatment with Dr. Cooper. Dilemma 4: A Psychologist in Turmoil Dilemma 5: A Tricky Situation Dilemma 6: Referral and Treatment Boundaries Dilemma 7: An Invitation to Assess Dilemma 8: A Session with the Spouse Dilemma 9: Psychologist as Character Witness Dan recently came out to his parents, who were accepting of his gay orientation and lifestyle. Hostname: page-component-7fc98996b9-g9qcd You are a therapist in a busy acute care hospital where you receive. Dr. Tell contacts you with the above scenario. What steps does the psychologist need to take? The physician, nurse practitioner, or physicians assistant will offer patients this important opportunity via a specially designed 4 x 6 card. The results and implications for counsellors, counsellor educators and researchers are discussed. Fowers and Davidov (2006) link the "multicultural movement" to classical writings about ethics in the philosophy literature,contrasting "virtue ethics"with merely following the rules. What are the ethical issues involved in this scenario? 8 0 obj You have shared a couple of patients with the psychiatrist in the past and have spoken with him by telephone a few times. Dr. What are Dr. Millers potential ethical issues in this situation? To provide hypothetical vignettes based on ethical/legal dilemmas in my own practice. You may access the ACA Code of Ethics and other ethics code at the WEBLINKS button on this website. Ethical Dilemmas in Counseling: A Case Study Examination The American Counseling Association (ACA) Code of Ethics was amended in 2014 to reflect the ever-changing social, political, and technological landscape which clinicians must navigate. Cynthia had already invested quite a bit of money into her private practice, and was determined to make it work, regardless of the type of clients she had to treat. Dr. Tell worked with a woman for several months on issues related to depression, anxiety, and relationship issues. Widely adopted as a textbook in graduate psychology courses in ethics and continuing education development, this innovative volume presents readers with over 100 different perspectives on crucial ethical issues and offers possible solutions from an expert ethics educator, psychologist, and former APA general counsel. If you have further questions, feel free to contact me. His family lives at a distance and provides minimal help. Sue schedules the appointment for early in the evening. Dr. Goodfriend is unclear whether Buddy is serious or joking. If you decide to provide information, would you consider communicating with the prior patients attorney? Because of his status as a well-known internist, he does not want to refer his daughter to a psychiatrist because he believes that he can handle the medication piece of her treatment. The prospective client was using her maiden name and gave no indication during the session that she knew about her ex-husbands treatment with the therapist. She is not sure that he completely understands what is happening or understands her version of informed consent for the additional services. Ethical Vignette Paper # Jodi Walters Liberty University. Dr. Thomas normally does not handle EAP services, but today several staff members are either ill or overbooked, so Dr. Thomas responds to EAP requests during the day. A therapist receives a letter from an attorney indicating that he has inherited an old car from Frank Palmer. My name is Dr. 2. Dilemma6: Referral and Treatment Boundaries, Dilemma9: Therapist as Character Witness, Dilemma 10: Multiple Relationships Revealed, Dilemma 14: The Psychology of Advertising, Dilemma 15: To Evaluate or Not to Evaluate, Dilemma 18: Co-authorship with a Former Patient. Therefore, we have a duty to report when our students or clientele is considering harming others or themselves. Feature Flags: { What, if anything, should the therapist do? Dr. Tell agreed to contact someone to discuss whether Dr. Tell had to report this information to the police or Child Protective Services. Your browser either does not support scripting or you have turned scripting off. . Does Dr. Goodfriend need to phone his high school friend to clarify his last comment? We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Dr. Crane currently works with an undergraduate student, Dan, on issues related to selfesteem and depression. Yet the dilemmas above speak of the profound difficulties we can face when thinking of our responsibilities and potential actions in real-life situations, especially difficult situations we might inadvertently find ourselves in. Kara, a therapist on the county hospitals psychiatric unit, is a recent graduate from a masters degree program in mental health counseling. Dr. Jordan is a therapist who typically works with a wide variety of patients. (1993). While confidentiality has been preserved, the dynamics of each case areisomorphicto a real clinical situation faced by a practicing psychologist. During this meeting, he realizes that while the other counselors generally behave in an ethical manner, they do not know the specifics of the code as well as hed like to. Dr. Goodfriend speaks with Buddy about once every six to nine months. The most frequent ethical dilemmas involved the limits of confidentiality, confusion about counsellors' professional roles in school settings, uncooperative behaviours among stakeholders, and suspected child sexual abuse. Both therapists are of the same profession. Mr. Tellanyone reveals that recently he had a conversation with his father in which the father commented how peaceful his wifes death was and how he hoped for a similar passing. To use provided clinical vignettes to practice how to recognize the ethical and legal issues. Ethical decision making for this study was defined as the degree to which decisions pertaining to confidentiality, parents' rights, and diversity and . She actually attended his graduation party briefly and hired him to cut her lawn for two years. Applicable State Codes/or Mental Health Laws Under the legislative information system code, it explains the standards of practice by counselors. The therapist recalls that the patient had always been good-natured, attended appointments regularly, and worked well in therapy. The ICU staff asks for your input. While discussing these issues, the patient suddenly stopped talking. Upon reflection, the therapist recalls that he had treated Mr. Palmer a number of years ago. Case Vignettes for Review Directions: The following cases are intended to facilitate the development of your ethical analysis and resolution capacities. However, after the session, the therapist feels uneasy about what his patient revealed. White Plains, NY: Longman. A therapist is treating a client who is involved in a legal proceeding. endstream The Submit Answers for Grading feature requires scripting to function. ethical dilemmas in counseling vignettes. Prior to their next session, Dr. Smith calls you for a consultation. iRE]7*ZG; K5|h{. Are there competing ethical principles? 4 Ethical Vignette "School counselors should acknowledge the vital role of parents/guardians and families." (American School Counselor Association, 2010, Section A.1.d.) Plenty engaging in a multiple relationship role in Mr. DiMenchas care? View all Google Scholar citations <>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> After the session is over, the therapist has time to reflect on her concerns. When asked about the reason for the referral, she said that her physician had referred her for anxiety. Because of busy primary care practices, the PASS-2 can be completed at home, if the office does not have internet access for patient use. 3. Abruptly, Mr. Drapier looks at his watch and leaves the office explaining that he is late for a business meeting. A therapist receives a phone message from a former patient. Dr. Solomon, feeling uncomfortable with the situation, contacts you for a consultation about the potential ethical issues for this case. By Dr. Stephen Behnke, APA Ethics Director February 2008, Vol 39, No. During the current session, the confides that he has made a new female friend. The treating therapist is questioning what to do. In a group setting, clients may no longer feel estranged from society or alone in their challenges, and instead view themselves as part of a community of people with shared experiences. An ethical decision-making model provides you with a set of guidelines for making ethical decisions. What concrete steps might be important before calling the physician back? To create paragraphs in your essay response, type

at the beginning of the paragraph, and

at the end. He needs assistance and monitoring with daily tasks, such as home care, shopping, transportation, understanding the settlement process, reading his mail, and paying his bills. Is Dr. Tell a mandated reporter in this situation? PsychBuilder Inc. developed the first internet-based administration and scoring of the Personality Assessment Symptom Scale-2, the PASS-2. Students and their parents/guardians rely on school counselors to provide counseling services based on ethically sound principles. During those calls, the conversations typically focus on careers, family members, and the whereabouts about other classmates. Next, most vignettes have more than one ethical issue that can be addressed. What are some of the potential ethical pitfalls in this scenario? In this new edition, Dr. Welfel provides the most current information on the market, including up-to-date coverage of the newly adopted ACA Code of . Does Dr. Goodfriend need to encourage Buddy to become involved in therapy if symptoms persist? The patient was in therapy for approximately one year. Dr. Goodfriend receives a call from Buddy, his very close high school friend. endobj She went on to detail how her boyfriend described how his uncle was involved in collecting and distributing child pornography but remained faithful to his aunt. The therapist knows that the ex-wife had been struggling with isolation and loneliness as well. The client indicated that she was hesitant to speak about the issue for fear of a breach of confidentiality. She was recently offered a position as a dual-diagnosis treatment counselor at a local drug and alcohol rehabilitation facility. My wife told me that I should see a therapist but I told her that I could talk with you and that it would be much cheaper.. T2 0#8r\ % Ethics and ethical codes are bounded by the cultural contexts in which they were produced. Simultaneously, he strongly believes he made the right decision. Kara then contacted the facility and let the supervisor know that she is not able to accept the position at this time, but that she plans to seek out the necessary training and supervision to work with substance abuse clients, and that she hopes the facility will consider her for the position once she has completed the necessary training. As the conversation continues, the therapist is surprised to learn that the patients new friend is the ex-wife of the therapists husband. Dr. Crane applauded and appreciated the students energy and creativity, but indicated some concern about dual role with the student. Dr. Lilith Crane, a therapist in the counseling center of a small rural campus, calls you on the phone for a consultation. Mr. DiMencha demonstrates a variety of cognitive deficits. : ethical dilemmas, burnout, stress, practicing counselors. Dr. Miller suggests that she meet with both Mr. and Mrs. Drapier to evaluate the marital situation. She recently received an offer to become a sales representative for a pharmaceutical company. endobj Additionally, Dr. Smith believed that some of the conclusions were in error, and had little support for those opinions in the body of the report. : Ethical and Legal Ramifications of Documentation Decisions. Programs that do not qualify for NBCC credit are clearly identified. Attempts to find social service agencies able to help him have not been successful. One afternoon Taras supervisor approached her and asked her if she would be interested in facilitating a group therapy session once a week at one of the centers other branches. Dr. Tell reminded her about confidentiality and the laws in Pennsylvania that would override it. The therapist phones the attorney and discovers that Mr. Palmer left him a 1993 fourwheel drive Ford Explorer. What do you believe is the best course of action? raised by clinical vignettes such as those below, Not knowing what to do, and realizing that the next patient is in the waiting room, the therapist takes the cash and sets up another appointment. In this paper I will discuss the ethical vignette as it deals with confidentiality and ethical dilemmas that counselor's face. The counsellor is also conscious. Dr. Solomon, a psychologist on an inpatient psychiatric treatment team, is concerned about the pending discharge of a current inpatient. An exploratory survey of school counsellors in the UK, their perceptions of confidentiality, information sharing and risk management, British Journal of Guidance & Counselling, Bir ilkretim okulu psikolojik danma ve rehberlik servisine yaplan bavurularn incelenmesi [An analysis of cases admitted to an elementary school guidance and counseling service during a period of four years], Teachers perceptions toward school counselors in selected private schools in Lebanon, Qualitative research: Introducing focus groups, Child abuse and neglect: A practical guide for professional school counselors, Social-cognitive development, ethical and legal knowledge, and ethical decision making of counselor education students, Can a parent do too much for their child? A survey of ethical dilemmas based on salient ethical issues in counseling supervision (i.e., dual . Ethical dilemmas of Turkish counsellors: A critical incidents study, Turkish school counselors experiences of reporting child sexual abuse: a brief report, Ethical judgments of counselors: Results from a Turkish sample, Breaching confidentiality to report students risk-taking behaviours to school administrators, Exploring the use of vignettes: From validity to trustworthiness, Okullarda yrtlen psikolojik danma ve rehberlik hizmetlerine ilikin okul psikolojik danmanlarnn grleri [Opinions of school counsellors on psychological counselling and guidance services carried out in schools], School counselors constructions of student confidentiality, Ethical transgressions of school psychology graduate students: A critical incidents survey, Alanda alanlarn gznden psikolojik danma ve rehberlik alannn sorunlar [Professional issues in counseling as perceived by individuals working in counseling settings], Mehmet Akif Ersoy niversitesi Journal of Faculty of Education, Okul psikolojik danmanlarnn ocuk istismaryla alma yeterliliklerine ilikin nitel bir aratrma [A qualitative research on the school psychological counselors competencies working with child abuse], Hacettepe University Journal of Education, retmen ve rencilerin rehber retmeni alglamalarna ilikin bir durum almas [A case study on the perception of the school counselor by students and teachers], The use of vignettes in qualitative research into social work values, Ortaokul mdrlerine gre okul gvenliine ynelik tehditler ve zm nerileri [Threats towards school security and solution suggestions for secondary school principals], Trakya Univerity Journal of Social Sciences, Okul psikolojik danmanlarnn okullarnda verdikleri psikolojik danma ve rehberlik hizmetlerini deerlendirmeleri [School counselors assessment of the psychological counseling and guidance services they offer at their schools], School counselors attitude and decision-making towards dual relationship and confidentiality situations in counseling, https://www.doi.org/10.14527/9786053183563.040, https://www.doi.org/10.17860/mersinefd.515865, http://eb.ted.org.tr/index.php/EB/article/viewFile/659/270, https://www.doi.org/0.1080/13645570050178594, https://files.eric.ed.gov/fulltext/EJ1158281.pdf, https://www.mevzuat.gov.tr/MevzuatMetin/1.5.5395.pdf, https://doi.org/10.17051/ilkonline.2017.342962, https://www.doi.org/10.1002/j.1556-6978.2005.tb00130.x, https://www.doi.org/10.1080/1754730X.2017.1285710, https://seahipaj.org/journals-ci/mar-2018/IJILPS/full/IJILPS-M-1-2018.pdf, https://www.doi.org/10.12984/egeefd.315891, https://files.eric.ed.gov/fulltext/EJ885152.pdf, https://doi.org/10.1002/j.1556-6676.1986.tb01120.x, https://www.doi.org/10.12711/tjbe.2017.10.2.0011, https://www.doi.org/10.1080/03069885.2012.718732, https://www.doi.org/10.17051/ilkonline.2019.612188, https://app.trdizin.gov.tr/publication/paper/detail/TVRZNU9USTRPQT09, https://dergipark.org.tr/tr/pub/ilkonline/issue/8587/106708, https://www.doi.org/10.1016/j.sbspro.2015.03.411, https://www.doi.org/10.1002/j.1556-6978.2010.tb00100.x, https://www.doi.org/10.1002/j.2161-007X.2013.00032.x, https://www.resmigazete.gov.tr/eskiler/2020/08/20200814-2.htm, https://www.doi.org/10.18506/anemon.425418, https://app.trdizin.gov.tr/makale/TXpZMU9EUTJOZz09/turkiye-nin-ruh-sagligi-yasasi-ile-imtihani, http://www.erguven.net/medya/okulveli.pdf, https://doi.org/10.1080/03069885.2014.987726, https://www.doi.org/10.1080/10538712.2015.1084072, https://www.doi.org/10.1080/10508422.2014.941981, https://dergipark.org.tr/tr/pub/kefad/issue/59420/853446, https://files.eric.ed.gov/fulltext/EJ1034752.pdf, https://doi.org/10.1207/S15327019EB1003_5, https://www.doi.org/10.16986/HUJE.2018044070, http://www.acarindex.com/dosyalar/makale/acarindex-1423936567.pdf, https://www.myk.gov.tr/index.php/en/haberler/53-hukuk-mueavirlii/2940-5-yeni-ulusal-meslek-standard-yaymland, https://www.doi.org/10.1177/1473325004041133, https://www.doi.org/10.26468/trakyasobed.502187, https://dergipark.org.tr/en/pub/kefdergi/issue/22606/241620, https://www.doi.org/10.3969/j.issn.1000-6729.2018.03.002. Ethics Vignette #2 A local psychiatrist is referred by his attorney for neuropsychological evaluation related to possible mild head injury ( traumatic brain injury) from a MVA. tiny black tadpole looking bug in bathroom; ff14 plasmoid iron lake location; top 10 most dangerous areas in cape town; cockapoo rescue michigan; floris nicolas ali, baron van pallandt cause of death; After six sessions, Mr. DiMencha suffered a significant concussion while at work. Workers Compensation refuses to pay for the case management services of an independent social worker. He also divulged that his risk-taking behavior has increased as well, such as speeding. He indicated that Dr. Cooper recommended that he discontinue a psychotropic medication in favor of an herbal remedy. Okul ruh sal hizmetlerinde yaanan sorunlar: Psikolojik danmanlarn grleri [Problems encountered on school mental health services: School psychological counselors opinions], Role stress among practicing school counselors, Ortaretimde grev yapan retmen ve okul yneticilerinin okul gvenliine ilikin alg ve beklentileri [Perceptions and expectations of teachers and school administrators working in secondary education regarding school security], It just doesnt feel right: A mixed methods study of help-seeking in Irish schools, Advances in School Mental Health Promotion, The need for ethical code of conduct among school guidance counsellors in Obio/Akpor local government area, International Journal of Innovative Legal & Political Studies, Okul psikolojik danmanlarnn kullandklar unvann mesleki kvan, psikolojik danman zyeterlii ve baz zniteliklerle yordanmas [Predicting the professional title of the school counselors with the professional pride and counselor self-efficacy], Psikolojik danmada etik ikilemler: Etik karar verme sreci [Ethical dilemmas in psychological counseling: Ethical decision making process], Eurasian Journal of Educational Research (EJER), An ethics challenge for school counselors, School counsellors attitudes and beliefs about child sexual abuse, Ethical dilemmas in college counseling centers, Okul psikolojik danma hizmetlerinde mesleki etik ihtiyalarn belirlenmesi [Determining the professions ethical requirements in school psychological counseling services], At risk of harm? Total loading time: 0 Buddy adds that he has had trouble sleeping, has stopped exercising, has little energy, and fleeting thoughts of hurting himself. The psychologist is involved in a busy practice, specializes in treating eating disorders, and receives only occasional referrals from this physician. Dr. Tell explained that the alleged perpetrator was several times removed from their sessions and she did not believe that she had the obligation to report it. Feeling guilty, the therapist calls you on the phone to discuss his feelings and any possible ethical concerns. Regulatory boards are the final authority on courses accepted for continuing education credit. Directions: The following cases are intended to facilitate the development of your ethical analysis and resolution capacities. ), Psikolojik danmanlk alannda mevcut ve gelien etik sorunlar [Current and developing ethical problems in psyhological counseling field], Sources of conflict between primary school principals and school counselors in Turkey, I wanna tell you a story: Exploring the application of vignettes in qualitative research with children and young people, International journal of Social Research Methodology, Using an ethical decision-making model to address ethical dilemmas in school counseling, An examination of the ethical dilemmas of school counsellors: Opinions and solution recommendations. After the initial greetings, the former patient indicates that she has finally started to write down more thoughts, memories, and recollections about her abusive experiences. What clinical concerns arise for you in this scenario? *(/#*rqX''W-JFZ/GBx=w.~o&rq.H $W^o}E|lgp After you finish you can compare your response and rationale with our response and our rationales for each of these vignettes. Out of options, Dan is asking Dr. Crane to be the faculty advisor. Since there is rarely a right or wrong answer for most ethical dilemmas and since the cases provide limited detail, it is possible that you can validly argue for an answer and/or explanation that differs from ours. Supervision Ethics Vignettes Client Worsens While Under the Care of Supervisee A 16-year-old girl who came to counseling for help with recurrent depression is exhibiting increasingly severe episodes of self-mutilation. During some individual time, the patient indicated to the psychologist that she has had it with her neighbor and has something planned that will make you all finally understand once she is discharged. Mr. Tellanyone had been caring for her and his father in his home for 6 years prior to her death. He also indicated that the relationship is taking on a more serious tone. Learning Objectives: !!jdUR{YUbYUKg$Hu/krtu/_Y1>6..7199l< What are the potential pitfalls in the scenario? The therapist knows her new boss, Mr. Biggy. It may rather be a sign that one is fully engaged in the life of a community. During the interview, she was told that she would need to work independently, with only limited supervision. She eventually blurted out that, during a heated discussion, her boyfriend indicated that looking at online pornography was not as bad as what his uncle did. Abstract All school counselors are considered mandated reporters. He indicates that, in order for him to benefit from the treatment, he feels a need to pay what he makes an hour. What factors make this situation potentially difficult for you as a therapist? Approaching ethical dilemmas. Mr. Tellanyone is feeling quite guilty about his mother. / ethical dilemmas in counseling vignettes. While these teaching tools have been developed by psychologists, the vignettes are likely similar to those dilemmas faced in other mental health, counseling, or helping professions. The therapist expresses her concerns about working with a patient whose father is prescribing medication. The PASS-2 is administered online, from any computer, iPad, or iPhone. Running Head: ETHICAL VIGNETTE. stream Are there any other concerns about the web developer/consultants strategies? February 27, 2023 . The supervisee is very worried and afraid to tell P. (1996). <> He drives the car to a local dealer who indicated that the Explorer is worth about $3,500. He also wondered if he should contact the patients lawyer, with her permission, to disclose his perceptions about the quality of the report and his perceptions about the conclusions. During the next session, Mr. and Mrs. Drapier arrive separately, but on time. American Counseling Association Ethical Dilemma "Counselors may be faced with a conflict between their duty to protect confidentiality, to . Are there additional considerations for how to approach the referring physician when calling back? Ethics Rounds Multiple relationships: A vignette Finding oneself in a multiple relationship is not necessarily a sign that one has engaged in unethical behavior. The treating therapist knows the local therapist who released the information, but does not have a strong relationship with him. He believed that the custody evaluator had made several significant errors in the report concerning the psychological health of his patient. To use suggested categories to consider options for ethical response to the dilemma. The cost of the online administration is $25, to be paid by the patient. What are the potential ethical issues with this case? This particular vignette, Swenson said, may well fail the two-prong test. locating a long-time friend who is willing to help him at home, referring him to a neuropsychologist for testing, engaging in lengthy discussions with his primary care physician and neurologist, participating in multiple conversations with the attorney, and trying to find a guardian or power of attorney. Mr. Biggy indicates that he wants to talk more about his feelings. His attorney believes that some good, written character references will really help out with the case. Dr. Smith also wondered if it was appropriate to bill Mrs. Simpson for his time in reviewing the report. Review each of the scenarios and indicate whether you agree or disagree with the counselors action. What are the ethical issues involved in this situation? Hence, the admission is voluntary. Dilemma 35: Initial Telepsychology Session for Free? Should Dr. Goodfriend call Buddy and offer a few referrals? When facing uncertainty, consult a colleague, refer to APA's Ethics Code and document your decision, advised APA Ethics Committee members. <> Prior to providing extra-therapy support, Dr. The survey consisted of 10 vignettes based on the above ethical issues in. What obligations does the therapist have to the parent? The executor is Mr. Palmers brother, who lives in a different state. What are some recommendations that you would make to the psychologist? However, upon his arrival in the emergency department, the medical record quotes the patient as saying, This wasnt supposed to have happened.. Harry then decides to attend a conference hosted by the ACA which will address the Code of the Ethics and the Standards of Practice in detail. Feeling somewhat uncomfortable with the medication management issue, the therapist indicates that she will have to look at her schedule and call him back. He is marginally coherent and unable to give any consistent responses. Identifying, addressing, and resolving ethical dilemmas is a dynamic process that requires counseling professionals to do more than simplistically apply the codes with respect for the uniqueness of each situation or circumstance. A psychologist works in an outpatient substance abuse treatment facility. 1LzLxG`kvP@>. Rob West, President and CEO of PsychBuilder Inc. located in San Jose, California. Dr. Smith suggests a referral to a therapist, but Mr. Biggy states that he feels more comfortable talking with Dr. Smith. << /Length 5 0 R /Filter /FlateDecode >> Dr. Bishop calls you for a consult about this situation. Review each of the scenarios and indicate whether you "agree" or "disagree" with the counselor's action. Legal and Ethical Issues in Working with Minor in Schools Presented by Dr. Carolyn Stone, University of North Florida . Can the psychologist contact Child Protective Services anonymously, provided that the client supply the name and address of the uncle. What are the possible steps Dr. Crane can take to mitigate any potential difficulties? Psychological Counselling and Guidance Department, Dokuz Eyll University, Izmir, Turkey, Get access to the full version of this content by using one of the access options below. A therapist had an intake appointment with a new client. Mrs. Simpson read the report and admitted that she did not understand some of the psychological jargon used in the report and had difficulty understanding what the conclusions of the report were. One day, Dr. Bishop receives a phone call from his contact at the institution. ethical dilemmas in counseling vignetteswvu mechanical engineering research. What factors make this situation potentially easy for you as a therapist? Innuendos are that she allegedly killed her neighbors pet, but this has been unproven by the police. Dr. Smith is now worried about the entire situation. Others sources will also be used. He struggles with understanding concepts and his conversation becomes tangential during the next two sessions. While the treatment team does not share Dr. Solomons concern and has started to make discharge plans, they have not spent as much individual time with the patient as Dr. Solomon. Dr. Smith asked if he needed to inform the patient of his impressions of the report and the seemingly erroneous conclusions. You arrive in the intensive care unit where the patients respiratory status is rapidly deteriorating.

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