Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, philosophy and health care

Friday, March 15, 2013

Vignette 23: A Simple Request

Dr. Smith was treating Mrs. Drapier for depression precipitated, in part, by a separation and pending divorce. There were contentious issues dealing with the custody arrangements of the children. A court appointed custody evaluator performed a child custody evaluation. Among other things, the report contained a psychological evaluation of the patient.

Mrs. Drapier thought it would be good for Dr. Smith to review the report in order to help him with their therapy.  Mrs. Drapier 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.

Dr. Smith decided to review the report.  He believed that the custody evaluator had made several significant errors in the report concerning the psychological health of his patient.  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.

Prior to their next session, Dr. Smith calls you for a consultation. 

Dr. Smith asked if he needed to inform the patient of his impressions of the report and the seemingly erroneous conclusions.  He feels stuck between being faithful to the patient and her needs without crossing a boundary as a treating psychologist.

He also wondered if he should contact the patient’s lawyer, with her permission, to disclose his perceptions about the quality of the report and his perceptions about the conclusions.

Dr. Smith also wondered if it was appropriate to bill Mrs. Drapier for his time in reviewing the report.

Dr. Smith also asked if it is ethical to bill the patient’s insurance company to review his impressions of a forensic report during a psychotherapy session. 

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