This paper analyzes the case of an e-therapist who received a mistakenly-sent e-mail from one of her clients. It uses three models of ethical reasoning- utilitarianism, Wallace’s Ethical Contextualism, and Kant’s Formalist Theory. The recommendation is that the e-therapist can argue that the e-mail is not protected by the confidentiality clause, since it is obviously incorrectly sent to her. The e-therapist should advise the wife to be truthful with her husband, since it will be unethical to go through a therapy, without genuine intentions of saving the marriage, and that such action will breach the validity of marital therapy and harm her profession’s credibility.
This paper analyzes the case of e-therapist who received a request for a marital therapy through e-mail from a couple having relationship problems. The wife of the client, however, had accidentally sent an e-mail to the e-therapist that revealed the true intentions of the former- to make it appear that the husband it at fault, to get a divorce, and to marry a long-time extra-marital lover, after the divorce. The ethical questions are: Should the e-therapist value confidentiality and privacy over honesty to the other client? Should the e-therapist inform the other client about this e-mail?
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The act utilitarianism is concerned with this question: What are the effects of a certain set of actions on the total balance of good and evil? (Velasquez et al., 1989). This question can be answered using several steps. First, the e-therapist should identity the options available that can be weighed with one another with regards to their impact on the total balance of good and evil, or on more pragmatic terms, the happiness and unhappiness of people involved (Velasquez et al., 1989). The first option is that the e-therapist will concede to the wife and continue with the therapy sessions, as if she did not receive the e-mail. The second option is that the e-therapist will argue that the e-mail is not part of the sessions, and therefore not protected by the confidentiality clause. As their therapist, however, she will ask the wife to be honest to her husband, or she will send him his wife’s e-mail, because the truth is central to therapy sessions.
The next step is to evaluate the harms and benefits of each option (Velasquez et al., 1989). For the first option, the harms are that the husband will be taken advantage of by his wife. His wife will manipulate sessions, to make it appear that the husband is at fault. It is not possible for the e-therapist to separate her therapy evaluations with the truth she knows. She will have a hard time conducting credible therapy sessions and this knowledge of the truth can also affect her conscience, as a person and as a professional. On the other hand, this option will make the wife and her lover happy in the long run. A larger settlement will be due to her after divorce, which will make them very pleased together. But is this happiness a source of goodness? Act utilitarianism does not just count the number of people happy only, but also the total goodness. Option 1 results to greater evil, not goodness, for all stakeholders, because of the malice and treachery involved.
The second option revolves around the truth and the confidentiality clause. Will the psychologist violate the confidentiality clause and make her vulnerable to a lawsuit? American Psychological Association’s (APA) (2010) Ethical principles of psychologists and code of conduct has a principle on confidentiality:
Psychologists have a primary obligation and take reasonable precautions to protect confidential information obtained through or stored in any medium, recognizing that the extent and limits of confidentiality may be regulated by law or established by institutional rules or professional or scientific relationship. (italics added, cited from APA, 2010).
On the other hand, Disclosure clause says that disclosing confidential information is also allowed when the intention is to: “….(3) protect the client/patient, psychologist, or others from harm (cited from APA, 2010). The e-therapist can use the Disclosure clause to protect her from lawsuit and to protect the husband from being used by his wife to get a larger divorce settlement. Furthermore, she can also argue that the e-mail is not even for her, and not part of the therapy session, so why should it be protected by the confidentiality clause? The e-therapist will then advise the client to be honest with her husband. This way, her husband will know the truth, the therapist’s conscience will no longer be bothered, and her profession will remain unchallenged. In the meantime, the malicious party, the wife and her lover, would have lesser happiness, but that is acceptable because their malignant intentions represent them as the greater evil in the society. Thus, based on utilitarianism, the e-therapist can follow her conscience and persuade the wife to be honest, since the confidentiality clause is not relevant in her case anyway and inform the wife that her actions will not be healthy for her as a person and it will also be unfair to her husband, who honestly wants to make their marriage work.
Wallace’s Ethical Contextualism
Wallace believed that there are no universally applicable or satisfactory ethical values for all cases (Ford, 2000, p.77). He noted that the context is important in determining the relevance of issues and the accurate ethical conflict (Ford, 2000, p.78). This means that the e-therapist must evaluate conditions based on relevant principles and intentions (Ford, 2000, p.78). The relevant principle is client honesty, because the e-mail is not protected by the confidentiality clause. The e-therapist has the main responsibility of protecting her clients from being abused, and also for her profession to be used for other unethical means. In this case, the husband is being abused by his wife. The wife is a dishonest and materialistic woman who wants to use the therapy as a ploy to get a greater settlement, after her divorce. The wife will then turn the credible psychology profession as a profession of sham. The e-therapist should not allow anyone to use her profession for selfish and unethical interests. She should stand up to the client and assert that the confidentiality clause does not apply. She should explain the options of honesty to the wife, because therapy is about getting people together, not about getting more money after divorce.
Wallace also asked why these decisions are significant to the people involved. This decision will be important to the e-therapist because this means that she will not violate the Code of Ethics of her profession (Ford, 2000, p.78). This option will also be important to the wife, because she will learn a valuable lesson in relationships and confidentiality clauses. This decision will also be important to the husband, who will no longer be tricked into a therapy that means nothing to his wife. Hence, Wallace’s ethical Contextualism also justifies the decision of the e-therapist to remain truthful to the wife and the husband, so that the sanctity of marital therapy will be protected from self-serving ends.
Kant’s Formalist Theory
Kant stressed that an action is right if it can be applied a priori as a universal law (Ford, 2000, p.62). If all e-therapists will help wives deceive their husbands, then many wives of rich husbands will be doing it. It will not be right because it will be unfair to the husbands. It will also not be right because marital therapy is for couples who want their marriages to work and not for serving self-serving materialist agenda. It will also not be right because this will undermine the sanctity of marriage and making it work. Finally, it will not be right for the profession to be used as means to unjust ends.
Kant also argues that people should be treated as an end and not as means to their ends (Ford, 2000, p.62). If the e-therapist agrees to the conditions of the wife, then they are both treating the husband as the means to the wife’s end. They are “using” the husband to advance the selfish interests of the wife. They are also using the profession as a means to an end. The wife will also be using the e-therapist as means to her end. This will not be right at all, to many stakeholders. Thus, Kant’s Formalist theory also asserts that the right thing to do is to inform the wife that the letter is not protected by the confidentiality clause and that she should be honest with her husband about her affair. A credible profession should not be tarnished by materialistic ends.
The e-therapist is bound to her confidentiality clause. However, the e-mail is not part of their therapy sessions and cannot be legitimately counted as part of the confidentiality promise. On the other hand, according to utilitarianism, Wallace’s Ethical Contextualism, and Kant’s Formalist Theory, the e-therapist can do the right thing that can maximize happiness and goodness, justice, and universality, by advising her client to tell the truth about her affair, or the e-mail will be used as evidence during the martial therapy sessions. The e-therapist, based on ethical considerations and guidelines, can disclose the e-mail to protect the other client from abuse of his wife.
American Psychological Association (APA).(2010). Ethical principles of psychologists and code of conduct. Retrieved May 30, 2010, from http://www.apa.org/ethics/code/index.aspx
Ford, G.G. (2000). Ethical reasoning in the mental health professions. Boca Raton, Florida: CRC Press.
Velasquez, M., Andre, C., Shanks, T., & Meyer, M.J. (1989). Calculating consequences: The utilitarian approach to ethics. Markkula Center for Applied Ethics at Santa Clara University. Retrieved May 30, 2010, from http://www.scu.edu/ethics/practicing/decision/calculating.html