Examining Ethical Case Examples

Week 4 – Assignment: Examine Ethical Case Examples
Assignment

For this assignment, you will read three forensic case examples and apply your understanding of the APA ethics code as well as the specialty guidelines for forensic psychology. The three case examples are found in this week’s resources.

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For each case, after reviewing your resources and reading the case example carefully, you will:

Identify any potential ethical issues related to the case.

Identify what APA guidelines apply to the case and explain how they apply to the case.

Identify what Specialty Guidelines for Forensic Psychology apply to the case and explain how they apply to the case.

Give a description of how you would resolve this ethical dilemma. Use your guidelines and resources to explain your solutions.

Finally, you will write a 1-2 page reflection on the process of working through these ethical dilemmas and your impression of the ethical struggles of a forensic psychologist.

Length: 4-5 pages total; 1 page each per dilemma, 1-2 page reflection

Your paper should demonstrate thoughtful consideration of the ideas and concepts presented in the course by providing new thoughts and insights relating directly to this topic. Your response should reflect scholarly writing and current APA standards.

ETHICS CASE #1

For this case, please read the case history below. In this scenario, you are a forensic psychologist working in a correctional facility. Your role is as the treating psychologist for this patient. You have been working with him for one year and have developed a solid rapport with him despite his distrust of others, particularly mental health professionals. You meet with him for weekly therapy sessions. In this time, while he is willing to speak with you, he avoids topics which he feels may cause him to be forcibly medicated; and you have been unable to get him to try psychotropic medications voluntarily. Recently, the prison has decided to attempt to get a court order to medicate the patient due to concern related to dangerousness and increasing psychiatric instability. They would like your cooperation in the court process. As you read this scenario and develop an understanding of the patient, also consider what ethical concerns you may have—particularly related to the specialty guidelines for forensic psychology and multiple relationships—and how you might resolve these issues.

INMATE NAME: DOE, JOHN

REASON FOR REFERRAL

Mr. Doe was referred for this psychological evaluation due to this the patient’s continued refusal to take psychiatric medication, continued active psychosis, and history of risk to others. This assessment was also conducted in order to get a better understanding of Mr. Doe’s emotional functioning, identify his strengths and weaknesses, provide suggestions that may aid in treatment planning, and help determine risk factors for his potential future violent behavior. He is currently being referred for 402.10 commitment to CPC.

LEGAL HISTORY

Mr. Doe is serving his first bid for Murder 1, Burglary 1, and Grand Larceny, with a life sentence. He is also accused of two murders in Canada, which charges are still pending. In the IO, it is reported that the patient first murdered two men in Canada before crossing the border with one of the victim’s vehicles. Per his parents’ report, the crimes in Canada were fairly graphic, involved a knife, and one of the victims was almost decapitated. In the U.S., it was reported that he shot a man in the back at his hunting camp before tying him to a four-wheeler and dragging him around. He then fled to the Mexican border in Texas. He was apprehended by a Border Patrol officer after he was noticed to have a rifle. Mr. Doe then assaulted the Border Patrol officer and has pending charges in Texas for this assault.

PERSONAL PROFILE AND RELEVANT HISTORY

Mr. Doe was born on 03/05/81, with no known complications. He had an unremarkable childhood, graduating high school in 1999. He was noted to have done well academically, had many friends in high school, although not in junior high, and was the co-captain of his high school football team. Records note a history of depression in junior high school.

After high school, he attended Alpha University in Canada, pursuing a degree in Engineering. He completed two years of school and was involved with a fraternity and other similar pro-social activities. He was noted to have had two girlfriends in the past, one of whom he had a sexual relationship with. Mr. Doe has one younger brother, Douglas, with whom he is very close. He is also supported by his parents, Bob and Mary Doe. Prior to Mr. Doe’s incarceration, he resided with his parents when he was not hospitalized.

During the summer of 2000, Mr. Doe went to Taipei as an English teacher. His parents reported that, when he returned home for the fall semester, his mental deterioration began. Records indicate that he was initially believed to be suffering from a depressive episode during the fall/winter of 2000 to 2001. He reported using marijuana daily between August 2000 to August 2001. He was noted to have gone on a drug binge in August of 2001, using cocaine, marijuana, ecstasy, and mushrooms for approximately one week while on a trip to Montreal with his fraternity brothers. Records from the family indicate that he had his first admitted hallucination of fighting a dragon at this time.

When he returned to school in fall 2001, he was further isolating himself, and had also become paranoid. Records from his family indicate that he was destroying and/or burying in the woods his personal belongings, including taking all of his clothes to a thrift store. He reported a need to “cleanse himself.” His family reported that he decreased his food intake to a half a piece of bread daily for the purpose of “ritual cleansing,” and to examine/overcome the concept of “what is need and what is want.” In September 2001, he locked himself in his room for five days, turning off the lights, unplugging the phone, TV, etc., and minimally drinking in an effort to “do well with control and self-discipline.” Between August and November of 2001, he lost 40 pounds. His family records note that he fell into a deep depression, which continued to occur the following years during the fall and winter months.

After Mr. Doe refused treatment and medication, he continued to deteriorate. In October 2001, he was reported to be mute often; and he overate to the point of physical pain. The patient reported that he was punishing himself. His parents reported that he often eloped to the woods for days at a time. He was brought, involuntarily, by police to Canada Hospital on 11/02/01. Hospital records indicated that he eloped on 11/05/01, was returned by his parents within hours, and subsequently eloped again on 11/06/01. He was found a week later by police, seeming to have lived in the streets for the duration of his absence. At this time, it was noted that he was not showering, for several weeks to months. Records indicate that he received intravenous medication for approximately one month due to his refusals to take oral medication. This was discontinued in December 2001 when Mr. Doe agreed to accept oral medication. His symptoms were noted to improve; however, he eloped on 01/14/02, and was not found by police.

According to his family, he then lived at home for the next few years, continuing to exhibit bizarre behaviors including: outings to the woods, sleeping with knives, having beliefs about a “troop” being after his family, paranoia regarding vampires, demonstration of poor hygiene including not showering or brushing his teeth for one year, and further isolation.

2003, there was an episode noted in which he painted himself all white, as well as everything in his room, indicating that he had been enlightened. He then left the home to try to enlighten others, but scared a homeless man and the police were called. He was not charged with anything due to his parents’ intervention and their subsequent report of his mental condition to police.

In March 2005, his parents reported that he unlawfully entered a dwelling. His parents indicate that he was not intending to harm anyone or steal anything, but that he was trying to get out of the elements after spending time in the woods. He was hospitalized at Canada Forensic Hospital in April 2005 due to unlawfully entering a dwelling and resisting arrest. Records indicate that he was found competent and capable of attending trial. His parents reported that the case was dismissed due to his psychiatric issues.

In July 2005, his family moved to another town in Canada. Records from the family note that he began using marijuana heavily again in the summer of 2005, often isolating himself behind the garage listening to rave music and “communicating with the stars.” In November 2005, he was admitted to the burn unit at a hospital after he burned his chest and back while burning the clothes he was wearing. His family records note that he was very psychotic during this episode and that the burns were intentional. His family noted “lashing” marks, as though he hit himself with a flaming article of clothing. Records indicate that he left the hospital AMA, and peeled off and ate all of his dead skin from the burns.

Records sent by his parents from his hospitalizations note Mr. Doe being involuntarily admitted, with the last occurrence in December 2005, due to being “acutely psychotic, delusional, without any insight into his illness, with periods of agitation, with high risk to act on his delusions if left untreated, with potential of danger to his own safety or safety of others.” It was noted that he “presented with significant disorganization in thought process with tangentially to loosening of association with persecutory delusions believing his family and himself being in life threatening danger including rape and murder. Up until recently, in his hospital room, he was keeping lots of garlic ‘to keep demons and vampires away.’ During most of his interviews he has been quite agitated with verbal aggression and body posturing and staring intently to intimidate others especially nursing and medical staff. On many occasions he has gestured to ‘curse’ the staff. He believes he has the ability to curse people and make them suffer.” Additionally it is noted that, prior to this hospitalization, he “was brought by police, after he had called two different police detachment units and reported life threatening danger to his parents. His family reported that he was extremely paranoid before his admission, often sleeping with a knife. Mr. Doe reported having an overwhelming ‘intuition’ or ‘sense’ that his parents were going to be murdered and his mother raped. At the time, he eloped from home, hitchhiked, he became insomniac, extremely agitated, his behavior became very paranoid (e.g. carrying a knife with him at all times, telling parents to take their lives if an attack is going to be imminent). His parents feared that he could act on his thoughts, e.g., ‘he could attack us.'” He was noted to have escaped in January 2006.

He was captured by police in January 2006 and returned to the hospital. He was later transferred to the Canada Hospital. At that time, he agreed to take Clozapine; and after his symptoms diminished, he was released in July 2006. Records from the family indicate that Mr. Doe was doing well and was believed to be taking the medication until December 2006. During this time when he was medication compliant, he was noted to be less isolated, to have enjoyed some activities, and that the entire family reported they had “a really great Christmas.”

In January 2007, he again began to isolate himself and become depressed. He was noted as becoming very persistent in seeking and using marijuana in early 2007. His family reported that he listened to rave music

ETHICS CASE #2

For this case, please read the case history below. In this scenario you are a forensic psychologist performing a risk evaluation on an adolescent offender. You have been hired by the student’s school to complete the evaluation.

As you read this scenario and develop an understanding of the patient, consider what ethical concerns you may have, particularly related to the APA guidelines and specialty guidelines for forensic psychology as they relate to informed consent. In your assignment, be sure to address issues related to the age of the patient and how you would achieve informed consent. In addition, please answer the following questions:

What would you do if consent is denied and the school would still like you to complete an evaluation?

What if you have consent; however, the patient presents with a concern related to his competency (i.e., he is acutely psychotic and/or has a significant intellectual disability)?

Psychodiagnostic Assessment

Name: Jim Smith

DOB: 1/10/2000

Age at Testing: 16 years 2 months

Reason for Referral:

Jim was referred for assessment by the school for a psychodiagnostic assessment secondary to some legal issues that occurred in this summer. Specifically, Jim was arrested for possession of incendiary devices. The school is seeking recommendations regarding Jim’s psychological needs.

Relevant Background information:

Jim Smith is a 16-year-old adolescent n who currently resides in a juvenile residential facility, where he has been since his arrest in July. According to records, Jim was charged with two counts of Possession of an Incendiary Device, Chem/Bio/Nuclear Weapon; one count of Possession of Hoax Incendiary Device, Chem/Bio/Nuclear Weapon; and one count of Unlawful Possession of Fireworks. These charges are in relation to a search of the family home, in which police found spent explosive devices, 22 BB and pellet guns, animal parts, and digital evidence that Jim may be preoccupied with Nazism. He is currently being held at the Department of Youth Services (DYS) detention facility while he awaits trial in Juvenile Court.

Prior to this arrest, Jim’s school conduct report notes seven incidents at school between 10/22/2013 and 05/11/15. These incidents include bumping into a boy on the playground with several peers; destruction of property in the school bathroom; refusing to work; using a teacher’s email to send an email to another school staff member which included the phrases “Aayy nigger” and “fuck you”;

ETHICS CASE#3

For this case, please read the case history below. In this scenario you are a forensic expert on violence risk assessment in adults. You often testify in courts about future risk of violence and are deemed by the courts as an “expert witness.” You have been asked to consult with the school related to this case and future dangerousness. As you read the case below, consider what ethical concerns you may have, particularly related to the specialty guidelines for forensic psychology and competence, and how you might resolve these issues.

Name: Michael Jones

DOB: 12/14/01

Relevant Background information:

Michael Jones is a 13-year-old adolescent who currently resides in Washington. He is a 7th grader in the SOAR classroom at the Middle School. SOAR is a special education classroom that provides both individual and group instruction to students with disabilities. He spends his time at school between two classrooms in which he receives individual and group instruction. In addition, he attends specials, lunch, and recess within the building with the rest of the student body. Michael currently receives these services due to a primary diagnosis of Intellectual Impairment and a secondary diagnosis of Communication Impairment. In the past, he was also diagnosed with Autistic Spectrum Disorder, but records and reports from his mother indicate that he no longer meets criteria for the disorder.

Michael received a neuropsychological evaluation in September 2012 which noted him to have delays in cognitive, language, academic, visual–spatial, and adaptive skills, placing him in the mild end of intellectual disability. Michael was also noted to have difficulties with working memory, cognitive flexibility, and impulse control. He was diagnosed with Intellectual Disability and Attention Deficit/Hyperactivity Disorder.

Michael’s IEP notes a communication impairment in addition to his intellectual disability, which affects his academic functioning. He is noted to require significant individual support when he is in classes outside of the SOAR program. There is also a noted concern related to difficulty making appropriate choices in relation to friends, and being easily manipulated into making the wrong decisions. He is noted to have difficulty understanding concepts related to relationships and dangerous social situations.

According to the school, Michael has had several incidents which have caused concern related to sexually inappropriate behavior. The first incident occurred in approximately June 2014 when Michael grabbed the buttocks of a peer-mentor. According to the school, this occurred on a school bus in which Michael was trying to touch a female mentor despite her telling him it was inappropriate. He was eventually able to do so when the peer sat down, and Michael placed his hand under her buttocks.

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