Kitchener Five Moral Principles

Kitchener (1984) identified five moral principles that are viewed as the cornerstone of our ethical guidelines. The five principles, autonomy, justice, beneficence, nonmaleficence, and fidelity. 1. Autonomy is the principle that addresses the concept of independence. The essence of this principle is allowing an individual the freedom of choice and action. It addresses the responsibility of the counselor to encourage clients, when appropriate, to make their own decisions and to act on their own values.

There are two important considerations in encouraging clients to be autonomous.

First, helping the client to understand how their decisions and their values may or may not be received within the context of the society in which they live, and how they may impinge on the rights of others. The second consideration is related to the client's ability to make sound and rational decisions. Persons not capable of making competent choices, such as children, and some individuals with mental handicaps, should not be allowed to act on decisions that could harm themselves or others.

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. Nonmaleficence is the concept of not causing harm to others. Often explained as "above all do no harm", this principle is considered by some to be the most critical of all the principles, even though theoretically they are all of equal weight (Kitchener, 1984; Rosenbaum, 1982; Stadler, 1986). This principle reflects both the idea of not inflicting intentional harm, and not engaging in actions that risk harming others (Forester-Miller & Rubenstein, 1992).

3. Beneficence reflects the counselor's responsibility to contribute to the welfare of the client.

Simply stated it means to do good, to be proactive and also to prevent harm when possible (Forester-Miller & Rubenstein, 1992). 4. Justice does not mean treating all individuals the same. Kitchener (1984) points out that the formal meaning of justice is "treating equals equally and unequals unequally but in proportion to their relevant differences" (p. 49). If an individual is to be treated differently, the counselor needs to be able to offer a rationale that explains the necessity and appropriateness of treating this individual differently. . Fidelity involves the notions of loyalty, faithfulness, and honoring commitments. Clients must be able to trust the counselor and have faith in the therapeutic relationship if growth is to occur. Therefore, the counselor must take care not to threaten the therapeutic relationship nor to leave obligations unfulfilled. Part II: In 2008, a licensed practical nurse who pled guilty to wrongfully disclosing a patient’s health information for personal gain faced a maximum penalty of 10 years imprisonment, a $250,000 fine or both.

Andrea Smith, LPN, 25, of Trumann, Arkansas, and her husband, Justin Smith, were indicted on federal charges of conspiracy to violate and substantive violations of the Health Insurance Portability and Accountability Act (HIPAA) in December. At the time, Smith worked as a nurse at Northeast Arkansas Clinic, a multispecialty clinic in Jonesboro, Arkansas. Smith accessed a patient’s private medical information on November 28, 2006, according to the indictment. She then shared that information with her husband, who on that same day, called the patient.

Justin Smith reportedly told the patient he intended to use the information against the patient in an upcoming legal proceeding. Northeast Arkansas Clinic has terminated Smith’s employment. The managed care company WellPoint Inc. has agreed to pay the U. S. Department of Health and Human Services $1. 7 million to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules. OCR’s investigation indicated that WellPoint did not implement appropriate administrative and technical safeguards as required under the HIPAA Security Rule.

The investigation indicated WellPoint did not: adequately implement policies and procedures for authorizing access to the on-line application database; perform an appropriate technical evaluation in response to a software upgrade to its information systems; or have technical safeguards in place to verify the person or entity seeking access to electronic protected health information maintained in its application database. As a result, the investigation indicated that WellPoint impermissibly disclosed the ePHI of 612,402 individuals by allowing access to the ePHI of such individuals maintained in the application database.