The counselor can refer to the law and to the code of ethics for the profession, and know that informing upon John is correct, given that someone's life is at stake. A counselor must strive to be objective, and in this case back up his or her actions based upon the law, and standardized codes of counseling ethics. A counselor who counsels ethically questionable individuals, such as a counselor in prison or for a support group of inmates, must still be mindful of ethics and the law when negotiating such ethical minefields.
In this instance, a deontological, or categorical, ethical system is required -- a counselor cannot rationalize that this situation is better or worse, relative to similar situations. "Rule deontological ethics...may be understood as the seeking of 'duty to do right'…why a decision was made and if it is based on a principle good for all…. rules to guide and protect individuals and groups and to prescribe desirable decisions and proscribe undesirable ones… State laws and policies, although a variation on the rule ethics idea, often prescribe what is endorsed by others," and in this case professional ethics and state law coincide (Bradley et al. 2010: 219-220). John should be informed of the counselor's ethical obligations; however, before the counselor takes the necessary actions, given the legal repercussions he might face as a result of the counselor's actions.
A further question arises as to what the counselor must inform the patient before the therapeutic process takes place. John might protest that he would not have revealed his HIV status, if he knew it...
The counselor should consider giving patients a full explanation about when he or she is legally obligated to reveal information that transpires during a counseling session.
An alternative, utilitarian view of the situation might suggest that if individuals feel that their HIV status will be used against them, and used to compromise their confidentiality, they will either 1. Not get tested in the first place 2. Get tested and not be candid with their counselors 3. Refuse to reveal their status to their partners, because of disclosure fears. However, the counselor can only give due consideration to this specific instance, and act as if setting precedent for situations in which the patient's HIV status is known and disclosed. He or she cannot excuse questionable ethical actions and deviations from the code, based upon hypothetical scenarios in the future, according to deontological ethics.
References
Barnett, Jeffrey & Ofer Zur. (2010). Ethics codes on confidentiality. Psychotherapy and Counseling. Zur Institute. Retrieved November 2, 2010 at http://www.zurinstitute.com/ethicsofconfidentiality.html
Bradley, Loretta J, Peggy P. Whiting, Bret Hendricks, & Laura S. Wheat. (2010). Ethical imperatives for intervention. The Family Journal, 18(2) 215-221.
Retrieved November 2, 2010 at DOI: 10.117711066480710364507
Indianapolis Star Examines HIV Confidentiality, Disclosure Laws. (2003, July 18). The Body.
Retrieved November 2, 2010 at http://www.thebody.com/content/legal/art11776.html
