The Necessity of Professional Disclosure and Informed Consent for Rehabilitation Counselors

Abstract

Within the rehabilitation counseling arena, professional disclosure and informed consent are critical concepts for the rehabilitation counselor to understand. Once understood, they become key components of a rehabilitation counselor’s daily practice. Counselors need to provide sufficient prior information about their evaluation and services to respect the individual’s right to make an informed choice about participating in the activities. This is one of the most important steps for the counselor to make at the outset of the relationship and thereafter. Yet, inconsistency abounds among rehabilitation counselors when it comes to providing a full and adequate disclosure, thereby ensuring the individual’s right to informed consent. This article addresses the history of these issues, the manner by which earlier versions of the Code of Professional Ethics for Rehabilitation Counselors addressed them, and the changes regarding disclosure and informed consent within the revised 2010 code. Because the code now requires written disclosure, this article provides guidance to rehabilitation counselors for incorporating proper professional disclosure and informed consent protocols into their daily professional activities.

Analysis of the Reported Ethical Complaints and Violations to the Commission on Rehabilitation Counselor Certification, 2006–2013

“…A final pattern of misconduct detrimental to client rights was inappropriate termination. In the same way that previous violations to professional disclosure led to the requirement of more structured approaches to professional disclosure at the start of services (Carlisle & Neulicht, 2010; Shaw & Tarvydas, 2001), a similar approach may be needed to improve the process of termination to ensure clients are aware of the reasons behind the termination as well as alternative resources, which may need to be provided in writing. As a complement to ensuring clients are informed of their rights prior to the start of services, there may be a need to more carefully consider client rights prior to the termination of services.…”

Informed Consent in Predictive Genetic Testing

“…At times the media can contribute to some of the misleading information about genetics and genetic testing. 69 One example of the media contributing to misunderstanding is illustrated in a story in the New York Times. With PGT there will always be a level of uncertainty.…”

“…The KefauverHarris amendment, established by the FDA to regulate new medications, required proof of efficacy and voluntary consent of subjects in drug trials. 69 As clarified by Beauchamp, this amendment required doctors to tell people it was an experimental drug. During this time, the government was more involved in regulations for human subject research and protection.…”

“…69 By respecting a person's choice, medical paternalism can be mini-mized. 70 However, because of past abuses, the focus on paternalism was replaced with a strong focus on autonomy.…”

“…Since DTC genetic testing companies can also conduct research from the samples being sent in, this area focuses on both the research subject and patient treatment models of informed consent. 69 As a result, accountability measures focus on the labs performing the research, the DTC genetic testing company, and the physician or counselor involved. Because individuals can be harmed by misleading or unsubstantiated info, labs conducting testing will be required to participate in genetics quality assurance program to ensure accuracy and validity of materials and results.…”