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American Annals of the Deaf

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Ethics in Mental Health and Deafness

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The plaintiff has the final burden of showing that the alleged harm caused by the defendant resulted in damages. If the first three required prima facie elements are proven, but there are no damages, the case is thrown out.

Did the deaf plaintiff lose a job and income because of the therapistís invalid, incompetent projective and IQ testing? Did a sexual relationship with the predatory therapist cause the deaf plaintiff a divorce and significant emotional damage? Did the deaf client kill him- or herself because the therapist hired an incompetent, unethical interpreter who revealed private client information to the community? Might the addicted deaf client have not incurred the cost of hospitalization if the unqualified therapist had referred him to a qualified therapist in a timely manner? Might the depressed deaf plaintiff with minimal English skills have not overdosed on the Zoloft prescribed by a psychiatrist who communicated by written notes?


For each of the following case studies, consider how the prima facie elements can be applied to

1.   assess the legal-ethical status of the therapist in each of the four elements of the malpractice suit.

2.   find the specific ethical code or ethical principle issue(s) likely to be raised by the deaf clientís attorney and expert witnesses.

3.   consider how you might have advised the therapist about reconciling practice, supervision, ethics, and law so the malpractice suit might have been avoided.

Case 1

Brad is a 51-year-old, recently divorced, deaf, licensed psychologist. He is a strong advocate for the rights of deaf people. Brad is a charismatic and controversial leader in great demand as a consultant and lecturer. Most recently, he has led the fight against cochlear implants for deaf children. While Brad enjoys all of this adulation, his extensive lecture travels leave him exhausted and leave his deaf clients with no one to contact in an emergency. It is sometimes difficult for Brad, some of Bradís colleagues, and his clients to separate out their perceptions of his political advocacy and his therapeutic work.

After Bradís divorce, he moved to a mid-sized town for a fresh start. He knew very few people in town, hearing or deaf. But the town had a school for the deaf and enough potential deaf adult clients to supplement his lecture/consulting income.

Bradís accomplishments stand in stark contrast to his background. He was the only deaf child in a very religious hearing family that could not communicate with him. Brad was a bright child who was enrolled in eight different KĖ12 public schools because of his fatherís frequent military transfers. He never had sign training or interpreters in school. Brad only blossomed and focused when a hometown vocational rehabilitation counselor who picked up on Bradís potential referred him to Gallaudet College.

Brad has essentially worked without clinical supervision since earning his PhD. He is among a handful of highly qualified deaf therapists in the United States. Bradís experience with hearing supervisors who use interpreters and know little about Deaf culture has been negative. Similarly, Brad struggles to keep up with his licensure maintenance continuing education requirements. He still experiences endless hassles arranging for interpreters for these continuing education workshops. Because of the low-level reading skills of most of his deaf clients, Brad does not use a written informed consent form.

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