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In its newly revised Code of Ethics and Standards of Practice (1995), the American Counseling Association has recognized terms and conditions under which counselors are justified in disclosing confidential client information to prevent third parties from contracting contagious fatal diseases This paper discusses and provides ethical guidelines for interpreting and applying the rule in cases involving sexually active, HIV-seropositive clients.
As the HIV/AIDS pandemic has continued to escalate, questions of professional ethics have emerged concerning the proper role of mental health counselors in responding to sexually active, HIV-seropositive clients whose sexual activities place others at risk of contracting this disease. The American Counseling Association (ACA) has responded to the challenge by inclusion of a "contagious and fatal diseases" rule in its newly revised code of ethics (ACA, 1995, B.I.d). While it remains to be seen whether this rule will satisfactorily meet the ethical challenges ahead for mental health counselors as they confront the rising HIV/AIDS pandemic, its value will indeed depend on how it is interpreted and applied.
The main purpose of this article is to discuss and provide ethical guidelines for interpreting and applying this newly adopted rule. Two sets of guidelines are proposed and shown to be supported by two main ethical traditions, utilitarian and Kantian theories of ethics. The first set of guidelines provides guidance for mental health counselors on when to disclose to the endangered sexual partners of HIV-seropositive clients. The second set provides ethical procedures of disclosure. THE ACA CONTAGIOUS, FATAL DISEASES RULE
The final draft of the ACA code of ethics was adopted by the Governing Council in April 1995. Prior to adoption, the ACA Ethics Committee proposed two draft revisions and invited membership comments on each. In response to its invitation for comments on the Second Draft (ACA, 1994, p. 20), I submitted a contagious, fatal diseases disclosure rule (personal communication, October 31, 1994). The proposed rule, which was based on "A Model Rule Concerning the Limits of Confidentiality in Cases Where Clients have a Contagious and Fatal Disease" (Cohen, 1990, p. 285), stated the following:
Contagious, Fatal Diseases Unless otherwise required by law, the general requirement that counselors keep information confidential does not apply when disclosure is necessary to prevent a client from communicating a fatal...