Munroe J Revised 1

1 Running head: INFORMED CONSENT AND CONFIDENTIALITY
Issues in Informed Consent and Confidentiality,

in the Practice of School Psychology
Learning Task Five
Jacqueline Munroe
EDPS 604: University of Calgary
Dr. Irene Estay


Ethical Vignette for School Psychologists
You are a psychologist working in a school board in which there is a policy that parents
must give informed consent before a report can be discussed with school staff or before a report
on the results can be placed in the childs file. After assessing a child who has been experiencing
learning problems since beginning school, and discussing the assessment results with the parents,
you are dismayed to discover that the parents refuse to have the assessment results discussed
with school staff because the results indicate that the student needs special resource help, in basic
skill areas. The parents say that only dummies have to get that kind of help and that they are
not willing to have their child labelled as a dummy. Although you try to explain the benefits of
such help and to negotiate at least a partial sharing of information with school staff, the parents
adamantly refuse and walk out of the interview. You are aware that, even if the child cannot
receive special resource help, there is much information from the assessment that could help the
teacher provide a more successful academic program (Companion Manual Vignette Research
#56).
The Role of School Psychologists
School psychologists most often work closely with school personnel, parents, and
guardians, to determine how to best support the 25-30 percent of children who may be
experiencing the following challenges: academic, cognitive, social and emotional (Canadian
Psychological Association [CPA], 2007). A move towards inclusive education began in 1977
with the Canadian Human Rights Act, followed by the Canadian Charter of Rights and Freedom
in 1983 (Kuniac, 2006). These legislative changes directed public attention towards additional
services for the inclusion of children with special needs in the regular school system (CPA,
2007). In 2007, an Alberta government audit of severe disabilities uncovered inconsistencies in

coding criteria in special education, leading to an Alberta Education reform in special
educational practice (Coranne-Johnson & Pei, 2012). Currently, Alberta Education has begun a
special education initiative called Setting the Direction with the mission being to work with all
education system partners and stakeholders to build an inclusive education (Alberta Education,
2009, p.5). Setting the Direction strives for an honourable and ethical inclusive education
system focusing on students and their families, striving towards an inclusive society overall
(Alberta Education, 2009, p. 12).
The practice of school psychology involves but it not limited to the administration and
interpretation of psychological tests to assess cognitive or emotional functioning (CPA, 2007,
p.1). The expertise of school psychologists may be necessary at various levels within the school
system involving family, teacher, school, or district wide assistance (CPA, 2007). According to
the National Association of School Psychologists (NASP), the nature of school psychology is to
benefit and provide services to many; however, this also leads to competing priorities and ethical
dilemmas (2008). To resolve these dilemmas, school psychologists in Canada adhere to the
Canadian Code of Ethics for Psychologists (CPA, 2000). While engaged in psychological and
educational assessment, one must constantly consider these ethical standards for the protection of
students rights, informed consent, and confidentiality.
Basics of Informed Consent
A challenging issue for psychologists working in school settings is one of informed
consent, and what exactly the student can access in the absence of parental involvement. When
obtaining informed consent, the Canadian Code of Ethics (CPA, 2000) states to seek as full and
active participation from others in decisions that affect them (I.16). In most Canadian
jurisdictions, 18 is the legal age of majority (Truscott & Crook, 2004). Children below the age of

majority typically require parental or guardian consent in order to proceed with any
psychological services. This affords parents a legal right to direct their children (Truscott &
Crook). Exceptions may exist for mature minors, who are children between the ages of 15-17,
deemed to possess average intelligence along with an ability to understand the nature, purpose,
risks, and benefits involved in the service being provided (CAP, 2010). Similarly, school
psychologists must be aware of guidelines (CAP, 2010) around independent student status. The
CAP (2010) states that under the School Act 1(m) an independent student be defined as one
between the ages of 16-18, who is living independently, or is considered under the Child, Youth,
and Family Enhancement Act (57.2). Independent students are able to provide their own consent
(CAP, 2001). Likewise, the CAP (2010) considers guidance and counselling services an integral
part of the school program (p.7). Consequently, parental consent is not required for the
provision of guidance and counselling services, however, this does not apply to psycho-
educational testing, where consent is still required (CAP, 2010). Guidelines for school
psychologists (CPA, 2007) further state that informed parental consent is not generally required
for the initial teacher-centered consultation, stage of referral. However, parental consent is
required for any further child centered step in the process such as behaviour consultation, student
centered intervention, and assessment (CPA, 2007).
Basics of Confidentiality
Another challenging issue for school psychologists is one of confidentiality, and who
exactly is entitled to access student information. According to the Psychologists Association of
Alberta (PAA), one of the top four complaints of professional misconduct is a breach of
confidentiality (2006). The Canadian Code of Ethics for Psychologists (CPA, 2000) states that
information remains confidential unless the client, or guardian, gives consent for disclosure (I.43,

I.44). Similarly, when providing services to minors, guidelines suggest that psychologists cannot
release (confidential) information pertaining to these minors, without informed guardian consent
(CAP, 2010). On one hand, the school psychologist must respect confidentiality (CPA, 2000)
and in the case stated above, issues relating to privacy (I.40). Similarly, the parents may choose
to withhold assessment information from other school personnel, based on the Charter of Rights
and Freedoms (1982) (Truscott & Crook, 2004). When the standards with which parents wish to
raise their children, conflict with ethical standards of the psychologist, a dilemma is sure to arise
(Truscott & Crook, 2004). The confidentiality dilemma occurs when psychologists and
counsellors working with children must decide between the legality of consent and the moral
issue of the childs best interest (Adelmen & Taylor, 1989). Furthermore, the dependent nature
of minors places increased responsibility on the psychologist to ensure safeguards exists to
promote their rights (Truscott & Crook, 2004).
Release of Confidential Information in the Absence of Informed Consent
Pertinent to the school psychologist in this vignette, is the issue of releasing confidential
information, in the absence of informed consent. Excluding instances of child abuse, court order,
duty to protect third persons from imminent danger, or a duty to protect vulnerable persons, we
all possess the right to decide who has access to our information (Truscott & Crook, 2004).
Professional guidelines for school psychologists (CPA, 2007) acknowledge that in certain
circumstances, withholding confidential information (such as school assessments) would clearly
not be in the best interest of the child. Psychologists should strive to report appropriate
information to other concerned professionals (I.46) if it is in the childs best interest (Adelmen &
Taylor, 1989). In the case of publicly funded agencies (third-party payers) consent to release
assessment information must be obtained prior to a child being designated by the district as

special needs (Alberta Education, 2009). This ensures an inability for parents to remove results
if they do not like, or agree with the diagnosis (HPA, 1998). However, they retain the ability to
deny special services for their child, including the creation and implementation of Individualized
Education Plans (IPPs). Parents may obtain a copy of this assessment by directing their request
towards the school principal, who would likely be considered head of the funding agency (CAP,
2005) and are subject to the Freedom of Information and Protection of Privacy Act (CAP, 2005).
Reports are the property of the school district and must remain in a protected area to ensure
confidentiality, and then kept for a minimum of 10 years following the assessment 11(2) (CAP,
2005). Information that results from assessments should only be shared with those involved in
the teaching and learning process, to best serve the interest of the student (CPA, 2007).
Perceived Inconsistencies / Resolution in Vignette #56
The following vignette is interesting to me as it seems to go against the above mentioned
third party exceptions to confidentiality. I would think that the schools policy should reflect
current standards of practice in psychology, and not abide by its own rules. The sentence which
explains that parents must give informed consent before a report may be discussed with school
staff or placed in a childs file, does not appear to be in keeping with the College of Alberta
Psychologists Standards of Practice, with special issues in client and third party requests (CAP,
2005). It is stated (CAP, 2005) that publicly funded agencies (the school board) would in fact
have access to results, as they provide (psychologists, test materials) and pay for the service of
assessments. A second obvious issue I see with the information presented in this vignette is the
fact that there was no mention of informed consent prior to conducting the assessment, and as
previously mentioned is inconsistent with current guidelines. I will proceed with attempting to
unravel this ethical dilemma as it stands, however, I cannot help but wonder if the true ethical

dilemma in this situation, is attempting to achieve school board policies that coincide with
current legislation. In this dilemma, I have gone with the following: as it was not explicitly stated
whether parental consent was achieved prior to the child being assessed by the school. However,
I have assumed that informed consent was gained initially as it is required by law (CAP, 2005) as
a minimum expectation for psychologists to uphold. The school is private, meaning that parents
pay to have their children attend, and as a result they indirectly (via tuition) pay for any
additional services the child may receive. Policy strives to account for this, by giving parents
additional control that involves further consent to release assessment information, after
assessment has been rendered. This policy leads to an unusual dilemma involving the inclusion
of assessment information in a childs school file and special educational access. This dilemma
would have been avoided if appropriate regulations for psychologists in Alberta were followed
regarding initial consent.
Step 1. Identification of the Individuals and Groups Potentially Affected by the Decision
The primary individuals potentially affected by any decision I make are the child, the
parents, the teacher, and myself. Less directly, the entire class may be affected by my decision,
as appropriate allocation of teacher time is an issue for all students.
Step 2. Identification of Ethically Relevant Issues and Practices, Including the Interests,
Rights, and Any Relevant Characteristics of the Individuals and Groups Involved and of
the System or Circumstances in Which the Ethical Problem Arose.
Using the chart outlined in the Canadian Code of Ethics for Psychologists (CPA, 2000), I
can identify 18 ethical values that require careful consideration in resolving my current dilemma.
Seven under Respect for the Dignity of Persons I, four under Responsible Caring II, five under
Integrity in Relationships III, and two under Responsibility to Society IV.

The Four Ethical Principles with their Respective Values and Standards as Found in the
Canadian Code of Ethics for Psychologists (2000)

I. Respect for the
Dignity of Persons

II. Responsible
Caring

III. Integrity in
Relationships

IV. Responsibility
to Society

1. General Respect
(I.1.-1.4)

1. General
Caring (II.1-II.5)

1. Accuracy/ Honesty
(III.1-III.9)

1. Development of
Knowledge (IV.1-
IV.3)
2. General Rights
(I.5-I.8)

2. Competence
& Self
Knowledge (II.6-
II.12)
2. Objectivity/ Lack
of Bias (III.10-III.13)
2. Beneficial
Activities (IV.4-
IV.14)
3. Non-
Discrimination
(I.9-I.11)

3. Risk/ Benefit
Analysis (II.13-
II.17)
3.
Straightforwardness/
Openness (III.14-
III.22)
3. Respect for
Society (IV.15-
IV.18)

4. Fair Treatment/
Due Process (I.12-
I.15)

4. Maximize
Benefits ( II.18-
II.26)

4. Avoidance of
Incomplete
Disclosure (III.23-
III.30)

4. Development of
Society (IV.19-
IV.29)

5. Informed Consent
(I.16-I.26)

5. Minimize Harm
(II.27-II.36)

5. Avoidance of
Conflict of Interest
(III.31-III.35)

5. Extended
Responsibility
(IV.30-IV.31)

6. Freedom of
Consent (I.27-I.30)

6. Offset/ Correct
Harm (II.37-II.44)

6. Reliance on the
Discipline (III.36-
III.38)

7. Protection for
Vulnerable Persons
(I.31-I.36)

7. Care of
Animals (II.45-
II.48)
7. Extended
Responsibility
(III.39-III.40)

8. Privacy (I.37-I.42)

8. Extended
Responsibility
(II.49-II.50)

9. Confidentiality
(I.42-I.45)


10. Extended
Responsibility (I.46-
I.47)

Principle / Value

PRINCIPLE I: RESPECT FOR THE
DIGNITY OF
PERSONS

Value: General Respect

I.1 Demonstrate appropriate respect for the
knowledge, insight, experience, and areas of
expertise of others.

Value: Fair Treatment / Due Process
I.12 Work and act in a spirit of fair treatment to
others.

Value: Informed Consent

1.16 Seek as full and active participation as
possible from others in decisions that affect
them, respecting and integrating as much as
possible their opinions and wishes.

My Thoughts

One of the distinctive features of the Canadian
Code of Ethics (2000) is the way in which
Principles are weighted (Sinclair, 1996).
Principle I, with its emphasis on moral rights,
is generally given the highest weight when
resolving ethical dilemmas. This I will keep in
mind as I go through the ethical decision
making process.

Whatever outcome occurs, I must demonstrate
appropriate respect for the thoughts and
opinions of the parents, no matter how
different they may be from my own. I would
like to communicate with them further;
however, I feel that this would be in violation
of this standard. They have given their
decision, and I must respect that.

Parental reactions aside, I must still work to act
in a spirit that will provide access to treatment
(additional supports) for the child in the most
ethical way.

This standard is central to what is creating this
dilemma because in working with minors, it is
really parental participation at play in obtaining
informed consent. In keeping with the College
of Alberta Psychologists (CAP) code of
conduct (2005) psychologist should not
provide services to a minor, without guardian
consent (14.2). Because I do not have parental
consent I may not precede with implementation
of special education resources, which
realistically is a decision which the child has
no say in but will impact them nonetheless.

I.24 Ensure, in the process of obtaining
informed consent, that at least the following
points are understood: purpose and nature of
the activity; mutual responsibilities;
confidentiality protections and limitations;
likely benefits and risks; alternatives; the likely
consequences of non-action; the option to
refuse or withdraw at any time, without
prejudice; over what period of time the consent
applies; and, how to rescind consent if desired.
(Also see Standards
III.23-30.)

I.26 Clarify the nature of multiple relationships
to all concerned parties before obtaining
consent, if providing services to or conducting
research at the request or for the use of third
parties. This would include, but not be limited
to: the purpose of the service or research; the
reasonably anticipated use that will be made of
information collected; and, the limits on
confidentiality. Third parties may include
schools, courts, government agencies,
insurance companies, police, and special
funding bodies.

Value: Freedom of Consent
I.27 Take all reasonable steps to ensure that
consent is not given under conditions of
coercion, undue pressure, or undue reward.

Value: Protection for Vulnerable Persons

No Specific Standard. Value Statement:
psychologists recognize that as individuals,

I feel that this standard was not fulfilled.
Because of the way the meeting ended, I was
not able to clearly make the purpose of the
assessment disclosure understood, nor did I
have time to discuss confidentiality between
professionals, when I attempted to negotiate
partial sharing of assessment information with
the parents. If I could only arrange another
opportunity to meet with the parents and
provide the necessary information to ensure an
informed decision was made. Although this is
what I feel would be right and in support of
this standard, I must proceed with caution. I
suspect further contact may be unethical.

This standard applies as I fear that I may not
have adequately clarified the purpose of the
service initially, when parents signed consent
for the assessment. Now, the parents are
refusing to sign the additional consent policy to
release this information. Perhaps if I had also
been clearer on what the parents wanted to see
out of this assessment (likely proof that their
child does not have a learning disability), I
could have prepared them for the unexpected.

This standard suggests that whatever decision I
make, I may not coerce the parents into doing
something they do not want to do (consent to
releasing assessment results). While I strongly
wish to ease their discomfort and resistance
through providing further information, I fear
that a second attempt at contact, no matter how
it is delivered (e.g. phone, mail, or sent home
with the child) may be in violation of this
standard. The parents may interpret any further
contact I initiate as an attempt to manipulate
their decision.

I need to do what I can to ensure that the
childs Right to Treatment is prioritized
ethically. In keeping with this standard, I may

family, group, or community vulnerabilities
increase, or as the power of persons to control
their environment or their lives decreases,
psychologists have an increasing responsibility
to seek ethical advice and to establish
safeguards to protect the rights of the person
involved.

Value: Confidentiality
I.43 Be careful not to relay information about
colleagues, colleagues clients, research
participants, employees, supervisees, students,
trainees, and members of organizations, gained
in the process of their activities as
psychologists, that the psychologist has reason
to believe is considered confidential by those
persons, except as required or justified by law.
(Also see Standards IV.17 and IV.18.

I.45 Share confidential information with others
only with the informed consent of those
involved, or in a manner that the persons
involved cannot be identified, except as
required or justified by law, or in
circumstances of actual or possible serious
physical harm or death. (Also see Standards
II.39, IV.17, and IV.18.)

Value: Extended Responsibility
I.46 Encourage others, in a manner consistent
with this Code, to respect the dignity of
persons and to expect respect for their own
dignity.

have to hold a meeting with the childs teacher,
to come at this dilemma in an alternate way
that does not require the recommended special
educational resources, rather simply classroom
resources. In any case, I must be extremely
careful to not involve information gained from
my activities as a psychologist in this situation.
Typically, assessment results are considered to
be confidential information and must be treated
accordingly. Autonomy vs. beneficence, which
has more weight? This is a difficult question,
as the autonomy does not belong to the child in
this case, yet the onus to do good for the
child remains pertinent.

As previously mentioned, as is school policy, I
am not at liberty to relay information to other
school personnel without consent of the
parents. However, since the teacher, has
already been involved in the referral, and is
another professional concerned with the
welfare of her student, perhaps I could share
the information providing reasonable steps
have been taken to ensure confidentiality of
this information has been understood. This will
ensure that accommodations are arranged and
will serve the best interest of this particular
child 25(1) (CAP, 2005). I know, this is likely
an inappropriate course of action due to
confidentiality issues, but will consider it
further on in the process.

This standard applies as it is a main reason
behind my dilemma. Ethically, I am obligated
to gain consent before sharing assessment
information with school staff. Perhaps the
parents will take it upon themselves to gain
new information and the outcome can be
revisited, however, I fear that this opportunity
passed when the meeting ended so abruptly.

I did encourage the parents to respect the
dignity of their child, and in turn of all children
with exceptional needs, by providing further
information regarding the nature of children
who require special services. I explained that

PRINCIPLE II: RESPONSIBLE CARING

Value: General Caring

II.1 Protect and promote the welfare of clients,
research participants, employees, supervisees,
students, trainees, colleagues, and others.

Value: Maximize Benefits

II.21 Strive to provide and/or obtain the best
possible service for those needing and seeking
psychological service. This may include, but is
not limited to: selecting interventions that are
relevant to the needs and characteristics of the
client and that have reasonable theoretical or
empirically-supported efficacy in light of those
needs and characteristics; consulting with, or
including in service delivery, persons relevant
to the culture or belief systems of those
served; advocating on behalf of the client; and,
recommending professionals other than
psychologists when appropriate.

II.22 Monitor and evaluate the effect of their
activities, record their findings, and
communicate new knowledge to relevant
others.

25-30 percent of children face various
challenges (social, emotional, developmental,
cognitive, or academic) due to neurological
deficits, and through no fault of their own.
Because of this, it is only fair that they should
receive additional supports, as they have
additional challenges. I know that knowledge
will help the parents abide by this standard,
and if I can, I must find a way to unobtrusively
provide it.

At the forefront of my mind in this situation, is
what is in the best interest of my client, and
how can these interests be served? While the
parents may not want special services for their
child, the school personnel, have a duty to
develop this child academically (NASP, 2008).
A lack of consent means that special
educational resources will not be provided,
therefore, we must strive to find in class
supports.

Again, I am striving to obtain the best services
for my client, and due to the vulnerable
position of children I must continue to
advocate on the childs behalf, and against the
wishes of the parents. Similarly, school
psychologists consider children and other
clients to be their primary responsibility, acting
as advocates for their rights and welfare
(NASP, IV. A. 1.). My new dilemma becomes
what is appropriate advocacy? Does this mean
I should support the teacher, does it mean I
should provide recommendations to the parents
(e.g. computer programs focusing on
acquisition of basic skills, websites to provide
relevant information on the child challenges)
so they may support their child at home?

If I do not communicate my findings (that this
child is in need of basic skills development) to
appropriate school personnel (teacher, resource
teacher), I feel I will be in breach of this
standard. Similarly, guidelines for school
psychologists in Canada state information
obtained from assessments should only be

I.23 Provide, in obtaining informed consent, as
much information as reasonable or prudent
persons would want to know before making
a decision or consenting to the activity. The
psychologist would relay this information in
language that the persons understand
(including providing translation into another
language, if necessary) and would take
whatever reasonable steps are needed to ensure
that the information was, in fact, understood.

Value: Minimize Harm
II.30 Be acutely aware of the need for
discretion in the recording and communication
of information, in order that the information
not be misinterpreted or misused to the
detriment of others. This includes,
but is not limited to: not recording information
that could lead to misinterpretation and misuse;
avoiding conjecture; clearly labelling
opinion; and, communicating information in
language that can be understood clearly by the
recipient of the information

Offset / Correct Harm
II.42 Be open to the concerns of others about
perceptions of harm that they as a psychologist
might be causing, stop activities that are
causing harm, and not punish or seek
punishment for those who raise such concerns
in good faith.

shared with those persons involved with the
teaching and learning process of the student
(CPA, 2007, p. 9). However, this would again
involve parental agreement 15(2) (CAP, 2005).

This standard would provide support for my
decision to reopen lines of communication. I
feel that I did not provide the parents with as
much information as they reasonably needed to
know. Psychologists must strive to allow
people to make informed decisions and this has
not yet been accomplished. Therefore, I must
somehow provide them with that information.
The way in which the parents exited the room,
leads me to suspect that they are not making
informed decisions, but rather decisions based
on emotion and impulse. I feel in advocating
for my client, it is my responsibility to attempt
to not only provide appropriate information,
but also attempt to ensure it is understood.

The value of minimizing harm, and exercising
discretion when communicating information, is
pertinent here. The parents do not want a
special needs label placed on their child for
fear that the stigma associated with special
needs services will cause more harm, than will
benefit from access to the services. In keeping
with the codes of conduct for psychologists
(CAP, 2005), I prepared appropriately to
facilitate understanding (35); however, I did
not have the opportunity to fully communicate
the information. I feel like what was
communicated misinterpreted, despite efforts
to the contrary. I consistently come back to
wanting to find an ethical way to correct this
miscommunication.

I need to be open to concern the parents have
regarding others perceiving their child in a
negative way, due to the results of my
assessment and special educational services. I
understand that it is sometimes easier to ignore
an issue, and hope it will go away on its own.
This standard suggests that I should stop
activities that are causing harm. The conflict is

PRINCIPLE III: INTEGRITY IN
RELATIONSHIPS

Value: Accuracy / Honest

III.8 Acknowledge the limitations of their own
and their colleagues knowledge, methods,
findings, interventions, and views.

Value: Objectivity / Lack of Bias

Evaluate how their personal experiences,
attitudes, values, social context, individual
differences, stresses, and specific training
influence their activities and thinking,
integrating this awareness into all attempts to
be objective and unbiased in their research,
service, and other activities.

III.11 Take care to communicate as completely
and objectively as possible, and to clearly
differentiate facts, opinions, theories,
hypotheses, and ideas, when communicating
knowledge, findings, and views.

III.13 Act quickly to clarify any distortion by a
sponsor, client, agency (e.g., news media), or
other persons, of the findings of their
research.

that I believe the parents to be the ones causing
harm to their child. Accepting school supports
and services could make all the difference as
basic skills development (especially pertaining
to reading) will impact each academic subject.
I am clearly not able to disclose information or
access additional services for this child without
informed parental consent. As such, I must
acknowledge the limitations of my findings, as
per this standard. I accept that this child will
not be benefited in the traditional way, (extra
services, IPPs) however; I must explore other
avenues through which this child can benefit.

This standard suggests that I must be aware of
my own biases in the situation. My job and
experience makes me an advocate on behalf of
students who require special needs services. I
have extensive training in identifying and
assisting children who may be experiencing
various challenges. I am also aware of how
effective extra support can be if implemented
appropriately. I must understand that the
parents do not share my opinion, as they have
their own experiences to draw from and guide
their decisions.

This standard suggests that I did my due
diligence when attempting to communicate the
assessment findings to the parents in an
objective way. They would never have guessed
my level of disbelief at their response.
However, this standard also states that
complete communication is necessary; I know
this was not carried out.

I fear that this standard is especially pertinent
to my dilemma, as I was unable to clarify the
parents distortion of what accessing special
resources would mean for their child. I should
have acted quickly to explain that their child
may be very capable of achieving at a grade
appropriate level, however, some changes may
be needed in the way they are taught or tested.
If given the time, I would have explained that
an Independent Program Plan (IPP) may

Value: Avoidance of Conflict of Interest

III.35 Inform all parties, if a real or potential
conflict of interest arises, of
the need to resolve the situation in a manner
that is consistent with Respect for the Dignity
of Persons (Principle I) and Responsible
Caring (Principle II), and take all reasonable
steps to resolve the issue in such a manner.

Value: Reliance on the Discipline

III.36 Familiarize themselves with their
disciplines rules and regulations,
and abide by them, unless abiding by them
would be seriously detrimental to the rights or
welfare of others as demonstrated in the
Principles of Respect for the Dignity of
Persons or Responsible Caring. (See Standards
IV.17 and IV.18 for guidelines regarding
the resolution of such conflicts.)

III.38 Seek consultation from colleagues and/or
appropriate groups and committees, and give
due regard to their advice in arriving at a
responsible decision, if faced with difficult
situations

PRINCIPLE IV: RESPONSIBILITY TO
SOCIETY

Value: Beneficial Activities

IV.7 Provide and/or contribute to a work
simply outline adaptations for the child.
Unfortunately, as previously mentioned, I
suspect the time for clarification has passed,
that information may have made a difference,
and I have missed my opportunity to fully
uphold this standard.

There is a definite conflict of interest here in
terms of what is in the best interest of the child
(receiving additional services) and what the
parents have decided. This standard suggests
that I should inform the parents of this conflict
of interest, yet the school policy states parents
have a right to withhold consent for access and
action, upon reviewing assessment
information.

I have reviewed practice guidelines for school
psychologists (CPA, 2007) that state informed
consent from a student of legal age or from a
parent or legal guardian of a younger student is
absolutely essential (p.11). However, I feel
that I must care responsibly for my client, and
provide them the right of access to appropriate
education, including special educational
services if need be.

I suspected this issue would come up one day,
yet have not experienced this before. I will
consult with my colleagues in different
districts nearby and take into account all they
have to offer on the matter. According to the
NASP consultation with peers, coupled with
ethical principles are the top two ways in
which school psychologists resolve ethical
dilemmas (2008). Likewise, I could consult
with the principal as he may have some
expertise in the area of providing for the
childs best interest, while still behaving
ethically, as I am sure this issue has come up
before, considering the schools unusual policy
pertaining to informed consent.

This standard suggests that although I may be
questioned (likely by the childs teacher)

environment that supports the
respectful expression of ethical concern or
dissent, and the constructive resolution of such
concern or dissent.

Value: Respect for Society

IV.18 Consult with colleagues, if faced with an
apparent conflict between abiding by a law or
regulation and following an ethical principle,
unless in an emergency, and seek consensus as
to the most ethical course of action and the
most responsible, knowledgeable, effective,
and respectful way to carry it out.
regarding the results of the assessment, I will
have to explain that I am unable to share that
information with her at this time. I must
understand and encourage her expression of
concern in the matter as she may feel like we
are harming the child by not disclosing the
results of the assessment and implementing
special educational services.

This standard suggests that I should and will
consult with colleagues in this dilemma. The
conflict appears to be between the law of
obtaining informed consent (to provide special
education resources, allow personnel access to
records) and the agreement of serving the best
interest of the client. I will carefully consider
advice given, in order to decide on the most
respectful, effective, and ethical course of
action.

Step 3: Consideration of How Personal Biases, Stresses, or Self-interest Might Influence the
Development of or Choice Between Courses of Actions
My initial reaction was disbelief. We have come such a long way in advocating for
children with special needs so that they can be afforded the same access to education as others,
despite whatever challenges they may be faced with. I cannot believe these parents would want
to take a step backwards. I also went through feelings of anger and frustration (which I of course
did not express) as I essentially wasted time assessing a child who will not benefit, when another
may have. I now feel guilty for not having better anticipated that type of reaction. I know that the
conversation could have taken a different course if I had only anticipated it and somehow
planned to lead the conversation in a strength and outcomes based direction. Maybe if I had
addressed confidentiality and their various other concerns before mentioning the words special
needs in relation to their child, we would have a different outcome. While I do not have
children, I have taught them, and I really feel for those who struggle without knowing why. My

years of experience spent teaching and training as a psychologist leads me to be biased in support
of coding, additional resources and full school personnel disclosure. I highly value the resources
and support this school offers and I have seen how effective the right IPP can be for children.
On the other hand, I must empathize with the parents. I know that often, learning disabilities
have a genetic basis, and in all likelihood either one or both parents also struggled with this issue
in school. It is possible they struggle still, and that their biases come from direct and painful
experiences. In reality, I am sure they acting in a way that they believe will best protect their
child. In years past, special education may have resulted in children being placed in different
schools or separate classrooms, and not working on regular curriculum. Similarly, I must also
be aware of the fact that this child has been struggling since beginning school. The parents may
have given up on the process of receiving help entirely due to the waiting period between first
noticing the struggle, and finally receiving an assessment is often long. They may have just
accepted that their child will struggle, possibly like they did, but will turn out alright.
Step 4. Development of Alternate Courses of Action
In principle, this dilemma presents no conflict, however, in practice there is more to
consider. As previously stated, in keeping with the information provided in the vignette, there
was no need to review the ethical dilemma in order to completely rule out one option, which
pertains to confidentiality. Legally and ethically I am not able to disclose the assessment results,
or any information I have gained through activities as a school psychologist to other school
personnel without parental consent. However, the confidentiality dilemma involves the
following: on one hand, the school psychologist must abide by maintaining confidentiality, yet
on the other hand, we should be most concerned with reporting appropriate information to other
concerned professionals, relating to what is in the childs best interest (Adelmen & Taylor,

1989). While it is clear that disclosing assessment information is the route I may not take, my
next priority becomes to ensure that the childs best interest is still somehow being served. The
moral principle of beneficence, and doing good for clients, makes it impossible for me to
accept the situation as it currently stands. Still, I am clearly bound by the ethical issues revolving
around confidentiality and informed consent. I feel that one of the following alternatives will
lead me to an ethical resolution.
Alternative 1.
I feel like my hands are tied in this situation, as there is no clear course of action. First, I
will allow a cool down period of a few days before contacting the parents again. I will look
outside of the CPA (2000) and seek further guidance from the ethical code of the NASP which
states, school psychologists respect the wishes of parents who object to school psychological
services and attempt to guide parents to alternative resources (I.15). I feel that this would also
be in keeping with the Canadian Code of Ethics (2000), as I would be demonstrating appropriate
respect for the knowledge, insight, and experience of the parents, while still advocating on behalf
of my client. I plan on calling the parents for a follow-up, (I realize this is very touchy, as they
likely want nothing to do with me at this point) and asking permission to simply send home a list
of recommendations that I have compiled (e.g. educational computer sites/games to target the
acquisition and strengthening of basic skills, suggestions on levelled read-aloud books to assist
with reading fluency). I will also include website links pertaining to understanding the challenges
of children with basic skills deficits, and parent support sites, to allow for communication with
others in similar situations. They may feel more comfortable exploring information once I have
removed myself from the process, and it is left up to them to peruse materials. I will express my
appreciation for any opportunity to hear further viewpoints, questions, or concerns. My attempt

to reopen lines of communication will only revolve around recommendations. Important here is
simply to provide access to information that may help that child at home, not to coerce the
parents into reaching a different decision.
Alternative 2.
I will hold a meeting with the childs classroom teacher who will be waiting to hear the results of
the assessment. I will inform the teacher of my inability to disclose assessment results due to a
lack of informed consent and explain that we must explore other avenues for providing support
to this child. I will ask the teacher what types of in-class assessments have been carried out on
this student, who has already been identified as a struggling learner. We will brainstorm various
assessments which may further assist in a greater comprehension of the childs learning needs
(e.g. Fountas and Pinnell Benchmark Assessment). Likely, much pre-referral data has already
been gathered and the teacher has formulated an opinion on what areas need to be supported in
the classroom for this child.
Arrange to meet again the following week to discuss assessment results and possible
implications for that child in the classroom. Based around teacher collected data and
observations, I recommendations various strategies which may be effective instructionally. This
course of action does not represent an ethical dilemma as teachers are expected to provide
individualized instruction for students if necessary. Similarly, I as the school psychologist am
expected to serve as support for teachers.
Lastly, the teacher meets with the parents to discuss only her own observations and
include parental observations on the strengths and weaknesses of the child. Armed with
strategies recommended by the psychologist, the teacher directs the outcome she believes will
work for the child, taking into consideration parental input. I do not attend this meeting. It is

scheduled by the teacher, with her and the parents (and possibly the child). I have removed
myself from the equation, suspecting that based on our history together, the parents will respond
negatively to my being present. Similarly, this meeting has nothing to do with my assessment
results; therefore, there is no need for me to be in attendance.
Step 5. Analysis of Likely Short-term, Ongoing and Long-term Risks and Benefits of Each
Course of Action on the Individual(s) / groups(s) Involved or Likely to Be Affected (e.g.,
Participants, Colleagues, the Discipline, Society, Self
Possible Positive Consequences Possible Negative Consequences

Alternative 1.
Lines of communication are re-opened which
allow for the correction of harmful
misinformation regarding special educational
services in general.

In the long term I suspect this alternative to
have the most potential to benefit. While my
goal is to support the child in the best possible
way, providing valuable recommendations and
weblinks to the parents may lead to new
knowledge gained. Often reconsideration of
beliefs occurs with new information, and the
parents may change their minds entirely.

Providing the parents with information to
review if they choose, may lead to an informed
decision, whatever that may be.

This alternative may be the best for giving
parents a degree of control in their childs
educational future, as they will have had ample
Parents respond negatively on the phone to my
sending recommendations home, and tell me
not to contact them again. Nothing new is
gained that will benefit the child.

Parents do not bother to look at
recommendations once received, therefore,
supports specific to this child are non-existent
in the home and at school. The child continues
to struggle with basic skills that negatively
impact each academic subject. Likewise,
although I am careful to send home only
recommendations and access to pertinent
information that I think will be of benefit the
child, the parents feel that I am trying to
influence their decision. They resist further, by
continuing to do nothing, and no supports are
implemented for their child.

This alternative will take a longer time to have
a positive effect on the child educationally, if it
does at all, since it depends on the parents
reaching a more informed decision which they
may not.

There is also a chance that the parents decide
to take nothing into consideration, and the
control they have over their childs educational

time (as much as they would like) to review
information and potentially revisit their
decision. If they can be in control of supports
for their child and recognize how effective they
can be, they may warm to the idea of supports
at school.

Upon learning about deficits in basic skill areas
through provided websites and resources, the
parents decide to go ahead with special
education programming and disclosure of
assessment results. They see other people who
have shared their views, gained knowledge on
the process, risks, and benefits, of special
education. They come to understand that
modern special educational services are not
like what they remember. They read about
parents who, like them were opposed to
labelling their child with an IPP and additional
resources, but who ended up benefiting.

This outcome respects the wishes of the parent.
It educates the parents, and they become their
childs advocate. The parents feel that the
change of heart was entirely up to them, as
they are the expert on their child.

Alternative 2.

In the short-term this alternative is the better
one. It will mean that the child is immediately
supported in some way by the teacher.
Through careful planning and data gathering,
the teacher is able to appropriately provide
classroom support for this child.

future will impact the child negatively. The
child will continue to struggle in class if the
teacher is not providing appropriate or
adequate supports.

Parents may look into the suggested resources
for information; however, refuse to identify
with other parents like them. They continue to
fixate on the idea that their child is not a
dummy and that avoiding that label means
keeping their child away from any special
education resources.

Again, the parents feel that I am trying to
manipulate their decision, through further
contact. They feel disrespected and distrustful
of psychologists. They continue to bring their
own experiences and biases into their
reasoning, rather than new knowledge. They
are resolved on the decision, and the belief that
their child will be fine, despite the struggles, as
they were fine despite theirs.

The teacher does implement appropriate
supports for this child and they succeed in the
classroom. The following year, that child is not
recognized as needing additional supports as
there is no IPP. Clearly, this is not the best
long-term solution as it leaves the child
unsupported in the near future. The
achievement of the child is left in the hands of
the current teacher, and without that teacher,
achievement drops.

Similarly, what if the current teacher does not
continue supports? An absence of an IPP may
lead to a lack of accountability in this childs

One role of a school psychologist is to support
teachers in their practices and instruction. I will
be providing support to this teacher, as is my
job, yet will not disclose information I have
gained through the assessment. Ethically, this
seems like a good direction to take.

In keeping with ethical standards, it is best to
include parents in the decision-making process
regarding their childs education. While it is
acceptable for me to meet with the teacher
regarding concerns pertaining to the child that
she has already stated, it is not acceptable for
me to include myself in any meeting involving
the parents and teacher. I am serving the best
interest of the child (given the fact that they
will not receive special education services
elsewhere) by guiding the teacher in her
practices. I am completely removed from the
equation, and it becomes one of classroom
practice, and classroom support, rather than
one of special education.

Meeting begins with the parents and teacher,
and goes favourably. Parents leave the meeting
feeling that this teacher actually cares about
their child and wants to do whatever will work
best for them. Parents feel heard and in control
of their childs educational future.

progress and the child may fall through the
cracks.

The teacher could miss the mark on what this
child requires, and focus on an instructional
style which is not effective. When it becomes
clear the supports are not leading to positive
outcomes, the child will have slipped further
behind academically.

This is very unlikely; however, if the parents
somehow find out about our team meeting and
that we have put supports for their child in
place without them (although we have a right
to do so) they may feel betrayed, leading
towards feeling of distrust towards
psychologists, teachers, and the educational
system in general. They may completely
remove any support for the teacher and school
efforts. They may speak badly about the
teacher and school at home, resulting in their
child developing a similar lack of respect for
school personnel and the process of education.

The parents feel that there is a conspiracy and
that the whole school is out to put their child in
special education. They may feel that school
personnel believe their child to be dumb and
requiring additional support. They become
unreasonable to any suggestions or
recommendations by the teacher. The teacher
is completely taken aback and experiences
feelings of stress around the situation.

Step 6. Choice of Course of Action after Conscientious Application of Existing Principles,
Values, and Standards

I believe my second alternative to best serve the interest of the client. I think the actions
and consequences of this alternative are more in keeping with the Canadian Code of Ethics
(2000) and the First Principle of Respect for the Dignity of Person. I will have respected the
experiences and desires of the parents, adhered to the ethical and legal issues revolving around
informed consent (sharing student assessment results, and putting information in the students
school file) and confidentiality (not sharing assessment), as well as protected vulnerable persons
to the best of my ability in ensuring supports were implemented. The parents are less likely to
feel that they are being coerced into anything (a true risk with Alternative 1) as the interview will
allow for them to be included and in control of the educational process. However, I think that the
values in Principle II are more supported in Alternative 1, as this course of action lends itself to
the parents gaining additional information needed to make a rational decision, in a somewhat
independent way (they can choose to look through the information or not). Similarly, Alternative
1 is the more likely to lead to what I (keeping my own biases in mind) consider to be the
correct decision for their child. Conversely, this alternative also seems to possess larger risks
as the potential for inaction (by the parents) is far greater. As the first principle, outweighs the
second on ethical matters, this and careful deliberation, has led me to what I believe to be the
most ethical course of action.
Again, I will consult with other school psychologists (although they are in various
districts) as to what they believe to be the correct course of action. Since the principal may also
be affected by whatever decision I make (they may be hearing about this from the parents) I
should likely consult with him to identify any additional concerns that I have not yet considered.
I should also inform the teacher in some way as to the possible repercussions of holding a

meeting with these parents, after having had such a negative and emotional reaction from them in
the past.
Step 7. Action with a Commitment to Assume Responsibility for the Consequences of the
Action.
This step implies that whatever decision I make will come with consequences and I must
be prepared to deal with them. Therefore, I must carry out the best course of action that I (the
principal and colleagues in various other school boards) can agree on, that provides the most
correct outcome according to the ethical principles of the Canadian Code of Ethics (2000).
Step 8. Evaluation of the Results of the Course of Action.
I need to evaluate whether the outcome I wanted (appropriate learning supports in the
classroom) has been achieved. I also need to evaluate other negative consequences which may
have resulted from my decision (e.g. the parents may have made a complaint, either against
myself or the teacher, with concerns of interfering school personnel). Worst case scenario, the
child is removed from the school.
Step 9. Assumption of Responsibility for the Consequences of Action, Including Correction
of Negative Consequences, If Any, or Re-engaging in the Decision-making Process If
Ethical Issue is not Resolved
It is possible that my chosen course of action will not work in the long run. Yet, I do
suspect it will provide the most immediate benefit to the child. The teacher is keen to help each
student and implement new suggestions. However, it is quite possible that my chosen course of
action may not work for the parents. They may continue to see additional support (although it is
only classroom support) as a negative outcome for their child. If this is the case, the teacher may
continue to implement whatever instructional strategies deemed to be appropriate, regardless of

parental support as she is the expert on the way children learn. Because the parents are unable to
control the way the teacher choses to instruct her students, Alternative 2, is the most beneficial
and least harmful outcome for the child. It removes the possibility of negative and uninformed
parental influence.
Step 10. Appropriate Action, as warranted and Feasible, to Prevent Future Occurrences of
the Dilemma (e.g., Communication and Problem Solving with Colleagues, Changes in
Procedures and Practices)
As mentioned initially, I suspect that the policies pertaining to psycho-educational testing
at this school are out of touch with what is currently expected of school psychologists. Informed
consent should be obtained prior to assessment only. This situation could be avoided in the future
if the school changes the policy that parents must give informed consent before disclosing
assessment results to other school personnel. It is understandable that from time to time,
assessment results will not be in keeping with parental expectations, especially if a diagnosis is
attached. We must not give parents the power to bury a diagnosis from school personnel, as they
do not have that right in the public school system. I need to further discuss this issue with the
principal so that we can bring current school policy up to date.


References
Alberta Education. (2009). Setting the direction framework. Retrieved from
http://education.alberta.ca/media/1082136/sc_settingthedirection_framework.pdf
Alberta Legislative Assembly. (1999). Health Professions Act. Edmonton: Author.
Canadian Psychological Association. (2000). Canadian code of ethics for psychologists
(3
rd
ed.). Ottawa, Author.
Canadian Psychological Association. (2001). Companion Manual to the Canadian Code
of Ethics for Psychologists(3
rd
ed.). (C. Sinclair, & J. Pettifor, Eds.) Ottawa, Ontario: Second
Printing.
Canadian Psychological Association. (2007). Professional practice guidelines for school
psychologists. Edmonton: Author.
College of Alberta Psychologists. (2010). Professional guidelines for psychologists -
Limits to confidentiality and consent for services: Special issues in working with minors.
Edmonton: Publisher.
College of Alberta Psychologists. (2005). Professional guidelines for psychologists
Special issues in client and third party requests. Edmonton: Author.
College of Alberta Psychologists. (2005). Standards of practice. Edmonton: Author.
Coranne-Johnson, R., & Pei, J. (2012). School psychologists - more than WISC jockeys.
Edmonton: University of Alberta.
Kuniec, M. (2006). An ethical framework to understanding Canadas mature minor
doctrine. Edmonton: University of Lethbridge.


National Association of School Psychologists. (2008). Professional ethics in school
psychology. MD: Author.
Psychologists Association of Alberta. (2006). A guidebook for starting and operating an
independent professional practice in psychology. Edmonton, AB: Author.
Psychologists Association of Alberta. (2010). The pivotal role of Alberta school
psychology services: A response to Alberta Educations setting the direction - A position paper.
Retrieved from
http://www.psychologistsassociation.ab.ca/sitewyze/files/Position_Paper__PDF.pdf
Sinclair, C. (1998). Nine unique features of the Canadian code of ethics for
psychologists. Canadian Psychology, 39, 167-76.
Taylor, L., & Adelman, H. (1989). Reframing the confidentiality dilemma to work in
childrens best interests. Professional Psychology: Research and Practice, 20, 78-83.
doi:10.1037/0735-7028.20.2.79
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Edmonton, AB: The University of Alberta Press.


Grading Criteria Weight
(19.5/20points)
APA Style - See APA Style Grading Criteria
The paper follows APA style in the presentation and organization of the
paper. OVER THE LIMIT OF PAGES BY 5. Few APA errors..
2.5/3 points
State why the topic is important 3/3 points
Demonstrate knowledge of relevant ethical principles and standards in
addressing the topic
4/4 points
Present two actual examples of dilemmas (they will usually involve conflict
between principles or between interests of different parties)
3/3 points
Demonstrate how you would resolved these dilemmas, e.g., how you apply
your knowledge and ethical decision-making skills
4/4 points
Describe how your personal values interface with the professional values
and whether this presents any dissonance or personal conflict for you. What
changes in the dilemmas described could have made it easier, or more
difficult, for your personally?
3/3 points
Great paper Jackeline. I certainly enjoyed your process and the dynamic of your thoughts..
Congratulations on your work enjoy the rest of your summer.

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1 Running head: INFORMED CONSENT AND CONFIDENTIALITY

Issues in Informed Consent and Confidentiality,

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