title: From colleague to patient: ethical challenges in integrated primary care.
abstract: Ethical codes and guidelines for mental health professionals focus on traditional avenues of practice, leaving considerable gaps for clinicians in unique settings, such as behavioral health providers in integrated primary care. In this article, an ethical scenario is presented, where a behavioral health provider is faced with a colleague physician seeking assistance for emotional distress. The scenario highlights important ethical questions about multiple relationships/conflict of interest, impaired colleagues, informed consent, and confidentiality. We review gaps in ethical guidance pertinent to the scenario and provide an eight-step rubric for ethical clinical decision making in integrated primary care.
authors.affiliation: Kathryn E. Kanzler, PsyD, ABPP, 779MDOS/SGOW, Malcolm Grow Medical Clinic, JB Andrews, MD 20762, USA. kathryn.kanzler@us.af.mil
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Kanzler
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Goodie
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Hunter
authors.forename: Michael Ann
authors.initials: MA
authors.lastname: Glotfelter
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Bodart
mesh_terms: D003219:Confidentiality / Q000941:ethics* / Q000592:standards; D016265:Conflict of Interest; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000592:standards; D007398:Interpersonal Relations; D007400:Interprofessional Relations / Q000941:ethics*; D008297:Male; D008499:Medical Records / Q000592:standards; D010348:Patient Care Team / Q000941:ethics / Q000458:organization & administration / Q000639:trends; D010815:Physician Impairment; D010817:Physician-Patient Relations / Q000941:ethics*; D011320:Primary Health Care / Q000941:ethics* / Q000458:organization & administration / Q000639:trends; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology* / Q000628:therapy