You have been seeing Ruben for six weeks. He initiated therapy because his male partner, Jim, recently tested HIV positive and Ruben is anxious about his own health. Ruben and Jim have had a sexual relationship for six months though Ruben does not consider himself gay because he is ‘masculine’ and when he does have sex with other men, he is the ‘active’ or penetrating partner.
Ruben is also married to Elena. They have two children, ages 2 and 5. Ruben and Elena came to the US from Mexico and have been legal residents for seven years. Ruben has been struggling with his feelings for Jim and Elena. He clearly cares for his family, enjoys being a father and speaks openly about the stress of keeping his relationship with Jim a secret. Without offering any explanation, Ruben has cut off all sexual contact with Elena and all contact with Jim since he found out Jim tested HIV positive.
Recently, Ruben tested positive at an anonymous test site. He refuses to tell Elena because the news would hurt her and bring shame to himself and his family. He also fears that if Elena found out, she would find ways to keep the children from him and tell his parents, who would be deeply disappointed.
Ruben continues to avoid sexual relations with Elena. However, during his next visit, he tells you that she has become ‘more seductive’ and hinted that she would like another child. Ruben states that it was too difficult to resist and admitted that he had unprotected sex with Elena twice. He hopes that he ‘got lucky’ and didn’t infect her. He doubts that he can stop having unprotected sex with her but refuses to tell her he is HIV positive. Ruben refuses to seek medical care because he ‘feels fine’ and doesn’t want a doctor to tell Elena his HIV status.
Ruben displays no signs of major mental disorders. He has no history of psychiatric problems or drug or alcohol abuse. Ruben tells you he would never contemplate suicide or abandon his family. You conclude Ruben’s primary defense mechanism is avoidance. He signed a limit of confidentiality statement when he entered treatment with you and he is currently committed to working on his issues in therapy.
In real community social work practice settings there can be complicated forces at work that social work practitioners must manage.
- Professional ethics for social workers which uphold confidentiality, protecting information confided by a client from disclosure to others without client authorization.
- Ohio’s HIV Felonious Assault Law which states you must disclose to anyone with whom you have sex that you are HIV+ before any sex act. These competing demands create a conflict between confidentiality for the client and the duty to protect those who might be harmed by the client’s actions.
- Most social service agencies hold a client’s confidentiality inviolate, i.e., irreproachable and upright, and have clear guidelines around confidentiality.
This case study puts you in an environment which, in practice, requires you to uphold agency policy.
Identify in bullet points:
- What are the consequences if you choose to violate Ruben’s confidentiality?
- What are the consequences if you disclose Ruben’s HIV status to Elena?
- What actions might you take, including consult and with whom, to mitigate, temper or placate the situation?
Shakespeare's disaster of Hamlet is thought to be Shakespeare's best catastrophe. All through this play Hamlet encounters an assortment of feelings anyway the feelings are depicted in Act III that characterize his character. Villa is displayed in a negative light in view of his managing Ophelia, his mom and the slaughtering of Polonius. In Act III Hamlet's actual identity came through and he was depicted as a cutthroat individual in light of his activities with different characters. Village's managing Ophelia uncovered that he was deceptive and was unforgiving in the manner in which he talked with her. Ophelia had stood up to Hamlet about the letters and blessings that he had given her and he lied saying I never gave you nothing (3.4.98). Villa later humiliates her by disclosing to her that he once cherished her anyway he doesn't currently. Poor Ophelia is embarrassed and says I was the more swindled (3.1.122). Ophelia really trusted that Hamlet had cherished her anyway he is presently denying everything, including the letters and endowments that he gave her. Obviously the maltreatment does not stop there. Villa advises Ophelia to Get thee to a cloister (3.1.123) with the goal that she won't breed more heathens and after that rebukes her for acting like a prostitute and painting (3.1.143) her face. Village reprimands her maxim that God has given you one face and you make yourselves another (3.1.143-144). Ophelia was crippled that Hamlet's honorable personality is here o'erthrown (3.1.150). Village absolutely showed himself to be hostile and unforgiving and his activities would offend anyone. Village's reprisal on ladies absolutely did not stop with Ophelia. The following lady to get Hamlet's fierceness is his very own mom, Gertrude. Gertrude called Hamlet to her space to attempt and discover what wasn't right with him. Notwithstanding, Hamlet had concluded that he would have been savage, not unnatural (3.2.370). Villa would tell his mom what he thought of her and would talk knifes to her yet utilize none (3.2.371); he would have been noxious with his words. Village continued to disclose to Gertrude that since she had hitched her first spouse's sibling so rapidly the sky were debilitated at the demonstration (3.4.52). She had hitched such a great man and when he kicked the bucket she wedded Claudius and dropped from such an elevated position. Village disclosed to her that she stewed in defilement, honeying and having intercourse (3.4.94). Gertrude was so harmed by this that she asked that he speak No more (3.4.103). Village shouted at her to Confess yourself to paradise. Apologize what's previous (3.4.151-152). Poor Gertrude could just react that thou hast split my heart in twain (3.4.158); Hamlet had made her extremely upset. Villa's tone and activities were so unnerving and inconsistent to Gertrude that she inquired as to whether Thou shrink not kill me (3.4.22)? Villa is unquestionably depicting a person that is coldhearted and without soul. A person that has an inner voice, confidence or respect could never fall back on startling their mom. Villa's rule of fear finished with him slaughtering Polonius. At the point when Hamlet had frightened his mom so much she got out for help and Polonius answered from behind the shades. Villa said How now, a rodent (3.4.25) and wounds through the drapery not knowing who was behind it. This would seem to have been a mischance anyway when Hamlet understood that it was Polonius he didn't demonstrate any regret. Villa was anticipating that it should be Claudius behind the window ornament anyway when he discovered that it was Polonius he said I took thee for thy better (3.4.33; he thought it was somebody more critical. Villa at that point continued to consider him a pitiable, rash, barging in trick (3.4.32). Villa just slaughtered a man but demonstrates no sorrow or regret over his activities. Rather he basically tells the rodent that he got what he merited. Toward the finish of the scene he hauls Polonius out of the room without respect or care. Taking everything into account, Hamlet demonstrated to everybody that he is really a corrupt individual with no regard for human life or the sentiments of others. Village even alluded to himself as pleased, vindictive, aggressive (3.1.126). All through Act III Hamlet lied, castigated and executed for his very own advantage. These are not the characteristics that somebody of a positive sort would have. The dealings that Hamlet had with Ophelia, his mom and the executing of Polonius demonstrate that Hamlet is a negative power to be figured with which was obviously decided in Act III.>GET ANSWER