Angela was hired to perform psychosocial assessments with clients served by a home-health agency. She was assigned to visit Mr. Harrak, who had recently been released from the hospital following a hip replacement. He and his wife had immigrated from Morocco several years ago at the request of their daughter. Mr. Harrak had limited English speaking ability, although his wife was fairly fluent in English, her second language.
At Angela’s first visit with Mr. Harrak, he was alert and resting comfortably on the sofa; the home appeared clean and orderly. His wife said that his pain was being managed successfully and he had been eating reasonably well, but his sleep was often disrupted due to stress. Since their move to the United States, Mr. Harrak had been having difficulties adjusting to the culture and he missed his family back home. When Angela approached Mr. Harrak to offer support, she observed several round, inflamed, bruise-like patches on his neck. Angela pointed them out with concern and was told by Mrs. Harrak that they were the result of wet-cupping procedures that she performed on her husband to help him relax and to support his healing. This treatment, she explained, was recommended by the Islamic prophet Muhammad and has been used in her home country ever since. Mr. Harrak nodded with a smile as his wife spoke and translated the conversation for him. Angela then concluded her visit and left the home.
As she drove back to the office, Angela wondered whether she should file a report with Adult Protective Services. She was concerned about Mr. Harrak receiving what appeared to be harmful treatments at the hands of his wife. Yet, Angela had no knowledge of cupping and needed to learn more. She also knew that she needed to consult with the nursing supervisor about next steps. Her decision had implications for Mr. Harrak, herself, and her organization.
Is there a potential ethical conflict? What is it? What are the competing “values” in this vignette?
Make distinctions between complex clinical issues and potential ethical conflicts.
