Legal and Ethical Considerations
Case managers operate within a legal and ethical framework that protects client rights and defines professional obligations. Questions here test whether you can identify the governing principle and apply it correctly.
Concepts to master
- Confidentiality and HIPAA: protected health information may be shared only for treatment, payment, or operations, or with valid authorization, unless an exception applies.
- Informed consent: voluntary, competent, and informed - the client must understand risks, benefits, and alternatives.
- Mandatory reporting: suspected abuse, neglect, or exploitation of children, elders, or dependent adults must be reported per law.
- Advance directives and guardianship: honoring documented wishes and recognizing when a surrogate decision-maker is authorized.
- Ethical principles: autonomy, beneficence, nonmaleficence, justice, and fidelity.
- Boundaries and dual relationships: avoid conflicts of interest and exploitation.
Traps in questions
- Confidentiality exceptions. Safety threats (e.g., duty to warn) and mandatory reporting override confidentiality - but only within legal limits.
- Consent without competence. A signature from someone lacking capacity is not valid consent.
- Ignoring directives. Documented client wishes must be honored even when family disagrees.
- Boundary crossings. Accepting gifts or forming personal relationships with clients is a red flag.
Worked example / rule of thumb
A client discloses intent to harm an identifiable person. The correct action is to follow duty-to-warn/reporting obligations - confidentiality yields to safety. Rule of thumb: when safety and confidentiality conflict, safety prevails within legal channels.