2. Cultural Values and Competent
Health Services to Minors
13-year-old girl of Arabic cultural heritage living in Boston, Massachusetts,
brought by her parents to a hospital emergency room after an assault by a
Based on her injuries, the hospital staff suspected that the attacker had
sexually assaulted the girl, but she and her parents refused medical
The family received a referral to see Janet Matthews, a clinical psychologist
in adolescent trauma. During their initial meeting with Dr. Matthews,
parents asked the psychologist not to discuss any sexual aspects of the assault
their daughter but to treat the psychological trauma from the assault in
told the psychologist that admitting a rape had taken place would cast a
on their daughter and make her ineligible to be married to men in their
knit ethnic community. When asked in private, the girl also requested that
issues not be discussed for the same reason.
Matthews does not know if she should agree to the parents and childs
is this an ethical dilemma? Which APA Ethical Principles help frame the
of the dilemma?
are the stakeholders and how will they be affected by how Dr. Matthews
might Irinas age and parents involvement in the referral affect how
Matthews can resolve this dilemma? How might state law on treatment
minors and HIPAA rules on access of guardians to a minors health care
influence Dr. Matthews decision? (See sections on A Word About
in the Preface of this book, on parental rights under Standards 3.10b,
Consent, in Chapter 6, and the Hot Topic at the end of Chapter 7
and Involvement of Parents in Mental Health Services for
attitudes, knowledge, and skills are required to develop a culturally
treatment plan for Irina (see the Hot Topic for Chapter 5
Irina likely to benefit from the treatment if the possibility of sexual aspects
trauma is not explored?
are APA Ethical Standards 2.01a, b, and c; 2.04; 3.04; 3.06; 4.01; 4.02;
10.10a relevant to this case? Which other standards might apply?
are Dr. Matthewss ethical alternatives for resolving this dilemma?
alternative best reflects the Ethics Code aspirational principles and
standards, legal standards, and Dr. Matthewss obligations to
Can you identify the ethical theory (presented in Chapter 3)
steps should Dr. Matthews take to ethically implement her decision
monitor its effect?