Case Study #1

The first time you meet your client, Kolby, he is in the throes of heroin withdrawal.  He has been sent to your clinic by the Circuit Court judge as part of an alternative sentencing program.  Kolby was arrested for CDS possession, quickly arraigned, and sent along to your clinic instead of going to lockup, because the judge recognized that Kolby's withdrawal symptoms and significant dependence on opiates would make treatment a more reasonable option.  While the doors at your clinic are not locked, Kolby understands that he must stay there or he will be arrested and transported back to jail.
Kolby hasn't had any heroin for about 30 hours by the time he arrives in your office.  During your intake interview, he is unable to focus on anything other than asking for the medication that will alleviate his withdrawal symptoms.  He vomits twice in your office, and is experiencing flu-like symptoms.  You're not able to collect a very clear history from Kolby, who quickly signs all of the forms you give him, including releases for confidential information and the informed consent agreement.  

Considering what you've read, analyze this situation in terms of valid informed consent.  Discuss whether or not you believe that Kolby is able to provide informed consent for his own treatment.  Consider that he was placed in treatment by a judge--is this coercive?  Also, consider his physical and mental state while you describe his rights and your responsibilities in terms of consenting to treatment.  

Follow the Steps in Ethical Decision Making model  Be sure to list all eight steps of the model and to cite information from your readings.  Listed below are the steps.
1. Identify the problem or dilemma
2. Identify the potential issues involved: is this a boundary issue, competence issue , confidentiality issue . list the people involved
3. Review the relevant ethical guideline/codes
4. Know the applicable laws and regulations.
5. Seek consultation
6. Consider all possible and probable courses of action.
7. Identify consequences of each course of action.
8. Decide on a course of action and follow through

Also answer this question as well.
Bonus (earn up to five extra credit points): The judge who has court-ordered Kolby to treatment has requested a report from you verifying that Kolby reported to treatment and is making progress.  Would you break confidentiality to provide this report to the judge?  Why or !!why not?  What considerations are involved in whether you would provide the report?
Please cite throughout!!