PAC 310 Module 1 Ethics, Law and Professionalism Example

Must, Should and Would: Ethics, Law and Professionalism in Addiction Counseling

Student Name

Psychology and Addiction Studies Program, Aspen University

PAC 310: Ethical, Legal and Professional Issues in Healthcare

Instructor Name

Month Day, Year

Must, Should and Would: Ethics, Law and Professionalism in Addiction Counseling

On one Monday at Ridgeline Recovery Services, a composite outpatient addiction program, three counselors faced three questions. A client's employer called to ask whether he was attending treatment. A client in early recovery invited her counselor to her daughter's graduation party. And a counselor noticed that a colleague had arrived smelling of alcohol for the second time that month. Each question involves law, ethics and professionalism, but in different proportions. This paper explains how the three differ, where they come from, how they relate in addiction work and why the field's particular circumstances make the distinctions important.

Three Sources of Obligation

Law consists of rules set by governments and enforced by penalties, from federal confidentiality regulations to state licensing statutes. Ethics consists of principles and standards about right conduct, set out for counselors in professional codes and grounded in broader moral principles. Professionalism concerns the conduct expected of someone in a professional role: competence, reliability, appropriate boundaries and accountability. The three overlap, but they are not the same. Something can be legal and unethical, and a professional standard can require more than either law or ethics requires on its own.

Where the Standards Come From

Kitchener (1984) argued that counselors should not rely on intuition alone in ethical decisions and proposed five principles to guide critical evaluation: respect for autonomy, doing good, avoiding harm, justice and fidelity, meaning keeping promises and being trustworthy. Professional codes translate such principles into specific standards. For addiction professionals, the NAADAC/NCC AP code of ethics, revised in 2021, sets standards for client welfare, confidentiality, professional responsibility, working across cultures, assessment, electronic practice, supervision and research (NAADAC, 2021). Laws, by contrast, come from legislatures and agencies and apply whether or not a counselor belongs to a professional association.

Comparing Law, Ethics and Professionalism

The table compares the three sources of obligation.

When Law and Ethics Agree

The employer's call is a case where law and ethics point the same way. Federal regulations at 42 CFR Part 2 guard the files of federally assisted addiction programs more tightly than general health privacy rules, and revisions finalized in 2024 aligned several of their provisions with HIPAA while keeping special limits on using records against patients (U.S. Department of Health and Human Services, 2024). Without the client's written consent, the counselor cannot confirm to the employer that he is a client at all. The ethics code's confidentiality standards say the same. The professional task is to decline courteously and then talk with the client about whether he wants to authorize limited disclosure.

When They Part

The graduation invitation shows the gap between law and ethics. No law forbids a counselor from attending a client's family event. Ethics, however, asks whether doing so would create a dual relationship that could impair the counselor's objectivity or exploit the client's trust. Professionalism asks how a thoughtful counselor would respond: acknowledging the client's pride, declining warmly, and perhaps marking the achievement in session instead. The absence of a legal rule does not end the analysis; it begins the ethical one.

When Professionalism Demands Action

The colleague who smells of alcohol raises a third kind of obligation. The counselor may have no legal duty to report, depending on state law, but the ethics code expects counselors to address colleague impairment that threatens clients, and professionalism requires acting rather than looking away. The usual first step is a private conversation or a report to the supervisor, following the program's policy, with the aim of protecting clients and helping the colleague reach treatment. Module 7 examines this duty in detail.

Why Addiction Work Carries Extra Risk

Several features of addiction work sharpen these issues. Clients face stigma and legal exposure, so a disclosure can cost them a job, custody or freedom. Many counselors are themselves in recovery and may share community ties with clients, which multiplies the chances of overlapping relationships. Treatment often involves courts, probation and child welfare agencies, which bring legal requests. And the work is emotionally demanding, which raises the risk of burnout and impairment. Each of these features appears again in later modules.

Using the Distinctions

The practical value of the distinctions is that they prompt the right questions in order. What does the law require or forbid here? What do my code's standards and the underlying principles ask? What would a thoughtful professional do, and who should I consult? Asking all three prevents the two most common mistakes: treating legal permission as ethical approval, and assuming that a good intention justifies breaking a rule.

Consultation as a Professional Habit

One habit connects all three sources of obligation: consultation. When law is unclear, a program's attorney or compliance officer can interpret it. When ethics is unclear, a supervisor or an ethics committee can help weigh principles. When professional norms are unclear, experienced colleagues can say how they handle similar situations. Consulting is not a sign of weakness; the codes expect it, and documenting a consultation shows that a decision was made carefully rather than alone.

Conclusion

Law tells counselors what they must do, ethics what they should do and professionalism what a good practitioner would do. In addiction work the three often agree, as in protecting a client's confidentiality from an employer's inquiry, but sometimes law is silent where ethics speaks, as with a client's invitation, and sometimes professionalism demands action where law does not, as with an impaired colleague. Understanding the differences, and asking all three questions, is the foundation for the dilemmas the rest of the course examines.

References

Kitchener, K. S. (1984). Intuition, critical evaluation and ethical principles: The foundation for ethical decisions in counseling psychology. The Counseling Psychologist, 12(3), 43-55. https://doi.org/10.1177/0011000084123005

NAADAC, the Association for Addiction Professionals. (2021). NAADAC/NCC AP code of ethics. https://www.naadac.org/code-of-ethics

U.S. Department of Health and Human Services. (2024, February 16). Confidentiality of substance use disorder (SUD) patient records (Final rule). Federal Register. https://www.federalregister.gov/documents/2024/02/16/2024-02544/confidentiality-of-substance-use-disorder-sud-patient-records