Mary Smith is a depressed elderly woman who was admitted to Polyclinic Hospital due to severe back pain. She was advised she might need surgery to correct the problem. You are her case manager at the Office of Aging, and she calls to say she is considering suicide. The constant back pain has made her feel like “just giving up.” Mary is currently at home, awaiting a surgery date. You know Mary has a supply of pain pills, and she says she wants to take all the pills. You feel there is a substantial risk that Mary might follow through on her threat. You should: 

a. Contact the Polyclinic orthopedic staff who are currently seeing Mary in the outpatient clinic. 

b. Maintain frequent contact with Mary, but respect her wishes to keep her suicide plans confidential. 

c. After discussing with Mary what you are about to do, contact crisis intervention. 

d. Advise the city police department of Mary’s suicide plans. 

The hypothetical practice situations that follow are designed to stimulate thinking and discussion on the issue of confidentiality. Each situation is followed by a multiple-choice list of possible responses you might make. Choose the responses that you consider the best. In some cases you might want to use more than one of the responses listed. Others may choose a different answer. Discuss with your fellow students the different possibilities and what might present the best outcome for the client.