KAMERON: AN AIDS CASE STUDY

Kameron: An AIDS Case Study

Kameron Smith, a 34 year old mixed race transgender male has reported for counseling.
He has reported to counseling because of symptoms of depression. Kameron has lost significant
weight, is reporting insomnia, trouble eating, lack of interest in other people or activities, and
lethargy. Kameron begins his sessions by telling the counselor about his background. He was
born a female named Katherine and was diagnosed with BDD in his mid-twenties. Two years
ago he completed all hormone treatments and had surgery to have breast tissue removed. He
lacks a support system because his family abandoned him when he transitioned. Kameron admits
going through a dark period before he transitioned. He admits to high risk sexual behavior and
drug usage. Kameron states that he has had no A&D issues in over a year and has refrained from
sexual activity about the same amount of time. Kameron claims that he has always struggled
with depression and he thought that finally fixing who he was supposed to be would cure him.
However, he claims that he only felt happy for a few short months after his surgery.
Sessions continue with Kameron over several weeks. Kameron discloses in last weeks
session that he has been HIV positive for about a year now and the virus has progressed into full
blown AIDS. Kameron is struggling with the grief and loss associated with his diagnosis. Also,
Kameron struggles even admitting to his disease because he feels ashamed. Kameron reports that
he is still not sexually active so he is not afraid he may be passing his disease on to anyone. He
claims he is too depressed to be engaged in any social activities in the first place.
Kameron begins to reveal that he is considering suicide. He assures the counselor that he
is only considering suicide because of his AIDS diagnosis and he does not want to die painfully
from the disease. He reports that his depression has nothing to do with why he is considering
suicide. Kameron does not have any immediate plans to commit suicide but does brainstorm,

KAMERON: AN AIDS CASE STUDY

with the counselor, moving to Oregon. He would like to take advantage of the Death with
Dignity Act offered there. Kameron claims he likes the idea of choosing his death legally and
with the support of a doctor. He states that that method makes it seem less horrible and
unacceptable. The counselor really tries to dig deeper onto where the source of his suicidal
ideation is coming from. The counselor is concerned that the desire stems from the depression
more so than the terminal illness. The counselor also questions whether or not those two aspects
of Kameron can even be considered as separate.
The counselor is concerned with whether or not to break confidentiality and report that
Kameron is in danger of hurting himself. The counselor applies the ACA Code of Ethics.
According to the Code of Ethics, confidentiality can be broken if the counselor senses serious
and foreseeable harm (ACA, 2014, B.2.a.). The counselor also considers the fact that she is
ethically able to maintain confidentiality if the client is diagnosed with a terminal illness and has
expressed interest in taking their own life (ACA, 2014, B.2.b.). With the assistance of
supervision, consultation, and the Keith-Spiegel & Koocher ethical decision making model, the
counselor decides to maintain confidentiality at this point in time. The counselor does not feel
that Kameron is in immediate danger. He has expressed interest in assisted suicide with a longterm goal of moving to Oregon attached to it. Kameron does not show any indication that he is
making an immediate plan to end his own life. Therefore, the counselor cannot feel ethically
sound in breaking confidentiality if the counselor does not believe that Kameron is in any
immediate harm. In the meantime, the counselor shall request Kameron increase the frequency of
his sessions, safety contract with Kameron, and work on fleshing through the emotions and
thoughts surrounding his diagnosis and depression. If Kamerons depression deepens or if his

KAMERON: AN AIDS CASE STUDY

suicide plans become more concrete and insistent, the counselor will revisit their decision at that
time.

Reference
American Counseling Association (2014). ACA Code of Ethics. Alexandria, VA: Author.