In the first scenario, Mary must balance both her and her client’s desire to continue what appears to be a comfortable and trusting therapeutic relationship with the need to provide the most effective service for the client. Clearly Mary is not qualified to provide the service this client needs. Is her plan for a crash course in transgendered treatment adequate? Should she make a referral to a more competent therapist? Should she work with the client to overcome the financial barriers he is facing? If Mary makes the wrong decision, she might either violate ethical guidelines or the law, or both. She may be committing a medical error and putting her client at risk of Defining ethics The word “ethics” is derived from both the Greek word “ethos,” which means character, and the closely related concept of “morals” derives from the Latin word “mores,” meaning customs. Ethics defines what is good for both society and the individual. Complicating the concept of ethics is the situation of competing ethical theories. On the bright side is that various theories offer various solutions to ethical conundrums (National Health Service [NHS; Scotland], 2018). Some examples are: ● Consequentialism : Consequentialism in its most basic form is utilitarianism, in which the end justifies the means. The outcome is all that matters, and the best outcome is characterized as “the greatest good for the greatest number,” a quotation often ascribed to the philosopher Jeremy Bentham. ● Deontology : This system of ethics, associated with the philosopher Immanuel Kant, values intentions and “focuses on rules, obligations and duties” (NHS, 2018). This ethical theory is rigid and can lead to judgmental or counterproductive behavior. ● Virtue ethics : This system relates to “the internalized moral characteristics, rational thought and practical wisdom of a virtuous person who possesses and lives the virtues” (NHS, 2018) The problem with virtue ethics is that it fails to offer clear guidance on how a virtuous person really would act. Implications for practice Ethical standards are, according to Reamer (2006), “created to help professionals identify ethical issues in practice and provide guidelines to determine what is ethically acceptable or unacceptable behavior.” What makes mental health work unique is its focus on the person as well as its commitment to the well-being of society as a whole. The social work profession adopted the first Code of Ethics for the social work profession in 1947. In 1960, following the formation of the National Association of Social Work, another code of ethics was drafted, with multiple revisions in the following years. Ethics have been developed for other national mental health licensing associations and boards that include among others, the American Association for Marriage and Family Therapy, the American Counseling Association, and the American Mental Health Association. The American Association for Marriage and Family Therapy “strives to honor the public trust in marriage and family therapists by setting standards for ethical practice. … The ethical standards define professional expectations” that are enforced by their own Ethics Committee. In the preamble to its Code of Ethics, the American Counseling Association describes its mission as the use of “the profession and
harm. Her actions may also result in Mary being sued and/ or censured. Joaquin must ask himself the question, “Am I considering crossing the boundaries of our professional relationship for my own needs or for those of my client?” Clearly both Joaquin and his client value a friendship, but what potential harmful impact could this have on one or both of them? Ethical decision-making is a complex process, requiring mental health practitioners to look at not just the immediate impact but also the long-term and future consequences of their actions. ● Principlism : This system is commonly used in healthcare and biomedical sciences and focuses on “four key ethical principles of autonomy, beneficence, non maleficence, and justice, which are shared by most ethical theories, and blends these with virtues and practical wisdom. This is an attempt to bring together the best elements of ethical theories which are compatible with most societal, individual or religious belief systems” (NHS, 2018; the principles mentioned above will be discussed later in the course). In the United States, principlism forms the basis of all codes of ethics in the health professions today. Though closely related, law and ethics do not necessarily have a reciprocal relationship. While the origins of law can often be based upon ethical principles, law does not prohibit many unethical behaviors. Likewise, adherence to certain ethical principles may challenge a mental health practitioner’s ability to uphold the law. For example, documenting that a service has occurred when it hasn’t may be unethical but not subject to prosecution. Unfortunately, it may take high-profile adverse consequences of unethical behavior, such as the discovery that a child under protective custody has been missing for months, to create new laws that support ethical standards of behavior. For instance, the State of Florida made the falsification of documentation, e.g., visitations that never took place, illegal for people employed as child welfare workers. practice of counseling to promote respect for human dignity and diversity.” And the primary mission of the National Association for Social Workers is to “enhance human well- being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty.” Being part of a professional association not only brings a wealth of knowledge and expertise to ethical issues but also certain rights and privileges for its members. But those benefits must not overshadow a mental health professionals commitment to promote ethical behavior on behalf of clients. When an individual identifies with a mental health profession, he or she is pledging to practice in an ethical and responsible manner. In addition to allegiance to the professional ethics and standards of practice it promotes, the individual also has a duty to support the values, rules, laws, and customs of the society of which he or she remains a part.
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Book Code: SWTX1525
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