Unintended actions Some mental health professionals may argue that an action is ethical as long as you are not intending harm and/or are not knowingly violating an ethical standard or law. Or, what about those unique situations that don’t readily lend themselves to a reference in law or codes of conduct? What defines prudent practice? Grappling with questions about what is unethical and what isn’t ethical is a situation faced by any person in the helping professions. Pope and Vasquez (2016) discuss the tendency to rationalize that an action is acceptable, as it relates to the practice of psychotherapy and counseling: This rationalization encompasses two principles: 1. Specific ignorance. 2. Specific literalization. It is important to bear in mind that these two “principles” are in reality ethical fallacies used to justify unethical behavior (Pope, 2013). Specific ignorance The principal of specific ignorance states that even if there is a law prohibiting an action, what you do is not illegal as long as you are unaware of the law. For example: Allison worked with a client who suddenly moved to another state. While in crisis, her client called a mental health practitioner in the other state to make an appointment. This mental health practitioner phoned Allison to gain insight into her new referral. Allison was unwilling to divulge any information without a written release from her client, but the new therapist was adamant about acquiring the information immediately and threatened to report Allison to their national association. Allison assumed that, because her client was in crisis, she could share information. Allison was
unaware of their association’s ethics rules as they pertained to disclosure during crisis. She grudgingly shared confidential information because she felt her client was at risk. Literalization The principal of literalization states that if we cannot find a specific mention of a particular incident anywhere in legal, ethical, or professional standards, it must be ethical. For example: Harry lived in a state that did not have an ethics board that specifically prohibited socializing with clients. Through Harry’s church he often came into contact with his clients because they were referred to him by the church pastor. He felt comfortable socializing on a regular basis with his clients and their families, within and away from church. Assisting mental health practitioners in resolving ethical dilemmas that may arise in practice is just one of several purposes for establishing ethical codes of conduct. Ethical standards of practice for mental health generally benefit both the practitioner and the public and include: 1. Identifying core values. 2. Establishing a set of specific ethical standards that should be used to guide mental health practice. 3. Identifying relevant considerations when professional obligations conflict or ethical uncertainties arise. 4. Providing ethical standards to which the general public can hold mental health professionals accountable. 5. Providing mental health ethical practice and standards orientation to practitioners new to the mental health field. 6. Articulating formal procedures to adjudicate ethics complaints filed against mental health practitioners.
INTERNAL ETHICAL GUIDES THAT DRIVE PRACTICE
Internal ethical values and morals play a large role in the overall conduct of a mental health practitioner. Character underlies ethical practice and bears some discussion. Right character demonstrates a mental health professional’s capacity to discriminate between a client’s need and his or her own. In addition, best practice in mental health demands that thorough inquiry is utilized in order to effectively understand and advocate for clients. In addition, utilizing good character in mental health practice also drives mental health practitioners to live authentically and demonstrate professional behavior. Good character pushes mental health professionals to constantly examine their own motives and intentions, and, when necessary, seek consultation. It is the ethical responsibility of every mental health practitioner to continue to seek professional growth and to examine personal and professional attitudes and behaviors. Conversely, lack of character in mental health practice reflects rigid and restricted professional growth. In his book, The Force of Character and the Lasting Life (2000), James Hillman reflects that “bad character would refer to a person with little insight. … (This) is simply one who does not imagine who he is. In short an innocent. Innocence has no guiding governance but ignorance and denial.” Kitchener (1984) has identified five moral principles that are essential ethics guidelines. These are reflected in current revisions of the NASW and ASWB ethical standards. They include: 1. Autonomy: Addresses the concept of independence and the responsibility of a counselor to encourage
clients, when appropriate, to make their own decisions and to act on their own values. Two important considerations in encouraging autonomy are: 1) Helping clients understand how their decisions and their values may or may not be received within the context of the society in which they live, and how they may impinge on the rights of others; and 2) the client’s ability to make sound and rational decisions. 2. Non maleficence: Is the concept of not causing harm to others; it is often explained as, “First, do no harm.” 3. Beneficence: Reflects the counselor’s responsibility to contribute to the welfare of the client by doing good and being proactive, and also to prevent harm when possible. 4. Justice: Is treating everyone equally while responding to unique individual differences and needs. If an individual is to be treated differently, the social worker needs to be able to offer an appropriate rationale. 5. Fidelity: Involves the notions of loyalty, faithfulness and honoring commitments. Note that in social work, “self-determination” is a term more likely to be used than “autonomy.” In the NASW Code of Ethics, self-determination falls under Standard 1, Social Workers’ Ethical Responsibilities to Clients. 1.02 Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals. Social workers may limit clients’ right to self-determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.
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