Ultimately, confronting implicit bias in healthcare is essential to creating a more just and equitable healthcare system
where everyone receives fair and equal treatment regardless of their background or characteristics.
INTRODUCTION
Healthcare professionals are required to provide ethical care to their patients and clients. Knowledge of a profession’s ethical standards and the boundary of acceptable professional conduct is crucial to the provision of ethical care. This course provides the healthcare professional with a general overview of ethical standards and principles, how
those standards are reflected in boundaries and boundary- setting, common boundary dilemmas faced in therapy, and how to apply a decision-making model when faced with those boundary dilemmas as is required by most healthcare professional organizations.
PROFESSIONAL CODES OF ETHICS
Healthcare professionals have an obligation to provide safe and effective care to those they serve. Levine and Courtois (2021) list five principles that are the cornerstone of professional behavior: 1. Altruism—The welfare of the client comes first. 2. Accountability—Healthcare professionals are accountable to the client and to the profession. 3. Excellence—Use interventions based on knowledge and expertise. 4. Felt duty—Help others and serve the client. 5. Respect—Show respect for clients, colleagues, students, trainees, and employees. To this end, all healthcare disciplines have established their own codes of ethical conduct to serve as guidelines for the safe and ethical treatment of clients. The understanding of these professional standards is the responsibility of each healthcare provider. The National Association of Social Workers (NASW) Code of Ethics (2021) states that “Professional ethics are at the core of social work. The Code offers a set of values, principles, and standards to guide decision making and conduct when ethical issues arise.” (Purpose section). The American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct (2017) further adds that their code of principles and standards “Applies to activities across a variety of contexts, such as in-person, postal, telephone, internet, and other electronic transmissions” (Introduction section). The American Counseling Association (ACA) Code of Ethics (2014), the National Board for Certified Counselors (NBCC) Code of Ethics (2023), and the American Association for Marriage and Family Therapy (AAMFT) Code of Ethics (2015) define the ethical obligations and practice of professional counselors for the protection of the public. A core tenant of all ethics codes are professional boundaries. Boundaries help to form the framework of ethical treatment. They provide the foundation for defining the roles of the participants in the therapeutic process, and they define the parameters, or correct limits of behavior, in the relationship. They may include details of role, time, place, money, gifts, self-disclosure, physical contact, and the limits of privacy and confidentiality and mandated reporting. They help to determine the distinction between interactions that would be considered appropriate within the therapeutic relationship with those that would be considered inappropriate and/or harmful. Boundary guidelines may also be used to evaluate professional conduct in disciplinary hearings. While extreme boundaries such as the prohibition of sexual contact with a client may seem clear, it is the more subtle and common day-to-day boundary questions that cause the most confusion for healthcare providers and clients. The concept of boundaries is a general one, yet questions of boundaries in the course of client care are specific to that particular client and therapist, at that particular time in therapy, and for a particular reason. Decisions about whether to cross or expand a boundary
can only be made with full knowledge in the context of professional ethics and behavior. The ethical standards and guidelines for healthcare professions are written in general terms so that they can apply to the varied roles professionals take on. They are not exhaustive, and just because conduct is not specifically addressed by a particular standard does not mean that the conduct is necessarily ethical or unethical. Each organization’s code of ethics addresses the core values, principles, and beliefs of that profession, outlining the standards to which the provider is held and to which their behavior can be judged as a way of protecting the trust and safety of the client. The majority of professionals are conscientious individuals who are committed to providing quality care. As such, they have often internalized ethical principles and concepts, and these guide their professional behavior without them even having to stop and consider whether a decision is ethical. Professionals tend to turn to the standards for guidance when situations are less clear cut. Knowledge about ethics and boundaries is an ongoing process since ethical decisions and the context in which they occur are ever changing. Situations are further complicated by the fact that some ethical situations and decisions also involve legal issues. All healthcare providers are required to follow the laws regulating their profession as well as the ethical principles guiding their professional behavior. When an ethical decision is clearly addressed and is consistent in both law and ethical standards, no dilemma exists, and the provider has a clear path for their decision. However, it is quite common for there to be conflict between law and ethical codes or for the particular situation to be only vaguely addressed by law, ethics code, or both. The APA Code (2017) states that “If psychologists’ ethical responsibilities conflict with law, regulations, or other governing legal authority, psychologists clarify the nature of the conflict, make known their commitment to the Ethics Code, and take reasonable steps to resolve the conflict consistent with the General Principles and Ethical Standards of the Ethics Code” (Standard 1.01). The NASW Code (2021) states that “Social workers’ ethical obligations may conflict with agency policies or relevant laws or regulations. When such conflicts occur, social workers must make a reasonable effort to resolve the conflict in a manner that is consistent with the values, principles, and standards expressed in this code.” (Introduction). The ACA Code (2014) adds that “If the conflict cannot be resolved… counselors, acting in the best interest of the client, may adhere to the requirements of the law, regulations, and/or other governing legal authority” (Standard 1.1.c).
EliteLearning.com/Psychology
Book Code: PYTX1325
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