2018) The problem with virtue ethics is that it fails to offer clear guidance on how a virtuous person really would act. ● 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. 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
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. of Ethics, the American Counseling Association describes its mission as the use of “the profession and 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.
THE THERAPEUTIC RELATIONSHIP
The relationship between the social worker and client sets the course for providing ethical treatment. Although many issues concerning this topic will be addressed throughout this course, the initial contact with the potential client sets the tone for treatment. For example, the first communication with the client can convey an atmosphere of support that sets the foundation for building trust. Professionals must also carefully consider that when services begin, the professional relationship should proceed with cultural Ethical dilemmas Not every issue of ethics can be covered by published standards or by codes of ethics. Social workers may find themselves confused about whether a situation borders on an ethical violation because the issue may not be clearly defined by the code. There also may not be an obvious violation or the social worker may not know how to proceed. These situations represent ethical dilemmas that are likely to occur in every social work practice. Barsky (2014) defines an ethical dilemma as a situation that creates some tension. He explains that in a true dilemma, there is no clear, single answer that satisfies all of the different ethical and legal imperatives that apply to the case. This situation may occur when: ● There are two ethical standards or rules that conflict. ● There are conflicts between the values of the social worker and those of the client. ● A conflict occurs between the obligations to an agency, versus the obligations to a client. ● Conflicts may occur due to religious, cultural, or political beliefs.
sensitivity. During the course of treatment, an effort must be made to revisit informed consent issues as the treatment plan evolves, as well as consult with other professionals to avoid the risk of potential ethical conflicts. Professionals need to take reasonable steps to ensure that clients understand the implications of any diagnosis, assessments, treatment, methods, HIPAA (Health Insurance Portability and Accountability Act) precautions, fees, and billing arrangements. ● No clear answer is apparent to meet the obligations or the ethical and the legal directives of the profession. One example of a common dilemma involves issues in decision making in end-of-life situations. An individual in an end-of-life stage may claim the right to terminate his or her own life. The laws vary concerning these issues throughout the United States. As of July 2019, nine states and the District of Columbia recognized legal physician-assisted suicide. Most other states considered the act to be illegal, and a few had left the legality or illegality unclear (ProCon.org, 2019). Some individuals may support this right; others believe the act would be committing suicide, and therefore wrong. Tensions develop between a social worker’s religious beliefs and professional beliefs, as well as what that social worker would do if he or she were either “pro-life” or “pro- choice.” The tension in such an ethical dilemma may be seen as a conflict between the ethical concepts of beneficence and non maleficence. The idea of beneficence is to promote good, and for a suffering patient, death may appear as a mercy, sparing the individual from chronic pain or some other form of suffering.
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Book Code: SWUS1524
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