all hold the answers to all the questions faced by licensed mental health practitioners. While both necessary and useful, some experts, such as Freud and Krug (2002a), argue that for ethical decision-making alone, codes of ethics are insufficient. In effect, they state that codes of ethics are frequently used as a risk management tool, offering guidelines for practice that may not be compatible with other goals set forth by a particular mental health focus. In addition, unique and unexpected ways ethical issues may emerge in clinical practice work against attempts to apply codes of ethics. For those reasons, Freud and Krug (2002a) propose that “ethical judgments are best made in small groups where members bring different perspectives and intuitions to the process while agreeing on basic humanistic values.” Still, codes of ethics are invaluable tools for guiding mental health practitioners toward ethical practice. Thus the authors recommend that, in general, codes of ethics be used to help guide professionals in decision making and include: 1. Increased attention to our moral intuitions and emotions : Rational, ethical decision making should be supplemented by a person’s emotions and intuition, as shaped by culture and profession. In an effort to maintain a rational, detached, and professional approach to service, mental health practitioners may ignore warning signals and gut instincts relevant to the reason for a decision. 2. Institutionalized opportunities for dialogue and ethical concerns : It is important to have safe, nonjudgmental group forums for open and regular discussion of ethical issues. 3. Open acknowledgment and respect for moral diversity within a shared body of basic values : The decision-making process works best when consulting with a diverse group of Applying the model We can use this model to critically examine the last scenario, that of David and his dilemma regarding placement of a child. David, a licensed marriage and family therapist, believes a child’s right to permanency would be better served by placement with an affluent, Caucasian, Christian family versus a middle class family of the same race as the child. He believes they are a very nice couple who have been waiting far too long for a child to adopt. David’s obligation is to the best interests of the child, so it is clear to whom he is committed. Therefore, the length of time one couple has spent waiting to adopt a child should not be a consideration. Finding the best family for the child is the primary consideration. In addition, standards regarding competence and social diversity require David to be knowledgeable about the child’s culture and the importance it will play in the child’s life. He also needs Conclusion Ethical dilemmas are varied, common, and complex. Ethical decision making can be difficult as well as time-consuming, while sometimes mental health practitioners are still left with a little ambivalence and uncertainty following their decision. Typically, Information This information is not intended to provide all of the details of the HIPAA Privacy Rule or of any other laws or guidelines. This presentation also does not constitute legal advice. If there is any discrepancy between the provisions of the HIPAA Privacy Rule, other laws or regulations, and the material in this presentation, the terms of the laws, rules, professional guidelines, and regulations will govern in all cases. Administration for Children and Families. (n.d.). Secondary Traumatic Stress. U.S. Department of Health and Human Services. Retrieved on May 8, 2020, from https:// www.acf.hhs.gov/trauma-toolkit/secondary-traumatic-stress Amer, A.B. (2019). “The ethics of veracity and its importance in the medical ethics.” Open Journal of Nursing, 9, 194-198. https://www.researchgate.net/ publication/331281044_The_Ethics_of_Veracity_and_It_Is_Importance_in_the_Medical_Ethics American Association for Marriage and Family Therapy. (2015). Code of Ethics.https:// www.aamft.org/Legal_Ethics/Code_of_Ethics.aspx References
individuals who share basic values but differ in perspectives and intuitions. Mental health practitioners also need to consider basic protocols and steps to take to increase their ability to make sound ethical decisions. While not all ethical dilemmas have a corresponding definitive solution, professionals can take reasonable steps to arrive at the best possible decision through an ethical decision- making model that would: 1. Identify the problem or conflicts between the ethical and legal expectations and requirements, including the values and duties that may conflict. 2. Understand and apply the state and national professional association code of ethics. 3. Identify the individuals, groups, and organizations that are likely to be affected by the decision. 4. Tentatively identify all possible courses of action and the participants involved in each, along with possible benefits and risks for each. 5. Thoroughly examine the reasons in favor of and opposed to each possible course of action, considering relevant: a. Ethical theories. b. Codes of ethics. c. Constitutional provisions, statutes, regulations, court decisions, and executive orders. d. Personal values (including religious, cultural, and ethnic values). 6. Consult with colleagues and appropriate experts. 7. Make and implement the decision and document the decision-making process. 8. Monitor and evaluate the decision. to consider the overall strengths offered by both families as well as any potential barriers to placement. One family has unlimited resources, while the other family has enough resources to afford a lifestyle typical of most families in the community. The person most affected by the decision will be the child. The prospective adoptive families will be impacted as well. To a lesser degree, so will the two adoption agencies. For example, they will wonder if one family may become disenchanted by the wait for an adoptive child and choose to go to another provider. There may be macro-level issues involved as well, given the debate at the national level concerning interracial adoptions. Again, these should not be a consideration, because the primary responsibility is to find the best family for the child, not to find a child for a family. David will ultimately keep this in mind when he makes his recommendation to the Court. there will be more than one person involved with the ethical decision-making process. It is always important to keep in mind that the power of supervision and consultation regarding any mental health practice ethical dilemma cannot be overstated. This information is not intended to describe all of the national mental health associations’ guidelines, but to ensure that learners are guided by their particular association’s code of ethics and state licensing regulations in order to make the most appropriate ethical decisions. Any case examples used within this course do not reflect actual individuals. American Counseling Association. (2014). 2014 ACA Code of Ethics.https://www. counseling.org/resources/aca-code-of- ethics.pdf American Medical Association. (2020). HIPAA Violations & Enforcement.https://www.ama- assn.org/practice- management/hipaa/hipaa-violations-enforcement American Society of Anesthesiologists. (2019). ASA-Endorsed Bill to Address Opioid Crisis Reintroduced in Congress.https://www.asahq.org/advocacy-and-asapac/fda-and- washington-alerts/washington-alerts/2019/04/asa-endorsed-bill-to-address-opioid-crisis- reintroduced-in-congress
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