Common Ethical Dilemmas - PowerPoint Presentation

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Common Ethical Dilemmas Encountered by CMHCs in Job Corps

Suzanne G. Martin PsyD, ABPPLicensed PsychologistBoard Certified Clinical PsychologistSlide2

Learning Objectives

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Polling Questions

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What Are Ethics?

Ethics express the professional values foundational to the profession.

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Background: APA Ethics Code

History 1953Growth of psychology after WWII as a profession. Revisions reflecting changes in profession & society (e.g., sexual intimacies unethical 1977). FunctionsUphold integrity of profession and protect public welfareEducational document Help practitioners maintain competenceSet of rules or standard for adjudication

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Principles of ethical practice

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ACA Code of ethics (2014)

Autonomy, or fostering the right to control the direction of one’s life; Nonmaleficence, or avoiding actions that cause harm; Beneficence, or working for the good of the individual and society by promoting mental health and well-being;

Justice

, or treating individuals equitably and fostering fairness and equality;

Fidelity, or honoring commitments and keeping promises, including fulfilling one’s responsibilities of trust in professional relationships; and

veracity, or dealing truthfully with individuals with whom counselors come into professional contact.

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Common areas of EThical Practice

Informed consentConfidentiality Evidence-based practice Respect for individual, culture, values Use of technology, telehealth

Responding to emergencies

Appropriate documentation

Referrals

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Ethical-Legal Conflicts

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Can you give an example where ethics and law may conflict?Ethics and policy?Ethics and Morals?

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Ethical Role Conflicts

Responsibility to:StudentSelfOthersSocietyFamilyInstitutions (Job Corps)Licensing Board

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Ethical Dilemmas

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What is an ethical dilemma?

An ethical dilemma arises when two or more of the values found in the ethical principles conflict. Such a dilemma is an ethical dilemma because its resolution must appeal to values.

www.apa.org/monitor/julaug05/ethics.aspx

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Personal and professional ethics, values, morals, & law

ProfessionalPersonal

Ethics:

What relevant standards and expectations are outlines by my professional Code of

Ethics?

Values: What relevant personal values apply in this case and where did they originate?Laws & Policy: Are there any legal obligations? Is there an agency policy that applies?

Morals: How does my behavior affect my relationship with others?

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Expand

http://www.socialworker.com/feature-articles/ethics-articles/What_Is_an_Ethical_Dilemma%3F/

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Ethical decision making models

Knowing at least one ethical decision making model is recommended to assist with problem solving through ethical dilemma.

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Polling Question

Does your professional association have a recommended model of ethical decision making to address ethical conflicts?YesNoUnsure

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THE APA HAS NO ETHICAL DECISION MAKING MODELThe means to comply with a standard may not be apparentTwo seemingly competing standards may appear equally appropriate

Application of a single standard or set of standards appear consistent with one aspirational principle but not another17Slide18

General Guidelines for ethical decision makingRecognize there is an ethical issue

Get the factsEvaluate alternative actionsMake a decision and test itAct and reflect on the outcome

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Important considerationsIdentify the competing ethical principles/values/morals/law/policy

Determine which principle has precedence and whyUnderstand how emotion factors into ethical decision making and moral judgementConsider cognitive biases

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Ethical Decision Making Model (Koocher & Keith-Speigel, 2008)

1. Determine that the matter is an ethical one2. Consult guidelines already available (ethics code, state board etc.)3. Consider sources that might influence decision

4. Consult with trusted colleague

5. Evaluate rights, responsibilities, and vulnerability of all affected parties

6. Generate alternative decisions

7. Enumerate consequences of making each decision 8. Make the decision9. Implement the decision

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APA 1.03 Conflicts Between Ethics and Organizational Demands  

If the demands of an organization with which psychologists are affiliated or for whom they are working are in conflict with this Ethics Code, 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. Under no circumstances may this standard be used to justify or defend violating human rights.

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Ethical Cases for discussion22Slide23

Ethical Dilemma #1During a session, a student complains about being bullied by a particular staff person.  You happen to know that this staff person has been written up numerous times and have heard in session from several students about his inappropriate and even threatening comments to them.  The students are afraid to report this to any other staff members because of fear of retaliation. 

Is there a conflict here? 

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Ethical Dilemma #2A male student informs you in session that a female student had reported to a teacher, in front of him and others at lunch, that she had been forced to perform oral sex on another student. The student stated that the teacher said they would address the issue with the alleged perpetrator.

You report this information to the Wellness Manager, the SART is convened and you are asked to meet with the alleged victim. You document the conversation in the SHR and share statements with the HWM. The matter was then turned over to the Safety Officer and the Administrator on Duty. In the meantime another staff member tells the alleged perpetrator the name of the student who reported the incident. The alleged perpetrator is later seen bullying the student who reported.

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Ethical Dilemma #3You have a 20-year-old

student who tells you she is pregnant and can’t afford to have another child (she already has 2 children - one of whom has special needs). She wants to terminate the pregnancy. You have strong faith-based objections to abortion and find it difficult to remain neutral to a discussion of her decision. You feel you have an obligation to try to dissuade her from following through with this decision which you believe is not in her best long term interest.Is this an ethical dilemma? If so how do you manage it?

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Ethical Dilemma #4You are seeing a student for anxiety and she tells you that one of her friends has talked about wanting to kill herself. She adamantly refuses to give you the student’s name because she doesn’t want to betray her confidence and lose her friendship. She asks you not to say anything but that the situation increases her anxiety.

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Ethical Dilemma #5

You have a student who was referred to you because she reported to her counselor that she sometimes hears voices of deceased relatives. In your assessment you find there is a strong cultural component and that many in her family also hears voices. You note that the voices are comforting and encouraging and are not “command type.” The Acting CD hears about this and is adamant that the student be medically separated. You disagree.What’s your next step?

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Ethical dilemma #6You have a new student who you have just assessed. They tell you that they researched you on the internet because they wanted to know more about you and saw that you are divorced and have 2 children, and are active in a local theater group. They said they researched you because they have been “burned before” by therapists and wanted to make sure you weren’t crazy.

Is this an ethical dilemma?

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Ethical Dilemma #7You receive a call from someone who says they are calling for the Law Office of West and Company and they have a complaint about an applicant who was denied admission. They state they have a Release to speak with you and start demanding information about your credentials and your phone assessment of the applicant 6 months ago. You are caught off guard and begin to respond and then realize you don’t have an authorization in hand and direct them to the Regional Office, They respond they will see you in court.

Did you do the right thing?

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Keep in Mind

You will make mistakesYou can’t help everyoneYou don’t know everythingYou can’t go it aloneHumility and a sense of humor are critical in keeping perspective

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Important Resources

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Join your state

professional association

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Regional Mental Health SpecialistsRegion 1 Peter Oropeza, PsyD

Oropeza.Peter@jobcorps.org Maria Acevedo, PhD (Puerto Rico) Acevedo.Maria@jobcorps.org

Region 2

Valerie Cherry, PhD

vcherryphd@gmail.comRegion 3 Eugia Meminger PhD Meminger.Eugia@jobcorps.org Region 4 & 6 Tamara Warner, PhD

Warner.Tamara.D@jobcorps.orgRegion 5 Helena Mackenzie, PhD Mackenzie.Helena@jobcorps.org

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Organizational Resources:

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APA Ethics Office

www.apa.org/ethics

and

APA Ethical Principles of Psychologists and Code of Conduct (2017) 

ACA Ethical Principles(2014) https://www.counseling.org/resources/aca-code-of-ethics.pdfNASW

https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

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ResourcesKoocher, G.P. & Keith-Spiegel, P. (2008). Ethics in Psychology and the Mental Health Professions: Standards and Cases (3 

rd e d.). New York: Oxford University PressPope, Kenneth S. (1991) Ethics in psychotherapy and counseling. San Francisco : Jossey-Bass,Walsh, R. T. G. (2015). Introduction to ethics in psychology: Historical and philosophical grounding. Journal of Theoretical and Philosophical Psychology, 35(2), 69-77.

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Comments/Questions

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