Gail Bieber, LCSW Clinical Director Counseling Recovery Services of OK Language of Ethics Objectives: 1) Explain descriptive terms that are part of the language of professional ethics 2) Determine individual values through interactive techniques & recognize how these personal values may impact our professional values. Root Causes of Ethical Dilemmas An Ethical dilemma is defined as: a difficult problem seemingly incapable of a satisfactory solution or a situation involving a choice between two equally unsatisfactory alternatives. Ethical dilemmas arise when moral claims conflict with each other. Competing Values - Confidentiality, Considerations of shrinking budgets, outcome measurements, time restraints, efficiency Competing Loyalties - e.g. individual versus family, agency Different cultures, races, genders, histories and religious/spirituality beliefs CLIENT CLINICIAN HURRICANE KATRINA, THE GILLETE FAMILY, AND CHOICES* For days, all one heard was that Hurricane Katrina was on its way. Social Worker Sharon Gillette’s husband was in Seattle on business and unable to find a flight to return to New Orleans. Sharon could not decide whether to try to leave or to stay because her house was on higher ground. People in New Orleans and throughout the region were struggling with preparations for the expected storm. Sharon’s child care provider, Mrs. Carlyle, called to say she was frightened and would not come the next morning because she had found a ride out of town with her son and family. With her husband still away, Sharon finally decided it would be best for her and her children to leave New Orleans and stay with family in Texas until the storm passed. Sharon phoned her supervisor to let him know she would be leaving New Orleans and would return as soon as possible after the storm passed. However, her supervisor informed her that she was being asked to report immediately to the Civil Emergency Center in the Louisiana Superdome to assist the many people-both able-bodied and those with physical and other challenges- who would be forced to stay in New Orleans because they did not have a way to evacuate. People were confused and anxious; many were trying to contact loved ones. What would Sharon do? Should she leave New Orleans for Texas as planned? Should she stay in New Orleans to help those in need? If she did stay in New Orleans, should she spend time trying to protect her home and children, or spend her time helping those in the Superdome? *R. Dolgoff, F. Lowenberg, D. Harrington: Ethical Decisions for Social Work Practice, eighth edition, 2009, pg. 11-12 Questions? Are values, ethics & morality (virtues) the same thing? If not, what is the difference? MORALITY: Consists of principles or rules of conduct that define standards for right behavior. They define the relationships among members of the society. Goldstein: “a moral sense…involves not only individual thoughts and actions but relationships with others” In the United States we have a broad consensus about some issues, we have deep divisions regarding what is “moral and what is not”? * What are some of those issues & how does it impact our practice? * We’d like to have a set of general rules for society, however, they do tend to vary. Morality for one is not morality to another. There are deep divisions in this society regarding morality. – Serve as guides or criteria for selecting good and desirable behaviors. “a value is not just a preference but it is a preference which is felt and/or considered to be justified.” (Kluckhohn, 1951) Values are a key element in the ethical decision-making process. Values Individual values Group values – held by subgroups within a society (religious, ethnic groups) Societal Values – values that are recognized by the majority portions of the entire social system or, at least by the leading members or spokespersons of that system. Professional Values – proclaimed by a professional group Generally these four value sets are complementary or reciprocal although they can be in conflict & differences can occur in interpretation, prioritization and intensity. Professional Values Clinical practitioners take their basic professional values from societal values; often a reflection and expansion of our personal values. Professional values are considered as primary in practitioners’ decision making and action. General consensus: Client participation, self-determination, and confidentiality Does Value Neutrality exist? Can we achieve Value Neutrality with our clientele? Ethics – contemporary meaning focuses upon what actions are morally right and with how things ought to be. Human Conduct Branch of philosophy dealing with human conduct “Ethics is not primarily concerned with getting people to do what they believe to be right, but helping them decide what is right” – (Jones, Sontag, Beckner, & Fogelin, 1977, pg. 8). Ethics are deduced from values (even though we often use them interchangeably). Ethics deals with what is right and correct. C. Levy (1976b) called ethics “values in action” – defined as the application of ethics to matters of life and death. Bio-ethics implies that a judgment should be made about the rightness or wrongness, goodness or badness, of a given medical or scientific practice. There are times when we, as clinicians, are concerned with both ethics and bioethics Bioethics What are some examples of Bioethical Dilemmas we may encounter in our professional life? Ethics – Clarifies the ethical aspects of professional practice. Professional What is the purpose of professional ethics? Professional Ethics are: intended to help practitioners to recognize morally correct practice and learn how to decide and act ethically in any professional situation. for the Protection of the public may also be enforced and provide sanctions through the license bureau Values Common to All of the Helping Professions Autonomy – client’s right to choose their own course of action, commonly known as selfdetermination (Western tradition). Some people think the next two are the same concept; they are closely related but differ in an important way Nonmaleficence – “above all else, do no harm” Beneficence – “avoiding” doing harm; stated in the positive: the value (or duty) of promoting good for and enhancing the well-being of others.s Justice – Corey, Corey and Callahan define justice simply as “providing equal treatment to all people” Values Common to Helping Professionals, cont. Fidelity – Honoring commitments made to clients. Implication is that of creating a trusting relationship that allows the client space and opportunity to make whatever changes are necessary in his/her life Veracity – Being truthful; if the worker doesn’t know the answer or can’t provide the answer (confidentiality, court order, etc), it’s far better to tell the client than to lie. Acknowledging errors rather than deceiving Good decisions are supported by sound reasoning. You are probably acting in an ethically responsible way concerning a client if you:* Maintain personal & professional honesty*, coupled with The best interests of the client* Without malice or personal gain* and Can justify your actions as the best judgment of what should be done based on the current state of the profession.* * Van Hoose and Paradise (1979) The following exercise (handout) was produced by the New England Regional Leadership Program. It is posted by the Center for Rural Studies for Public Use. The Center for Rural Studies assumes no responsibility for the contents. Interpreting the Results: Question 1: the areas of life that you do well or that seem naturally right to you are also possible sources of your most basic values, but try to discriminate between physical talent and what ‘feels right’ about it for clues about values. Question 2: Moments of inspiration that cause a change are moments that affect you deeply and shape values related to what you value in life. Questions 3 & 5: These are directly related to what you value in life! Question 4: Areas of growing or changing awareness about your life, so they are especially important to understand. How do you express these values in your work? *Lois M. Frey, UVM Extension, contributed to this material Deontology? Utilitarianism? – This philosophy is linked to Plato, Immanuel Kant; rightness by rules rather than the outcomes. “Follow only the principle that you want everyone to follow”. Fixed moral rules which should hold under all circumstances. Ethical rules are right because they comply with such an imperative, or because the principle that supports the decision is sound. Rightness based upon outcomes (John Stuart Mill & Jeremy Bentham) “Which choice creates the greatest good for the greatest number? Ethical Absolutism Ethical relativists No fixed rules, and further, the way to judge an action is to examine the ‘goodness’ or ‘badness’ of it’s consequences 1. 2. 3. Who is Helpful? What are my choices? When have I faced a similar dilemma? *Strom-Gottfried, K. (2007). Straight Talk about Professional Ethics. Lyceum Books, Inc., pgs. 27-51 Helpful, Choices, History of Dilemmas 4. Where do ethical and clinical guidelines lead me? 5. Why am I selecting a particular course of action? 6. How should I enact my decision? Professional guidelines, course of action, how to act on the decision Does it pass the decision-making tests?* 1. Publicity – Can it withstand the light of day? 2. Reversibility – presents a version of the Golden Rule; would your choice of options be the same if you were in the client’s shoes or if your child, parent, friend, spouse were subject to the same decision. 3. Smell – Does the choice we’re making live up the community standards, legal standards, or our own gut instincts about right and wrong. 4. Mom or Mentor – Consider an individual whose integrity we trust, who holds us in high regard. How might that person solve this dilemma? How would they view us in light of the course of action we’re choosing? *Strom-Gottfried, K. (2007). Straight Talk about Professional Ethics. Lyceum Books, Inc. Rank in order from (1) highest importance of priority to (7) lowest importance or priority for the following ethical principles: a. Autonomy and freedom b. Equality and inequality c. Least harm d. Privacy and confidentiality e. Protection of life f. Quality of life g. Truthfulness and full disclosure THANKS FOR BEING HERE TODAY!!! MY HOPE IS YOU LEARNED MORE ABOUT YOURSELF AS YOU APPROACH ETHICAL DILEMMA IN YOUR ROLE AS A PROFESSIONAL Gail Bieber, LCSW, Clinical Director Counseling & Recovery Services of Oklahoma 7010 S. Yale #215 Tulsa, OK 74136 TELEPHONE: 918.492.2554 E-MAIL: gbieber@crsok.org