Ethical Considerations in Ibogaine Therapy
Sandra Karpetas
Iboga Therapy House
Global Ibogaine Therapy Alliance (GITA)
2nd International Ibogaine Therapy Provider Conference
Barcelona, Spain 2010
Why do we need ethical
standards?
Ethical insensitivity can contribute to:
–
Health and safety problems
–
Dissatisfied clients/patients
–
Public relations problems
–
Financial problems
–
Legal problems
–
Organizational challenges
How can ethics in therapy be
helpful?
Ethical Standards:
–
Increase the quality of care and services provided
–
Increase transparency and accountability
–
Help to protect clients and therapists from undue harm
–
Foster greater recognition from the public domain
–
Create conditions for maximizing therapeutic potential
Ethical Guidelines
Internationally Recognized Ethics in Therapy and
Research:
–
Beneficence: Promotion of well-being
–
Non-malfeasance: Avoid potential harms
–
Dignity: Respect for the person
–
Informed Consent: The person's right to information, to ask
questions and to weigh the risks/benefits before making a
decision
–
Transparency: Open communication about policies/procedures,
disclosure of key information for client decision making
–
Confidentiality: Respect for privacy
–
Feedback: The right to provide feedback, whether positive
Beneficence: Promotion of wellIbogaine therapists should promote health in all aspects of their
being
programming, procedures and policies.
This includes key concepts such as health promotion, harm
reduction
and physical, psychological, emotional, spiritual and social wellbeing
–
Foster knowledge, skills, attitudinal changes and supports
needed to help people engage in safer and healthier lifestyles
–
Avoid deficit thinking, build on strengths and support positive
Non-malfeasance: avoid potential
harms
–
There is an urgent ethical responsibility to decide whether
the risk is too great for some participants, and thus to act
to reduce or eliminate the risk even if that means stopping
or modifying the therapy.
–
Therapists also have a responsibility to continuously
educate themselves and remain up to date on ibogaine
safety related information. Neglect of this responsibility can
be considered negligence and/or misconduct and may
contribute to adverse events and/or death.
Dignity: Respect for the person
–
Respect autonomy and support informed decision-making
–
Accept and work with individual differences in client
characteristics in both preventing and responding to
potential challenges. These include unique risks
associated with gender, age, sexual orientation,
cultural/religious identity, etc...
–
Recognize that the realities of poverty, class, racism, social
isolation, past trauma, discrimination, labels, stigma and
other social inequalities affect both people's vulnerability to
and capacity for effectively dealing with self care.
Informed
Consent
The client has a right to information, to ask questions and to
weigh the risks and benefits before making a decision to
undergo therapy
Minimal Risk
If potential subjects can reasonably be expected to regard the
probability and magnitude of possible harms implied by
participation in the research to be no greater than those
encountered by the subject in those aspects of his/her everyday
life that relate to the research, then the research can be regarded
as within the range of minimal risk.
-Tri Council Policy Statement 1998
What does an ethical consent form
consist
of? form should include:
A
proper consent
–
Introduction/Background Information about ibogaine
–
Ibogaine's Legal Status in the country where therapy takes
place
–
Therapeutic and Other Procedures from start to finish - in
detail (include search, source of ibogaine, dosing,
monitoring protocols, complementary/additional therapies,
etc...)
–
Ibogaine's Potential Effects, Side Effects and Risks
–
Emergency Protocols (including specifics of what you
would do in case of an adverse event, injury or death)
What does an ethical consent form
consist of?
–
Potential Benefits (including a disclosure regarding no
guarantee that it will help)
–
Quitting or Withdrawing from Participation in the Therapy including your procedures and risks should someone
decide to leave the site of therapy whilst under your care
–
Data Collection, Publication and Communication of Results
- disclose any plans to share information with others/public
–
Confidentiality - handling and storage of personal info,
files, medical info etc... plus staff/team confidentiality
agreements
What does an ethical consent form
consist of?
–
Alternative Sources of Therapy – ibogaine therapy is not
the only option and not necessarily the easiest/safest
–
Incentives– disclose any vested interests including
financial
–
Client Rights and Responsibilities - include DWF Bill of
Rights, outline client responsibilities, the right to file
incident or grievance reports and how to do so
–
Who to contact for more information – include contact info
–
The actual Informed Consent statement page to be signed
Elements
of abeconsent
form:
Each page should
numbered and
have a space at the
–
bottom for initials acknowledging the following statement:
I have read the contents of this page. I have had the
opportunity to ask questions about it, and I understand what it
says.
–
Initials____
The form should be written in an easy to understand
manner (8th grade reading level). Complicated terms
should be defined in an easy to understand way
–
The actual informed consent statement page – include a
statement regarding minimal risk
–
Space for date, signature of client and witness
signature/date
Note: A copy should be available for client without extra
Confidentiality
–
Respect for privacy before, during and after care
–
Handling and storage of sensitive information:
- keep all files/personal/medical info secure and locked
- consider using a secure server w/ SSL certificate
- do not use publicly-accessible computers
•
–
Ask client how they prefer to be contacted and when
Omit personally identifying info in
publications/reports/discussions
–
Each staff member should sign a confidentiality agreement
Feedback
Every client (regardless of whether they paid for the services
or not) has the right to provide feedback, whether positive
and/or negative and to file a grievance or incident report if
they deem necessary.
It is the responsibility of the therapy provider to provide
information on how to do so.
Ibogaine Incident or Grievance Report Form:
http://www.doraweiner.org/incident.html
A few other considerations:
Compassion, empathy, strong interpersonal, listening,
counseling and facilitation skills are of utmost importance.
Individuals on the staff/team should possess the following:
–
Recognition of and respect for diversity
Awareness of one’s own learning process
–
Ability to be attentive/good listening skills
–
–
–
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Trust in one’s way of working
Ability to work with authority
Willingness to do one’s own inner work
Also: Have a fair and just conflict resolution policy in place
Sandra Karpetas
sandra_k@ibogatherapyhouse.net
+ 1 604 785 0924
www.ibogatherapyhouse.net
Global Ibogaine Therapy Alliance
www..ibogainefederation.org