Mental health professionals face many complex questions in the course of their work with clients and patients. Among the most difficult are dilemmas that involve ethical issues. This book presents a forthright exploration of these dilemmas and the ethical considerations they raise. Drawing on extensive interviews, the author identifies common ethical problems that practitioners encounter. What happens, for example, when personal interests intrude into therapy? How can the therapist make an accurate assessment of his or her appropriateness (...) as a care provider for a particular patient? What about confidentiality? How are problematic financial arrangements best addressed? The author goes on to show how these dilemmas may be intensified by the unique assumptions of different therapeutic orientations--individual, group, family, marital, and organizational--and how professionals can learn from such experiences to better understand and apply their particular approach. This analysis--and the words of the therapists themselves--provide both a guide to practice and a unique store of experience for the growing number of researchers and students concerned with ethical problems in psychotherapy. (shrink)

The Oxford Handbook of Psychotherapy Ethics explores a whole range of ethical issues in the heterogenous field of psychotherapy. It will be an essential book for psychotherapists in clinical practice and valuable for those professionals providing mental health services beyond psychology and medicine, including counsellors and social workers.

Perhaps no other population exposes the clinician to more moral and legal dilemmas than clients with an HIV-positive diagnosis. What does the therapist do about the HIV positive patient who is having sex with unnamed partners and refuses to stop? What should be said in end-of-life decisions? What of the adolescent who is HIV positive but whose guardian does not wish the youth to be informed of his status?

Psychiatrie und Psychotherapie sind Bereiche medizinischer Praxis, die in besonderer Weise ethische Fragen aufwerfen. Die Beiträge des Bandes hierzu werden durch zwei übersetzte Beiträge des polnischen Psychiaters Antoni Kępiński (1918-1972) erweitert. Diese eröffnen neue Perspektiven in der Diskussion um ethische Fragen in der Psychiatrie.

The work of every school of psychotherapy and every therapist is inevitably structured by a value system and requires codes of ethics and practice. This book addresses the conscious and unconscious aspects of the value system in which therapists are situated. Values and Ethics in the Practice of Psychotherapy and Counselling explores the central issues through the experience of the contributors, each of whom is well known in this field. Each chapter will raise questions for the reader which (...) will stimulate individual thinking about practice or can form a basis for discussion and debate for training or graduate groups. The book is firmly rooted in practice. Each chapter deals with a different aspect of the psychotherapist's work beginning with the general underlying principles, continuing through matters of technique and on to contextual issues. Finally the book moves to the outer world, politics and spirituality as ways of connecting inner and outer, social and individual. The arrangement of chapters allows for flexibility and creativity while providing a coherent structure. Values and Ethics in the Practice of Psychotherapy and Counselling is recommended reading for psychotherapists, psychoanalysts and counsellors in training and practice. (shrink)

This work is about the deceptive nature of psychotherapy. In particular, it is about those therapies that claim to provide the client with insight and self-knowledge when in practice they are a means of social control absorbing clients into socially acceptable norms. Through a philosophical analysis of key concepts such as knowledge, insight, and subjectivity, and through an examination of mechanisms intrinsic to psychotherapeutic practice, such as power, interpretation, and suggestion, this monograph unveils how psychotherapy deludes clients into (...) believing they have discovered their true self. Rather than gaining self-knowledge and insight into their true or core self, clients are subtly reconstructed and reconfigured along prevailing social values. Furthermore, the very epistemological and metaphysical world-view clients are deceived into believing is highly suspect and founded upon a fascistic understanding of knowledge. As an alternative to such domination, psychotherapy needs to reconstruct itself along Nietzschean-Deleuzian lines where the focus is on multiple identities, difference, and creativity. Rather than focusing on an analysis of past memories to alleviate symptoms such as anxiety or depression, therapeutic intervention should aim for a non-repressive conception of self-knowledge and insight based upon a creative future and not a regretful past. This entails a different understanding of knowledge and reality that is not based on subjugating the world to what we know about it, but on immersing ourselves within reality in all of its concrete richness. And such an approach is preferable not because it is “true” but because it is more liberating. (shrink)

This work is about the deceptive nature of psychotherapy. In particular, it is about those therapies that claim to provide the client with insight and self-knowledge when in practice they are a means of social control absorbing clients into socially acceptable norms. Through a philosophical analysis of key concepts such as knowledge, insight, and subjectivity, and through an examination of mechanisms intrinsic to psychotherapeutic practice, such as power, interpretation, and suggestion, this monograph unveils how psychotherapy deludes clients into (...) believing they have discovered their true self. Rather than gaining self-knowledge and insight into their true or core self, clients are subtly reconstructed and reconfigured along prevailing social values. Furthermore, the very epistemological and metaphysical world-view clients are deceived into believing is highly suspect and founded upon a fascistic understanding of knowledge. As an alternative to such domination, psychotherapy needs to reconstruct itself along Nietzschean-Deleuzian lines where the focus is on multiple identities, difference, and creativity. Rather than focusing on an analysis of past memories to alleviate symptoms such as anxiety or depression, therapeutic intervention should aim for a non-repressive conception of self-knowledge and insight based upon a creative future and not a regretful past. This entails a different understanding of knowledge and reality that is not based on subjugating the world to what we know about it, but on immersing ourselves within reality in all of its concrete richness. And such an approach is preferable not because it is “true” but because it is more liberating. (shrink)

Most books about ethics focus either on the origins of ethics, or on the application of ethical thinking to a single form of therapy. This book sets out to span a range of very different forms of therapy and explores the similarities and the differences between the ethical thinking of the practitioners concerned. By looking at ethical issues in different therapeutic settings the reader is challenged to reconsider the working assumptions which underpin familiar therapeutic practice. Readers of (...) Forms of Ethical Thinking in Therapeutic Practice are offered the unique opportunity to gain insights into the ethical thinking of experienced practitioners offering strikingly different services to their clients and working in contrasting contexts. Essential reading for all practitioners in counselling and the therapies, students, trainers, supervisors and providers of therapeutic services. (shrink)

The text is extensively referenced, but practical in its approach, giving real life examples and cases based on therapeutic practice.

Background: In Hospital Emergency Department and Emergency Medical Services professionals experience situations in which they face difficulties or barriers to know patient’s advance directives and implement them. Objectives: To analyse the barriers, facilitators, and ethical conflicts perceived by health professionals derived from the management of advance directives in emergency services. Research design, participants, and context: This is a qualitative phenomenological study conducted with purposive sampling including a population of nursing and medical professionals linked to Hospital Emergency Department and Emergency (...) Medical Services. Three focus groups were formed, totalling 24 participants. We performed an inductive-type thematic discourse analysis. Ethical considerations: This study was approved by ethical committees of Ethical Commitee of Clínic Hospital (Barcelona) and Comittee of Emergency Medical Services (Barcelona). The participants received information about the purpose of the study. Patients’ anonymity and willingness to participate in the study were guaranteed. Findings: There were four types of barriers that hindered the proper management of patients’ advance directives in Hospital Emergency Department and Emergency Medical Services: personal and professional, family members, organisational and structural, and those derived from the health system. These barriers caused ethical conflicts and hindered professionals’ decision-making. Discussion: These results are in line with those of previous studies and indicate that factors such as gender, professional category, and years of experience, in addition to professionals’ beliefs and the opinions of colleagues and family members, can also influence the professionals’ final decisions. Conclusion: The different strategies described in this study can contribute to the development of health policies and action protocols to help reduce both the barriers that hinder the correct management and implementation of advance directives and the ethical conflicts generated. (shrink)

This study investigates the ethical aspects of deploying and researching into so-called climate engineering methods, i.e. large-scale technical interventions in the climate system with the objective of offsetting anthropogenic climate change. The moral reasons in favour of and against R&D into and deployment of CE methods are analysed by means of argument maps. These argument maps provide an overview of the CE controversy and help to structure the complex debate.

Ethics and Values in Psychotherapy examines the ways in which the ethical convictions of both therapist and client contribute to the practical process of psychotherapy. Practitioners are increasingly focusing on the issue of their extensive--and often problematic--ethical influence on clients as they attempt to agree on guidelines and standards for professional practice. Alan C. Tjeltveit argues that any discussion of ethical practice in psychotherapy must be carried out in connection with traditional ethical theories. (...) The author draws on scientific, clinical, and philosophical approaches to address issues such as: the role of therapy in society; the goals and outcomes of psychotherapy; techniques and practices; the existence and operation of values; and the intellectual and social context in which therapy takes place. This comprehensive study is a significant contribution to the debate on the ethical character of psychotherapy. (shrink)

In this paper, I discuss some central ethical aspects of self-forgiveness. A first comparison is made between interpersonal forgiveness and self-forgiveness. It would seem that self-forgiveness follows much of the same structure as interpersonal forgiveness, although with some exceptions. One noticeable difference is that with self-forgiveness, the forgiver and forgiven is one and the same person. The main ethical question discussed is when self-forgiveness is morally permissible. I argue that self-forgiveness is only morally permissible when the wrongdoer acknowledges (...) wrongdoing and display genuine repentance. He must also, insofar as possible, ask the victim for forgiveness before contemplating self-forgiveness. (shrink)

The psychosocial morbidity associated with HIV infection and responses to such infection may exceed morbidity associated with medical sequelae of such infection. This paper argues that negative judgements on those with HIV infection or in groups associated with such infection will cause avoidable psychological and social distress. Moral judgements made regarding HIV infection may also harm the common good by promoting conditions which may increase the spread of HIV infection. This paper examines these two lines of argument with regard (...) to the ethical aspects of psychological bases of health care, clinical contact, public perceptions of AIDS and the comparative perspective. It is concluded that the psychosocial aspects of HIV infection impose ethical psychological, as well as medical, obligations to reduce harm and prevent the spread of infection. (shrink)

Background: A predictive genetic test for Huntington’s disease can be used before any symptoms are apparent, but there is only sparse knowledge about the long-term consequences of a positive test result. Such knowledge is important in order to gain a deeper understanding of families’ experiences. Objectives: The aim of the study was to describe a young couple’s long-term experiences and the consequences of a predictive test for Huntington’s disease. Research design: A descriptive case study design was used with a longitudinal (...) narrative life history approach. Participants and research context: The study was based on 18 interviews with a young couple, covering a period of 2.5 years; starting 6 months after the disclosure of the test results showing the woman to be a carrier of the gene causing Huntington’s disease. Ethical considerations: Even though the study was extremely sensitive, where potential harm constantly had to be balanced against the benefits, the couple had a strong wish to contribute to increased knowledge about people in their situation. The study was approved by the ethics committee. Findings: The results show that the long-term consequences were devastating for the family. This 3-year period was characterized by anxiety, repeated suicide attempts, financial difficulties and eventually divorce. Discussion: By offering a predictive test, the healthcare system has an ethical and moral responsibility. Once the test result is disclosed, the individual and the family cannot live without the knowledge it brings. Support is needed in a long-term perspective and should involve counselling concerning the families’ everyday life involving important decision-making, reorientation towards a new outlook of the future and the meaning of life. Conclusion: As health professionals, our ethical and moral responsibility thus embraces not only the phase in direct connection to the actual genetic test but also a commitment to provide support to help the family deal with the long-term consequences of the test. (shrink)

Battlefield euthanasia, the purposeful killing of wounded soldiers (or even civi- lians) in order to hasten their foreseeable death, has been an issue in military medicine and in soldiers’ moral codes at all times. During conflicts since anti- quity, there have been severely wounded who would not die immediately but whose fate seemed clear, nevertheless. But can it ever be morally justified to kill those wounded out of mercy in order to end their suffering? Can death ever be the (...) better option? And if so, what conditions have to be fulfilled? This paper investigates some of the moral aspects of battlefield euthanasia. Analogies to physician-assisted suicide in civil settings will be drawn and contrasted with the additional aspects that the military environment adds to the problem. (shrink)

Postmerger integration is a highly challenging and demanding task. Its success depends not only on economic factors but also on the organisational members' feelings and their personal contribution to the new entity. Mergers are usually made for the sake of profitability in the first place, whereas less attention is paid to employees in such situations. This article describes various ethical observations made in our study on corporate mergers in the Nordic Electro-business industry. We examine how the organisational change was (...) experienced by personnel, what kinds of ethical reflections surfaced in different phases of the process, and what conclusions might be drawn from them. The main focus is on the ethical meanings that emerged in our interviewees' stories spontaneously, without the topic of ethics having been separately brought up in the interview situation. The organisational members: we interviewed 35 electro-business employees who were either transferred from Vattenfall's contracting unit to the acquiring company or were already working there at the time of the merger. These persons were interviewed twice: first in 2001, the year of the initial merger, and again in 2005, 4 years from the start of the process and 1 year from the final ownership change. The merger process seemed to lead to decreased responsibility among the organisational members, which highlights the discrepancy between genuine ethical thinking and executive talk. Our study also revealed a dramatic shift in the moral attitudes of the managers who fell from power in the turmoil of organisational change. This moral dimension is evident in their sharply critical argumentation against the new operating model and new corporate management, as well as in their eventual indifference and non-commitment to the organisation. The ethical meanings of 'the good life' and a happy work community slowly disintegrated and were replaced by a longing for the earlier communality and sense of togetherness in their old organisation. This meant that 'the good life' would have to be sought elsewhere. (shrink)

The neoclassical paradigm assumes that shareholders'' utility is solely a function of their wealth, and prescribes that management should act in a manner consistent with share price maximization. The stakeholder view also assumes that shareholders'' utility derives from wealth, but prescribes that managers must balance the shareholder wealth maximization objective against the rights of other constituencies. Thus, while neoclassicists and stakeholder theorists have different prescriptives for management behavior, their definitions of the shareholders'' interest are consistent — shareholders are self-interested economic (...) agents whose utility is best served by share price maximization. However, if shareholders are other-interested, and attack importance to ethical and moral values, then both the neoclassical and stakeholder view derive from invalid assumptions. In this paper, I present evidence that much shareholder behavior is ethically motivated. As a result, the basis for both the neoclassical and the stakeholder view are weakened. (shrink)

A lot of interest has been generated by the possibility of deriving gametes from embryonic stem cells and bone marrow stem cells. These stem cell derived gametes may become useful for research and for the treatment of infertility. In this article we consider prospectively the ethical issues that will arise if stem cell derived gametes are used in the clinic, making a distinction between concerns that only apply to embryonic stem cell derived gametes and concerns that are also relevant (...) for gametes derived from adult stem cells. At present, it appears preferable to use non-embryonic stem cells for the derivation of gametes. Adult stem cell derived gametes do not present any problems with regard to the moral status of the human embryo, bypass the safety risks linked to SCNT and do not present any ambiguity or novel problems with regard to informed consent, psychological consequences for the child or genetic parenthood. A remaining ethical concern, however, regards the safety of the procedure in terms of the welfare of the resulting children. This should spark a thorough reflection on how far one must go to accommodate a person’s wish to have a genetically related child. (shrink)

As a consequence of the collapse of a building in Barcelona, in December 1990, it was discovered that a large number of dwellings, mainly in Barcelona but also in other towns of Catalonia, were affected by a structural defect known as aluminosis, consisting of a deterioration of the reinforced concrete manufactured using aluminous cement, which considerably reduced its strength and that of the steel embedded in the concrete. This brought to light a series of economic, social, political and also (...) class='Hi'>moral problems, such as the use of the aluminous cement itself — a quality product but which requires careful handling —, the lack of regulation concerning the product and its use in construction, the poor state of repair of the buildings affected, the careless manner in which they had been built, the lag in technical knowledge, the financial situation of the people affected by the aluminosis, etc.This document provides a full account of the events and their historical, technical, economic and legal background, paying particular attention to the ethical problems created by the situation. (shrink)

Introduction to ABA, ethics, and core ethical principles -- Contextual factors that influence ethical decision-making -- Creating behavioral systems to support ethical behavior in autism treatment -- Identifying your scope of competence in autism treatment -- The decision-making process of evidence-based practice -- Interdisciplinary collaboration -- Common errors and mistakes made during ethical analyses and application.

Two recent events have caused renewed anxiety concerning the ethics of donor transplantation. The first is the report of the British Transplantation Society and the second is the Bill introduced by Mr Tam Dalyell MP (see page 61 of this issue) in which he seeks to establish by law that unless an individual in his life time has expressly contracted out his organs may after death be used for transplantation. Dr Mahoney in this paper therefore examines from the point of (...) view of ethics some of the personal and social aspects of both proposals. (shrink)

Professor Dunstan has selected certain aspects of the preceding papers on artificial insemination by donor and subjected these to the scrutiny of a moral theologian.

Rapid development of e-learning courses for ethics-and-compliance programs led to substantial success in producing engaging multimedia training toolkits aimed at breaking through barriers of indifference and distrust by combining learning with fun. However, a pleasant training experience is no guarantee of its ultimate success in improving organizational ethics. Drawing on Paivio’s Dual Coding Theory, this paper presents a model for evaluating multimedia learning from a moral viewpoint. The main argument advanced in the paper is that entertaining multimedia training modules, (...) as commonly offered in the business world, may deliver an unintended message which runs counter to the very goal of ethics training. The Rocked or Shocked? videogame—a multimedia-based ethics training module—will serve as a case study for detecting the complicated role of entertainment in ethics training and examining the ethical meanings conveyed through the pictorial/event channel. The paper concludes with recommendations for the design of multimedia ethics training. (shrink)

The purpose of this study was to describe the extent to which nurses perceive the ethical dimensions of clinical practice situations involving patients, families and health care professionals. Using the composite theory of basic moral principles and the professional standard of care established by legal custom as a framework, situations involving ethical dilemmas were gleaned from the nursing literature. They were reviewed for content validity, clarity and representativeness in a two-stage process by expert panels. The situations were (...) presented in a written format to a convenience sample of nurses (n = 125), who were primarily staff nurses (65.6%). Respondents' judgements about whether the main issue of each situation concerned ethics ranged from a low of 0.8% to a high of 40%. From analyses of the categories into which the majority of subjects placed each situation, it was concluded that these nurses generally perceived ethics as the main issue in situations that directly involve patients' autonomy. Analysis yielded unanticipated findings about the themes in ethical situations to which nurses in practice may respond. (shrink)

Theories of ethical leadership provide important insights about the effect of leader’s ethics on the relationship between leaders and followers. However, there is an increasing demand for addressing key constructs that enhance the capacity to explain theoretical aspects of ethical leadership. The purpose of this study is to expand the theoretical framework of ethical leadership based on Korean traditional leadership by focusing on personal cultivation, morality, and social responsibility. Using a framework of intrapersonal process as leadership and (...) core value and competence as components of leadership, this study examines the ethical aspects of Korean traditional leadership and provides the implications to further develop the theory of ethical leadership. It is found that ethical integrity ensued from sugi is an essential precondition to develop leadership, and the core value of ethical leadership includes Zhixin-Chijing and the competence co.. (shrink)

Psychotherapy holds out the promise of help for people who are hurting and in need. It can save lives and change lives. In therapy, clients can find their strengths and sense of hope. They can change course toward a more meaningful and healthy life. They can confront loss, tragedy, hopelessness, and the end of life in ways that do not leave them numb or paralyzed. They can discover what brings them joy and what sustains them through hard times. They (...) can begin to trust, or to trust more wisely. They can learn new behaviors in therapy and how to teach themselves new behaviors after therapy ends. They can question what they always believed was a given. They can find out what matters most to them, and how to stop wasting time. They can become happier, or at least less miserable. They can become better able, as Freud noted, to love and to work. They can learn how to accept and love themselves just as they are and accept others who are different from them. Our ethics acknowledge and affirm our profession's responsibilities. This book was written to help strengthen, deepen, and inform ethical awareness and the sense of personal ethical responsibility. Its job is to help you hold onto the ideals-including ethical ideals-that called you into the profession to begin with, to help you develop and fulfill those ideals. There will be so much-trust us on this-that tends to dull ethical awareness, to make ethics drift out of focus, to create barriers between you and your ideals, to replace ethics with pseudo-ethics and ethics placebos. Fatigue, endless paperwork, unrealistic expectations, illness, family crises, not being able to make ends meet, burn out, threats of job loss, insurance coverage that doesn't come close to meeting the needs of our clients, biases that have not been addressed, and so many other forces can pressure us into cutting ethical corners. This book is intended to help you develop a strong and healthy resistance to such forces, to help you weather them without losing your ethical awareness and ideals. (shrink)

Acting on what started as a hunch, Dr. Francis Martin has cataloged well over 20,000 distinct approaches to counseling and psychotherapy that are advertised on the webpages of licensed, practicing mental health providers. No doubt some portion of them are harmful, but the sheer volume of advertised practices and techniques, often with names deceptively similar to actual evidence-based practices, should be cause for concern among all stakeholders in the helping professions - from educators and researchers to policy makers and (...) insurance companies and, especially, consumers. Based on this significant original study, and drawing from other research and supports, Therapy Thieves describes a near-universal crisis in the field and recommends ways to rescue mental health care from itself. The crisis is caused by declining competence among counselors and psychotherapists who have failed to regulate themselves and who, therefore, deliver inadequate - if not harmful - services. In presenting a simple, yet powerful indictment of the field, Dr. Martin advocates for major reforms in several areas of mental health care, including how prospective licensees are trained, supervised and licensed, a major reworking of professional ethics, and the need to establish regulations for mental health care providers. In short, the book calls for major, specific, and urgently needed reforms. (shrink)

Psychotherapy is a well-established, efficacious, and fully accepted treatment for mental disorders and psychological problems. Psychotherapy is an interpersonal practice engaging patient values, interests, and personal meanings at every step. Thereby, psychotherapy abounds with moral issues. In psychotherapy ethics, numerous moral issues converge, including self-determination or autonomy, decision-making capacity and freedom of choice, coercion and constraint, medical paternalism, boundaries between health and illness, insight into illness and the need for therapy, dignity, under- and overtreatment, (...) and much more. The Oxford Handbook of Psychotherapy Ethics covers the whole range of ethical issues in the heterogenous field of psychotherapy, closing a commonly perceived gap between ethical sensitivity, technical language, and knowledge among psychotherapists. The primary audience is psychotherapists in clinical practice. Furthermore, the Oxford Handbook of Psychotherapy Ethics addresses the whole range of professionals providing mental health services beyond psychology and medicine including counselors, social workers, nurses, or ministers. The Oxford Handbook of Psychotherapy Ethics is not only intended for a clinical audience but also for a philosophical/ethical audience. The goal of the is to explicitly link the two disciplines by fostering a productive dialogue between them, enriching both the psychotherapeutic encounter and the ethical analysis and sensitivity within and outside the clinic. (shrink)

Background: Textbooks are central for the education of professionals in the health field and a resource for practitioners already in the field. Objectives: This article focuses on how 12 textbooks in psychiatric nursing and psychiatry, published in Norway between 1877 and 2012, describe and present people with psychosis. Research design: We used qualitative content analysis. Ethical considerations: The topic is published textbooks, made available to be read by students, teachers and professionals, and no ethical approval was required. Findings: (...) The analysis shows that all 12 textbooks describe and present people who are considered as psychotic from a ‘perspective from above’. In this perspective, the readers are learning about psychosis in the professional’s language and from the author’s viewpoint. Most often the textbooks communicate a universal image of people with psychosis, a description that fits with the diagnostic criteria. The analysis also shows that two textbooks in psychiatric nursing combined this perspective with a ‘perspective from within’. Here, the readers are learning about psychosis from the patients’ own viewpoint. The authors communicate a personal, psychotic universe that differs from various people, even if they have the same diagnosis, and the descriptions are focusing on the patient as a whole person. Discussion and conclusion: Drawing partly on Rita Charon’s writings about narrative knowledge in the health field, and partly on insights from Martha Nussbaum and her concept of narrative imagination, we argue that mental health professionals need to learn about, understand and fathom what patients go through by reading, listening to and acknowledging the patients’ own stories and experiences. Cultivating the capacity for empathy and compassion are at the very heart of moral performance in the mental health field. A valuable moral resource in that regard is leading textbooks and how they describe and present people with severe mental illness. (shrink)

AimIn case of extremely rare diseases, case reports are often the only experience to draw from for evidence-based management. Carmi syndrome is a rare, mostly lethal combination of junctional epidermolysis bullosa and pyloric atresia. During an ethical board, there were differences in perception of mortality rate. We tested the hypothesis that the cumulative mortality of single case reports is lower than that of multiple case series.CaseA baby girl was born at 33 weeks gestation with Carmi syndrome. The treatment options (...) discussed in an interdisciplinary ethics board were a palliative approach versus surgical gastrojejunostomy. Because about one third of operated children described in case reports survived, we opted for surgical treatment. The patient died a painful death 4 weeks later.MethodsThe PubMed database was systematically searched for reports of Carmi syndrome. Single case reports were compared to case series in terms of outcome.ResultsA total of 102 cases of Carmi syndrome were identified in the literature. Mortality of single case reports was 17 out of 27 patients (63%), while that of case series was higher at 62 out of 74 patients (84%,p = 0.036).ConclusionsSelection and publication bias may lead to inflation of survival rates in single case reports because successful cases are more likely to be published in the literature. These biases may lead to inappropriately aggressive treatment in futile cases. Clinicians should be cautious when discussing prognosis and making decisions based on the cumulative experience of case reports of extremely rare or novel diseases. (shrink)

Background Non-technical skills are cognitive and interpersonal skills underpinning technical proficiency. Ethical values and respect for human dignity make operating room nurses responsible for nursing decisions that are clinically and technically sound and morally appropriate. Aim To learn what ethical issues operating room nurses perceive as important regarding non-technical skills. Research design Qualitative individual in-depth interviews were conducted. The interviews were analysed using Braun and Clarke’s six phases for thematic analysis. Participants and research context Eleven experienced perioperative/operating room (...) nurses working in an operating unit at a Norwegian university hospital. Ethical considerations Approval was given by The Norwegian Social Science Data Service in care of the hospital’s Data Protection Officer. Findings Three main themes were found: respect and care for the patient, making the patient feel safe, and respect within the perioperative team. These features or themes, which incorporate collaboration and communication, are closely connected to patient safety. Discussion Defending the patient’s dignity is part of caring for and respecting the patient. The manner in which the operating room team collaborates is important for the patient to feel safe and secure. Poor teamwork may have dire consequences. Reciprocal respect within the team includes respect for each other’s tasks and responsibilities and to talk to one another in a friendly manner. Conclusion Being respectful and contributing to a caring atmosphere are central ethical skills in the operating room. To patients, harmonious teamwork translates into a feeling of safety and being cared for. The nurses see respect and patient safety, and respect and reciprocal politeness among the members of the perioperative team as central ethical non-technical skills. Lack of respect influences the team negatively and is detrimental for patient safety. Good communication is an important safety measure during surgery and creates a feeling of good ‘flow’ within the operating room team. (shrink)

Proponents of empirically supported treatment have argued that psychotherapists have an ethical obligation to make an EST the first choice in clinical practice. This paper challenges this idea. The EST program assumes a model of therapy as technology or applied science that poorly fits the reality of psychotherapeutic practice. The problems brought to therapy implicate fundamental questions regarding what constitutes a good life. A therapeutic response to such problems is not a technical means to change a circumscribed disorder, but (...) an engagement with the client that has relevance to broader moral concerns. Further, the picture of therapy as technology of change implicitly proposes views of a good life, while not acknowledging that it is doing so. 2012 APA, all rights reserved). (shrink)

Behandlungsfehler in der Psychotherapie sind bisher kaum erforscht. Eine empirisch gestützte Kategorisierung von Behandlungsfehlern stellt einen ersten Schritt dar, sich evidenzbasierten ethischen Empfehlungen zum Umgang mit solchen Fehlern zu nähern. Zielsetzung dieser Arbeit ist es, dafür erste Grundlagen zu erarbeiten, die auf Erfahrungen von Praktikern Bezug nehmen. Nach einer systematischen Literaturrecherche wurden 30 semistrukturierte Interviews mit approbierten Psychotherapeuten unterschiedlicher Ausrichtungen (Schulen) geführt und anhand der qualitativen Inhaltsanalyse nach Mayring ausgewertet. Die beschriebenen, alltäglich auftretenden Behandlungsfehler konnten in technische, normative, Einschätzungs- und (...) Systemfehler klassifiziert werden. Viele der technischen und Einschätzungsfehler wurden als reversibel angesehen; sie könnten sogar konstruktiv für die Behandlung nutzbar gemacht werden. Das Versäumnis, einen Fehler zu korrigieren, wurde als Hauptfehler betrachtet. Bei normativen Fehlern sei mit rechtlichen oder berufspolitischen Konsequenzen, aber auch mit Vertrauensverlust und Therapieabbruch zu rechnen. Für Systemfehler fühlten sich die befragten Therapeuten nicht verantwortlich; hier seien berufspolitische Änderungen nötig. Die Ergebnisse zeigen, dass die Befragten zu der Empfehlung tendieren, Psychotherapiepatienten in passender Form über Behandlungsfehler aufzuklären und in die entstehenden Konsequenzen einzubeziehen. Fazit: Psychotherapeuten äußern sich aufgeschlossen gegenüber einer transparenten, konstruktiven Fehlerkultur – eine wesentliche Voraussetzung für Fehlerprävention. Häufig resultiert erst durch die fehlende Korrektur eines (alltäglichen) Fehlers ein Behandlungsfehler, der Konsequenzen hat (z. B. Scheitern der Therapie). Um diesem entgegenzuwirken, zeichnet sich eine Befürwortung für eine passende Form der Patientenaufklärung über Fehler ab. (shrink)

This essay aims to morally evaluate psychotherapy as it is currently practiced through the lens of sales/exchange ethics. The main focus of the essay is on psychotherapists’ claims to special expertise at diagnosing and treating mental illness. I review the research evidence relevant to these claims and conclude that these claims are not supported by the available evidence. Psychotherapists do not appear to be any better than actuarial tests at diagnosing mental illnesses, and meta-analyses of psychotherapy outcome studies (...) casts serious doubt on the existence of treatment expertise. Given that the expertise that psychotherapists claim to have is lacking, those seeking psychotherapy are not adequately informed about the quality of the product that they are seeking. Using Holley’s principles of sales ethics as a springboard, I argue that this situation is morally unacceptable; thus the current practice of psychotherapy is morally impermissible. I provide and evaluate some suggestions for rectifying this problem. The most important of these is Dawes’s suggestion that psychotherapists be licensed according to their use of experimentally confirmed diagnostic and treatment methods. (shrink)

The comprehensive guide to ethics "An excellent blend of case law, research evidence, down-to-earth principles, and practical examples from two authors with outstanding expertise. Promotes valuable understanding through case illustrations, self-directed exercises, and thoughtful discussion of such issues as cultural diversity."--Dick Suinn, president-elect 1998, American Psychological Association "The scenarios and accompanying questions will prove especially helpful to those who offer courses and workshops concerned with ethics in psychology."--Charles D. Spielberger, former president, American Psychological Association; distinguished research professor of psychology, University (...) of South Florida The authors draw on their professional experience, empirical studies, and case examples to examine the ethical responsibilities that confront psychotherapists and counselors in their day-to-day practice. They offer insights into contending with the sometimes competing demands of clients' needs, formal ethical principles, personal values, and evolving legal standards in a range of areas--including fees, informed consent, sexual concerns, confidentiality, documentation, and supervision. (shrink)

Presenting an outline of the version of Islamic ethics that is embedded in the textual legacy of the Islamic legal tradition, Abdulaziz Sachedina argues that this juridical ethics is an important, even dominant form of ethics in modern Islam. He notes that this form of ethics has been challenged by modernity and examines the variety of ways in which legal ethical thinkers have reacted to these challenges.

Psychologists are ethically obligated to obtain informed consent to psychotherapy "as early as is feasible" (American Psychological Association, 2002, p. 1072). However, the range of topics to be addressed includes both information that may be immediately and uniformly applicable to most clients via policy or rule, as well as information that is not immediately presentable because it varies widely across clients or emerges over time. In this study, licensed psychologists were surveyed regarding the earliest feasible point at which they (...) could provide information regarding specific aspects of psychotherapy. Results indicate that, although psychologists believe that they are capable of presenting some information, such as payment and confidentiality policies, at the outset, they believe that a discussion of more substantive issues, such as psychotherapy duration, goals, orientation, and activities, can take place only after some therapy has transpired. Implications are discussed regarding the process and event models of informed consent. (shrink)

The Hellenic medical ideas have found appreciation among people over centuries. Though the initial concept remained the same, methods or ways to achieve desired aims have changed. Since Hippocrates, new generations of physicians have worked hard to find more powerful types of therapies to relieve their patients and make treatment less burdensome. The struggle of medicine is very specific and requires, apart from practical skills, a clear personal commitment to help people wisely. From the Early Antiquity, both medicine and medical (...) ethics go together. Wherever Hippocratic medicine is practiced, an appropriate moral pattern accompanies it because the Hellenic doctor offered purely clinical data and his art should not be separated from anthropology, ethics and religion. (shrink)

Ethical mysticism, by S. Coit.--The ethical import of history, by D. S. Muzzey.--The tragic and heroic in life, by W. M. Salter.--Distinctive features of the ethical movement, by A. W. Martin.--Ethical experience as the basis of religious education, by H. Neumann.--"All men are created equal," by G. E. O'Dell.--How far is art an aid to religion? by P. Chubb.--Evolution and the uniqueness of man, by H. J. Bridges.--The spiritual outlook on life, by H. J. Golding.--The ethics (...) of Abu'l Ala al Ma'arri, by N. Schmidt.--Life's unused moral force, by H. Snell.--Is the ideal real? by G. A. Smith.--Some ethical tendencies in the professions, by R. D. Kohn.--On the art of living, by W. Boerner.--The relation of the ethical ideal to social reform, by J. L. Elliott.--Concerning tolerance, by R. F. Dewey.--Ethical culture in Germany after the war, by R. Penzig.--A confession of faith, by S. B. Weston.--"Hearing the witnesses," by J. Gutmann. (shrink)

Relates the amusing holiday misadventures of Zelda Hammersmith, whose good intentions only lead to trouble.

This book takes a unique organizational approach towards understanding the concept of ethics in educational systems. It provides a global perspective and connects theory and praxis through team-based simulations, case studies and scenarios, thus presenting an integrative approach towards tackling teachers' withdrawal behaviors.

According to Ágnes Heller’s plans in 1989 and 1990, the last volume of her moral trilogy should have been entitled A Theory of Proper Conduct. In 1996 the third volume finally appeared with the title An Ethics of Personality. Its content: a series of philosophical dialogues between many dramatis personæ. The change in style and methodology of the third volume led to many criticisms, amongst them Mihály Vajda’s questioning of the whole project’s consistency. The present paper aims to engage (...) these criticisms by retracing the presence in An Ethics of Personality of the themes that, according to Heller’s previous intentions, should have informed the last part of her moral theory. The contribution analyses Heller’s definitions of modern paideia and moral wisdom, the issue of the possibility of happiness for modern people, and the philosophically problematic concept of moral aesthetics. In conclusion, the ‘literary’ methodology of the book is put in relationship with the non-prescriptive aspect of ethics. (shrink)

BackgroundThe legal and ethical guidelines of psychological professional associations stipulate that informed consent by patients is an essential prerequisite for psychotherapy. Despite this awareness of the importance of informed consent, there is little empirical evidence on what psychotherapists’ attitudes towards informed consent are and how informed consent is implemented in psychotherapeutic practice.Methods155 psychotherapists in Switzerland completed an online survey assessing their attitudes regarding informed consent. ResultsAmong the surveyed psychotherapists, there was a high consensus on important information that should (...) be communicated to patients in the context of informed consent. Almost all psychotherapists rated confidentiality and its exemptions (95%) and self-determined decision-making (97%) as important. The importance to disclose information regarding fees and the empirical effectiveness of the provided treatment, were both seen as important by more than 80% of participants. The disclosure of personal information about the therapist was rated as important by 60%. Other aspects, which are not direct components of informed consent but rather overarching goals, were also evaluated rather homogeneously: self-determined decision making of the patient was rated as important by almost all of the surveyed psychotherapists (97%). The following components were also judged as important by a majority of the participants: promotion of hope (80%) and discussion of treatment goals (93%). Most psychotherapists described the implementation of informed consent as an ongoing process, rather than a one-time event during the first session of therapy. Therapists’ age, postgraduate training, treated patient group, and setting influenced attitudes towards informed consent.ConclusionsThe present study shows that informed consent is perceived by psychotherapists as both a challenge and a resource. The implementation of informed consent in psychotherapy requires further research from a clinical and ethical perspective. (shrink)

Cultivating trusting psychotherapy bonds is complex, challenging, and a critically important topic. In Trusting in Psychotherapy, the author posits that trusting cannot be understood apart from trustworthiness and that therapists should give equal attention to the task of becoming trustworthy to their patients. Blending developmental science and ethical thought, the author elucidates such topics as what it means to trust in the practice of psychotherapy; the many facets of trusting and trustworthiness; attachment relationships; the central role (...) of hope in trust; and the ethical-moral basis of trusting and trustworthiness. (shrink)

Preface : how and why the stories came to be -- Introduction : self-deception and red flags -- Sammy meets the wolf : meet the characters who will decide the cases -- I'm not your monkey : loss of control with a difficult client -- Junk yard therapy : self-delusion and exploitation -- Rats! : warring colleagues -- The John : a predator at work and play -- The raid on Hollywood Boulevard : the professional role vs. the right to (...) a private life -- Kill the boss : when clients threaten physical harm -- Broken : Bartering gone bad -- Baby steps off a cliff : the slippery slope to sexual exploitation -- Car crash : a simple disclosure with unforeseen consequences -- Mad FAX : what not to do when clients don't pay -- The star catcher : the undoing of a troubled psychotherapist -- Vampire : Countertransference exploding -- Epilogue : a transformed Dr. Halsey goes home. (shrink)

Based on the first research study to specifically study ethics in adoption practice, this book offers an in-depth exploration of the history of values in ...