scholarly journals Embodied Ethical Decision-Making: A Clinical Case Study of Respect for Culturally Based Meaning Making in Mental Healthcare

2021 ◽  
Author(s):  
Megz Roberts
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Treatment ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Meaning Making ◽  
Hospital Setting ◽  
Mental Healthcare ◽  
Clinical Case Study ◽  
Culturally Based

AbstractHow does embodied ethical decision-making influence treatment in a clinical setting when cultural differences conflict? Ethical decision-making is usually a disembodied and rationalized procedure based on ethical codes (American Counseling Association, 2014; American Dance Therapy Association, 2015; American Mental Health Counseling Association, 2015) and a collective understanding of right and wrong. However, these codes and collective styles of meaning making were shaped mostly by White theorists and clinicians. These mono-cultural lenses lead to ineffective mental health treatment for persons of color. Hervey’s (2007) EEDM steps encourage therapists to return to their bodies when navigating ethical dilemmas as it is an impetus for bridging cultural differences in healthcare. Hervey’s (2007) nonverbal approach to Welfel’s (2001) ethical decision steps was explored in a unique case that involved the ethical decision-making process of an African-American dance/movement therapy intern, while providing treatment in a westernized hospital setting to a spiritual Mexican–American patient diagnosed with PTSD and generalized anxiety disorder. This patient had formed a relationship with a spirit attached to his body that he could see, feel, and talk to, but refused to share this experience with his White identifying psychiatric nurse due to different cultural beliefs. Information gathered throughout the clinical case study by way of chronological loose and semi-structured journaling, uncovered an ethical dilemma of respect for culturally based meanings in treatment and how we identify pathology in hospital settings. The application of the EEDM steps in this article is focused on race/ethnicity and spiritual associations during mental health treatment at an outpatient hospital setting. Readers are encouraged to explore ways in which this article can influence them to apply EEDM in other forms of cultural considerations (i.e. age) and mental health facilities. The discussion section of this thesis includes a proposed model for progressing towards active multicultural diversity in mental healthcare settings by way of the three M’s from the relational-cultural theory: movement towards mutuality, mutual empathy, and mutual empowerment (Hartling & Miller, 2004).

Ethical Decision-Making in School Mental Health

2021 ◽  
Author(s):  
James C. Raines ◽  
Nic T. Dibble
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
School Psychologists ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
School Mental Health ◽  
Codes Of Ethics ◽  
National Association

Ethical decision making in school mental health provides mental health professionals with a seven-step approach to managing ethical predicaments. It combines guidance from four major codes of ethics, including the American School Counseling Association, National Association of School Nurses, National Association of School Psychologists, and National Association of Social Workers. Ethical issues are endemic for mental health professionals working with minors in a host setting like schools. New interventions, evolving technologies, and a patchwork of ethical and legal guidelines create a constant stream of new ethical dilemmas. Longstanding and complex questions rarely give way to quick and easy answers. The seven-step model presented here enables readers to apply a practical process that minimizes their liability and protects their students. Beginning with an introduction of the moral, legal, and clinical foundations that undergird ethical practice, the authors present an ethical decision-making model with seven steps: know yourself and your responsibilities, analyze the dilemma, seek consultation, identify courses of action, manage clinical concerns, enact the decision, and reflect on the process. The second edition includes meticulously updated chapters based on recent changes to all of the codes of ethics over the past 10 years. It also has a new chapter on the universal issue of ethical recordkeeping. This handy guide is written for multidisciplinary teams of mental health professionals, including school social workers, school psychologists, school nurses, and school counselors. It provides a trusty resource with the following elements: Clearly organized chapters that introduce a process approach to ethical decision-making; Interprofessional and collaborative approach to working with other stakeholders; Case examples and practice exercises illustrate real work application of ethical guidelines; and Glossary, web resources, and U.S. Supreme Court decisions on students’ civil rights.

Review and Document the Process

2021 ◽  
pp. 170-191
Author(s):  
James C. Raines ◽  
Nic T. Dibble
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Case Studies ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Decision Making Process ◽  
Iatrogenic Effects

After reviewing and documenting the process, this chapter argues that it is unethical to stop the ethical decision-making process with implementation. The chapter recommends monitoring and evaluating the consequences of the ethical decision by engaging in post-decision activities. It uses two case studies where well-meaning mental health professionals inadvertently created iatrogenic effects for their clients. It details what went wrong in each case and how outcomes might have been improved. In these situations, mental health professionals are strongly encouraged to re-engage the ethical decision-making process on behalf of their clients, including apologizing for missteps previously made.

Theological Ethics Relevant to Mental Health and Psychiatry

2018 ◽  
Author(s):  
Daniel H. Grossoehme ◽  
Mary Lynn Dell
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Attitudes And Beliefs ◽  
Theological Ethics ◽  
Demographic Information ◽  
World Religions ◽  
Faith Traditions ◽  
Historical Origins

This chapter defines several commonly used terms in discussions of world religions, spirituality, and the contributions to and overlapping concerns of theological ethics and bioethics. Brief summaries of six major world faith traditions are offered, including historical origins, demographic information, basic theological tenets, and key themes in the religions’ ethics. Attitudes and beliefs about life, illness, suffering, medical care, end of life, and mental health care are discussed. Points at which theological ethics inform use of the Jonsen Four Topics Model are reviewed. Readers are provided a list of resources for additional reading and study at the intersection of theological and medical ethics. Although this chapter is not intended to be an exhaustive review of major world faith traditions, readers are reminded that understanding aspects of the religious and spiritual traditions and their imperatives for living may be of great importance to patients and their ethical decision making.

The scope of psychiatric ethics

2021 ◽  
pp. 3-10
Author(s):  
Sidney Bloch ◽  
Stephen A. Green
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Professionals ◽  
Moral Agency ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Professional Associations ◽  
Theoretical Frameworks ◽  
Ethics In Psychiatry ◽  
Evaluative Terms

Ethical decision-making is no easy matter, as absolutes of right and wrong, good and bad, should and ought, and other evaluative terms are elusive. Both providing the best attainable care for the patient and conducting scientific research guided by lofty ethical principles are paramount. This chapter, an introduction to the fifth edition of Psychiatric Ethics, outlines how the book aims to promote the moral agency of psychiatrists and mental health professionals when relating to patients and their families, colleagues, professional associations, and other organizations, and the society in which they work. It summarizes theoretical frameworks used in ethical decision-making and the range of topics discussed in the other 24 chapters, and offers guidelines to mental health students and graduate clinicians about how to master the field of ethics in psychiatry.

scholarly journals Putting Restraint on Chemical Restraint: Exploring the Complexity of Acute Inpatient Mental Health Nurses' Experience of Chemical Restraint Interventions

2020 ◽  
Vol 2 (2) ◽  
pp. 29-53
Author(s):  
Michelle Danda
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Policy Development ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Research Question ◽  
Mental Health Nurses ◽  
Chemical Restraint ◽  
Inpatient Mental Health ◽  
Research Findings

While there is a growing body of research available on general restraint intervention in acute adult psychiatric settings, relatively little is known about nurses’ experiences of administering chemical restraint. The research question explored in this study was: what are mental health nurses’ experiences of using chemical restraint interventions in times of behavioural emergency on adult inpatient acute mental health units? Through this Canadian study understanding of direct care nurses’ first-hand experiences of the use of chemical restraint interventions was sought. Eight adult acute inpatient mental health nurses were interviewed using hermeneutic phenomenological method. Two major themes that emerged from data analysis are explored to illuminate the existing tension between therapeutic, person-centred care and coercive control to maintain safety: taking control to maintain safety and working within constraints. Integral ways that nurses make meaning from administering chemical restraint were found, as well as some of the complex clinical and ethical decision-making aspects involved in psychiatric nursing care. Implications for practice, education, and policy are discussed. Research findings indicated a need for further focus on medication best practice, policy development and nurse education. These exploratory research findings can be used to both inform and challenge dominant inpatient mental health practice to guide nurses, health care leaders, and policy makers by increased understanding of the complex ethical decision making required for use of chemical restraint interventions.

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