Motivational Interviewing: III. On the Ethics of Motivational Intervention

1994 ◽  
Vol 22 (2) ◽  
pp. 111-123 ◽  
Author(s):  
William R. Miller
Keyword(s):  
Motivational Interviewing ◽  
Ethical Issues ◽  
Readiness To Change ◽  
Intervention Strategy ◽  
Perceptual Bias ◽  
Motivational Intervention ◽  
Ethical Concerns ◽  
Middle Way ◽  
Motivation For Change ◽  
Readiness Level

This article is intended to promote consideration and discussion of ethical issues in motivational interventions. The popular concept of client “denial” encompasses a broad range of motivational behaviors including lying, perceptual bias, unawareness, ambivalence, resistance and reactance. The “problem of motivation” typically arises when a therapist perceives a problem and sufficient need for change in someone who does not share this perception. In considering how to respond to such situations, one can conceive of a continuum of levels of readiness to change, and of therapeutic strategies ranging from passivity to coercion. Ethical concerns arise when there is a perceived mismatch between readiness level and intervention strategy. Motivational interviewing is a middle way between passivity and coercion, seeking to evoke intrinsic motivation for change by making salient the inconsistency of problem behavior and that which is more deeply valued. The concern that this approach is “manipulative” combines a descriptive element and an evaluative component. Three possible descriptive meanings are discussed: that it effectively alters behavior, that it does so in persons not seeking or requesting change, and that it may operate through processes not immediately apparent. Ethical concerns regarding motivational intervention are considered within this broader context.

The Ethics of Motivational Interviewing Revisited

1995 ◽  
Vol 23 (4) ◽  
pp. 345-348 ◽  
Author(s):  
William R. Miller
Keyword(s):  
Motivational Interviewing ◽  
Motivational Intervention ◽  
Ethical Judgments ◽  
Ethical Concerns

In two separate commentaries, Withers and Seager offer constructive critiques of “The Ethics of Motivational Intervention.” It is difficult to render ethical judgments regarding a method apart from the goals and contexts within which it is to be applied. A clearer and transtheoretical understanding of the mechanisms underlying the efficacy of motivational interviewing may better inform future discussions of these ethical concerns that pertain to psychotherapy more generally.

THE IMPACT OF BRIEF MOTIVATIONAL INTERVENTION AT THE START OF AN OUTPATIENT DAY PROGRAMME FOR ALCOHOL DEPENDENCE

2000 ◽  
Vol 28 (2) ◽  
pp. 121-130 ◽  
Author(s):  
Samantha Dench ◽  
Gerald Bennett
Keyword(s):  
Alcohol Dependence ◽  
Readiness To Change ◽  
Drop Out ◽  
Drinking Behaviour ◽  
Motivational Intervention ◽  
Problem Recognition ◽  
Post Intervention ◽  
Brief Motivational Intervention ◽  
Motivation For Change ◽  
The Impact

Motivational intervention, a strategy to increase motivation for change, was tested as an addition to treatment at the start of an outpatient programme for alcohol dependence. Admissions to the programme were randomly allocated to either a motivational or educational procedure. The three motivational constructs of the SOCRATES-8A Readiness to Change questionnaire (Ambivalence about change, Recognition of problems, Taking Steps to change) were used as measures of motivation for change. At one week post-intervention, motivational participants reported significantly greater levels of problem recognition. The motivational group's post-intervention scores were significantly higher on the Taking Steps scale and significantly lower on the Ambivalence scale. There was no difference on measures of engagement in treatment or drop-out from the outpatient treatment programme. For the population as a whole, a relatively low pre-intervention score on the Ambivalence scale was predictive of drop-out. Results support the efficacy of motivational intervention for decreasing self-reported levels of ambivalence about change and for increasing problem recognition and taking steps towards change. More detailed research with a longer follow-up period is needed to determine whether this has any impact on other vectors of motivation for change, including participation in treatment, outcome expectancy and drinking behaviour.

scholarly journals Big Data: Some Ethical Concerns for the Social Sciences

2021 ◽  
Vol 10 (2) ◽  
pp. 36
Author(s):  
Michael Weinhardt
Keyword(s):  
Social Sciences ◽  
Big Data ◽  
Ethical Issues ◽  
Online Behavior ◽  
Ethical Concerns ◽  
Ethical Implications ◽  
The Social ◽  
And Behaviors ◽  
State Actors

While big data (BD) has been around for a while now, the social sciences have been comparatively cautious in its adoption for research purposes. This article briefly discusses the scope and variety of BD, and its research potential and ethical implications for the social sciences and sociology, which derive from these characteristics. For example, BD allows for the analysis of actual (online) behavior and the analysis of networks on a grand scale. The sheer volume and variety of data allow for the detection of rare patterns and behaviors that would otherwise go unnoticed. However, there are also a range of ethical issues of BD that need consideration. These entail, amongst others, the imperative for documentation and dissemination of methods, data, and results, the problems of anonymization and re-identification, and the questions surrounding the ability of stakeholders in big data research and institutionalized bodies to handle ethical issues. There are also grave risks involved in the (mis)use of BD, as it holds great value for companies, criminals, and state actors alike. The article concludes that BD holds great potential for the social sciences, but that there are still a range of practical and ethical issues that need addressing.

Motivational Interviewing: A Special Ethical Dilemma?

1995 ◽  
Vol 23 (4) ◽  
pp. 335-339 ◽  
Author(s):  
Jacqueline M. J. Withers
Keyword(s):  
Motivational Interviewing ◽  
Behaviour Change ◽  
Ethical Dilemma ◽  
Ethical Issues ◽  
Life Goals ◽  
Psychological Interventions ◽  
Problem Behaviour ◽  
General Sense ◽  
Therapeutic Goals ◽  
Motivational Interventions

This paper aims to contribute to the discussion of the ethical issues in motivational interventions which have recently been raised by Miller (1994). Motivational interviewing is typically used when a therapist perceives a need for behaviour change in someone who is ambivalent about such change. Motivational interviewing aims to evoke motivation by making salient the inconsistency of continuing with a problem behaviour and other longer term or wider life goals. Miller (1994) discussed what was manipulative about this approach and considered both a descriptive and evaluative component. The ethics of motivational interviewing are considered here, within the context of psychological therapy in a general sense, and questions whether the ethical issues relevant to motivational interviewing are different from other psychological interventions. A distinction between the goals and the means of obtaining therapeutic goals is suggested as useful.

Commentary: The Broader Context of Long-Term Care Ethics

2016 ◽  
Vol 25 (3) ◽  
pp. 554-556
Author(s):  
Jason Lesandrini ◽  
Carol O’Connell
Keyword(s):  
Care Setting ◽  
Long Term Care ◽  
Ethical Issues ◽  
Term Care ◽  
Ethical Concerns ◽  
Healthcare Settings ◽  
Care Facilities ◽  
Ethics Program ◽  
Made In

Ethical issues in long-term care settings, although having received attention in the literature, have not in our opinion received the appropriate level they require. Thus, we applaud the Cambridge Quarterly for publishing this case. We can attest to the significance of ethical issues arising in long-term care facilities, as Mr. Hope’s case is all too familiar to those practicing in these settings. What is unique about this case is that an actual ethics consult was made in a long-term care setting. We have seen very little in the published literature on the use of ethics structures in long-term care populations. Our experience is that these healthcare settings are ripe for ethical concerns and that providers, patients, families, and staff need/desire ethics resources to actively and preventively address ethical concerns. The popular press has begun to recognize the ethical issues involved in long-term care settings and the need for ethics structures. Recently, in California a nurse refused to initiate CPR for an elderly patient in a senior residence. In that case, the nurse was quoted as saying that the facility had a policy that nurses were not to start CPR for elderly patients.1 Although this case is not exactly the same as that of Mr. Hope, it highlights the need for developing robust ethics program infrastructures in long-term care settings that work toward addressing ethical issues through policy, education, and active consultation.

Mapping the Ethical Issues of Digital Twins for Personalised Healthcare Service (Preprint)

2021 ◽  
Author(s):  
Pei-hua Huang ◽  
Ki-hun Kim ◽  
Maartje Schermer
Keyword(s):  
Ethical Issues ◽  
Digital Health ◽  
Personalised Medicine ◽  
Healthcare Services ◽  
Ethical Values ◽  
Ethical Concerns ◽  
Digital Twins ◽  
Research Gap ◽  
Process Oriented ◽  
Personalised Healthcare

BACKGROUND The concept of digital twins has great potential for transforming the existing healthcare system by making it more personalised. As a convergence of healthcare, artificial intelligence, and information and communication technologies, personalised healthcare services developed under the concept of digital twins raise a myriad of ethical issues. While some of the ethical issues are known to researchers working on digital health and personalised medicine, currently there is no comprehensive review that maps major ethical risks of digital twins for personalised healthcare services. OBJECTIVE This paper fills the research gap by identifying major ethical risks of digital twins for personalised healthcare services. We first propose a working definition for digital twins for personalised healthcare services (DTPHS) to facilitate future discussion on the ethical issues related to these emerging digital health services. We then developed a process-oriented ethical map to identify major ethical risks against each of the different data processing phases. METHODS This research aims to address this research gap by providing a comprehensive analysis of major ethical risks of DTPHSs. Due to the scarcity of literature on DTPHSs, we are unable to perform a systematic review of ethical concerns over DTPHSs. Thus, we resort to literature on eHealth, personalised medicine, precision medicine, and information engineering to identify potential issues. We develop a process-oriented ethical map to structure the inquiry in a more systematic way. The ethical map allows us to see how each of the major ethical concerns emerges during the process of transforming raw data into valuable information. RESULTS The process-oriented ethical analysis identified ten operational problems and the relevant ethical values. By structuring the operational problems and relevant ethical values in a clear logical flow, this process-oriented ethical map allows developers of DTPHSs and stakeholders to have a comprehensive overview of major ethical risks while refining the design of DTPHSs. The ethical values section on the map also helps developers of DTPHSs better understand which values they ought to consider while developing solutions for an operational problem they encounter.   CONCLUSIONS It is challenging to address all of the major ethical risks a DTPHS might encounter proactively without a conceptual map at hand. The process-oriented ethical map we propose here can assist developers of DTPHSs in analysing ethical risks in a more systematic manner. CLINICALTRIAL N/A

scholarly journals Jogo patológico e motivação para mudança de comportamento

2009 ◽  
Vol 21 (2) ◽  
pp. 345-361 ◽  
Author(s):  
Cristiane Cauduro de Souza ◽  
Jaqueline Garcia da Silva ◽  
Margareth da Silva Oliveira ◽  
Simone Armentano Bittencourt ◽  
Suzana Dias Freire
Keyword(s):  
Motivational Interviewing ◽  
Pathological Gambling ◽  
Stages Of Change ◽  
Web Of Science ◽  
Readiness To Change

O Jogo Patológico é um transtorno com impacto significativo na sociedade, acarretando prejuízos sociais, financeiros e emocionais aos indivíduos. Neste artigo, realizou-se uma revisão sobre a patologia que envolve o hábito de jogar e as possibilidades terapêuticas envolvidas, principalmente o aspecto motivacional como fator essencial no tratamento. Considerando que a motivação para mudança é um importante aspecto a ser considerado na elaboração de estratégias e intervenções nesta patologia, a presente revisão relaciona o Jogo Patológico com o tema da motivação para mudança. Foram consultadas as bases de dados Pschynfo, Web of Science, Medline e Lilacs com os descritores pathological gambling, gamblers, treatment, stages of change, motivational interviewing e readiness to change, entre 1990 e 2008. Também foram analisados livros e artigos que não se encontravam nas referências das fontes indexadas. Da literatura científica pesquisada, observou-se que a maioria dos estudos sugere mais pesquisas com ensaios controlados para tratamento desta patologia e ressalta que a motivação do paciente parece ser fundamental como fator preditivo em qualquer modalidade terapêutica.

scholarly journals The ethical concerns of seeking consent from critically ill, mechanically ventilated patients for research – A matter of possessing capacity or surrogate insight

2018 ◽  
Vol 13 (3) ◽  
pp. 107-111 ◽  
Author(s):  
Avelino C Verceles ◽  
Waqas Bhatti
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Informed Consent ◽  
Critically Ill ◽  
Ethical Issues ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Ethical Concerns ◽  
Multiple Factors ◽  
Ventilated Patients

Conducting clinical research on subjects admitted to intensive care units is challenging, as they frequently lack the capacity to provide informed consent due to multiple factors including intensive care unit acquired delirium, coma, the need for sedation, or underlying critical illness. However, the presence of one or more of these characteristics does not automatically designate a potential subject as lacking capacity to provide their own informed consent. We review the ethical issues involved in obtaining informed consent for medical research from mechanically ventilated, critically ill patients, in addition to the concerns that may arise when a legally authorized representative is asked to provide informed consent on behalf of these patients.

scholarly journals ETHICAL CONCERNS REGARDING MALE CIRCUMCISION CULTURE: A SELECTED ETHNICAL GROUP

2017 ◽  
Vol 5 ◽  
pp. 737-740
Author(s):  
Cabangile N. Ngwane
Keyword(s):  
Male Circumcision ◽  
Ethical Issues ◽  
Cultural Practices ◽  
Target Population ◽  
Way Of Life ◽  
Community Culture ◽  
Ethical Concerns ◽  
Indigenous Group ◽  
Values And Beliefs ◽  
Hiv Aids

: Traditional cultural practices reflect values and beliefs of members of a community. Culture is an umbrella term, which explains common things people share such as language, customs, beliefs and the way of life. This paper seeks to look at male circumcision culture of a certain indigenous group in South Africa. Male circumcision is associated with ethnic marks, virility, masculinity, rite of passage to manhood however, there are many ethical concerns centering on male circumcision. Hence, this paper seeks to explore the ethical concerns surrounding male circumcision culture of a selected ethnical group in order to contribute to ethical execution of the practice. Little has been done on ethical issues surrounding male circumcision. The fallacy surrounding this phenomenon needs further investigation. The paper intends to contribute to the debate on male circumcision as a way of mitigating HIV/AIDS infections. The Social Norm Theory has been used to explain the phenomenon under study. The constructivist research paradigm enabled the interviewing of participants from the target population, as the study is inductive in nature. The key finding was that they do male circumcision mostly in an unethical way that it also affects women and children. They also do it based on the misconception and the fallacy that they will not get HIV/AIDS.

Ethical concerns in Neonatal Intensive Unit: A Case Analysis

2021 ◽  
pp. 247-250
Author(s):  
Alma Juliet Lakra ◽  
Monica Rita Hendricks
Keyword(s):  
Neonatal Sepsis ◽  
Ethical Issues ◽  
Quality Care ◽  
Family Members ◽  
Case Analysis ◽  
Hypothetical Case ◽  
Neonatal Nurses ◽  
Ethical Concerns ◽  
The Family ◽  
Ethical Perspectives

Neonatal nurses frequently encounter neonatal ethical issues related to provision of safe and quality care and communication in the NICU setup. This article discusses the hypothetical case of baby John diagnosed with neonatal sepsis. The ethical perspectives related to care and communication with the family members while their baby is receiving treatment in the NICU will be explored through the application of the QUAR framework.

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