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.

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.

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).

Implement the Decision

2021 ◽  
pp. 154-169
Author(s):  
James C. Raines ◽  
Nic T. Dibble
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Ethical Decision Making ◽  
Golden Rule ◽  
Decision Making Process ◽  
Positive Outcomes ◽  
Course Of Action ◽  
Fiduciary Responsibility

Implementing the decision begins by double-checking that the course of action that is chosen passes six ethical tests prior to enactment. The chapter focuses on six final checks: the Golden Rule, fiduciary responsibility, justice and fairness, publicity, universality, and mitigation of harm. It recommends that mental health professionals be prepared to justify the decision by managing criticism. Criticism can be assuaged by emphasizing protection of the client, a focus on the present, and the positive outcomes achieved. It recommends that clinicians document their ethical decision-making process and use established parameters to justify their decision.

scholarly journals Principals’ moral agency and ethical decision-making: Towards transformational ethics

2015 ◽  
Vol 10 (5) ◽  
Author(s):  
Sabre Lynn Cherkowski ◽  
Keith D Walker ◽  
Benjamin Kutsyuruba
Keyword(s):  
Decision Making ◽  
Transformational Leadership ◽  
Moral Agency ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Best Interests ◽  
Leadership Responsibility ◽  
Decision Making Processes ◽  
The One ◽  
The Cost

This descriptive study of the ethical decision-making among a group of Canadian principals provides a rich portrait of how and why principals engage their moral agency through their decision-making processes. Using a leadership responsibility framework linking moral agency and transformational leadership, the researchers found that: modeling moral agency is important for encouraging others to engage their own moral agency in the best interests of all children; despite efforts to engage in collaborative decision-making, principals are often faced with the reality that they are the one to absorb the cost of the decisions; and principals tend to engage less often in transformational aspects of leadership as part of the decision-making process. More research is needed to understand how school leaders can engage more often and more substantially in transformational leadership among their teachers and staff and how they build moral agency capacity in their schools.

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