Friday, September 12, 2008

Moral and Ethical Assumptions in Counseling

Moral and Ethical Assumptions in Counseling
a. Principle ethics
i. The belief that you have to strictly codify “right” and “wrong” behavior
(1) Usually what gets codified is a socially constructed understanding that itself draws from commonly held general principles in the population
ii. Ethical codes are written very broadly, specific situations are mentioned only rarely, which can be frustrating if you need help with a particular ethical issue
(1) Scene in the Simpson’s Movie “There’s no answers here!”
(a) Same problem with ethical codes, they present a mindset, general rules for ethical behavior
(b) In essence, the ethical codes are necessary (they form a base) but not sufficient (they are necessarily broad and imprecise)
iii. Ethics specify behavioral guidelines for a given group of people
(1) Club membership
(a) You can break ethics sometimes without breaking the law
(2) Law specifies what you can’t do legally
(a) Goes for everybody, can land you in jail if you break them
(3) You know you’re in legal trouble if:
(a) Legal proceedings have been initiated
(b) Lawyers are involved
(c) You are in danger of having a complaint of misconduct filed against you
iv. Sometimes the law and the code don’t get along
(1) What you are ethically bound to do may be legally problematic
(a) Consult a lawyer (hate to say it, but it’s true)
(i) Issues due to counseling minors, ethics vs. law
(2) Some ethics codes (like APA) specify that if there is a contradiction between the law and the code, obey the law in a manner to best approximate the ethical code
b. Principle ethics is a philosophical orientation towards “right” behavior
i. Establishing a set of obligations and the methods to meet said obligations
ii. Using said method to solve a dilemma/dilemmas
iii. Use the framework to solve future dilemmas
(1) It’s very “rule-focused”
c. Virtue ethics are aspiration-al
i. Four philosophical core virtues:
(1) Prudence
(2) Integrity
(3) Respectfulness
(4) Benevolence
ii. Here’s a sample list of virtue ethics in psychology
(1) 1. Autonomy
(a) Self-determination, freedom to choose
(i) We shouldn’t interfere with that
1) But often we do
(b) This is one of the reasons why it is so important to be aware of one’s own values
(c) We won’t know we’re pushing a moral agenda unless we know we have one
(i) Always present clients options, even if you don’t like some of them
(2) 2. Nonmaleficence
(a) Avoid doing harm (actively or passively)
(i) Vindictiveness disturbingly common in our field
1) “I’m giving them what they deserve”
2) Fine line sometimes between tough love and just petty meanness
a) Be aware of cultural differences when diagnosing
i) “White man’s clinic”
(3) 3. Beneficence
(a) Promote “good” for others
(i) Defined as “dignity and welfare”
1) Loaded with assumptions . . .
(b) Note that this particular virtue is PRO-active
(i) Have you done any good in the world today?
1) Be aware of the client’s context and what “good” is for them
2) Don’t dismiss your own “good” but try to find a middle ground with them
3) One culture CAN positively inform another culture
a) What I learned about the value of extended family
(4) 4. Justice
(a) Be fair to everyone, don’t have double-standards
(i) Justice is an issue when interventions don’t work, or are harmful with certain populations
(ii) Justice is an issue when assessments work for one group, but not another (yet are claimed to be valid)
(iii) Justice is an issue when you have a double-standard in your pro-bono work
(iv) Justice is an issue when you give certain clients the benefit of the doubt and not others . . .
(5) 5. Fidelity
(a) You make a promise, you keep that promise
(i) Your word becomes FACT
(ii) You are LOYAL to your clients
(iii) You need to live up to your end of informed consent
(iv) Clients need to trust the therapeutic relationship
1) My own experience with counseling
a) My counselor no-showed to 50% of our sessions
(6) 6. Veracity
(a) Closely related to fidelity
(b) Be truthful with your clients
(i) Lies of commission vs. lies of omission
(ii) Painful honesty is sometimes required of us
(iii) Clients need to know that they can trust what you say
(iv) “I’m going to speak to medical to see if we can get you an appointment sooner”
1) By golly, you’d better go and chat with medical
2. Ethics do not arise in a vacuum
a. They are themselves philosophical ideas, loaded with assumptions
b. Note that ethical virtues (and ethical principles) focus around helping an individual, usually to feel better or behave more productively. This is a fundamental assumption of counseling theory
c. We, as a society, very much value such worthy ideas as individual freedom, happiness, and the inherent rights of the individual
i. This has HUGE positive benefits
(1) Freedom from oppression, repression, and arbitrary authority
(2) Both individually and socially
(3) The ability to choose one’s own destiny
(a) Counseling both mirrors society and magnifies it
(i) We help perpetuate both the positive and negative of these values
d. Psychology furthers the modern ethos of the importance of individual rights, freedoms, and pursuits of happiness
i. The individual, however, is seen as a “bounded, masterful self”, its own source of happiness and misery (Cushman)
ii. A “punctual” self, a singular point of consciousness, radically disconnected from other points of consciousness (also Cushman)
(1) Denies the power of relationality
(2) Denies powerful moral obligation, responsibility, etc.
(a) “Only you can make you happy”
(i) WHAT?????
e. Pursuit of individual happiness and the good life are certainly worthwhile goals
i. Possible unfortunate side-effects of this:
(1) People looking out for themselves and their own benefits first, without concern to greater societal needs
(2) Greater disconnection with others as people increasingly look within for meaning
(3) Go to psychotherapists to ameliorate the necessary anomie that accompanies this
(4) Only to have it perpetuated by individualistic therapy
f. Another effect of the individualistic nature is the centrality of meaning in the self
i. The individual knows, subjectively, what the source of his or her individual happiness is
ii. Given that happiness is the ultimate goal, and only the individual knows what will make them happy, the individual is the ultimate arbiter of what is “best”
(1) All individuals differ - what is ultimately best differs
3. The issue of Relativism
a. Constructionists object to the individualism of psychology
i. Posit instead that meaning is not located within a given individual, but rather within the meanings created by society
ii. We are, rather than completely, ontologically, separated from others, we are instead co-constructed by society, fundamentally inseparable from others in society
b. Although constructionism does a lot to explain our engagement with society and meaning, there is still a problem: If moral meaning comes from society, and societies differ, morals are relative to societies
i. Where do individual cultures end?
(1) Countries, states, counties, religions organizations, fraternities, families, even individuals
ii. Different approach, same ultimate problem
c. Disadvantages of relativism
i. It allows us to treat crucial moral concerns as items for “ironic play” in our counseling
ii. We have to treat them as serious to respect the clients, but they can’t really be serious because everything is relative - ironic
iii. Cultural clashes are inevitable
(1) “I’ll only see the counselor if she’s Catholic” (Mormon, Baptist, Buddhist, etc.)
(a) “Will he respect my values, even though the culture of psychology denies the validity of values?”
(2) “Men’s milk” – you would be legally obligated to report abuse
(3) Relativism is inconsistent
(4) Could it be that we don’t feel values are fundamentally relative?
(a) When we feel strongly about things we do not feel that our emotion is invalid or stupid
(i) If everything is relative, why fight, why advocate, why change?
1) Why is happiness “good?”
a) Why would anyone want to perpetuate happiness except for very relativistic (and ultimately invalid) reasons?
(5) Illogical “the ultimate truth is that there is no truth”
(a) The ultimate in living truthfully is to live as though truthful living was impossible . . .

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