KIN 401 Ethics

• What are Professional Ethics?


  The analysis & determination of how members of a group of professionals ought to act when judged against a system of values & are fundamentally aspirational in nature & focus on the highest ideals of human awareness, intentions, reasoning, & behaviour
• What are values?


  Concepts of what is good & are acknowledged in thought & action
• What is required to be in a profession?

  1. Must be an intellectual activity based on a particular body of knowledge, rather than routine
  2. Practical rather than theoretical
  3. Orientated toward service to society
• What is the only province/territory to not have professional regulations in Canada?

  Yukon
• What are professional regulations?

  Regulations that protect the public by setting standards for admitting members into the profession, identifying members at risk to harm the public, & sanctioning those who have harmed a recipient
• What are entrance standards?


  Standards that are necessary to prepare someone to safely offer services to the public under the title of their profession
• What are regulatory practice standards/standards of professional conduct?

  Set minimum prescriptive & proscriptive standards of professional behaviour
• What is an ethical dilemma?

  A situation that requires ethical action but the professional is required to perform 2 or more mutually exclusive actions

  • Ethical principles are in conflict
  • can be ethical residue following a situation
• What is deontological ethics (principlism)?


  * Categorical Imperative (Kant):

  • commands/moral laws person must follow regardless of their desires & extenuating consequences

  *Principle-Based:

  • rightness or wrongness of act
  • practitioners act on & follow out of an internal sense of duty
  • principles are not negotiable
  • based on a finite number of principles (Respect for autonomy, nonmaleficence, beneficence, & justice)
  • principles are overarching, but should not be the only guide to ethical behaviour
• What is teleological ethics (consequentialism, utilitarianism)?


  The good is determined by the consequences of the act

  2 Subtypes-

  • Act Utilitarianism: an act is evaluated on the consequences it produces in a particular situation & the balance of good over bad
  • Rule Utilitarianism: an act is right if the rule dictating the act maximizes happiness or the greatest good for the greatest number (hybrid consequentialism & principlism)
• What are relational ethics (ethics of care, feminist ethics)?

  * Relational

  • importance of personal relationships
  • values consensus, social context, & cooperation
  • each act is right or wrong based on the impact on the relationships of people involved
  • ethical act= caring towards someone else
  • looks at qualitative importance of relationships when deciding action
• What are virtue ethics (character ethics)?

  Excellence of character

  * people who have these virtues engage in ethical acts

  • an action is right if it is what a virtuous agent would characteristically do
  • focuses on the qualities professionals should develop & the character that should be developed to reach profession's goals
  • 5 focal virtues (compassion, discernment, trustworthiness, integrity, conscientiousness)
• What are relative ethics?

  Recognizes that moral values differ from person to person, culture to culture, & period of time to period of time

  • no moral standards are absolute
  • individuals must bear responsibility for ethical decision making, rather than relying on principles
• What are new casuistry?

  Focuses on concrete cases & analysis of cases, & derives ethical principles from those cases

  *bottom up process from cases to principles
• What are the components of moral behaviour?

  • moral sensitivity
  • moral reasoning
  • moral motivation
  • moral character
• What is moral sensitivity?


  Recognizing a situation has implications for the welfare of someone else
• What is moral reasoning?


  Thinking through the alternative once the situation has been recognized as having moral dimension
• What is moral motivation?


  Once options are evaluated, the next step is to decide whether or not to follow through on the ethical choice
• What is moral character?


  Carrying out a moral action to its conclusion

  *sometimes uncomfortable & comes at personal cost
• Relationship between 4 Ethical Perspectives

  
• What are ethical principles?

  • Autonomy: freedom to make one's own choices & take actions based on one's own personal values & beliefs
  • Nonmaleficence: obligation to do no harm upon others
  • Beneficence: obligation to act for the benefit of others
  • Justice: fair, equitable, & appropriate treatment of others
  • Fidelity: fulfilling one's responsibility of trust
  • Veracity: truthfulness
• What are focal virtues?

  • Compassion: regard for another's welfare & an awareness of misfortune & suffering
  • Discernment: being able to make fitting adjustments without being unduly influenced by extraneous factors
  • Trustworthiness: warranting confidence in one's character & conduct
  • Integrity: knowing one's own personal ideals & being faithful to them
  • Conscientiousness: acting to determine what is right, intend to do what's right, & putting effort towards doing what is right
• What are code of ethics?

  Prepared & governed internally be each profession

  *International, National, Provincial

  *Broader, set of principles
• What are code of conducts?

  Prepared & governed internally within a specific context

  *Some professions include codes of conduct with codes of ethics

  *Principles & rules
• What are types of codes?

  • Aspirational: broadly worded ideals & principles that don't define any precise right or wrong behaviour *Strong recommendations but not enforceable (pro bono work)
  • Educational: combines ethical principles with explicit interpretations to help professionals make informed decisions in moral ambiguous contexts
  • Enforceable: set of standards that describes behaviours required & proscribed by the profession
• What are functions of professional codes of ethics?

  • set standards for professional work
  • safeguard interest of clients
  • internal control mechanism
  • guidance
  • protect professionals from outside intervention & supervision
  • preserve public trust in professionals
  • ensure status of profession & legitimacy of remuneration
  • protect rights of professionals against unfounded complaints
• What are limitations of codes of ethics?

  • application to any one setting/situation is limited (diverse populations, variety of activities)
  • professions change rapidly (codes reflect what is agreed upon, not ethical ideal)
  • sometime focus too much on minor issues
  • not cookbooks for responsible behaviour
• CPA (Canadian Psychological Association) Decision Making Model

  1. Identify who is potentially affected by decision

  2. Identify ethically relevant issues & practices (interests, rights, characteristics of those involved)

  3. Consideration of own personal bias, stress, & self interest

  4. Develop alternative course of action

  5. Analysis of short & long term risks & benefits of each course of action

  6. Choice of action after "conscientious application" of existing principles, values, & standards

  7. Action, with commitment to assume responsibility

  8. Evaluation of results

  9. Assume responsibility, including correcting negative consequences or re-engaging in ethical decision-making model

  10. Appropriate action to prevent further occurrences of dilemma
• CCA Decision Making Model

  1. Identify key ethical issues

  2. Identify relevant articles from the codes of ethics

  3. Identify ethical principles relevant to situation

  4. Consider how principles can be applied & possible conflict among principles

  5. Consider personal feelings & intuitions

  6. Identify appropriate plan of action
• Virtue-Based Ethical Decision Making

  1. Consider personal feelings/intuitions

  2. Consider how personal values can show caring for client

  3. Consider how decision affects others

  4. Consider what decision you feel best publicizing

  5. Consider what decision best defines you as a person
• What two conditions are essential for autonomous decisions?

  • Liberty: independence from controlling influence
  • Agency: capacity for intentional action
• What fundamental ethical principle underlies the precepts of confidentiality?

  Respect for autonomy affirms the right to decide who has access to information

  Honouring confidentiality demonstrates the ethical virtues of integrity, trustworthiness, & respectfulness
• What are the limits of confidentiality?


  *could be based on specific profession

  • client request for release of information
  • court orders
  • client complaints & litigation
  • provincial law (parental legal right to information)
  • duty to warn & protect(report other health professionals in cases of incompetence, sexual misconduct, hospitalization for psychiatric care/treatment for dugs & alcohol
• What is meant by non-maleficence?

  The obligation not to inflict harm on others

  * First do no harm (a client should leave you no worse than when they came to see you)

  *Also includes avoiding preventable risks of harm

  *evaluate risks of their activities with clients
• What is mean by beneficence?

  The obligation & responsibility to do good

  *principles of beneficence demand much more than the principle of nonmaleficence because agents must take positive steps to help others, not merely refrain from harmful acts

  Positive Beneficence: providing benefit to others

  Utility: balancing of benefits, risks, & costs to produce the best overall results
• What are the components of professional competence?

  *Incompetent practice increases harm to a client & decreases potential for helping

  • Knowledge: being schooled in the history, theory, & research of one's field, including knowing limits of current understanding (continuous study & education)
  • Skill: being able to apply knowledge in work with clients
  • Judgement: knowing when to apply knowledge & skills in particular circumstances
  • diligence: consistent attentiveness to client needs, & working hard to help them (avoiding unnecessary risks)
• What are professional boundaries?

  The role expectations of the professional-client relationship, where most ethical expectations are enacted

  * protects the client & professional

  * maintain safe working environment
• What are boundary violations?

  Failure to keep the professional relationship within the required roles & expectations
• What are dual/multiple relationships?


  Relationships with a client that are secondary to professional relationship (or multiple professional relationships)

  *secondary relationship could compromise the judgement of the professional & the clients response to service (potential to slippery slope to other unethical conduct, such as sexual relationships & breach of confidentiality)

  *Multiple professional roles might also present a conflict as to where professional loyalty lies
• What is temperance?

  Character trait of moderation & self-restraint

  *reflects self control

  *encourages self-reflection & alignment with professional goals & ethical standards