Psychiatric ethics as professional and biomedical ethics -- The distinctiveness of the psychiatric setting -- Psychiatric ethics as virtue ethics -- Elements of a gender-sensitive ethics for psychiatry -- Some virtues for psychiatrists -- Character and social role -- Case studies in psychiatric virtues.

Stay up-to-date on the ethical and legal issues that affect your clinical and professional decisions! Ethical and Legal Issues for Mental Health Professionals: A Comprehensive Handbook of Principles and Standards details the ethical and legal issues that involve mental health professionals. Respected authorities with diverse backgrounds, expertise, and professional experience discuss contemporary theories emphasizing professional ethics, the ramifications of professional actions and decisions, and ethical standards on teaching, training, research, and publication. This informative handbook provides invaluable (...) up-to-date information and guidelines vital for every mental health professional. This book is a thorough examination of ethical behavior which can be used as a reference source for the professional or a textbook for graduate students. The handbook itself is divided into five sections. The first section is a detailed introduction of ethics, law, and licensing. The second section presents general ethical principles like competence, integrity, and respect for individual rights and dignity. The third section examines confidentiality, privilege, consent, and protection. The fourth section focuses on general ethical standards in practice, including sexual contact, multiple relationships, and bartering. The fifth section presents the ethical principles and standards in teaching, training, and research. Appendices include the Ethical Principles of Psychologists and Code of Conduct (American Psychological Association, 2002) and the Code of Ethics of the National Association of Social Workers (National Association of Social Workers, 1999). Ethical and Legal Issues for Mental Health Professionals: A Comprehensive Handbook of Principles and Standards discusses: the history of basic approaches and issues in ethical philosophy five fundamental areas in the process of developing competence the necessary ingredients for the mental health professional's practice of integrity aspirational versus enforceable standards of ethics concern for the welfare of others as a core ethical principle the notion of social responsibility in the ethics codes of psychologists and social workers ethical principles, statutes, and case law protecting privacy and confidentiality issues involving the therapist-patient privilege the "duty to protect" doctrine and relevant legal issues the dynamics of multiple relationships and boundary violations sexualized dual relationships between psychologists and patients possible conflict of interest in bartering for services the requirements and implementation of maintaining patient records to avoid ethical and legal problems possible ethical dilemmas involving referrals and fees much, much more This Handbook is an essential resource for all mental health professionals, including psychologists, psychiatrists, social workers, counselors, therapists, and graduate students in mental health and the related fields. Ethical and Legal Issues for Mental Health Professionals: A Comprehensive Handbook of Principles and Standards is the first of three volumes under this title. The following volumes will focus on forensic settings and special populations/special treatment modalities. (shrink)

By way of a case story, two common presuppositions in the academic debate on conscientious objection in healthcare are challenged. First, the debate typically presupposes a sharp division between conscience-based refusals based on personal core moral beliefs and refusals based on professional reasons. Only the former might involve the moral gravity to warrant accommodation. The case story challenges this division, and it is argued that just as much might sometimes be at stake morally in refusals based on professional (...) reasons. The objector's moral integrity might be equally threatened in objections based on professional reasons as in objections based on personal beliefs. Second, the literature on conscientious objection typically presupposes that conflicts of conscience pertain to well-circumscribed and typical situations which can be identified as controversial without attention to individualising features of the concrete situation. However, the case shows that conflicts of conscience can sometimes be more particular, born from concrete features of the actual situation, and difficult, if not impossible, to predict before they arise. Guidelines should be updated to address such ‘situation-based’ conscientious refusals explicitly. (shrink)

Se realiza una revisión bibliográfica con el objetivo de analizar los diferentes códigos éticos y deontológicos internacionales, regionales y nacionales de los que se nutre la especialidad de psiquiatría. Se concluye que el comportamiento ético se basa en el sentido de la responsabilidad individual de cada psiquiatra hacia cada paciente y en la capacidad de ambos para determinar cuál es la conducta correcta y más apropiada. Las normas externas y las directrices, tales como los códigos de conducta profesional, las aportaciones (...) de la ética y de las normas legales, no garantizan por sí solas la práctica ética de la medicina, pero constituyen un importante marco referencial. A literature review was performed with the objective of analyzing the various international, regional and national ethical and deontological codes that the psychiatry specialty feeds on. It is concluded that ethical behavior is based on the sense of individual responsibility of each psychiatrist to each patient and the ability of both to determine what the correct and appropriate behavior is. External standards and guidelines, such as professional codes of conduct, the study of ethics and legal standards alone do not guarantee the ethical practice of medicine but are an important framework. (shrink)

Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of ‘bricolage’ which means our approach was inductive. Most participants report (...) positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices. (shrink)

This second paper explores psychiatrists’ ethical obligations in the face of the failure of the social contract – inherent failures in distributive justice, the failure of the sovereign and the reconstitution of the social contract in post-conflict societies. Such situations present many sources of ethical tension between the professional ethical obligations of psychiatrists to their individual patients and to their society.

Over the course of an illustrious career, the late Bernard Diamond established himself as the preeminent forensic psychiatrist of the century. _The Psychiatrist in the Courtroom_ brings together in a single volume Diamond's pivotal contributions to a variety of important issues, including the nature of diminished capacity, the fallacy of the impartial expert, the predictability of dangerousness, and the unacceptability of hypnotically facilitated memory in courtroom proceedings. Ably introduced and edited by Jacques M. Quen, M.D., a close colleague of Diamond's (...) and leading historian of forensic psychiatry, these writings enable experts and neophytes alike to track Diamond's evolving positions while clarifying where current legal and psychiatric opinion converge -- and diverge -- on a host of critical topics. For the forensic specialist, _The Psychiatrist in the Courtroom_ is not only an invaluable reference work but a compassionate reminder of the clinician's obligation to protect patients in legal proceedings. And in an age when clinicians are increasingly called into court, the book will be no less valuable to psychoanalysts and other mental health professionals eager for an introduction to the intricacies of judicial reasoning. Then, too, owing to Diamond's clinical acumen, the book is a compelling human document. With great erudition and deep compassion, Diamond tackles these and other knotty questions, always with an eye to clarifying the legal and clinical implications of the answers. By combining superb clinical gifts with an incisive understanding of legal principle, Diamond produced a seminal corpus whose relevance to discussions of therapeutic ethics and to legal debates will continue well into the next century. (shrink)

Relationships between patients and psychiatrists are shaped by a complex array of factors. The clinical experience centers on diagnostic and treatment decisions occurring in the context of a structured relationship that is regulated by principles of professional ethics and personal boundaries. At the same, however, patients and psychiatrists are unique and autonomous agents with emotional responses to one another that may evoke a wish for a personal friendship or other sorts of personal relationships that are outside the (...) bounds of the usual professionally defined structures. Negotiating the tension between the need for professional regulation and the desire for developing a friendship with certain patients can present clinical and ethical challenges in psychiatric practice. Pragmatist reasoning can help the psychiatrist and patient to successfully negotiate the dilemma that may arise when either or both of them wishes to develop a personal friendship but still adhere to the ethical tenets of the patient/psychiatrist professional dyad. (shrink)

Genealogy of the treatment model -- Expert knowledge and encounters with futility -- Treatment plans : mandatory narratives of progress -- Representative payeeships : the deep logic of dependency -- Commitment orders : the practice of consent and constraint -- Coercion, confidentiality, and the moral contours of work.

Objectives: To identify ethical attitudes about involuntary admission (known in Great Britain as formal admission) in mental health professionals and lay-people in England and Germany, especially looking at possible differences between Mental Health Professionals who are directly involved in the involuntary admission process and those who are not.Method: Three scenarios of potentially certifiable patients (known in Great Britain as sectionable patients) were presented to identify attitudes. A questionnaire asked about attitudes towards involuntary admission as well as treatment. A questionnaire analysis (...) was then performed.Results: There were similar attitudes towards involuntary admission between laypeople and mental health professionals involved in the involuntary admission process with the exception of professionals not actively involved in the involuntary admission process. Neither personal or professional experience with mental illness nor the different legal frameworks between Germany and England influenced attitudes much. Support for involuntary admission broadly increased with age.Conclusions: Psychiatrists and other mental health workers are in tune with society with regards to attitudes to involuntary admission. People involved with mentally ill patients but not in the involuntary admission process have negative attitudes towards involuntary admission. This may influence Mental Health Tribunals suggested in the new draft Mental Health Bill (2002) for England and Wales, because these Tribunals will potentially lack any involvement of professionals involved in the involuntary admission process. (shrink)

After revelations of participation by psychiatrists and psychologists in interrogation of prisoners at Guantánamo Bay and Central Intelligence Agency secret detention centers, the American Psychiatric Association and the American Psychological Association adopted Position Statements absolutely prohibiting their members from participating in torture under any and all circumstances, and, to a limited degree, forbidding involvement in interrogations. Some interrogations utilize very aggressive techniques determined to be torture by many nations and organizations throughout the world. This paper explains why psychiatrists (...) and psychologists involved in coercive interrogations violate the Geneva Conventions and the laws of the United States. Whether done with ignorance of professional ethical obligations or not, these psychiatrists and psychologists have crossed an ethical barrier that may best be averted from re-occurring by teaching medical students and residents in all medical specialties about the ethics principles stemming from the 1946–1947 Nuremberg trials and the Geneva Conventions, together with the Ethics Codes of the World Medical Association and the American Medical Association; and, with regard to psychiatric residents and psychological trainees, by the teaching about The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry and the Ethical Principles of Psychologists and Code of Conduct, respectively. In this way, all physicians and psychologists will clearly understand that they have an absolute moral obligation to "First, do no harm" to the human beings they professionally encounter. (shrink)

Ethical issues are pivotal to the practice of psychiatry. Anyone involved in psychiatric practice and mental healthcare has to be aware of the range of ethical issues relevant to their profession. An increased professional commitment to accountability, in parallel with a growing "consumer" movement has paved the way for a creative engagement with the ethical movement. The bestselling 'Psychiatric Ethics' has carved out a niche for itself as the major comprehensive text and core reference in the field, covering a (...) range of complex ethical dilemmas which face clinicians and researchers in their everyday practice. This new edition takes a fresh look at recent trends and developments at the interface between ethics and psychiatric practice. Coming ten years after the third edition, the editors have observed several emerging aspects of psychiatric practice requiring coverage, as a result, 5 new chapters have been added, including cutting edge topics - such as neuroethics. All other chapters have been fully revised and updated. The book will continue to be essential reading for psychiatrists, psychologists, other mental health professionals, and bioethicists, as well as of interest to policy makers, managers and lawyers. (shrink)

Utilitarianism is one of the “grand Enlightenment” moral philosophies. It provides a means of evaluating the ethical implications of common and unusual situations faced by psychiatrists, and offers a logical and ostensibly scientific method of moral justification and action. In this first of our two papers, we trace the evolution of utilitarianism into a contemporary moral theory and review the main theoretical critiques. In the second paper we contextualize utilitarianism in psychiatry and consider its function within the realm of (...) the professional ethics of psychiatrist as physician, before applying it to two dilemmas faced by psychiatrists as individuals and as members of a profession. We conclude that psychiatry must search beyond utilitarianism in grappling with everyday clinical scenarios. (shrink)

The research questions was: 'How do psychiatrists describe their responses to patients' suicidal deaths in the light of a published model of consolation?' The textual data (n = 5) was a subset of a larger (n = 19) study. Thematic analysis showed a main theme, 'unburdening grief', and six themes. Embedded in the results is a story about suffering that reveals that, through ethical reflectiveness, a meaning of suffering can be recreated that unburdens grief and opens up new understandings (...) with and among disciplines. This can help to prepare health professionals to respond to people who suffer because of suicidal death. (shrink)

In Codes of Ethics and the Professions 12 contributors, including philosophers, historians, lawyers, nurses, psychiatrists, and a journalist seek answers to a range of tough questions. Do we need codes of ethics? How do we go about creating them? Can codes of ethics be misused and abused? How should they be enforced, regulated and revised?

Social welfare workers in the protective services field—among them social workers, psychologists, and psychiatrists—are expected to follow the laws of the state in which they practice, but are also bound by their professional code of ethics. Often this does not present a problem, but at times ethical and legal expectations differ. This is particularly problematic where the professionals may be seen as agents of control, reporting possible child abuse, conducting child abuse investigations, inspecting homes, monitoring families, removing children (...) from their homes and the like, often working with or reporting to law enforcement agents where expectations are different and codes of ethics absent. This paper explores the relationship between law and professional ethics, and, in particular, situations in which actions and decisions can be legal yet unethical or ethical but yet illegal. It then analyzes some critical child protective service activities where Child Protective Services (CPS) workers exert significant control over parents and children, and where the legal and ethical requirements may differ. Finally, the paper discusses the problems that CPS professionals face when law and ethics collide, and suggests various steps to resolve some of these conflicts. (shrink)

Psychologists and psychiatrists recently started using electronic mail (e-mail) to conduct therapy. This article explores relevant ethical and legal issues including, among others, the nature of the professional relationship, boundaries of competence, informed consent, treating minors, confidentiality, and the duty to warn and protect. To illustrate these complex issues, two services currently operating are discussed. To address potential hazards to clients and the profession, a new ethical standard for e-mail therapists is offered.

A murder case that had some features in common with the Tarasoff case occurred in Sasebo City, Japan, in 2014. A 15-year-old high school girl was murdered and her 16-year-old classmate was arrested on suspicion of homicide. One and a half months before the murder, a psychiatrist who had been examining the girl called a prefectural child consultation centre to warn that she might commit murder, but he did not reveal her name, considering it his professional duty to keep (...) it confidential. Article 134 of the Japanese Criminal Law states that doctors should not disclose patient information obtained in clinical practice without a legitimate reason, but the Japanese Supreme Court has not specified what constitutes a legitimate reason. Mass media and commentators suggested that the murder could have been prevented if the psychiatrist had disclosed the girl's name to the authorities or had isolated her coercively in a psychiatric ward. However, the authors disagree with such claims. This article discusses obligations imposed on concerned individuals and third party members in cases involving ethical dilemmas regarding patient confidentiality and information disclosure. It is concluded that everyone should fulfill their obligations to prevent such tragedies and one should judge the appropriateness of others’ actions based not on the consequences of their actions, but on the processes used to decide on a course of action and their commitment. It is necessary for us to establish a society in which concerned parties can do what they think is ethically best without fearing ungrounded charges. (shrink)

Consideration of ethics has established a firm place in the affairs of psychiatrists. An increased professional commitment to accountability, together with a growing "consumer" movement has paved the way for a creative engagement with the ethical movement. Psychiatric Ethics has carved out a niche for itself as a major comprehensive text and core reference covering the many complex ethical dilemmas which face clinicians and researchers in their everyday practice. This new edition takes a fresh look at recent trends (...) and developments at the interface between ethics and psychiatric practice.For this edition, Sydney Bloch and Paul Chodoff are joined by Stephen Green, a clinical professor in ethics and psychiatry at Georgetown University, in leading 29 of the finest scholars in the field from around the world. Eleven new contributors join the team of authors. They include Drs. Beauchamp, Gutheils, Sabin, McGuffin, Szmulter, Gabbard and Holmes. Since the second edition, the editors have observed several emerging aspects of psychiatric practice requiring coverage. As a result, six new chapters have been added covering the ethical aspects of community psychiatry, managed care, psychiatric genetics, resource allocation, codes of ethics and boundary violations. All others chapters have been fully revised and updated.The book will continue to be essential reading for psychiatrists and other mental health professionals, as well as of interest to ethicists, policy makers, managers and lawyers. (shrink)

Character strengths profiles in the specific setting of medical professionals are widely unchartered territory. This paper focused on an overview of character strengths profiles of medical professionals (medical students and physicians) based on literature research and available empirical data illustrating their impact on well-being and work engagement. A literature research was conducted and the majority of peer-reviewed considered articles dealt with theoretical or conceptually driven ‘virtues’ associated with medical specialties or questions of ethics in patient care (e.g., professionalism, or what (...) makes a good physician). The virtues of compassion, courage, altruism, and benevolence were described most often. Only a limited number of papers addressed character strengths of medical students or physicians according to the VIA-classification. Those articles showed that the VIA-character strengthsfairness, honesty,kindness, andteamworkwere considered most often by respondents to be particularly important for the medical profession. Available cross-sectional (time span: six years) and longitudinal (time span: three years) data regarding VIA-character strengths profiles of medical professionals were analyzed (N= 584 medical students, 274 physicians). These profiles were quite homogenous among both groups. The character strengthsfairness,honesty,judgment,kindness, andlovehad the highest means in both samples. Noteworthy differences appeared when comparing medical specialties, in particular concerning general surgeons and psychiatrists, with the former reporting clearly higher levels of e.g.,honesty(d= 1.02) orprudence(d= 1.19). Long-term results revealed significant positive effects of character strengths on well-being and work engagement (e.g.,perseveranceon physicians’ work engagement) but also significant negative effects (e.g.,appreciation of beauty and excellenceon students’ well-being). Further,hopewas significantly associated both positively with physicians’ well-being and negatively with students’ work engagement, possibly indicating specific issues concerning medical education or hospital working conditions. According to the modern-day physician’s pledge, medical professionals should pay attention to their own well-being and health. Therefore, promoting self-awareness and character building among medical professionals could be a beneficial strategy. (shrink)

BackgroundDepressive disorders are a common form of psychiatric illness and cause significant disability. Regulation authorities, the medical profession and the public require high safety standards for antidepressants to protect vulnerable psychiatric patients. Ketamine is a dissociative anaesthetic and a derivative of a hallucinogen. Its abuse is a major worldwide public health problem. Ketamine is a scheduled drug and its usage is restricted due to its abuse liability. Recent clinical trials have reported that ketamine use led to rapid antidepressant effects in (...) patients suffering from treatment-resistant depression. However, various flaws in study designs, and possible biased reporting of results, may have influenced those findings. Further analyses of ketamine use are needed to ensure patient safety.DiscussionThe use of ketamine in research and treatment of depressive disorders is controversial. Recently, mental health professionals raised ethical concerns about an ongoing ketamine trial in the UK. Also, a Canadian agency reviewed the existing evidence and did not recommend prescribing ketamine to treat depressive disorders. Findings obtained from tightly controlled research settings cannot be easily translated to clinical practice as substance abuse is commonly comorbid with depressive disorders. An effective antidepressant should reduce severity of depressive symptoms without liability problems. Although the US FDA has not approved the use of ketamine to treat depressive disorders, some psychiatrists offer off-label repeat prescription of ketamine. Prescribing ketamine for treating depressive disorders requires substantial empirical evidence. Clinicians should also consider research findings on ketamine abuse. Depressive disorders can be chronic conditions and the current evidence does not rule out the risk of substance abuse after repeat prescription of ketamine. Off-label ketamine use in treating depressive disorders may breach ethical and moral standards, especially in countries seriously affected by ketamine abuse. This article presents two real-world clinical vignettes which highlight ethical principles and theories, including autonomy, nonmaleficience, fidelity and consequentialism, as related to off-label ketamine use.ConclusionWe urge clinicians to minimise the risk of harming patients by considering the empirical evidence on ketamine properties and attempting all standard antidepressant therapies before considering the off-label use of ketamine. (shrink)

Suicide is the 10th leading cause of death in the United States and the second cause of death among those ages 15–24 years. The current standard of care for suicidality management often involves an involuntary hospitalization deemed necessary by the attending psychiatrist. The purpose of this article is to reexamine the ethical tradeoffs inherent in the current practice of involuntary psychiatric hospitalization for suicidal patients, calling attention to the often-neglected harms inherent in this practice and proposing a path for future (...) research. With accumulating evidence of the harms inherent in civil commitment, we propose that the relative value of this intervention needs to be reevaluated and more efficacious alternatives researched. Three arguments are presented: (1) that inadequate attention has been given to the harms resulting from the use of coercion and the loss of autonomy, (2) that inadequate evidence exists that involuntary hospitalization is an effective method to reduce deaths by suicide, and (3) that some suicidal patients may benefit more from therapeutic interventions that maximize and support autonomy and personal responsibility. Considering this evidence, we argue for a policy that limits the coercive hospitalization of suicidal individuals to those who lack decision-making capacity. (shrink)

“An original, compelling, and provocative exploration of ethical issues in our society, with thoughtful and balanced commentary. I have not seen anything like it.” —Alan Lightman, author of Einstein’s Dreams Drawing upon the author’s two decades teaching medical ethics, as well as his work as a practicing psychiatrist, this profound and addictive little book offers up challenging ethical dilemmas and asks readers, What would you do? A daughter gets tested to see if she’s a match to donate a kidney to (...) her father. The test reveals that she is not the man’s biological daughter. Should the doctor tell the father? Or the daughter? A deaf couple prefers a deaf baby. Should they be allowed to use medical technology to ensure they have a child who can’t hear? Who should get custody of an embryo created through IVF when a couple divorces? Or, when you or a loved one is on life support, Who says you’re dead? In short, engaging scenarios, Dr. Appel takes on hot-button issues that many of us will confront: genetic screening, sexuality, privacy, doctor-patient confidentiality. He unpacks each hypothetical with a brief reflection drawing from science, philosophy, and history, explaining how others have approached these controversies in real-world cases. Who Says You’re Dead? is designed to defy easy answers and to stimulate thought and even debate among professionals and armchair ethicists alike. (shrink)

Background: The magnitude of bullying and harassment among psychiatrists is reportedly high, yet no peer-review published studies addressing this issue could be found. Therefore, it was decided to conduct a pilot study to assess the degree of the problem, the types of bullying/harassment and to provide some insights into the situation.Methods and Principal Findings: Following multiple focus group meetings, a yes/no response type questionnaire was developed to assess the degree and type of bullying and harassment experienced by psychiatrists. (...) Over a 3-month period the questionnaire was administered to a random sample of 60 psychiatrists. 57 out of the 60 psychiatrists reported harassment and bullying. Frequencies of the following response variables are presented in descending order: rumours 40% ; defamation 20% ; passing remarks 20% ; false accusations 15% ; threats 13.3% ; verbal abuse 13.3% ; unjustified complaints 13.3% ; promotion blocked 13.3% ; humiliation 13% ; bad reference given 10% ; credentials questioned 8.3% ; physical attacks 5% ; termination 5% ; derogatory remarks 1.7% and 1.7% were subjected to personal work. As a result of being subjected to harassment, 66.7% of the psychiatrists did not take any action, whereas 33.3% confronted the person they believed responsible. Asked whether the bullying and harassment caused distress, 18.3% of the psychiatrists did not report any effect, 30% reported mild distress, 40% moderate distress and severe distress was reported by 11.7%.Conclusions: It was concluded that the magnitude of bullying and harassment among psychiatrists may be quite high, as evidenced by this pilot study. There is a need for extensive systematic studies on this subject and to establish strategies to prevent and address this issue at a national and regulatory level. (shrink)

On October 25, 1946, three weeks after the International Military Tribunal at Nuremberg entered its verdicts, the United States established Military Tribunal I for the trial of twenty-three Nazi physicians. The charges, delivered by Brigadier General Telford Taylor on December 9, 1946, form a seminal chapter in the history of medical ethics and, specifically, medical ethics in war. The list of noxious experiments conducted on civilians and prisons of war, and condemned by the Tribunal as war crimes and as crimes (...) against humanity, is by now more or less familiar. That list included: high-altitude experiments; freezing experiments; malaria experiments; sulfanilamide experiments; bone, muscle, and nerve regeneration and bone transplantation experiments; sea water experiments; jaundice and spotted fever experiments; sterilization experiments; experiments with poison and with incendiary bombs. What remains less familiar is the moral mindset of doctors and health care workers who plied their medical skill for morally questionable uses in war. In his 1981 work, The Nazi Doctors, Robert Jay Lifton took up that question, interviewing doctors, many of whom for forty years continued to distance themselves psychologically from their deeds. The questions about moral distancing Lifton raised have immediate urgency for us now. Military medical doctors, psychiatrists and psychologists serve in U.S. military prisons in Guantánamo, Abu Ghraib, Kandahar, and, until very recently, in undisclosed CIA operated facilities around the world where medical ethics are again at issue. Moreover, they serve in top positions in the Pentagon, as civilian and military heads of command, who pass orders and regulations to military doctors in the field, and who are in charge of the health of enemy combatants, as well as U.S. soldiers. Because we recently marked the sixtieth anniversary of the judgment at Nuremberg, I want to awaken our collective memory to the ways in which doctors in war, even in a war very different from the one the Nazis fought, can insulate themselves from their moral and professional consciences. (shrink)

BackgroundWe examine the incidence of medical tribunal decisions and disciplinary actions (DAs) against healthcare professionals (HCPs). In addition, we studied whether an intimate relationship between an HCP and patient as part of the medical tribunal decision is associated with an increased likelihood of disciplinary actions.MethodsWe conducted a nationwide cohort analysis on the downloadable medical tribunal decisions from a medical disciplinary tribunal in the Netherlands from 2010 to 2017.ResultsWe found that 117 (2.8%) of the 4,046 medical tribunal decisions involved an alleged (...) intimate relationship between an HCP and patient. In these medical tribunal decisions the likelihood of a disciplinary action was significantly increased (odds ratio [OR] 12.97, 95% Confidence Interval [95% CI] 7.11–23.64). In addition, we found that nurses and psychiatrists are more frequently accused of and receive disciplinary actions due to intimate relationships than other HCP groups.ConclusionsWe found a limited number of medical tribunal decisions involving an intimate relationship. Especially given the total number of medical tribunal decisions and the number of yearly HCP-patient interactions, the number appears small. Furthermore, an alleged intimate relationship or inappropriate sexual conduct is associated with an increased likelihood of disciplinary action. Future research should obtain statistics on the number of intimate relationships that actually start between HCPs and patients. (shrink)

ObjectiveTo provide insights on emergent ethical tensions experienced by mental health practitioners during system re-organisation, which is sufficiently grounded in empirical data at the local level to inform policy on recovery at institutional and provincial levels.MethodEthnographic methods using narrative and critical phenomenological resources over 24 months.FindingsEveryday ethical tensions emerged at the confluence of different experiences of time, for example, how a context of increasing pressure to decrease patients’ length of stay at the hospital challenged efforts to listen to and advocate (...) for what mattered to patients and maintain the integrity of interventions. In this context, practitioners drew on clinical language and that of personal recovery to strategically ‘push back’, ‘play with’ or ‘take back’ time.DiscussionExamining everyday practices through ethnographic methods can illuminate the everyday ethical tensions that arise when mental health professionals and psychiatrists grapple with, often competing, goods. Critical phenomenological resources can help expand the structural considerations in empirical ethics, excavate underground practices and raise questions about the conceptual categories undergirding normative ethics. Experiencing-with practitioners in clinical contexts as they encounter and creatively resolve ethical tensions also propose a normative ethics of possibility, to help bridge the gap between empirical and normative ethics.ConclusionFocus on the relationship between policy, temporal practices and ethics suggests a reconfiguration of time and re-imagination of ethics in institutional settings in ways that can ultimately benefit patients and professionals alike. (shrink)

This study explored several proposed relationships among professional ethical standards, corporate social responsibility, and the perceived role of ethics and social responsibility. Data were collected from 313 business managers registered with a large professional research association with a mailed self-report questionnaire. Mediated regression analysis indicated that perceptions of corporate social responsibility partially mediated the positive relationship between perceived professional ethical standards and the believed importance of ethics and social responsibility. Perceptions of corporate social responsibility also fully mediated (...) the negative relationship between perceived professional ethical standards and the subordination of ethics and social responsibility. The results suggested that professions should develop ethical standards to encourage social responsibility, since these actions are associated with enhanced employee ethical attitudes. (shrink)

The evolution of the internet and associated social media pose novel challenges for psychiatric ethics. Issues surrounding emotional contagion, personal identity, and misinformation figure importantly among these new challenges, with important consequences for consumers of mental health services, as well as psychiatrists and other mental health professionals. The evolution of the internet and associated social media pose novel challenges for psychiatric ethics. Issues surrounding emotional contagion, personal identity, and misinformation figure importantly among these new challenges, with important consequences for (...) consumers of mental health services, as well as psychiatrists and other mental health professionals. (shrink)

Professional Ethics: A Trust-Based Approach explores the unique nature of professional duty and virtue in light of the trust that professionals must invite, develop, and honor from those they intend to serve.

In Professional Ethics and Civic Morals , Emile Durkheim outlined the core of his theory of morality and social rights which was to dominate his work throughout the course of his life. In Durkheim's view, sociology is a science of morals which are objective social facts, and these moral regulations form the basis of individual rights and obligations. This book is crucial to an understanding of Durkheim's sociology because it contains his much-neglected theory of the state as a moral (...) institution, and it provides an understanding of his critique of anomie and egoistic individualism. The growing interest in cultural revolution and moral regulation make this edition of Durkheim's classic work especially timely. The new preface by Bryan Turner sets the book in its intellectual and historical context, and illustrates the relevance of this work to present day debates on the state, society, and moral regulation. (shrink)

In principle, there seem to be three main ways in which society can react when people commit crimes under influence of mental illness. (1) The standard model. We excuse them. If they are dangerous they are detained in the interest of safety of the rest of the citizens. (2) The Swedish model. We hold them responsible for their criminal offence, we convict them, but we do not sentence them to jail. Instead, we sentence them to psychiatric treatment. (3) My model. (...) We sentence them to jail, but offer them (voluntary) psychiatric treatment. The advantages of my model are obvious. We get a clear delineation of roles. We allow the psychiatrist to be just a doctor, not a warden. We liberate psychiatry of the objective of deciding whether people who were mentally ill when they committed criminal offences ‘could have acted otherwise’— a hopeless task. We allow that psychiatrists live up to their professional ethical code (the Hawaii Declaration). We treat psychically ill persons as ‘normal’, we allow them to repent their crimes, which renders easier their recovery. However, two objections to my model come to mind. First of all, is it not unfair to sentence people to jail who could not help doing what they did? And, secondly, the question of fairness set to one side, is it not inhumane to sentence mentally ill persons to jail? Is it not inhumane to the mentally ill persons themselves, and does it not mean that they will be a burden to other prisoners? In my paper I show that, if our system of criminal punishment takes a civilised form, neither of these objections carries any weight. (shrink)

I am not trying to present a full concept of professional ethics of an academic. I would like to focus on philosophical and ethical reflection of the specific area of an academic work in Slovakia. Almost two hundred years ago, the Slovak enlightenment philosopher Ján Feješ (1764 - 1823) responded to the situation of his era and he stated that a reviewer must, in the given area, be even better educated than the author himself. A different example can be (...) found in Honoré de Balzac’s great novel Lost Illusions where he also described journalistic practice of the first half of the 19th century. Part of the novel was based on his own experience with acrimonious critique. The situation concerning, for example academic reviewing in Slovakia in the present day is, possibly in some instances, even more critical than Feješ or Balzac suggested. This no longer concerns the quality of papers and book of essays but the number of works published; and evaluation of academics is partly dependant on whether they have published in a reviewed or a non-reviewed book, indexed journals, worldly known publishers, etc. There has to be a just requirement placed on critical reviews, as Feješ and others cautioned, and that is that they should not be informative reviews only for the sake of someone getting a reviewed work but truly critical reviews from people qualified in the given area of academic subjects and the aim of which should not lie in settling scores or expressing personal preferences but a constructive view of the issue. The problem in Slovak academic community (especially in humanities and social sciences), however, lies in the fact that critical reviews are not considered a challenge for discussion or polemics but are shifted to the personal level including settling scores with the critical reviewer. Quoting and referencing is another problematic area in Slovak academic life, which, in the present period, has almost become a fetish, as it is a criterion of qualification enhancement and evaluation of academics. That is why quotations and references are artificially made for colleagues, friends and acquaintances, or even already published works are faked to contain quotes and references for the needs of future qualification enhancement. To summarise, I would like to propose three aims which could become a part of professional ethics of the academics (in Slovakia). (shrink)

Teachers' Professional Ethics: Theoretical Frameworks and Empirical Research from Finland is intended for international readers in education who want to learn the theoretical frameworks that guide teachers' ethics and that help them address concrete challenges in their everyday work. Scholars and teachers from different countries can use this book to widen their understanding of the Finnish educational system and teacher ethics. The authors provide examples of concrete moral dilemmas in teaching that can be more effectively navigated with the rational (...) principles and guidelines that philosophies of different ethical frameworks can provide. They argue that teachers require ethical skills, especially ethical sensitivity, in order to select the most beneficial course of action concerning diverse students in inclusive education. They should be purposeful in their profession to develop the motivation and resilience to continue their demanding but fulfilling work with long-term goals. Moreover, they should acknowledge their implicit beliefs and possible stereotypes to be able to provide equal learning opportunities to their students and to build democratic moral communities in their schools. In this book, ethical sensitivity, purposeful teaching, and incremental beliefs concerning learning are seen as important prerequisites for teachers' professional ethics. We discuss these aspects with examples from our empirical studies in Finnish schools. (shrink)

The author's aim is to prove that certain moral principles will always be etched into laws when the interest of society demands it and when morality as a set of norms guiding behavior no longer functions in an expected manner outside the system of law. In this paper, it is argued that morality is constituted within the law in a more profound way as well as in a way which is also much more difficult to identify than, for example, conventional (...) instructions concerning professional ethics may indicate. The main thesis is that de facto there are no particular professional ethics of lawyers beyond or above the ethical principles binding all people. (shrink)

The Code of Ethics of the American Speech-Language-Hearing Associations states....hold paramount the welfare of persons served professionally. But how do clinicians balance the financial demands of their service-oriented business with their interest in the welfare of the people they serve? In this text, Dr Resnick explores the various aspects of applied ethics to give speech-pathologists and audiologists a better understanding of professional ethics and what it means for the conduct of a profession. Solving ethical dilemmas, working with ethics committees, (...) and other practical issues are covered to promote the preservation of professional ethics in daily practice. (shrink)

The cause of ethical failure in organisations often can be traced to their organisational culture and the failure on the part of the leadership to actively promote ethical ideals and practices. This is true of all types of organisations, including the professions, which in recent years have experienced ongoing ethical problems. The questions naturally arise: what sort of professional culture promotes ethical behaviour? How can it be implemented by a profession and engendered in the individual professional? The answers (...) to these questions are of interest to business ethicists since the causes of ethical problems in business are often the same and the professions, as ethically challenged organisations, make useful and informative analogues for the measures to be adopted or avoided when the attempt is made to raise the ethical standards of business.Given this focus on the professions, it will be argued that the usual, direct attempts to control unethical behaviour by using codes of ethics, legislation and self-regulatory regimes, are not successful. (shrink)

Author applies four models of professional ethics of politicians (Aristotle’s virtuous citizen, Machiavelli’s prince, Erasmus’ man of values and Weber’s responsible politician) to politics and politicians in Slovakia since the first half of the 20th century to the present. According to author, there is possible to identify Milan Hodža with Weber’s model, Alexander Dubek with Aristotle’s one, Vladimír Meiar and Robert Fico are identified with Machiavelli’s model and Iveta Radiová with Erasmus’ model of professional ethics of politician in (...) Slovakia. (shrink)

The complexities of professional ethics are best understood and interpreted within their sociohistorical context. This paper focuses on the experience of 20 rural psychologists from across Canada, a context rife with demographic and practice characteristics that may instigate ethical issues. Employing hermeneutic phenomenology, these qualitative research results are indicative of professional struggles that impacted the participants’ experience of professional ethics and raised key questions about policy and practise. Concerns regarding competition highlight potential professional vulnerability, beget the (...) idea of fostering general psychological practice, and question the role of professional bodies in addressing rural shortages. Dependency on government funding models and decisions highlights the benefits and medical cost-offset effect of psychological services’ role in funded medical care. The controversial prescriptive authority debate for psychologists raises myriad concerns that are particularly salient to rural practitioners. These include changes to training and practice, with risks of psychopharmacology gaining prominence over behavioural health interventions. National inconsistencies in level of registration add to the growing shortage of practitioners. Finally, the results illuminate the need for advocacy to move beyond the literature and into public policy to increase public awareness, decrease the stigma of mental illness, and develop rural Canadian psychology. Although limited to this study, these results allowed for a fuller and more robust understanding of rural practice in consideration of professional ethics, which may inform policy, science, or ethical clinical practice. (shrink)

The circumscribed quadrature of professional ethics aims to show the necessary shift from deontology to professional ethics, from deontological codes to ethical codes. While deontology and the deontological codes that materialise from it set their sights on professionals' responsibilities, professional ethics and the ethical codes that should derive from it would set their sights on the professional act, on its successful performance. In this way, the stress comes to be placed not only on the professional's (...) responsibility, although that too, but also on the necessary orchestration of the responsibilities shared at numerous levels by everyone involved in the performance of the professional act. The author identifies and typifies five elements present in the professional act. Four of them involve direct the protagonism of the professional, the recipient of the professional service, the institution that makes the service possible and from which the professionals' service is offered, and finally the human factor, the people who are behind the aforementioned factors and their nature, the professional, the recipient of the services and institutions. And each of these factors paves the way for a series of diversified protagonisms: inter-professional cooperation, receiver of professional services and their human environment around them, macro and micro institutions, diverse human profiles. However, all of this takes place within the framework of the fifth important element in professional ethics: a given, specific society as a circumscription of the four elements cited above, which sets the moral bar, a set of convictions and desired collective ethics which unquestionably also affect the performance of professional acts. With this reflection, we take note of the necessary co-responsibility in the provision of professional services, a co-responsibility which we could express simply in healthcare terms: it is not enough to merely have sound healthcare professionals if we do not have good patients with favourable affective environments, nor sound healthcare institutions, nor serious people who are socially committed to their work and their role, nor a society that believes in and fosters given identifiers of the personal and professional health to which we aim. The reflections in this proposal embark on a pathway of reflection which, we believe, deserves to be further explored. (shrink)

The aim of the paper is to pick out the grounds of the fact, that more and more professional ethics codexes are permanently being formulated. The author high_lights the essence, the menanig and the functions of professional ethics codexes, seeing them as the institutionalized forms of professional ethics, which is a part of applied ethics. She puts stress on the connections between the society, the profession and its ethical codex. The philosophical and ethical grounds of the (...) class='Hi'>professional ethics codexes are examined as well. (shrink)

_ This scholarly article explores the critical role of professional ethics in the field of counseling and psychotherapy. Ethical considerations are fundamental to maintaining the integrity and trustworthiness of mental health professionals. The paper examines the core principles and ethical guidelines that govern the practice of counseling and psychotherapy, addressing the complexities and challenges that practitioners may encounter. Through an in-depth analysis, the article emphasizes the significance of ethical decision-making, confidentiality, cultural competence, and ongoing professional development in fostering (...) positive therapeutic outcomes. _. (shrink)

Proposals for an ethical code for scientists raise questions about the usefulness of the framework of professional ethics for debating relevant issues surrounding ethics and science. Is science a profession and if so should its professional ethic be self-derived or subject to external input? What needs to be addressed is the nature of the 'good' that science promotes. Explanations of science as a public good in terms of knowledge and diversity are possibilities, but science's answer to the basic (...) philosophical question of hope in the human condition should not be overlooked. (shrink)

This article questions the commonly held view that professional ethics is grounded in general ethical principles, in particular, respect for client (or patient) autonomy and beneficence in the treatment of clients (or patients). Although these are admirable as general ethical principles, we argue that there is considerable logical difficulty in applying them to the professional-client relationship. The transition from general principles to professional ethics cannot be made because the intended conclusion applies differently to each of the parties (...) involved, whereas the premise is a general principle that applies equally to both parties. It is widely accepted that professionals are required to recognize that clients or patients possess rights to autonomy that are more than the general rights to personal autonomy accepted in ordinary social life, and that professionals are expected to display beneficence toward their clients that is more than the beneficence expected of anyone in ordinary social life. The comparative component of professional ethics is an intrinsic feature of the professional situation, and thus it cannot be bypassed in working out a proper professional ethics. Thus, we contend, the proper professional treatment of clients or patients has not been explained by appeal to general ethical principles. (shrink)

Professional Ethics, viewed as a managerial challenge and opportunity in this study, deals with the often overlooked conceptions, actions and behavior of individuals who see themselves both as members of a profession and as members of an organization. Managers have to deal with this dual loyalty and inherent potential for conflict. This is of particular importance for new types of organizations when wanting to develop and sustain an ethical platform for the ultimate goal - assuring that future business decisions (...) of individuals are in "ethical balance" with the organization's own values and goals. (shrink)

In principle, there seem to be three main ways in which society can react when people commit crimes under influence of mental illness.(1) The standard model. We excuse them. If they are dangerous they are detained in the interest of safety of the rest of the citizens.(2) The Swedish model. We hold them responsible for their criminal offence, we convict them, but we do not sentence them to jail. Instead, we sentence them to psychiatric treatment.(3) My model. We sentence them (...) to jail, but offer them (voluntary) psychiatric treatment.The advantages of my model are obvious. We get a clear delineation of roles. We allow the psychiatrist to be just a doctor, not a warden. We liberate psychiatry of the objective of deciding whether people who were mentally ill when they committed criminal offences ‘could have acted otherwise’— a hopeless task. We allow that psychiatrists live up to their professional ethical code (the Hawaii Declaration). We treat psychically ill persons as ‘normal’, we allow them to repent their crimes, which renders easier their recovery.However, two objections to my model come to mind. First of all, is it not unfair to sentence people to jail who could not help doing what they did? And, secondly, the question of fairness set to one side, is it not inhumane to sentence mentally ill persons to jail? Is it not inhumane to the mentally ill persons themselves, and does it not mean that they will be a burden to other prisoners?In my paper I show that, if our system of criminal punishment takes a civilised form, neither of these objections carries any weight. (shrink)

Professional Ethics is a textbook designed for budding engineers to understand important ethical concepts that will enable them to effectively resolve the moral issues they will face in real professional situations. It also provides an understanding of the interface between social, technological and natural environments.

It is imperative to understand the factors that influence clinical competency. Consequently, it is essential to study those that have an impact on the process of attaining clinical competency. A grounded theory approach was adopted for this study. Professional competency empowers nurses and enables them to fulfill their duties effectively. Internal and external factors were identified as affecting clinical competency. A total of 36 clinical nurses, nurse educators, hospital managers and members of the Nursing Council in Tehran participated in (...) this research. Data were obtained by semistructured interviews. Personal factors and useful work experience were considered to be significant, based on knowledge and skills, ethical conduct, professional commitment, self-respect and respect for others, as well as from effective relationships, interest, responsibility and accountability. Effective management, education systems and technology were named as influential environmental factors. Personal and environmental factors affect clinical competency. Ethical persons are responsible and committed to their work, acquiring relevant work experience. A suitable work environment that is structured and ordered also encourages an ethical approach by nurses. (shrink)