WORKING WITH CHILDREN: AN ETHICS FRAMEWORK FOR HEALTH PROFESSIONALS
“AN OUNCE OF PRACTICE IS WORTH MORE ACKNOWLEDGEMENT: THAN TONS OF ETHICS IN THE TIME OF COVID-19 PREACHING” WHAT YOU WILL LEARN FROM THIS PRESENTATION: Mahatma Gandhi ▪ A CONCEPTUAL UNDERSTANDING OF ETHICS ▪ APPLICATION OF ETHICS IN PROFESSIONAL PRACTICE WHAT YOU WILL BE ABLE TO DEVELOP: AN INDIVIDUALISED ETHICS FRAMEWORK ▪ RELEVANT TO YOUR PROFESSIONAL PRACTICE
PART 1: CONCEPTUAL UNDERSTANDING
SHAKING THE DUST OFF ETHICS DEFINED AS A ETHICS IS A BRANCH ETHICS IS OF PHILOSOPHY MORAL CONCERNED PHILOSOPHY THAT “INVOLVES WITH WHAT IS OR CODE OF SYSTEMATISING GOOD FOR MORALS DEFENDING & INDIVIDUALS & PRACTICED BY RECOMMENDING SOCIETY AN CONCEPTS OF RIGHT INDIVIDUAL AND WRONG OR A GROUP BEHAVIOUR ” EXAMPLE OF ETHICS REFLECT AIMS ETHICS: CODES OF & STANDARDS OF CONDUCT FOR PROFESSION & ALLIED HEALTH PROMOTE PROFESSIONALS INTROSPECTION
ETHICS, MORALS & PRINCIPLES … ETHICS = RULES PROVIDED BY AN EXTERNAL SOURCE – FOR EXAMPLE THE HEALTH PROFESSIONS COUNCIL OF S.A MORALS = INDIVIDUAL’S OWN PRINCIPLES REGARDING RIGHT & WRONG – BASED ON THEIR ASSUMPTIONS, VALUES AND BELIEFS PRINCIPLES = A MORAL RULE OR BELIEF THAT GUIDES YOUR ACTIONS
ETHICS, MORALS & PRINCIPLES … ETHICS ARE ABOUT REALITY AND ALSO ABOUT HOW THE WORLD SHOULD BE EXAMPLE: BELIEF: LIFE IS SACRED (ALSO A VALUE) PRINCIPLE: TERMINATION OF PREGNANCY IS WRONG & IMMORAL (ALSO MORALITY). ASSUMPTION: A FOETUS IS A FULL HUMAN WITH RIGHTS BEFORE BIRTH ETHICS: A PROFESSIONAL MAY NOT IMPOSE THEIR BELIEFS ON A CLIENT WHO IS REQUESTING AN ABORTION WITHIN THE PROVISIONS OF THE LAW CODE OF CONDUCT: DEFINES HOW A PERSON REQUESTING A TERMINATION SHOULD BE TREATED
WHAT’S IN YOUR ETHICS TOOLBOX? PERSONAL ETHICS (SOCIALISATION) YOUR RELIGIOUS, SOCIAL & CULTURAL BELIEFS; BELIEFS ABOUT GENDER, HUMAN SEXUALITY, JUSTICE ETC. VIRTUE ETHICS (AM I GOOD) HOW YOU LIVE YOUR LIFE – WHAT YOU BELIEVE IT MEANS TO BE A “GOOD PERSON” – YOUR CRITERIA FOR JUDGING OTHERS MEAT OR NOT? CHARITY OR NOT? SPIRITUAL DISCIPLINE OR NOT? KEEPING YOUR WORD (INTEGRITY) OR NOT?
WHAT’S IN YOUR ETHICS TOOLBOX? CONSEQUENTIAL ETHICS (ACTIONS & INACTIONS) WHAT IMPACT IS MY BEHAVIOUR HAVING ON THE WORLD AND OTHERS? IS IT DOING MORE GOOD OR HARM? PEOPLE? ENVIRONMENT? DEONTOLOGICAL OR DUTY ETHICS (REASON) WHAT DO MY ETHICAL PRINCIPLES TELL ME TO DO? WHAT DO I OWE? WHAT AM I RESPONSIBLE FOR? HOW DO I DECIDE BETWEEN CONFLICTING DUTIES?
PART 2: UNPACKING ETHICS – THE FOUNDATIONS OF OUR PRACTICE
GENERAL ETHICAL PRINCIPLES UNIVERSALLY ACCEPTED PRINCIPLES FOR ALL ENDEAVOURS ▪ JUSTICE – FAIRNESS & EQUITABLE DISTRIBUTION OF CARE/RESOURCES ▪ BENEFICENCE – DOING RIGHT THING FOR PATIENT ▪ NON-MALEFICENCE – DOING NO HARM (INTENTIONAL OR NOT)
GENERAL ETHICAL PRINCIPLES ▪ ACCOUNTABILITY – ACCEPT RESPONSIBILITY & CONSEQUENCES ▪ FIDELITY – KEEPING ‘PROMISES’ – HIGH STANDARDS ▪ AUTONOMY – PATIENT SELF- DETERMINATION ▪ VERACITY – BEING TRUTHFUL WITH THE PATIENT
7 INTERNATIONAL ETHICAL PRINCIPLES FOR WORKING WITH CHILDREN 1.VALUE & 2.UPHOLD RESPECT RELATIONSHIP OF CHILD EACH WITH OTHERS & CHILD AS INTERDEPENDENCY UNIQUE
7 INTERNATIONAL ETHICAL PRINCIPLES FOR WORKING WITH CHILDREN 3.FACILITATE: 4.HELP: OPTIMAL GROWTH PREVENT, PROTECT DEVELOPMENT & TREAT, REMEDIATE POTENTIAL
7 INTERNATIONAL ETHICAL PRINCIPLES FOR WORKING WITH CHILDREN 6.OPPOSE: 5.USE INFORMATION DISCRIMINATION APPROPRIATELY: OPPRESSION PRIVACY EXPLOITATION CONFIDENTIALITY RIGHT TO INFO
7 INTERNATIONAL 7. MAINTAIN: ETHICAL PERSONAL & PROFESSIONAL INTEGRITY PRINCIPLES FOR KNOWLEDGE & SKILLS DEVELOPMENT WORKING WITH CO-OPERATION WITH COLLEAGUES CHILDREN MONITOR SERVICE QUALITY CONTRIBUTE TO DEVELOPMENT OF SERVICES & POLICY
THE HIERARCHY OF ETHICS THE SOUTH AFRICAN CONSTITUTION & THE BILL OF RIGHTS SOUTH AFRICAN LAWS - LEGISLATION SPECIFIC PROFESSIONAL CODES OF CONDUCT AND ETHICS
PROFESSION-SPECIFIC ETHICS CONTRACTS SCOPE OF INFORMED PRACTICE CONSENT & RECORDS IDENTIFYING WHO DUAL RELATION- PSYCHOMETRY/ THE CLIENT IS SHIPS ASSESSMENTS CONTINUED SUPERVISION PROFESSIONAL CONFIDENTIALITY DEVELOPMENT
TO TREATMENT: 12 SPECIAL MENTION: TO SEX: 16 AGES OF TO ABORTION: ANY AGE CONSENT FOR S.A TO CONTRACEPTIVES: 12 CHILDREN TO HIV TEST: 12 TO OWN ADOPTION: 10
CONTEMPORARY ETHICS PERSONAL DIVERSITY PROFESSIONAL DISCLOSURE COMPETENCE BOUNDARIES TO CLIENTS (“CULTURAL SENSITIVITY”) “SPECIAL MULTI- GENDER NEEDS” DISCIPLINARY DIVERSITY YOUNGSTERS TEAM-WORK BURN-OUT & ELECTRONIC COMMUNICATION COMPASSION & SOCIAL MEDIA FATIGUE – SELF CARE “TELE - THERAPY”?
“TO PRACTICE ISN’T TO PART 3: DECLARE I AM BAD. TO PRACTICE IS TO APPLICATION - DECLARE THAT I CAN BE ETHICAL PRACTICE IN BETTER.” ACTION DAN HEATH
PROFESSION VS A JOB? REQUIRES EXTENSIVE TRAINING REQUIRES INTELLECT & APPLICATION PROVIDES AN IMPORTANT SERVICE TO SOCIETY OFFERS LATITUDE IN EXERCISING SKILLS & JUDGEMENT - POWER IS LARGELY DONE IN PRIVATE THE RELATIONSHIP BETWEEN PROFESSIONAL & CLIENT NEEDS TO BE ETHICAL & REGULATED
A QUICK DETOUR: DELIBERATE PRACTICE PROF ACTIVITY EMPHASISING SKILLS & IF LINKED TO KNOWLEDGE PRACTITIONER DEVELOPMENT + ETHICS ‘BORING PERFORMANCE & RIGOROUS SELF- OR INTIMIDATING’ CLIENT OUT- EXAMINATION = ☺ COMES THEY QUALITY COME ALIVE INTERVENTION MORE LIKELY TO BE CONSCIOUS & ETHICAL
RESEARCH INTO THE EFFECTIVENESS OF PSYCHOTHERAPISTS IDENTIFIES THE CLINICIAN AS ACCOUNTING FOR A GREATER PERCENTAGE OF EFFECTIVENESS IN RELATION TO CLIENT OUTCOMES THAN DOES THE TREATMENT MODALITY THE DEGREE TO WHICH A PROFESSIONAL ENGAGES IN DELIBERATE PRACTICE ESPECIALLY HAS BEEN FOUND TO BE SIGNIFICANTLY RELATED TO OUTCOMES IN PSYCHOTHERAPY, TEACHING & MEDICINE
❑ SUPERVISION ❑ REVIEW OF AUDIOVISUAL WHAT MAKES RECORDINGS (ALONE & WITH PEERS) FOR DELIBERATE ❑ LIVE SUPERVISION PRACTICE? ❑ READING JOURNALS & LITERATURE ❑ FOCUSED LEARNING IN SPECIFIC MODELS OF INTERVENTION ❑ TRAINING WORKSHOPS
❑ REVIEWING PAST SESSIONS ❑ WRITTEN PLANS FOR FUTURE SESSIONS WHAT MAKES ❑ CASE DISCUSSION WITH FOR COLLEAGUES DELIBERATE ❑ VIEWING MASTER VIDEOS PRACTICE? ❑ READING CASE EXAMPLES ❑ TENDING TO SELF-CARE & EMOTIONAL NEEDS
DILEMMAS IN PRACTICE: THE ETHICS TRIANGLE BEST INTERESTS/ GREATER GOOD SELF OTHER
ETHICAL DECISION – MAKING A 6 STEP MODEL ❑ STEP 4 ❑ STEP 1 OBSERVATION BALANCE ❑ STEP 2 ❑ STEP 5 ACTION IDENTIFICATION ❑ STEP 6 ❑ STEP 3 REFLECTION CONSULTATION
ETHICAL DECISION – MAKING A 6 STEP MODEL STEP 1: OBSERVATION STEP 2: IDENTIFICATION RECOGNIZE ETHICAL ISSUE/ IDENTIFY STAKE HOLDERS EVENT IDENTIFY WHO HAS AN DEFINE CHARACTERISTICS INTEREST IN THE ISSUE COMMIT TO RESOLVE PINPOINT APPLICABLE ETHICAL PRINCIPLES IDENTIFY WHO IS RESPONSIBLE ASCERTAIN CULTURAL CONSULTS CODES SYSTEMS INVOLVED ACKNOWLEDGE YOUR FEELINGS & BIASES
ETHICAL DECISION – MAKING A 6 STEP MODEL STEP 3: CONSULTATION STEP 4: BALANCE TO OBTAIN INFORMATION & LINK: CONNECT BEHAVIOUR ASSISTANCE AND OPTIONS TO CODES/PRINCIPLES & BRAINSTORM POSSIBLE VIRTUES/VALUES SOLUTIONS WEIGH THESE UP IDENTIFY CONSEQUENCES ASK WHAT CAN BE DONE TO DISCUSS – INVOLVE CLIENT IN INCREASE CLIENT AUTONOMY DECISION MAKING IF APPROPRIATE
ETHICAL DECISION – MAKING A 6 STEP MODEL STEP 6: REFLECTION STEP 5: ACTION REFLECT ON PROCESS & PREPARE & PLAN FOR SOLUTION IMPLEMENTATION OF SOLUTION IDENTIFY & RATE OUTCOMES COMMIT TO WHEN YOU WILL DETERMINE WHAT YOU ACT WOULD LIKE TO DO IDENTIFY CONSEQUENCES DIFFERENTLY IN FUTURE OF INACTION IDENTIFY YOUR NEEDS – EG: ACT TRAINING?
CHALLENGES TO MAINTAINING ETHICAL PRACTICE “IF WE DON’T CHANGE DIRECTION, WE’LL END UP WHERE WE’RE GOING” PROF IRWIN COREY
CHALLENGES TO ETHICAL PRACTICE WHAT WE FACE WHAT WE NEED TO DO ▪ THINK CRITICALLY ▪ COVID, POVERTY & INEQUALITY ▪ PROTECT THE MOST ▪ OVERWHELMING NEED & LIMITED VULNERABLE FIRST RESOURCES ▪ TOLERATE MORAL AMBIGUITY ▪ TOP-HEAVY BUREAUCRACIES WHICH LACK ACCOUNTABILITY ▪ ACCEPT ETHICS ALIGNMENT IS AN ONGOING PROCESS ▪ A CULTURE OF VIOLENCE ▪ CORRUPTION & STATE CAPTURE ▪ FAKE NEWS & MISINFORMATION
SELF-COMPLETE ETHICS FRAMEWORK TO ASSIST YOU IN DOING A PERSONAL AND PROFESSIONAL AUDIT
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