Ethics and the Community Rehabilitation Provider

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Ethics and the Community Rehabilitation Provider

• Teleconference Presentation
• Laura Ritterbush, M.S., CRC
• March 11, 2008

2
Websters Dictionary

• Ethic the discipline dealing with what is good
  and bad and with moral duty and obligation a
  set of moral principles or values
• Ethics the principles of conduct governing an
  individual or group

3

• Patterson states that along with knowledge and
  skills, rehabilitation counselors and community
  service providers must (a) use the knowledge
  and skills in an ethical manner, (b) recognize
  ethical dilemmas that are inherent in their
  profession, (c) possess ethical decision-making
  skills to resolve ethical dilemmas. (p.181)

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Rehabilitations Code of Ethics

• The Commission on Rehabilitation Counselor
  Certification (CRCC) was incorporated in 1974.
• Certified over 35,000 Counselors
• CRCC sets the standard for quality
  rehabilitation counseling services
  (www.crccertification.com)
• The current code of professional ethics for
  rehabilitation counselors became effective Jan.
  1, 2002.

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Code of Ethics

• Provides a guide, not answers
• More than 1 code may apply and possibly
  contradict
• Serve as a means to maintain professional
  accountability and to protect the public from the
  potential damage incurred by substandard
  behaviors (Vacc, N, Juhnke, G., Nilsen, K. p.
  223, 2001)

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CRC Code of Professional Ethics

• 11 Sections
• A The Counseling Relationship
• B Confidentiality
• C Advocacy and Accessibility
• D Professional Responsibility
• E Relationships with Other Professionals
• F Evaluation, Assessment, and Interpretation
• G Teaching, Training, and Supervision
• H Research and Publication
• I Electronic Communication and Emerging
  Applications
• J Business Practices
• K Resolving Ethical Issues

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Ethics and the Law

• Counselors also need to be guided by laws
• Need to be aware of legal impact
• Code of Ethics should add to or clarify the law,
  not be above it

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Ethics

• Many times our decisions dont directly involve
  the codes or laws, but they operate in areas
  that laws and regulations dont reach (Kidder,
  p.15).
• Toughest decisions will be those that put one
  right against another.

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Ethics Skill Set

• Those skilled in ethics recognize
• Acting ethically may not feel good
• May require choosing a lesser harm over a greater
  harm, or violating one ethical principle to
  uphold another
• Acting ethically requires consideration of the
  public trust in the profession
• Acting ethically requires tolerating the
  ambiguity of ethical decision making
• Patterson (1998), p. 192

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Codes and Ethical Principles

• All the Codes fall under the umbrella of 5
  ethical principles

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5 Basic Ethical Principles

• Autonomy
• Beneficence
• Nonmaleficence
• Justice
• Fidelity
• Beauchamp Childress 1989

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Autonomy

• Websters Definition
• The quality or state of being self-governing
  self-directing freedom and especially moral
  independence
• The right to make your own decisions (right or
  wrong)
• Balance between autonomy and doing what is
  perceived to be best for the client
• Will look different for every client

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Beneficence

• Websters Definition
• The quality or state of doing or producing good
• This is the foundation of the rehabilitation
  counseling process (or any professional
  relationship in the disability field)

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Nonmaleficence

• Websters Definition
• Non not other than reverse of absence of
  a) the act of committing harm or evil b) a
  harmful or evil act
• Do no harm
• This is 2 fold both self and others

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Nonmaleficence

• Potential areas of harm
• Wrong services provided
• Misuse of assessment results
• Developed plans are not carefully monitored
• Patterson (1998)

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Justice

• Websters Definition
• The quality of being just, impartial, or fair
• Equal access and equal treatment

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Justice

• Who gets accepted into the program?
• Believing in the dignity and worth of all
  individuals with disabilities, rehabilitation
  counselors must guard against discriminating on
  the basis of a clients disability, ethnicity,
  gender or personality. Limited resources also
  influence justice in rehabilitation, when
  counselors must decide (a) who is most needy or
  (b) whether to expend more on one client and less
  on other clients (Patterson, p 186).

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Fidelity

• Websters Definition
• The quality or state of being faithful accuracy
  in details
• Synonyms loyalty, honesty
• This principle includes confidentiality and
  informed consent
• Keeping promises

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Ethical Dilemma

• 2 or more ethical principles are in conflict
• Must know your own values
• These will sometimes differ from your profession
  and/or those you work with
• Must learn to watch for your own values in your
  decisions to ensure you are not imposing your
  values on your client vs. following basic ethical
  principles

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Ethical Behavior

• According to Patterson (1998) ethical behavior
  requires the skills needed to
• Recognize ethical situations
• Understand the code of ethics and laws that
  effect how you practice
• Apply the principles of autonomy, beneficence,
  nonmaleficence, justice, and fidelity
• Integrate the above principles when you find them
  conflicting

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Ethical Behavior Contd

• Identify competing interests which are involved
  in an ethical dilemma
• Critically evaluate ethical decisions you make
• Establish collaborative relationships based on
  mutual respect and informed consent with clients
• Continually monitor your own behavior and upgrade
  your knowledge and skills

22
Ethical Decision Making

• Adapted from Tymchuk (1982)
• Identify the problem/dilemma
• Identify the conflicting ethical principles
• Identify the codes that apply to each of the
  principles/dilemma
• Generate potential courses of action
• Consider the potential consequences of all
  options
• Choose a course of action
• Evaluate the selected course of action
• Implement the course of action

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A Balancing Act

• Caseload needs vs. individual needs
• Money vs. needs
• Social change vs. autonomy and beneficence

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Example for Rehabilitation Counselor

• In your community there is a Community
  Rehabilitation Provider who you believe does not
  offer very good services. You are tempted to
  leave them off the list of choices for your
  clients or discourage people from picking them.

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Example for Community Rehabilitation Provider

• An employer is ready to hire one of your
  individuals who has a mental illness. He knows
  your agency works with people with disabilities
  and calls you to ask about the disability. Hes
  nervous because he cant see the disability so
  doesnt know what he is dealing with. Your
  client has told you he does not want any
  information divulged.

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Resources

• Beaucamp, T. L., Childress, J.F. (1989).
  Principles of Biomedical Ethics (3rd ed.). New
  York Oxford University Press.
• Kidder, R. (1995). How Good People Make Tough
  Choices Resolving the Dilemmas of Ethical
  Living. New York William Morrow Company Inc.
• Patterson, J. (1998). Ethics and Ethical
  Decision Making in Rehabilitation Counseling. In
  R. Parker E. Szymanski (Eds.), Rehabilitation
  Counseling Basics and Beyond (pp. 181-207).
  Austin, TX Pro-Ed.
• Tymchuk, A.J. (1982). Strategies for resolving
  value dilemmas. American Behavior Scientist, 26,
  159-175.

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Resources

• Vacc, N, Juhnke, G., Nilsen, K. (2001).
  Community mental health service providers codes
  of ethics and the Standards for Educational and
  Psychological Testing. Journal of Counseling and
  Development, 79, 217-224.
• Websters Ninth New Collegiate Dictionary.
  (1989). Springfield, MA. Merriam-Webster Inc.
• www.crccertification.com