Making Ethical Choices: Self-Reflection and Beyond
1. Michele Miele, M.A., M.S.
Allison Bashe, Ph.D.
John Gavazzi, Psy.D. ABPP
Jay Mills, Ph.D., ABPP
2. Describe why self-reflection should be a
consistent part of the ethical choice-making
process
Understand the purpose and usefulness of the
ethics autobiography for use in ethics courses
Identify basic components of ethical choice-
making
3. Self-Reflection
◦ Introspection and the willingness to learn:
Fundamental nature
Purpose
Essence
Personal challenge of Self-reflection (Dr. X)
Challenge: Reflect on your ‘self’ your person
4. The Advisory Committee on Colleague
Assistance ACCA
Self-awareness:
Physical and psychological wellness
Factors affecting professional functioning
Self-care involves:
Prevention
Awareness
Positive Ethics
5. Buddhist psychologist:
◦ Teach self-care to clients
◦ Model it by practicing self-care
You cannot give something that you do not have
yourself
◦ Eastern society – Caring for self – to give to others
◦ Western society - Caring for self - act of selfishness
6. Do we practice what we recommend to our
clients ?
If not, why ?
Do you over-identify with the ‘helper’ role ?
Do you adopt a separated view of the “us and
them”?
Do we ourselves practice the most primary step in
therapy that we ask of our clients ? Which
is . . .
7. Leads to greater understanding of self
◦ Why do we do what we do ?
◦ Why do we say what we say ?
◦ Why do we feel what we feel ?
Self-discovery
◦ How do you react and respond internally to our external
world ?
◦ Our inner-self is a dynamic in every interaction
◦ Awareness of who and what affects us; why and how ?
8. Elements of a system interact:
◦ Activity ceases to be solely independent
◦ Behavior depends on inter-dynamics
Humans of a social system interact:
◦ Activity ceases to be solely independent
◦ Behavior depends on inter-dynamics
Perceptual channels:
Intrinsic dispositions
Extraneous information
9. Inter-dynamics of your environment
◦ Intrinsic and extrinsic = You
Aristotle’s belief of self-awareness
◦ Self-awareness is identical to objects of awareness
◦ Knower = object of knowledge
“Since the known is known, and the knower is
the known . . . the knower is known.”
10. You are NOT an empty vessel
◦ Knowledge enters and interacts with ‘self’
◦ Reaction: Inter-dynamic of our perception and knowledge
In Aristotle's time
◦ People were powerless to ‘think’
◦ Expected to submit to the authority of the law, religion
◦ Only the great philosophers knew how to ‘think’
Release the oppressive garment
◦ Liberty to ‘think’
◦ Knowledge integrates with Self
◦ Outcome: Development of Self-identity
11. Objectivity vs. Subjectivity
◦ Respond to our external world vs. understanding our
intrinsic nature
Aristotle’s four states of character:
◦ Virtuous person acts properly, willingly with no effort
liberated (Integrated)
◦ Strong willed person makes himself act properly
strict boundaries (Assimilated)
◦ Weak willed person tries to act properly, and fails
loose boundaries (Separated)
◦ Vicious willed person act improperly without regret
rebellious (Marginalized)
12. Self-reflection autobiography - weak-willed – Choice
The Nursing and Midwifery Council:
◦ ‘Your character must be sufficiently good for you to be capable of
safe and effective practice without supervision’
Turning 18
◦ “Today you do what is right because it is what is expected of you,
tomorrow you do what is right because it is what you want to do”
Human being as opposed to a Human doing
13. Professional Virtue:
◦ Integrating a sense of Ethical Identity
Internal evaluation and reflection
Awareness of your ‘self’ and your ‘ethics’
Merging personal and professional ethics
Responses to your inter-dynamic world
Becomes a part of your ‘being’ rather than your ‘doing’
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Princeton UP
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Handelsman, M., Gottlieb, M., & Knapp, S. (2005) Training Ethical Psychologists: An
Acculturation Model. Professional Psychology: Research and Practice 36 , 59–65.
15. Knapp, S. (2006). Practical ethics for psychologists: A positive approach . Washington, DC:
American Psychological Association.
Michalon, M. (2001). "Selflessness" in the service of the ego: contributions, limitations and
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Understanding taboos that hurt us and our clients. Washington, DC: American
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Engineering Ethics. Science of Engineering Ethics, 17,109–132.
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19. Ethics becomes cornerstone of professional
identity
Respects individual backgrounds
Learning becomes a process “going from inside
out”
Represents a more positive approach
Provides a common language
23. Builds on the process of ethical acculturation
Demonstrates importance of self-reflection
Helps with integration and emotional connection
Helps to identify acculturation strategies
Becomes a point of reference
31. Looking at how well a psychologist integrates
his/her values and behaviors into the ethical
culture of psychology
Psychology has a set of normative principles and
behaviors related to ethical behavior and
appropriate conduct
32. APA’s Code of Conduct
Commonwealth Psychology regulations found in
the Psychology Law and Practice Act
Federal Regulations, such as HIPAA
Court decisions aka case law
33. The APA Ethical Principles and Code of
Conduct do not include a model of
ethical decision-making
Other resources dictate behavior, but do not
highlight how to work through dilemmas
35. The means to comply with a standard may not
always be readily apparent
Two seemingly competing standards may appear
equally appropriate
Application with of a single standard or set of
standards appear consistent with one or more
aspirational principle, but not another
37. Often ethical dilemmas involve apparent conflicts
between respect for patient autonomy versus
beneficence
or
Respect for autonomy versus general or public
beneficence
38. Identify the competing ethical principles
Help to determine which principle has precedence
and why
The importance of emotion in ethical decision-
making and moral judgments
39. S Scrutinize
H Hypothesize
A Analyze
P Perform
E Evaluate
40. 1. Goal is to define the problem by identifying the
conflicting ethical principles
2. Generate a wide range of possible solutions
and identify pros and cons
3. Merge or knit the possible solutions together in a
way that maximizes the benefits and limits the
disadvantages
4. Implement
5. Look back or evaluate
41. “integrative framework”
steps two and three generate solutions that
maximize your personal values within the context
of your professional role
42. Avoid dichotomous thinking– either I have to do x or
y.
For example, either I have to warn the potential
victim of a threat or I have to protect
confidentiality.
43. Malcolm Gladwell’s book “Blink”
Jonathan Haidt’s book on Moral Intuition
Jay Mills article on emotions in ethical decision-
making
44. Fear Passion
Anxiety
Calmness/Centered
Empathy
Disgust
Respect/Sympathy
Disrespect
Positive emotions related to our good
Negative emotions related to ethics decision-making skills and ethical
and moral decision-making knowledge
46. The Fundamental Attribution Error
Availability Heuristic
Trait Negativity Bias
Confirmation Bias
47. Dunning-Kruger Effect: a cognitive bias in which
unskilled individuals suffer from illusory
superiority, mistakenly rating their ability as much
higher than average.
Poor performers fail to learn from their mistakes.
And, they fail to internalize direct feedback from
others.
49. Knowledge base: APA code, Pennsylvania law,
regulations
Become Aware of emotional factors
Cognitive biases/situational factors
Outcomes are uncertain
Editor's Notes
Berry 1980 Maintenance = Degree to which people hold onto the values and traditions of their culture of origin Notions based on: Family influences Religious and spiritual backgrounds Models of professional relationships we have experienced (teacher-student) Models of other relationships (friends) In terms of ethical acculturation, students will have preexisting notions of right and wrong professional behavior Contact and Participation = Degree to which people adopt the traditions and values of their new culture In terms of ethical acculturation, adopting the ethical culture of psychology means valuing the APA ethical standards
In this slide, the N/S axis represents Maintenance where north is high maintenance and south is low maintenance The W/E axis represents Contact/Participation where west is high contact and east is low contact Integration = high on both maintenance and contact = best choice = Most coherence between personal and professional identities Marginalization = low on both maintenance and contact = may be temporary strategy where students give up their own moral sense but don’t yet appreciate professional ethics Other two are a mismatch between personal morality and professional identity Separation = high in maintenance but low in contact = make decisions based more on personal morality and less on professional principles = could feel alienated from profession Assimilation = low in maintenance but high in contact = give up too much of personal morality and ove-ridentify with the profession = could lead to overly simplistic applications of professional principles
Several advantages over approaches that focus more heavily on rules and cases Cornerstone = important at all stages of our professional development Backgrounds = students are not empty vessels = family, other professional roles Inside out = Shulman, 1999 = helpful to id personal ethics first = thereafter can see explicitly how personal and professional ethics interact Positive = Handelsman, Knapp, and Gottlieb, 2002 = we are active in our morality and engaged in a process = Ethical Acculturation is a process of developing and maintaining a professional identity, not just adopting a list of rules Common language = Difficulty grasping ethics principles is an example of acculturation stress, thus statements/decisions are not “unethical” but rather reflect a particular strategy (e.g., separation)
We need to reflect actively and decide how much of our own personal morality can be adapted to our growing knowledge and appreciation of the ethical culture of psychology Acculturation is an ongoing developmental process We want to develop a strategy of integration
Provides an opportunity to id and clarify personal, cultural, and family of origin values Things that go into it include the ones here plus Culture, Traditions, Motivations, Ideals, Experience in other professions Opportunity to ask: What is your idea of right and wrong personal behavior and where does this conception come from? What did you learn from your family of origin about right and wrong?
How do personal ethics interact with or conflict with professional ethics? Opportunity to ask: What is your idea of right and wrong professional behavior, and where does this conception come from? What experiences have you had in the field and what ethical dilemmas have you already encountered? What professional ethics in the field are most compatible with your own personal values, and which professional ethics are least compatible?
Again emphasizes that students are not passive players in their learning Maintains the theme of acculturation Integration = Students prior experiences connected to your learning goals and concepts of your ethics course Emotional engagement that can facilitate learning and motivation Point of reference = throughout the course students (and you) can refer back to these
Presentation heavily based on my article with others Built on work by Berry on Acculturation Handelsman, Knapp and Gottlieb’s work on Positive Ethics and Ethical Acculturation as a framework for teaching ethics Shulman credit for inside out Tjeltveit (Chelt-Vait) for the quote I used in my talk
Tjeltveit (Chelt-Vait) = 2006 = “ Retrieval of one’s ethical heritage, the implicit and perhaps unconscious source of automatic ethical assumption, may be particularly important….This retrieval permits us to develop intellectually rich and nuanced ethical commitments, commitments that are at once consistent with who we have been and that– because carefully examined– become fully ours in the present.”
Be creative Particularly consider how values you would first think would be positive, could conflict with ethics principles in certain cases