2. The changes: to ... Generic Talking therapy as both personal and social action + Team and agency Multiple ethical perspectives offered Other approaches to expressing ethics included Relational ethics Role specific Talking therapy as personal/individual action Individual practitioner Ethic of client autonomy dominant Ethical principles dominant
3. Ethic of client autonomy -strengths Challenges assumptions about professional power Strengthens client power and influence by directing attention to the client’s right to be self-governing Directs attention to importance of free and informed consent, confidentiality, rejects manipulation for social ends
4. Ethic of client autonomy - limitations Culturally biased - presupposes atomistic and individualistic approach to self Leaves an ethical void when limitations to autonomy encountered - dependency/lack of capacity, suicidal intent(?), harm to others Weak on practitioner’s valid rights Inhibits awareness of wider social context and responsibilities - self in relationship
5. Innovations – new principles Fidelity -honouring the trust placed in the practitioner ethic of relationship trustworthiness, boundaries, confidentiality, mutual respect Closely matches ethic of autonomy in Western culture but adaptable to other social and cultural contexts
6. Innovations - autonomy Autonomy - respect for client’s right to be self-governing addresses power imbalance, informed consent, confidentiality, clients as ends in themselves -not means to an end - ie rejects manipulation for beneficial social ends
7. Innovations - new principles Beneficence - promoting client’s well-being Non-maleficence - avoidance of harm previously implicit as subsidiary principles vulnerable clients incapable of autonomy prohibition on exploitation responsibility for dependent clients who are vulnerable to harm?
8. Innovations - new principles Justice - fair and impartial treatment of all clients and the provision of adequate services respect for human rights and dignity conscientiously considering any legal requirements fairness and avoidance of discrimination striving for fair and adequate provision of services
9. Innovations - new principles Self-respect - fostering the practitioner’s self-knowledge and care of self controversial but important in relationship with client’s, colleagues and others appropriate application of all the previous principles to self personal and professional development validates life outside talking therapies
10. Strengths and limitations of principles Dominant in professional ethics Good way of expressing prospective expectations and retrospective justification Rational, analytic and action orientated impersonal and detached? BUT Ethics in practice are informed by underpinning ethical commitment, values, and experienced as personal moral qualities ….
11. Values Values inform principles respect for human rights and dignity integrity of practitioner-client relationships enhancing quality of professional knowledge alleviating personal distress and suffering facilitating a sense of self that is meaningful …
12. Personal moral qualities Empirical evidence that the practitioner’s personal qualities are foremost in clients’ sense of safety and quality of relationship Cannot be required by definition Need to be deeply rooted in the person as an act of personal commitment Qualities are what we aspire to
13. Personal moral qualities Empathy Sincerity Integrity Resilience Respect Humility Competence Fairness Wisdom Courage
14. Overall effect Recognition that profession is maturing and facing complex ethical challenges for which there may be several appropriate responses Change the professional culture and ethos from conformity to rules to ethical accountability and engagement Fostering ethical understanding and practice intrinsic ethics - ethical mindfulness
