Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Professional Conduct. Show all posts
Showing posts with label Professional Conduct. Show all posts

Friday, February 16, 2018

Health Care Workers & Moral Objections I: Procedures

Mike LaBossiere
Talking Philosophy
Originally published on January 18, 2018

Here is an excerpt:

But, this moral coin has another side—entering a profession, especially in the field of health, also comes with moral and professional responsibilities. These responsibilities can, like all responsibilities, can justly impose burdens. For example, doctors are not permitted to instantly abandon patients they dislike or because they want to move to a better paying position. As such, ethics of a health worker refusing to perform a procedure based on their moral or religious views requires that each procedure be reviewed to determine whether it is one that a health care worker can justly refuse or one that is a justly imposed burden.

To illustrate, consider a doctor who is asked to keep prisoners conscious and alive during torture performed by agents of the state. Most doctors, like most people, would have moral objections to being involved in torture. However, there is the question of whether this would be something they should be morally expected to do as part of their profession. On the face of it, since the purpose of the medical profession is to heal and alleviate suffering (a professional ethics that goes back to the origin of western medicine) this is not something that a doctor is obligated to do even in the face of moral objections. In fact, the ethics of the profession would dictate against engaging in this behavior.

Now, imagine a health care worker who has sincere religious or moral beliefs that when a person can no longer sustain their life on their own, they must be released to God. As such, the worker refuses to engage in procedures that violate their principles, such as keeping a patient on life support. While this could be a sincerely held belief, it seems to run counter to the ethics of the profession. As such, such a health care worker would seem to not have the right to refuse such services.

The article is here.

Monday, May 22, 2017

Half of US physicians receive industry payments

Michael McCarthy
BMJ 2017; 357

Nearly half of US physicians receive payments from the drug, medical device, and related medical industries, and surgeons and male physicians are more likely to do so, a US study has found.

The study leader, Jona A Hattangadi-Gluth, of the University of California, San Diego, based in La Jolla, said that most payments were relatively small but that many specialists receive more than $10 000 (£7750; $9160) a year from industry, including 11% of orthopedic surgeons, 12% of neurologists, and 13% of neurosurgeons.

She said, “The data suggest that these payments are much more pervasive than we thought and [that] there is much more money going directly to physicians than maybe people recognized.”

The researchers analyzed data from 2015 collected from Open Payments, a program created by the 2010 Affordable Care Act that requires biomedical manufacturers and group purchasing organizations to report all general payments, ownership interests, and research payments paid to allopathic and osteopathic physicians in the US.

The article is here.

Sunday, March 5, 2017

What We Know About Moral Distress

Patricia Rodney
AJN, American Journal of Nursing:
February 2017 - Volume 117 - Issue 2 - p S7–S10
doi: 10.1097/01.NAJ.0000512204.85973.04

Moral distress arises when nurses are unable to act according to their moral judgment. The concept is relatively recent, dating to American ethicist Andrew Jameton's 1984 landmark text on nursing ethics. Until that point, distress among clinicians had been understood primarily through psychological concepts such as stress and burnout, which, although relevant, were not sufficient. With the introduction of the concept of moral distress, Jameton added an ethical dimension to the study of distress.

Background

In the 33 years since Jameton's inaugural work, many nurses, inspired by the concept of moral distress, have continued to explore what happens when nurses are constrained from translating moral choice into moral action, and are consequently unable to uphold their sense of integrity and the values emphasized in the American Nurses Association's Code of Ethics for Nurses with Interpretive Statements. Moral distress might occur when, say, a nurse on a busy acute medical unit can't provide comfort and supportive care to a dying patient because of insufficient staffing.

The article is here.

Monday, February 13, 2017

Psychologist recounts interrogation of terror detainee

Shawn Vestal
Spokesman-Review
Originally published January 25, 2017

Here is an excerpt:

Jessen’s account was part of a series of documents recently released as part of a Freedom of Information Act request by the ACLU, which has filed a lawsuit against Jessen and his former business partner, James Mitchell. The interview represents the fullest public description of his role from Jessen, who lives in Spokane and operated a for-profit interrogation firm downtown staffed with former Fairchild Air Force Base officers. He has repeatedly denied interview requests from reporters.

The lawsuit against the two contractors is proceeding through federal court in Spokane. Rahman, through his family, is one of three named plaintiffs.

Jessen was interviewed as part of the CIA investigation into Rahman’s death at a “black site” known as the Salt Pit in Afghanistan in 2002. Rahman was a suspected Afghan militant and the CIA records refer to him as a member of al-Qaida.

In his interview, Jessen said his role varied from observer to hands-on interrogator, but makes clear he was closely involved. Another document says Jessen had six “sessions” with Rahman.

The article is here.

Saturday, September 17, 2016

Psychiatrist diagnosed local optician without meeting him

By Kelly Bennett
CBC News
Originally posted: Aug 25, 2016

A Burlington optician is outraged after discovering a psychiatrist he'd never met wrote a critical two-page psychiatric evaluation about him without ever seeing or talking to him.

The optician, Jay Hakim, filed a complaint with the provincial medical regulator, which concluded the psychiatrist's conduct was appropriate.

Hakim appealed the regulator's decision; that appeal was held in a hearing downtown Hamilton on Wednesday.

The case raises "some very serious consequences for society" if it's allowed to stand, Hakim argued.

It also parallels issues raised in the United States over whether psychiatrists can ethically provide opinions on the mental health of presidential candidates they've never met.

The article is here.

Monday, May 23, 2016

Our research was key to the 10,000-hour rule, but here’s what got oversimplified

Anders Ericsson and Robert Pool
Salon.com
Originally posted April 16, 2016

Here is an excerpt:

Research has shown this to be true in field after field. It generally takes about ten years of intense study to become a chess grandmaster. Authors and poets have usually been writing for more than a decade before they produce their best work, and it is generally a decade or more between a scientist’s first publication and his or her most important publication — and this is in addition to the years of study before that first published research. A study of musical composers by the psychologist John R. Hayes found that it takes an average of twenty years from the time a person starts studying music until he or she composes a truly excellent piece of music, and it is generally never less than ten years. Gladwell’s ten-thousand-hour rule captures this fundamental truth — that in many areas of human endeavor it takes many, many years of practice to become one of the best in the world — in a forceful, memorable way, and that’s a good thing.

On the other hand, emphasizing what it takes to become one of the best in the world in such competitive fields as music, chess, or academic research leads us to overlook what we believe to be the more important lesson from the study of the violin students. When someone says that it takes ten thousand — or however many — hours to become really good at something, it puts the focus on the daunting nature of the task. While some may take this as a challenge — as if to say, “All I have to do is spend ten thousand hours working on this, and I’ll be one of the best in the world!”—many will see it as a stop sign: “Why should I even try if it’s going to take me ten thousand hours to get really good?” As Dogbert observed in one “Dilbert” comic strip, “I would think a willingness to practice the same thing for ten thousand hours is a mental disorder.”

The article is here.

Sunday, August 9, 2015

What, exactly, does yesterday’s APA resolution prohibit?

By Marty Lederman
Just Security
Originally posted August 8, 2015

By an overwhelming vote of 156-1 (with seven abstentions and one recusal)–so lopsided that it stunned even its proponents–the American Psychological Association’s Council of Representatives yesterday approved a resolution that the APA describes as “prohibit[ing] psychologists from participating in national security interrogations.”

What does Approved Resolution No. 23B do, exactly?  As I read it, it does three principal things, in ascending order of importance:

1.  It reaffirms an existing APA ethical prohibition that psychologists “may not engage directly or indirectly in any act of torture or cruel, inhuman, or degrading treatment or punishment,” a prohibition that “applies to all persons (including foreign detainees) wherever they may be held”; and it “clarifies” that “cruel, inhuman, or degrading treatment or punishment” (CIDTP) should be understood not (or not only) as that term is defined in the U.S. Senate’s understandings of, and reservations to, the Convention Against Torture, but instead in accord with the broadest understanding of CIDTP adopted by any international legal body at the relevant time:  the definition “continues to evolve with international legal understandings of this term.”

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3.  Finally, and most significantly, the Resolution establishes a new prohibition that “psychologists shall not conduct, supervise, be in the presence of, or otherwise assist any national security interrogations for any military or intelligence entities, including private contractors working on their behalf, nor advise on conditions of confinement insofar as these might facilitate such an interrogation.”

The entire article is here.

Thursday, April 9, 2015

Ethical Framework for the Use of Technology in Mental Health

Online Therapy Institute

Here is an excerpt from their resource page:

A competent practitioner working online will always adhere at least the following minimum standards and practices in order to be considered to be working in an ethical manner.

Practitioners have a sufficient understanding of technology.

Technology basics are required for practitioners who choose to deliver therapeutic services via technology. Practitioners will possess a basic understanding of technology as the technology relates to delivery of services


  • Encryption: Practitioners understand how to access encrypted services to store records and deliver communication. Records storage can be hosted on a secure server with a third-party, stored on the practitioner’s hard drive utilizing encrypted folders or stored on an external drive that is safely stored.
  • Backup Systems: Records and data that are stored on the practitioner’s hard drive are backed up either to an external drive or remotely via the Internet.
  • Password Protection: Practitioners take further steps to ensure confidentiality of therapeutic communication and other materials by password protecting the computer, drives and stored files or communication websites.
  • Firewalls: Practitioners utilize firewall protection externally or through web-based programs.
  • Virus Protection: Practitioners protect work computers from viruses that can be received from or transmitted to others, including clients.
  • Hardware: Practitioners understand the basic running platform of the work computer and know whether or not a client’s hardware/platform is compatible with any communication programs the practitioner uses.
  • Software: Practitioners know how to download and operate software and assist clients with the same when necessary to the delivery of services.
  • Third-party services: Practitioners utilize third-party services that offer an address and phone number so that contact is possible via means other than email. This offers a modicum of trust in the third-party utilized for such services as backup, storage, virus protection and communication.

Monday, April 14, 2014

Episode 6: Ethical Analysis of Vignettes (Number 1)

Dr. Richard F. Small joins John to discuss ethical decision-making, ethics education, and vignette analysis.  Rick and John will use information from Episodes 4 and 5 to demonstrate the differences among ethical issues, clinical concerns, legal matters, and risk management.  They will utilize the SHAPE decision-making model in conjunction with the acculturation model to demonstrate ways to consider ethical and clinical decision-making.  There will be some discussion on risk management and legal issues.  They will also discuss possible emotional issues that complicate decision-making skills.

At the end of this podcast, the listener will be able to:

1. Outline the relevant factors if the SHAPE decision-making model,
2. Identify the competing ethical principles in the vignettes, and,
3. Practice integrating personal values with professional ethics.

Find this podcast in iTunes


Click here to purchase 1 APA-approved Continuing Education credit

Listen directly from here




Resources

Episode 4: Ethical Decision-making (Part 1)

Episode 5: Ethical Decision-making (Part 2)

American Psychological Association's Ethical Principles of Psychologists and Code of Conduct

Handelsman, M. M., Gottlieb, M. C., & Knapp, S. (2005). Training ethical psychologists: An acculturation model. Professional Psychology: Research and Practice, 36, 59-65.

Motivated Moral Reasoning in Psychotherapy
John Gavazzi and Sam Knapp

Nonrational Processes in Ethical Decision-making
Mark Rogerson, Michael C. Gottlieb Mitchell M. Handelsman Samuel Knapp  & Jeffrey Younggren

Link to Dr. Small's Practice

Sunday, January 26, 2014

Not All Multiple Relationships are Created Equal

By Ofer Zur
Independent Practitioner, 34/1, 15-22. 2014.

Introduction

Most mental health professionals have attended risk management and ethics workshops where one of the central messages was the dire warning that multiple relationships are generally unethical, inherently harmful, mostly prohibited, and should be avoided.  While the term "unethical" is thrown about liberally when it comes to multiple relationships, the fact is that none of the major professional organizations' codes of ethics prohibit all forms of dual or multiple relationships.

The entire article is here.