The Application of Virtue Ethics to the Practice of Counseling Psychology

Virtue Ethics in Counseling Psych

This dissertation can be found in the public domain here.

NJ school district moves to fire teacher who made anti-gay Facebook comments

By Star Ledger Staff

 

It was three months ago when anti-gay comments posted on Facebook by a Union High School teacher caused a nationwide controversy. Now, those comments may cost the instructor her job.

The Union Township school board announced today it has filed tenure charges against Viki Knox, the longtime teacher and faculty adviser to the high school’s Bible study group.

Board president Francis R. Perkins said the charges were formally filed in late December after a three-month investigation of Knox’s conduct, the first step in what could be a lengthy and costly process to fire her.

"Every student, no matter what race, creed color or sexual orientation ought to be able to come to school and feel comfortable in a learning environment that’s welcoming and nurturing," Perkins said.

Knox, 50, who has been on paid administrative leave, could not be reached. Sandy Oxfeld, Knox’s attorney, said he would have no comment on the case while it is in litigation.

The move by the Union school board has rekindled a broader issue of free-speech rights of teachers in the growing age of social media.

The entire story is here.

Contracts with Patients in Clinical Practice

By Michael L Volk, Sarah R Lieber, Scott Y Kim, Peter A Ubel, & Carl E Schneider

(Volume 379, Issue 9810; January 7)

Written documents called contracts are increasingly present in clinical practice and medical publications.

There are behavioural contracts for management of so-called difficult patients, opioid contracts, suicide prevention contracts, and healthy living contracts.

Some practices have even asked patients to sign contracts in which they promise not to litigate or post defamatory comments on the internet.

Despite widespread adoption, the use of contracts in medicine has had little critical appraisal.

Patients' contracts do different things in different clinical situations: they can serve administrative purposes, by deterring mistreatment of clinical personnel or diversion of narcotic drugs; some are educational, drawing patients' attention formally to information; and others clarify expectations and foster transparency, such as when a prospective organ recipient agrees to respect rules on substance misuse.

Other contracts--e.g., for suicide prevention--can help doctors to express concern for their patients, or help patients hold themselves to better health practices, by bolstering willpower with a written commitment (Ulysses contracts).

The effectiveness of contracts in general is uncertain.

[snip]

A unilateral or authoritarian style of implementing contracts might cause patients to feel threatened or coerced, and perhaps even to view the contract as a "prelude to abandonment".

[snip]

In view of the inconclusive evidence about the effectiveness of these contracts and their possible disadvantages, we have some recommendations.

First, clarify terminology; written patient-physician agreements generally do not fit the usual definition of a contract.

Second, clarify aims; for example, if the main aim is to state non-negotiable terms (such as substance-misuse criteria for transplant candidacy) it would be franker to label the document an acknowledgment of clinical policies.

Third, treat the contract as part of a therapeutic process--a standard form contract is one thing, and helping patients set and meet goals is another.

This is the fundamental principle behind motivational interviewing, a technique with strong empirical support.

Finally, patients should be given resources and assistance to meet their goals; for example, structured weight-loss programmes work better than advice to diet and exercise.

[snip]

Whenever possible, written agreements should be bilateral, tailored to the individual patient, and presented in a way that signals continuing commitment.  Otherwise, we risk alienating patients and damaging the therapeutic alliance."

Thanks to Ken Pope for the story and excerpts.

British science needs 'integrity overhaul’

Medical Academics Voice Concern Over Research Misconduct

By Daniel Cressey

Nature

British scientists are fundamentally failing to deal with research misconduct, which is widespread in the country, leading experts have warned.

At a conference in London yesterday, participants were united in calling for more action on the issue.

“There is a recognition that we have a problem,” said Fiona Godlee, editor-in-chief of the British Medical Journal (BMJ) and one of the driving forces behind the meeting.

Coinciding with the meeting, a BMJ survey of 2,782 doctors and medical academics showed that 13% claimed to have firsthand knowledge of “inappropriately adjusting, excluding, altering or fabricating data”. Six per cent said that they were aware of cases of possible research misconduct at their institutions that they thought had not been properly investigated.

Research-integrity issues in the United Kingdom have long been fretted over. Last year the House of Commons science and technology select committee said that they found “the general oversight of research integrity in the UK to be unsatisfactory”. Similar concerns have been raised by others, going back more than a decade.

Elizabeth Wager, chairwoman of the international Committee on Publication Ethics, warned the meeting that one US editor had told her that UK institutions are the worst to deal with in cases of suspected misconduct. “Our reputation in the world is not looking good,” she said.

She added that although the concern is being driven mainly by medical researchers, their worries apply to other scientific fields.

UK mechanisms for ensuring ethical conduct in research “need to be strengthened”, concluded a communiqué from the meeting. In addition, the meeting said, the UK Research Integrity Office (UKRIO) should be enhanced, and ongoing funding for it should be secured. (At one point last year, the future financing of UKRIO was unclear, although it now seems to be secure.)

The entire sotry can be found here.

Texas Abortion Law Can Go Into Effect Immediately

Associated Press

AUSTIN, Texas—A federal appeals court cleared the way Friday for the immediate enforcement of a new abortion law in Texas requiring doctors to conduct a sonogram before the procedure.

The three-judge panel on Tuesday lifted a temporary stay issued by a district court judge who found the new law potentially unconstitutional, but didn't issued a legal mandate. On Friday, the judges agreed to a request by Texas Attorney General Greg Abbott to cut short the typical three-week waiting period between a ruling and its implementation.

The new law requires doctors to conduct a sonogram before performing an abortion, to show the woman the image, to play the fetal heartbeat aloud and describe the features of the fetus at least 24 hours before the abortion. There are exceptions in the case of rape, incest, fetal deformities and for women who have to travel great distances to reach a doctor.

The most recent order doesn't give time for doctors fighting the law to appeal the decision, which under normal circumstances woudn't have gone into effect until Jan. 31. The Center for Reproductive Rights, which supports the doctors, didn't have an immediate reaction to Friday's order.

The entire story is here.

American College of Physicians Ethics Manual - Sixth Edition

American College of Physicians Ethics Manual -- The college released a new version of its professional guidelines and included a section about considering costs involved in treatment. "The manual is not a substitute for the experience and integrity of individual physicians, but it may serve as a reminder of the shared duties of the medical profession. ... Physicians must base their counsel on the interests of the individual patient, regardless of the insurance or medical care delivery setting. ... Physicians have a responsibility to practice effective and efficient health care and to use health care resources responsibly. Parsimonious care that utilizes the most efficient means to effectively diagnose a condition and treat a patient respects the need to use resources wisely and to help ensure that resources are equitably available" (Snyder et al., 1/3).

The supplement to the code of ethics can be found here.

Assisted suicide should be legal, says major report to parliament

MPs told that people with a terminal illness could be safely offered the choice to end their own lives

By Esther Addley

The Guardian

Originally published Wednesday 4 January 2012

MPs should consider changing the law on assisted suicide to allow some terminally ill people to end their lives at home with the help of their doctor, a major report into the subject has concluded.

The Commission on Assisted Dying, chaired by the former lord chancellor Lord Falconer, says a choice to end their own lives could be safely offered to some people with terminal illnesses, provided stringent safeguards were observed.

Describing the current law on assisted dying as "inadequate and incoherent", the commission will today outline a legal framework that would permit only those who had been diagnosed with less than a year to live to seek an assisted suicide, and then only if they met strict eligibility criteria. These would include:

• Two independent doctors were satisfied with the diagnosis.
• The person was aware of all the social and medical help available.
• They were making the decision voluntarily and with no sense of being pressurised by others or feeling "a burden".
• They were not acting under the influence of a mental illness, and were capable of taking the medication themselves, without help.

The 400-page report follows a year of investigation by the commission, whose members also include the former Metropolitan police commissioner Lord Blair, a former president of the General Medical Council, a leading consultant in disability equality, an Anglican priest, and medical, mental health, palliative care and social care specialists.

The rest of the story is here.

Report Finds Most Errors at Hospitals Go Unreported

By ROBERT PEAR

New York Times - Health

Published: January 6, 2012

Hospital employees recognize and report only one out of seven errors, accidents and other events that harm Medicare patients while they are hospitalized, federal investigators say in a new report.

Yet even after hospitals investigate preventable injuries and infections that have been reported, they rarely change their practices to prevent repetition of the “adverse events,” according to the study, from Daniel R. Levinson, inspector general of the Department of Health and Human Services.

In the report, being issued on Friday, Mr. Levinson notes that as a condition of being paid under Medicare, hospitals are to “track medical errors and adverse patient events, analyze their causes” and improve care.

Nearly all hospitals have some type of system for employees to inform hospital managers of adverse events, defined as significant harm experienced by patients as a result of medical care.

“Despite the existence of incident reporting systems,” Mr. Levinson said, “hospital staff did not report most events that harmed Medicare beneficiaries.” Indeed, he said, some of the most serious problems, including some that caused patients to die, were not reported.

Adverse events include medication errors, severe bedsores, infections that patients acquire in hospitals, delirium resulting from overuse of painkillers and excessive bleeding linked to improper use of blood thinners.

The rest of the story is here.

Prison psychologist loses license, job

Former staffer who faked rape has license suspended by the Board of Psychology

By Laura Newell, Telegraph Staff Writer

Laurie Ann Martinez

A psychologist who allegedly faked her own rape earlier this year has lost her job with the California Department of Corrections and Rehabilitation.

Laurie Ann Martinez, a licensed psychologist for the state prison system who worked at New Folsom Prison, was terminated from her post. Her last day was Dec. 22, three days after her court appearance.

Her license has also been suspended by the state Board of Psychology.

The board is seeking to permanently revoke her license.

“The criminal allegations against Ms. Martinez are serious enough to warrant this action,” said Board Executive Officer Robert Kahane. “Our mission is to protect consumers, and we think allowing Martinez to continue to practice poses a threat to consumer health and safety.”

The rest of the story is here.

Other posts related to this story can be found here and here.