Professional and Ethical Issues, Lecture notes of Ethics

Download Professional and Ethical Issues and more Lecture notes Ethics in PDF only on Docsity!

Professional and

Ethical Issues

ISW Day 2 Sue Walsh, Univ of Sheffield March 2018

Aims for the session

— Contextualise the discussion of ethics- the value of

seeing the ‘whole picture’.

— To discuss relevant philosophical/conceptual ideas

— To discuss challenges of ethical practice

— To apply principles in practice

Exercise 1

— What does being unethical mean to you?

— Discuss in pairs and feedback

— https://youtu.be/_SsccRkLLzU

— https://youtu.be/vDGrfhJH1P

Thinking about ethics and supervisory practice (taken from Scaife 2009)

— An ethical framework is like scaffolding around action made up of

moral philosophy, professional codes of behaviour, values inherent in the therapeutic models, personal ethics, the law, organisational context (Bond, 2008)

— General principles of ethical decision making- moral philosophical

underpinnings. — Kant absolute duty — Consequentialist theories — Virtue theory — Adopted by medicine in 1920’s/ 30’s led to a framework of a professional community guiding their own professional action. However BRI scandal, Shipman, Liverpool Cancer Care Pathway suggest the complexities.

Professional codes

— The relationship between ethics and

professionalism

— The limits of Codes of Ethics

Ethical principles- a possible framework to explore ethical dilemmas in supervision Scaife/

— Autonomy -The principle that individuals have rights to

freedom of action and choice.

— Eg the developmental model of supervision emphasises the right to

more autonomy of supervisees as they become more experienced practitioners

— Fidelity Being faithful to promises made and to ‘right’/

proper practices Attention to this principle helps supervisors to think carefully about what they can reasonably promise to supervisees during the contracting process with care taken not to go beyond what is possible. Eg. confidentiality

— Justice Ensuring that people are treated fairly ‘fair-

opportunity rule’ requires that the supervisee be provided with sufficient assistance to overcome any disadvantaging conditions resulting from her or his learning abilities or difficulties, or social context. Eg. providing more supervision to a struggling supervisee versus equity to all; no discrimination.

— Non-maleficence Striving to prevent harm

The needs of one person or group may be privileged over another, eg children and families

Case study 1 — You are supervising an older more experienced senior nurse in your team with 10 years experience. The whole team is under pressure and under scrutiny and there is a general worry about impending job cuts. You have noticed that recently a number of clients have dropped off of her case list. Uncharacteristically, she is arriving late for supervision and is unprepared and when things need following up she is not doing that and you have to keep remembering to follow things up. How might you go about addressing these issues in your supervision? v adapted from Pickvance (2016)

Case study 2

— Your trainee who is pregnant has been working with

a male client for a time limited therapy. The client is asking increasingly personal questions of the trainee about her and the baby. Your trainee arrives at supervision tearful and afraid. — How might you go about addressing these issues in supervision? v Adapted from Pickvance (2016)

Factors to consider

— Case study 1- speaking openly and honestly

(embedded in your contract). Validated worries and life stress. Explore impact on work on self. Explore steps to be taken ( discuss manager, reduce work, go off sick), refocus the work drawing on theoretical model)

— Case study 2 –balance leaping in vs. review of real

threat. Explore how trainee had managed any boundary infringements- had she discussed them with client, the meaning of these interpretations, leading to assessment of risk and whether to carry on

Factors to consider

— Case study 3- how empowered do you feel to

influence practice of an experienced colleague? Accountable to own professional body. Tension between absolute duty and breaching client confidentiality, the safeguarding reporting issue, cultural differences, a matter of professional judgement vs enacting a legislative duty

Francis Report 2013

— A FOCUS ON FINANCIAL AND GOVERNANCE ISSUES AND

NOT CLINICAL STANDARDS. Debate underway about the extent to which senior management can be held to account

Ethical and legal issues in

supervision

— Confidentiality

— Vicarious responsibility

— Responsibility to clients/ensuring standards

— ‘Due process’

— Supervisor competence/accountability/power

— Colleagues