Abstract
Professional ethics is the responsibility linked to an occupation or profession. Individuals engaged in these economic activities have vital role of taking decisions over others. The professional code describes the techniques of using these powers. The codes propose guidelines for directing the values of profession. Learning ethical code does not assure ethical conduct on the part of professionals. The National Association of Social Work (NASW) code states that a code of ethics cannot settle all ethical disputes rather they set ethical values, principles and standards to which professionals aim to practices and finally which reviews their action.
American Psychological Association (APA) code on the other hand adds that ethical standards need a personal obligation to a life long effort to perform ethically. These codes are compared with real life experiences of health care professionals and medical practitioners when they face ethical issues and possible solutions are discussed in the article (Leighton & Killingbeck 2000).
Introduction
Bertrand Russell has inscribed in a piece of writing that, worthless information develops ones life through motivation and significant process. This in turn tends to improve the happiness of all concerned. This is an age of information and information technology plays a vital role in supporting the business in facing the acute competition and with stand in the competitive market. In the contemporary competitive world the adherences of values is gaining more importance. The profession or action of a person is related to ethics. The action can either be a positive or negative one and the positive value creates foundation for integrated society by spreading humanitarian morals. On the other head negative values works on the reverse direction.
Values are developed for smooth functioning of any individual action. The aspect of trust is crucial for any business to continue. Transparency is most essential for good governance of corporate affairs. Likewise accountability is also crucial for the success of any business.
On maintaining transparency, the liability for decision and action are known to the professional and it becomes easy to ensure that there will be accountability towards their work. There is a great significance for applied philosophy in both business values and professional ethics. The application of knowledge with confidence and thought will definitely lead to success. Therefore there is a requirement for coordination of action uniformly to overcome the barriers in professional life (Vittal 2001).
Based on research, psychologists try to develop convincing and consistent knowledge on ethics. They apply it in various contexts of human behavior. The aim of psychologists is to extend the knowledge of behavior and use it to develop the condition of both individuals and the society. They also assist the community in making decisions concerning the human behavior. There are certain general set of values upon which they derive their work. These codes give basic principles and policies that involve major challenges faced at workplace. The key objective is welfare and protection of individuals and individual rights. To operate ethically, there is a necessity for self-motivated set of ethical standards.
Literature Review
Certain ethical issues faced by professionals in the service sector may be studied to compare whether the guideline provided in APA and NASW comprise solution to these problems. Emotionally deprived of mental ailments, many individuals in rural areas require health care needs. But ultimately many barriers block them from getting sufficient care. Some ethical issues too arise in the health care in rural areas, and these problems influences the delivery of health care services and experience of the patients. The availability of restricted resource in rural region lead to conflicting roles, therapeutic restrictions among families, caregivers and patients, the opportunity to provide only generalistic care, restricted resources to discuss clinical ethics, challenges in maintaining the confidentiality of patients and will lead to more stress for rural health care workers(Roberts, Battaglia & Epstein 1999).
Ethical issues arise when nurses participate in the resolution of patient problems and this impact their practices of ethical standards and policies because they are morally involved with the condition of patients and lead to a situation of dilemma (Penticuff & Walde 2000).
Pain management is associated with ethical issues because doctors and nurses have a different view from the policies laid down in the ethical standards. These issues are related to the general under treatment provided to patient with acute pain, especially in the case of the elderly, treatment of pain at the ends of life (Ferrell et al 2001). In the neonatal intensive care unit nurses face ethical issues with respect to their decision to withdrawing and withholding treatment for infants born with low weight (Becker & Grunwald 2000).
Another dilemma faced by nurses comprises the situation when neuro imaging is performed in infants and children because they do have the maturity to decide whether to under go the treatment or not (Hinton 2002).Ethical issues also arise in the storage and retrieval of genetic information (Ethical, Legal, and Social Issues). The abuse of the elderly person is yet another problem encountered (Bergeron& Gray 2003).
Lack of information and knowledge on HIV infection can create dilemma for health care givers while providing assistance in an environment with meager resources (Moatti, et al 1995).
Internists also face ethical dilemma because they are new to the profession and do not have much workplace practical experience to deal with problematic issues. The contribution of clinical nurse specialist to maintain a healthy work environment is immense (Disch, Walton & Barnsteiner 2001).
On evaluating the number of accidents happening, it is larger proportion in rural areas than in metropolitan areas. The acute use of alcohol in America has lead to much violence. The misuse of banned substances is increasing among these rural residents. In addition to the mental illness and mess caused by the use of substances, they are experiencing painstaking symptoms during certain seasons. Even people in those areas affected my natural disaster are too experiencing the same. The rural suicide rates have also gone high. The caregivers are also experiencing the same ethical issues due to the lack of sufficient infrastructure and resources. The treatment of patients suffering from mental illness is an issue concerning the caregivers (Moatti, et al 1995). The ethical standards set forth by American Psychological Association (APA) are definite rules implemented for conduct. These standards are not complete, which does not mean that if a behavior is not particularly defined by ethics code, it does not require being either ethical or unethical. The general standards related to the professional and scientific activities are:
- Applicability of ethics code: the activities are analyzed under these ethical standards only if it is a part of work related function. Persona behavior of a worker does not fall under the purview of ethics.
- Law and ethics. If the conduct of a person comes under the purview of legal action, the person will be subject to undergo legal sentences.
- Professional and scientific relationship: It provides the services in the context of a definite professional role.
- Services should be provided only according the requirements of the profession as per the competence of the person due from basic education.
- Maintaining expertise: Those engaged in the professional activities keep a practical level of awareness on professional information in their area of activity.
- Basis for scientific and professional judgment: They depend on systematically and professionally ensuing information for taking judgments.
- Explaining the nature and results of psychological services while providing the services should be practically understandable to the receiver in an appropriate manner.
- Human differences: Those situations were the age; gender, race etc influence the work relating to an individual or group, there the experience and training acquainted will guarantee the skill of their service.
- Respect for other.
- Work without any kind of discrimination.
- Sexual harassment: Workers are required to work and let work in a comfortable manner without causing sexual harassment.
- Other harassment: humiliating a person with whom they work together is not entertained.
- Personal problems and conflicts: They abstain from an activity which is supposed to harm a person with whom they owe a professional obligation.
- Avoiding harm: They try to take necessary measure to avoid harm to their clients with whom they have obligations, moreover if the situation is unavoidable, they try minimizing the effect.
- Misuse of psychologists influence: They are prepared to safeguard against personal or political factors that may misuse their influence.
- Improper use of the works of psychologists.
- No multiple relationships to be maintained at work place.
- Barter: They are avoided from accepting the non monetary remunerations from their clients as it creates misrepresentation of the professional relationship.
- Exploitative relationship: They are not supposed to exploit persons or engage in sexual relationships, because such relationships harm judgment.
- Consultation and referrals: with appropriate approval they organize for suitable consultations which are subject to contractual law and obligations.
- The requirement of a third person may not be provided unless there is proper authority given to that extent.
- Delegation of work should be according the to the rule of the work.
- Proper records should be maintained for work completed.
- Records and data: They create, maintain and retain the data in accordance with the law.
- Fees and financial agreement: For the service rendered they reach on an agreement regarding the compensation.
- Accuracy in reports to payers and funding sources: They are supposed to mention accurately the payers for services and the nature of service provided.
- Referrals and fees: When ever some payment is met on account of services rendered other than the employee-employer relationship, then the payments should be based on the services rendered and not on the base of the referral (Ethical Principles Of Psychologists 1992).
The key task of social works profession is to develop the society and help the community to meet their basic needs. This profession centralizes on the well being of human beings in a common framework. The essential part of the social work is addressing the external forces creating burdens in the society. They help and bring changes with and on behalf of clients. The assignment of social work profession is entrenched in a set of values. These values held by the social workers, are the reason and view points for their act. The values and principles must be balanced with in the intricacy of human knowledge. Professional codes are the central part of social work. The profession has a responsibility to clear the values, principles and standards that guide the behavior of social workers. The codes of ethics put forward by NASW confirm six purposes:
- It recognize the core value on which the mission is based,
- It reviews the principles that reflects the core values and set standards that direct the social wok practice,
- It helps to recognize the appropriate thoughts when professional doubts or requirements arise,
- It offer standards to link the accountability of social work profession,
- It socializes the new entrants to the field of social works by describing the mission, values, ethics, principles and standards.
- It communicates the standards that are used to access whether any unethical conduct are been engaged in by the social workers (NASW Code of Ethics).
The NASW code of ethics is planned to provide a direction to everyday professional behavior of social workers. It is according to the context the codes must be considered. The NASW code does not state, which standard are more important. Chances of conflicts are always prevailing among the social workers on account of the values, principles and standards. There are many complex cases in social works where with a single answer the issues cannot be solved. Under these circumstances a social worker should judge all the values, principles and standards in this code that are pertinent to any condition. Apart from this code there is many other basis of information concerning ethical thinking that may be helpful. Among the codes of ethics the social workers should consider the NASW code of ethics as their prime basis. A sensible dealing of situations arising out of the conflicts between personal and professional values is accepted. There may also be situations when ethical commitments may clash with the policies or law. In such situations the social worker is supposed to solve the issue with the values, principles and standards articulated in the code. In case an apt resolution cannot be sort out, then the appropriate consultation should be done before deriving at the final decision. The NASW code of ethics is used by NASW and the individuals and organizations that accept it as an outline for further reference. Breach of the standards in this code does not involve a legal liability. Such resolutions can be made only in legal proceedings. Suspected infringement of code would be considered as an area under discussion and it may be left to group review process. These processes are usually separate from legal and administrative procedures and are lined from legal reviews. A code of ethics cannot assure ethical behavior. The social workers actions must effect from their personal obligation.
NASW requires all to follow ethics at workplace. The following core values and ethical principles set forth morals to which all social workers should aim.
- Value-Service: Principle – Their primary aim should be to serve the society.
- Value-Social justice: Principle – Overcoming social injustice.
- Value- Dignity and Worth of the Person: Principle – Intrinsic self respect and giving importance for the person.
- Value- Integrity: Principle – A reliable behavior is expected from the social workers.
- Value- Competence: Principle – They perform with in their area of skill and extend their professional know-how.
They frequently attempt to extend their professional knowledge and skills and apply them in practice. They should aim to add to the knowledge support of the profession (NASW Code of Ethics).
The enhanced codes of ethics start with a preface clarifying the role and responsibilities. The opening of many codes states the common aim of the profession. The NASW code declares that social works develops individual well being and helps in meeting the basic needs of the society, with special attention to people deprived of poverty and other ailments. In addition to this they provide common welfare to the society and promote better living condition. They assist in promoting social, economic and political justice. The codes progress from general statements to set of core values. The ethical principles are the outcome of services of core value. The prime role of social workers is to facilitate the helping hand in needs and addressing their social difficulties. The ethical principles are intended to clear a general set of values for profession and provide aims to which members should desire. Besides that the ethical principles present the base for more specific ethical standards that are regarded as the basis for incriminating someone for breaching the ethical code before the professional association of ethics committee.
Most codes have an ethical principle besides non exploitation, and the APA codes sets definite ethical standards against it. The APA code aim to support the relationship between ethical standards and legal standards. On the other hand the observance and infringement of the code may be considered as evidence in certain cases depending on the situations. There are certain real life conditions that create ethical dilemmas, which even definite ethical standards cannot cover. In most of these cases the NASW codes are very helpful in resolving these differences of opinion. In addition to this there are other means of information about ethical thoughts that are very useful. The social workers should be aware of the conflicts between personal and professional values and they need to be in a situation to resolve them responsibly (Leighton & Killingbeck 2000).
There are some issues that affect the rural mental health professional while maintaining ethical situation with respect to non sexual dual relationship. Though there are professional guidelines to regulate the conduct, specific guidelines for practical decision making is lacking. Moreover there are some complementary opinions between various ethical codes and unethical behavior.
Alternative guidelines will be helpful to solve problems in these relationships. Dual relationship is defined as the relationship between the health care giver and the patient which is beyond the normal relationship on medical grounds. This term has widely been misunderstood as sexual exploitation of client. An ethical code of conduct is violated when the relationships of individuals go beyond the boundary of normal conduct from the sexual perspective and there is exploitation of the relationship of peers. There are various types of dual relationships, were both the parties concerned may be friends. On finding the real way of dual relationship in rural society can be an enriching and challenging experience. The evaluator must analyze each relationship and decide on the risk and benefit factors.
In rural society there are various psychotherapists with broad range of unavoidable dual relationship conditions. As they are presented with a wide range of dual relationships, it is essential for them to be careful in judging the potential impact of dual relationship, and conduct a risk benefit analysis to know how to proceed. At certain times consultation provides better ethical decision. According to APA, when psychologists are asked to render services to people for whom appropriate mental health services are not available, they provide such services to ensure that it is not left out if they make rationale effort to obtain the skill required. Code of ethics is usually written from a generally perspective and it limited to generally perceived circumstance and does not give in depth details about behavioral changes and problems.
All the codes limit the boundary violations, such as the sexual relationships, exploitative business relations, etc. The code evidently permits the dealings with respect and dignity and avoiding such behavior that are harmful and result in harm to the society. The rural settings are clearly set by the solitude and low density of population. When boundary crossings are part of structured clinical interventions, on the other hand boundary violations are always unethical and can be illegal too (Zur 2006).
The National Association of Social Workers (NASW) have covered the way for the detection of professional social work practice through the commitment of NASW code of ethics as a standard of practice (Lay, Khaja, McGuire & Grass 2008).NASW points out that workers should observe equity and harmony at workplace to substantiate the requirement of all involved. It is the essential duty of the social worker to be aware of the political situations and initiate changes in policy and legislation to improve the social conditions for the betterment of the society and there by promoting the social justice. NASW states that professionals should promote working conditions in a manner that due respect are given for social differences and culture from the universal perspective. The discrimination and exploitation of groups should be prevented by these social workers by ensuring proper safety to them, were by ensuring the social justice (Leighton & Killingbeck 2000).
Discussion
The overlapping role is utmost in the rural villages where personal relations are given due consideration. These relationships are ethically problematic when considering the treatment boundaries. While analyzing the problems faced by the healthcare providers in treating the patients, according to APA the main harms perceived is with overlapping relationships. The health care givers experience the bind of caring each individual while treating the patients. Health care givers in the villages establish exclusive groups to provide ethical guidance so that they can deal issues in a positive manner.
Conclusion
The need of proper mental health care is an important criterion in the rural area while considering the above facts. Even the importance of the health care assistants has to be taken under consideration while discussing this issue (Frontier Ethics 1999).
With respect to pain management, ethical dilemma is vibrant. The solution for this can be met by commitment of individuals and health care system (Ferrell et al 2001). The ethical dilemma involved the criteria used to care and handle the patients. There was consideration for the approach done to serve each patient according to the actions ethically correct towards each patient. The role of nurses can be improved by including the role of parents in decision making (Becker & Grunwald 2000).
A partnership with clinicians enables them to have a proper working environment (Disch, Walton & Barnsteiner 2001). The ethical mode of treatment is ensured in neuro imaging of infants if precise principles are laid down in the ethical codes for medical practitioners (Hinton. 2002). By reducing the stress among the care givers the problems encountered by the elderly persons can be minimized (Bergeron& Gray 2003).The ethical dilemma on the opinion of the general practitioners will support it to an extent (Frontier Ethics 999). Internists with least experience have little access to ethical consultation and physicians should be trained to handle such situations. Thus both APA and NASW should be customized for its application where professionals encounter ethical dilemmas.
Reference
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