Working with people PSYC376

When the Law and ethical code clash, which one overrides the other?

The Law

When was the Ethics code published?

2003, a new version is in the works

4 core principals of Ethics code

1.      Respect for the Dignity of Persons and Peoples

2.      Responsible Caring

3.      Integrity of Relationships

4.      Social Justice and Responsibility to Society

Which 2 languages is the Ethics code written in?

English & Te reo

Is the code of ethics more individualist or more collective in framework

more collectivist: empases on community and culture, less on behaviour of a singular individual.

Are health professionals required to follow the ethics code like the law? 

No, it is an aspirational guidline  

The 4 fundamental principles of medical ethics

1. Autonomy

2. Beneficence

3. Nonmalefience

4. Justice

Priciple of: Autonomy

1. support self determination

2. make informed and reasonable decisions

3. act on the decided decisions

Principle of Beneficence

1. do good

2. to act in the benefit of people where ever possible

3. produce the best outcome for others by choosing actions from which the benefits maximally outweigh the costs and risks

Principle of Nonmaleficence 

1. Do no harm 

2. An obligation 

3. refrain from causing deliberate harm

4. avoid actions that might potentially cause harm

5. if harm is unavoidable, ensure it is minimised as far as possible and the benefit outweighs the cost/risks

Principle of Justice

1. seeking fairness in all work

2. ensuring that the benefits of our activities are fairly distributed

Structure of the code

Four principles > Values > Practice implications

How are value statements to be used in the ethics code?

To follow as guides to aspire to that level of professional care

ie “psychologists will enhance integrity in relationships by recognising, and where relevant, declaring their values and beliefs.”

how are practice implications to be followed in the ethics code?

A display how health professionals should act in situations that involve a particular value.

(value statement is the standard of care professionals are committed to upholding)

Nonmaleficence means:

Principle 1: Respect for the dignity of persons and people involves:

1. respect and caring 

2. informed consent & freedom of consent 

3. confidentiality and right to privacy 

4. non-discrimination

5. awareness and sensitivity to diversity

6. upholding the Treaty of Waitangi  

Principle 2: Responsible Caring includes:

1. showing active concern

2. awareness of power structures, recognising vulnerability

3. providing beneficial services

4. do not engage in or promote harmful activities

5. respect the rights of clients to make their own decisions

6. upholding the Treaty of Waitangi

Principle 3: integrity in relationships

1. respect, accuracy, openness

2. appropriate boundaries

3. avoiding conflicts of interest

4. seeking to do right in relations with others

5. honesty and accountability in all professional dealings with all people (professional, students & clients)

6. upholding the treaty of waitangi

principal 4: social justice and responsibity to society 

1. sharing and promoting knowledge

2. prevention of misuse of knowledge

3. monitoring the professional practice

4. staying current in knowledge and practice 

5. upholding the treaty of waitangi   

what is ethical reasoning?

the clash between ethical principles

example: client autonomy vs best interest of client 

What action should be taken when ethical conflict arises?

1. Follow a process

2. Document it entirely

What is step 1 of the ethical decision-making process?

step one:

Identity the issues and the practices that are ethically relevant

what is step two of the ethical decision-making process?

Develop alternative courses of action,

preferably in consultation with a professional colleague or supervisor.

what is step three of the ethical decision-making process?

For each identified course of action analyse the likely short term, ongoing, and long-term risks and benefits for the individual(s) and/or group(s) involved or likely to be affected.

what is step four of the ethical decision-making process?

Conscientiously apply the principles, values and practice implications to each course of action in the light of the identified risks and benefits and decide which offers the best balance between these.

what is step five of the ethical decision-making process?

Take the chosen course of action, accepting responsibility for the consequences of the chosen course of action.

what is step six of the ethical decision-making process?

Evaluate the consequences of the action, correcting negative outcomes in possible and, if the issue(s) originally identified are not resolved, re-engage in the decision making process.

How can the ethical decision making process be more culturally sensitive

1. awareness of biases: race, cultural differences, customs and beliefs

2. consider all perspectives offered

3. including the client in the decision making process

4. if necessary use culturally approipate supervision

5. following ethical guidelines doesn’t automatically translate into ethical decisions review regulations and law that might contradict cultural knowledge and understanding

6. negotiate, seek consensus. settle on agreement/disagreement.

which one expects a higher standard of practice?

In a complex situation, is the ethics code an acceptable reason for acting out of what is normally expected by health professionals?

No never an excuse or a “out’ for professionals.

What is the difference between “May” & “Must”

Must is not negotiable

May is the expectation to follow

name 6 legislation and code acts

1. Code of Ethics

2. Code of Health and Disability Services Consumers’ Rights 1996

3. Privacy Act 2020 

4. Health Information Privacy Code 2020

5. Treaty of Waitangi

6. Pae Ora (Healthy Futures) Act 2022

Key areas of the HDS consumers rights act 1994 (heath & disability)

1. applies to every person who uses health and disability services

2. applies to every provider that offers health and disability services

Within the HDS consumers rights act 1994, what is the age of consent?

there is not age of consent,

a child is deemed a consumer and have the same rights in services as adults

incompetence to consent must be established, it can NEVER be assumed

how to determine incompetence to be able to give consent?

Can incompetence (consent) be easily determined? 

No, every consumer is presumed competent to make informal choices unless there are reasonable grounds for believing the consumer is not competent.

Health information privacy act 2020

can any information be collected by healthcare providers?

no, only want is necessary.

Dispose of information when finished

Only disclose the information if you have a good reason

Te Tiriti o Waitangi

What differences are there in the wording of the English and Te reo document?

Differ in wording and interpretation

particularly regarding sovereignty

What are the three P’s of Te Tiriti o Waitangi?

Partnership

Participation

Protection

What is cultural Safety?

1. refection on ones own cultural identity 

2. how their own culture impacts their professional work

3. understanding self

4. rights of others 

5. to be able to work with all people who are different from them