Well Howdy Ethical Clinicians!
Welcome the new and improved Clinical Ethics Blog. We started this blog way back in 2014, but it has been in hibernation for the last two years. We are excited to roll it out again, with some improvements. Welcome!
Some of you may be wondering why this blog has been created. Isn’t it pretty clear what is and isn’t ethical behavior in our profession? Can’t we just look at our Code of Ethics and Scope of Practice to figure out the best ethical action in clinical situations? If we aren’t sure what to do, shouldn’t we just go to our supervisors and ask for guidance? What can this blog give that you can’t get anywhere else? Well, a lot actually.
The major issue is that Ethics is not taught, at least not in the traditional format. But it needs to be. It’s ironic that the one topic we have to rigorously repeat in our training is ethics, yet it is the one topic that is not typically taught. We attend ethics trainings at least every 2 years, sure, but those trainings typically use the water-cooler technique, rather than a traditional teaching format.
The water-cooler technique of teaching uses inductive reasoning, meaning we create principles based on our experiences. We get into ethical dilemmas or we observe them in others, and then wonder what we should have done differently, or what principle could have helped to guide us to an ethical action. We meet our colleagues at the proverbial water-cooler and discuss the event AFTER it has occurred. The trainings we attend are filled with vignettes and attendees are asked to contribute vignettes of things that have happened to them. Don’t get me wrong, vignettes are wonderful tools that I use often, but they should be used to illustrate an existing principle or point, rather than to BE the principle or point.
Think about it. If ethics truly were innate, and if all we needed was some practice and clinical vignettes to bring to life what we already knew inside, then one would find a significant decline in the amount of ethical violations the longer a clinician is in the profession. Yet there is no evidence that longevity in the profession is correlated with few or decreased level of ethical violations. In fact, the opposite is true. In other words, if we are not becoming more ethical as we professionally age, then there is something wrong with how we are being taught.
What I am promoting is a different way of learning ethics, a more traditional way of teaching that is utilized with other topics in our field. It’s pretty simple, really. The idea is to teach someone to be an ethical clinician, so that they are prepared BEFORE an ethical dilemma enters their practice. Of course, dilemmas will occur, no education can completely omit them, but the number will be greatly reduced if clinicians can learn to strengthen their ethical practice before it is tested. Clinicians will also learn to detect red flags early and what to do and where to go for help before the dilemma becomes disaster.
This is how we wrote Ethics for Addiction Professionals (2014) and this blog will unveil the specifics in building an ethical practice. So welcome! And read on…