"The Bush administration and Congress are in concert on the goal of developing a fleet of unmanned aircraft that can reduce both defense costs and aircrew losses in combat by taking on at least the most dangerous combat missions. Unmanned combat aerial vehicles (UCAVs) will be neither inexpensive enough to be readily expendable nor-- at least in early development-- capable of performing every combat mission alongside or in lieu of manned sorties. Yet the tremendous potential of such systems is widely (...) recognized, and allies as well as potential adversaries are moving quickly to mount their own research and development programs. The United States is committed to fielding UCAV capabilities by 2010, principally for the missions of suppression of enemy air defense and deep strike, which are among the highest risk tasks for the Air Force and naval aviation."--Overview. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law (...) and medicine, truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

Counseling Ethics for the 21st Century prepares students to address ethical issues arising in contemporary counseling practice. Drawing on their own clinical and practical experiences, authors Elliot D. Cohen and Gale Spieler Cohen present detailed, realistic, and engaging clinical case studies along with a comprehensive five-step model that can be used to manage the complex ethical problems raised throughout the book. Each chapter focuses on particular virtues in the context of examining a particular counseling issue, including (...) online counseling, digital record keeping, and social media. Students will be empowered to define problems, identify relevant facts, conduct ethical analyses, and make the best decisions for their clients. (shrink)

Ethics and Decision Making in Counseling and Psychotherapy has a distinct and timely focus on counseling as a profession. Chapters address the mental health professions, values in counseling, decision making, ethical principles, ethical standards, technology, ethical climate, and office/administrative practices. The early chapters present a foundation for ethical practice of the profession and provides solid building blocks to the more advanced perspectives in later chapters. Chapters on specialty practice are lively and contemporary overviews of these practice (...) areas in counseling that reflect more recent trends to increased differentiation of these areas of practice. Each specialty has its own chapter to allow for an extended discussion of the unique aspects of the field that provide clarity to understanding the particular ethical issues and standards that apply in each specialty. The specialty areas recognized by CACREP are included: mental health counseling; school counseling; couple, marital, and family counseling; rehabilitation counseling; addictions counseling; career counseling; and group counseling. This book is broad in its coverage of the most practiced specialties in mental health practice, and provides an efficient and effective overview of the broad scope of particular areas addressed in counseling. (shrink)

This edited volume comprehensively examines the critical ethical challenges that arise in the practice of counselling and psychotherapy. It translates philosophical positions and professional ethical guidelines in a way that can be applied to practice. The various chapters focus on specific ethical issues that emerge in working with a range of different client groups; for example, children, couples and families. While some ethical imperatives are common across the board, others could be more closely associated with certain client groups. Practitioners might (...) experience uncertainty in working with vulnerable client groups; for example, lesbian/gay/transgender/intersex (LGBT) clients, or persons who report intimate partner violence. Several chapters raise questions, provide information and additional resources to enhance ethically informed practice. Chapter contributions also highlight the ethical dilemmas that might be unique to certain contexts; for example, private practice, schools and consultation-liaison settings. This volume also addresses contemporary and relatively less understood playing fields like 'digital ethics' related to therapist-client interface in the internet space and the navigation of ethical dilemmas in the newly emerging field of employee assistance programmes which address mental health needs in the corporate sector. Written by experienced practitioners of psychotherapy, and culturally contextualized, this is a valuable resource for academics and practitioners interested in psychotherapy and counselling. (shrink)

Psychotherapy holds out the promise of help for people who are hurting and in need. It can save lives and change lives. In therapy, clients can find their strengths and sense of hope. They can change course toward a more meaningful and healthy life. They can confront loss, tragedy, hopelessness, and the end of life in ways that do not leave them numb or paralyzed. They can discover what brings them joy and what sustains them through hard times. They can (...) begin to trust, or to trust more wisely. They can learn new behaviors in therapy and how to teach themselves new behaviors after therapy ends. They can question what they always believed was a given. They can find out what matters most to them, and how to stop wasting time. They can become happier, or at least less miserable. They can become better able, as Freud noted, to love and to work. They can learn how to accept and love themselves just as they are and accept others who are different from them. Our ethics acknowledge and affirm our profession's responsibilities. This book was written to help strengthen, deepen, and inform ethical awareness and the sense of personal ethical responsibility. Its job is to help you hold onto the ideals-including ethical ideals-that called you into the profession to begin with, to help you develop and fulfill those ideals. There will be so much-trust us on this-that tends to dull ethical awareness, to make ethics drift out of focus, to create barriers between you and your ideals, to replace ethics with pseudo-ethics and ethics placebos. Fatigue, endless paperwork, unrealistic expectations, illness, family crises, not being able to make ends meet, burn out, threats of job loss, insurance coverage that doesn't come close to meeting the needs of our clients, biases that have not been addressed, and so many other forces can pressure us into cutting ethical corners. This book is intended to help you develop a strong and healthy resistance to such forces, to help you weather them without losing your ethical awareness and ideals. (shrink)

The comprehensive guide to ethics "An excellent blend of case law, research evidence, down-to-earth principles, and practical examples from two authors with outstanding expertise. Promotes valuable understanding through case illustrations, self-directed exercises, and thoughtful discussion of such issues as cultural diversity."--Dick Suinn, president-elect 1998, American Psychological Association "The scenarios and accompanying questions will prove especially helpful to those who offer courses and workshops concerned with ethics in psychology."--Charles D. Spielberger, former president, American Psychological Association; distinguished research professor of (...) psychology, University of South Florida The authors draw on their professional experience, empirical studies, and case examples to examine the ethical responsibilities that confront psychotherapists and counselors in their day-to-day practice. They offer insights into contending with the sometimes competing demands of clients' needs, formal ethical principles, personal values, and evolving legal standards in a range of areas--including fees, informed consent, sexual concerns, confidentiality, documentation, and supervision. (shrink)

The paper discusses the manner and extent to which Epicurean ethics can serve as a general philosophy of life, capable of supporting philosophical practice in the form of philosophical counseling. Unlike the modern age academic philosophy, the philosophical practice movement portrays the philosopher as a personal or corporate adviser, one who helps people make sense of their experiences and find optimum solutions within the context of their values and general preferences. Philosophical counseling may rest on almost any (...) school of philosophy, ranging — in the Western tradition from Platonism to the philosophy of language or logic. While any specialist school of philosophy may serve valuable purposes by elucidating specific aspects of one’s experiences and directing future action, the more ‘generalist’ the philosophy used as the basis for counseling is, the broader and more far-reaching its potential impact on the person undergoing counseling. Epicurean ethics is a prime example of a philosophy of life that is suitable for philosophical counseling today. Its closer examination reveals that, contrary to superficial opinion, it is not opposed to Stoicism and may in fact incorporate Stoicism and its antecedent virtues (including many Christian virtues) in a simple yet comprehensive practical system of directions for modern counseling. (shrink)

Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non-invasive prenatal testing (NIPT) in first-trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value-consistent choices and personalized informational preferences. We argue for a three-step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical-technical information and are asked to make a decision about screening; (3) during post-test counselling, women are supported in decision-making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre-test) counselling, where techniques for expanding genome analysis and burdensome test-outcomes challenge counselling of patients. (shrink)

Informed consent is a key condition for prenatal screening programmes to reach their aim of promoting reproductive autonomy. Reaching this aim is currently being challenged with the introduction of non‐invasive prenatal testing (NIPT) in first‐trimester prenatal screening programmes: amongst others its procedural ease—it only requires a blood draw and reaches high levels of reliability—might hinder women’s understanding that they should make a personal, informed decision about screening. We offer arguments for a renewed recognition and use of informed consent compared to (...) informed choice, and for a focus on value‐consistent choices and personalized informational preferences. We argue for a three‐step counselling model in which three decision moments are distinguished and differently addressed: (1) professionals explore women’s values concerning whether and why they wish to know whether their baby has a genetic disorder; (2) women receive layered medical‐technical information and are asked to make a decision about screening; (3) during post‐test counselling, women are supported in decision‐making about the continuation or termination of their pregnancy. This model might also be applicable in other fields of genetic (pre‐test) counselling, where techniques for expanding genome analysis and burdensome test‐outcomes challenge counselling of patients. (shrink)

Survival after solid-organ transplantation has improved significantly, and many contemporary transplant recipients are of childbearing potential. There are limited data to guide decision-making surrounding pregnancy after transplantation, variations in clinical practice, and significant knowledge gaps, all of which raise significant ethical issues. Post-transplant pregnancy is associated with an increased risk of maternal and fetal complications. Shared decision-making is a central aspect of patient counselling but is complicated by significant knowledge gaps. Stakeholder interests can be in conflict; exploring these tensions can (...) help patients to evaluate their options and inform their deliberations. We argue that uniform, evidence-based recommendations for pregnancy after solid organ transplantation are needed. Conducting research, including patient-engaged studies, in this area should be priority for the transplant community. (shrink)

The book is concerned with the shifting notions of self and identity and develops a Foucauldian analysis that examines these inherently philosophical notions in ...

A two-part survey was conducted, where respondents reported ethically challenging incidents encountered in the previous two years and actions taken to address them. 132 certified counseling psychologists participated and reported 136 ethical dilemmas. The top categories of dilemmas pertained to breaking confidentiality between respondents and clients, including mandatory reporting, collaborating with education associates, and interjecting by the authority. 82% of the respondents took actions to address the dilemmas. These actions ranged from steering a middle course, upholding professional ethical standards, (...) seeking consultation to taking no actions. Potential environmental contributors to the dilemmas and actions taken to address them were explored. (shrink)

The paper explores the extent to which Epicurean ethics as a general philosophy of life can be integrated in a composite pragmatist approach to philosophical counseling. Epicureanism emerged in a historical era that was very different from the modern time and addressed a different philosophical ethos of the time. This alone makes it difficult for Epicureanism to satisfy all of the normative criteria for a modern ethics. On the other hand, the paper discusses aspects of the modern (...) ‘external’, duty- and demand-driven ethics that may contribute to the emergence of some of the main issues for modern philosophical counseling. The author points out aspects of Epicurean ethics that are potentially powerful tools to address the issues of mood and meaning in philosophical counseling, and thus serve as a contemporary complement to a complex duty-bound, yet pragmatist view of ethics. (shrink)

Psychotherapists and counsellors confront several ethical dilemmas as they tend to provide effective services. There has been much debate among psychotherapists and counsellors alike around the utility of therapeutic contracts. Some view contracts as being restrictive to the therapeutic process and often hindering the work done in sessions. In contrast, many counsellors and psychotherapists use those agreements to revisit specific therapeutic topics and establish the guidelines necessary for this professional arrangement. No matter the opinion or preference of contracts, the development (...) of written and/or verbal consent of specific topics in psychotherapy remains essential. This remains one of the formal features of the arrangement and starting relationship in current counselling and psychotherapy practice. This paper aims to discuss the necessity and ethical demand of therapeutic contract in counselling and psychotherapy practice. (shrink)

Genetic counseling is viewed as a therapeutic interrelationship between genetic counselors and their clients. In a previous relational ethics research project, various themes were identified as key components of relational ethics practice grounded in everyday health situations. In this article the relational ethics approach is further explored in the context of genetic counseling to enhance our understanding of how the counselor-client relationship is contextually developed and maintained. Qualitative interviews were conducted with six adult clients undergoing (...) genetic counseling for predictive testing. Engagement, dialogue and presence were revealed as relevant to genetic counselor-client relationships. A relational ethics approach in genetic counseling challenges the concept of nondirectiveness and may enhance the outcome of counseling for both counselor and client. (shrink)

This article argues that standard models of person-centred care (PCC) and shared decision making (SDM) rely on simplistic, often unrealistic assumptions of patient capacities that entail that PCC/SDM might have detrimental effects in many applications. We suggest a complementary PCC/SDM approach to ensure that patients are able to execute rational decisions taken jointly with care professionals when performing self-care. Illustrated by concrete examples from a study of adolescent diabetes care, we suggest a combination of moral and psychological considerations to support (...) the claim that standard PCC/SDM threatens to systematically undermine its own goals. This threat is due to a tension between the ethical requirements of SDM in ideal circumstances and more long-term needs actualized by the context of self-care handled by patients with limited capacities for taking responsibility and adhere to their own rational decisions. To improve this situation, we suggest a counseling, self-care, adherence approach to PCC/SDM, where more attention is given to how treatment goals are internalized by patients, how patients perceive choice situations, and what emotional feedback patients are given. This focus may involve less of a concentration on autonomous and rational clinical decision making otherwise stressed in standard PCC/SDM advocacy. (shrink)

This article aims to summarize the current ethical issues in the field of clinical and counseling psychology and the process of developing professional ethical standards in China. First, through a review of the history of counseling and psychotherapy in China, general background information is provided. Important ethical issues are then discussed based on the results from several empirical studies. Finally, the process of developing the new edition of the Chinese Psychological Society Code of Ethics for Clinical and (...) Counseling Psychology, the main contents as well as the considerations taken into account in the development of this code are presented. (shrink)

Philosophical counseling is a diverse and burgeoning type of mental health service delivery. Despite competing approaches to theory and practice, the field has largely strayed from an ethical critique of its methodology and counselor training requirements. This article outlines several ethical considerations and training recommendations that are proposed to bolster the quality and effectiveness of philosophical practice. As philosophical counseling gains increasing recognition in North America, recently established national organizations in philosophical practice may profit from revisiting their interim (...) codes for professional conduct Proposed training suggestions for counselor preparation may further assist institutions and board-regulated agencies in establishing competent and acceptable standards of client care. (shrink)

It will be argued that face-to-face relationships potentially provide an essential educational basis for the good. Without such a relationship, for example in the education of professionals and in their practices in general and counseling in particular, there may be far less possibility for truth and justice, and a far greater possibility that violence will be done. In examining issues of counseling as a practice of ethics in terms of ideas of truth, justice, and responsibility, is there (...) an ethical postmodern basis on which we can assist in an embodied way so that we can help others not do violence to others? Indeed, is it possible for us as professionals not to interrupt our own and others? continuity, not to play roles in which we no longer recognize ourselves and whereby we betray not only our commitments but our own substance? An exploration of the above questions will be made with particular reference to some implications of ethics as espoused by Emmanuel Levinas. (shrink)

El diagnóstico prenatal como opción reproductiva más difundida a nivel mundial se refiere a métodos para investigar la salud del feto. Entre sus objetivos está la detección de malformaciones congénitas en la vida fetal y permitir la interrupción del embarazo. Un enfoque ético, basado en el respeto por las personas y a la confidencialidad, evitando el daño y respetando la autonomía, son las claves de un asesoramiento genético óptimo. Se realizó una revisión bibliográfica con el objetivo de exponer algunas consideraciones (...) éticas en la práctica asistencial de la genética médica, a partir de los principios fundamentales de la bioética vinculados al diagnóstico prenatal y al proceso de asesoramiento genético, ya que estos aspectos éticos en la práctica de la genética médica es una temática relativamente joven que ha estado influida por el desarrollo de la bioética y la solución de los dilemas éticos y sociales en la práctica médica. Prenatal diagnosis, as the world widest spread reproductive option, refers to fetus health research methods. Fetal life congenital malformation detection and allowing termination of pregnancy are among its main objectives. An ethical approach, based on respect for people and for confidentiality, avoiding hurt and respecting autonomy, is the key towards optimum genetic counseling. A bibliographic review was conducted. Its objective is to set out some ethical considerations in medical genetics health care practice starting from bioethics fundamental principles, which are linked to prenatal diagnosis and to the genetic counseling process; since dealing with issues related to these ethical aspects in medical genetics practice is a relatively new subject that has been influenced by the development of bioethics and the solution to ethical and social dilemmas in medical practice. (shrink)

With the reduction in diseases due to nutritional deficiencies and infection, disorders which are wholly or partly genetic are becoming relatively more important in all branches of modern medicine. Genetic counselling has developed in recent years from just explaining to an individual or a couple the risk of them producing a handicapped child, to the possibility in many cases of better diagnosis and active intervention to reduce the risks. At the same time antenatal screening programmes have been introduced to detect (...) women who may be carrying a fetus with a severe handicapping anomaly. The ethical aspects of these advances are considered in this article. A practical approach to the resolution of any dilemmas is proposed which concentrates on the duties incumbent on doctors and other health care workers involved with patients who have or may carry genetic disorders. (shrink)

This paper will first introduce the development of professional ethics of counseling and psychotherapy in mainland China. Ethical awareness is often limited due to variations in training experiences. Aligning with ethics codes can also bring challenges due to nuances within Chinese culture. Furthermore, the authors discuss the ethical challenges regarding the principles of multiple relationships, informed consent, and confidentiality in the context of Chinese culture. These ethical issues are often discussed within an individualistic cultural frame and presentation (...) from a collectivist culture offers a unique perspective in the ethics literature. (shrink)

Standards and Ethics for Counselling in Action is the highly acclaimed guide to the major responsibilities which trainees and counselors in practice must be aware of before working with clients. Author Tim Bond outlines the values and ethical principles inherent in counselling and points out that the counselor is at the center of a series of responsibilities: to the client, to him/herself as a counselor and to the wider community. Now fully revised and updated, the second edition examines issues (...) fundamental to the process of counselling. A wide range of ethical problems is discussed and advice is given for resolving these dilemmas. Topics covered include: confidentiality, legal aspects of counselling, working with suicidal clients, false or recovered memory, record keeping, and the importance of adequate supervision. Full of practical information and guidance, the second edition of Standards and Ethics for Counselling in Action will be essential reading and a continuing source of reference for all those involved in counselling training and practice. (shrink)

The author, a scientist working in clinical genetics, outlines the functions of the genetic counsellor and discusses some of the ethical issues involved. The paper is based on one given at a London Medical Group conference.

Legal and ethical issues involved in group work are reviewed and discussed. Variations in different professional ethics codes are discussed. Recommendations for consideration by group leaders are made.

Are dual relationships always detrimental? Speaking the Unspeakable provides an in-depth exploration of client-practitioner dual relationships, offering critical discussion and sustained narrative on thinking about and being in dual relationships. Lynne Gabriel draws on the experiences of both practitioners and clients to provide a clear summary of the complex and multidimensional nature of dual relationships. The beneficial as well as detrimental potential of such relationships is discussed and illustrated with personal accounts. Subjects covered include: · Roles and boundaries in dual (...) and multiple role relationships · Client experiences and perceptions of being in dual and multiple role relationships · Developing a relational ethic for complex relationships This book offers an insightful and challenging portrayal of dual relationships that will be welcomed by therapists, trainers, trainees and supervisors. (shrink)

Book reviewed in this article: Coping with Genetic Disorders. By John C. Fletcher. Genetics, Ethics and Parenthood. Edited by Karen Lebacqz. Screening and Counseling for Genetic Conditions: The Ethical, Social, and Legal Implications of Genetic Screening, Counseling, and Education Programs. A report of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research.

: The accelerated discovery of gene mutations that lead to increased risk of disease has led to the rapid development of predictive genetic tests. These tests improve the accuracy of assigning risk, but at a time when intervention or prevention strategies are largely unproved. In coming years, however, data will become increasingly available to guide treatment of genetic diseases. Eventually genetic testing will be performed for common diseases as well as for rare genetic conditions. This will challenge genetic counseling (...) practice. The ethical principles that now guide this practice take into account the personal nature of test decision making, the need to respect individual self-determination, and the importance of client confidentiality. Certain of these principles may have to be modified as genetic testing becomes more widespread in order to meet the changing needs of clients and society. This paper offers recommendations to ensure that genetic counselors will take a leading role in the future delivery of ethical genetic services. (shrink)

Respect for patient autonomy has served as the dominant ethical principle of genetic counselling, but as we move into a genomic era, it is time to actively re-examine the role that this principle plays in genetic counselling practice. In this paper, we argue that the field of genetic counselling should move away from its emphasis on patient autonomy and toward the incorporation of a more balanced set of principles that allows counsellors to offer clear guidance about how best to obtain (...) or use genetic information. We begin with a brief history of how respect for patient autonomy gained such emphasis in the field and how it has taken on various manifestations over time, including the problematic concept of nondirectiveness. After acknowledging the field's preliminary move away from nondirectiveness, we turn to a series of arguments about why the continued dominance of patient autonomy has become untenable given the arrival of the genomic era. To conclude, we describe how a more complete set of bioethical principles can be adapted and used by genetic counsellors to strengthen their practice without undermining patient autonomy. (shrink)

The work of every school of psychotherapy and every therapist is inevitably structured by a value system and requires codes of ethics and practice. This book addresses the conscious and unconscious aspects of the value system in which therapists are situated. Values and Ethics in the Practice of Psychotherapy and Counselling explores the central issues through the experience of the contributors, each of whom is well known in this field. Each chapter will raise questions for the reader which (...) will stimulate individual thinking about practice or can form a basis for discussion and debate for training or graduate groups. The book is firmly rooted in practice. Each chapter deals with a different aspect of the psychotherapist's work beginning with the general underlying principles, continuing through matters of technique and on to contextual issues. Finally the book moves to the outer world, politics and spirituality as ways of connecting inner and outer, social and individual. The arrangement of chapters allows for flexibility and creativity while providing a coherent structure. Values and Ethics in the Practice of Psychotherapy and Counselling is recommended reading for psychotherapists, psychoanalysts and counsellors in training and practice. (shrink)

This book offers numerous questions and answers about ethics in counselling and therapy, training, counselling supervision, research and other important issues. The authors bring psychodynamic, person-centred, integrative or eclectic approaches to their selection of questions and answers. They also bring a variety of experience from independent practice, institutional and voluntary agency settings. Between them they have experience as counsellors, psychotherapists, trainers, counselling supervisors and authors. The questions cover a range of issues that practitioners need to consider including: confidentiality, constraints (...) and the management of confidentiality; boundaries, dual and multiple relationships, relationships with former clients; non-discriminatory practice, issues for individuals and agencies; competence and the proper conduct of counsellors and therapists and the profession's responsibilities to deliver non-exploitative and non-abusive help to clients. Questions of Ethics in Counselling and Therapy also contains three appendices offering useful information. It is written in a clear, accessible style and is aimed at a wide readership in counselling and therapy, ranging from trainees to more experienced practitioners. (shrink)

Patient counseling is a cornerstone of ethical pharmacy practice and high quality pharmaceutical care. Counseling promotes patient compliance with prescription regimens and prevents dangerous drug interactions and medication errors. Counseling also promotes informed consent and protects pharmacists against legal risks. However, economic, social, and technological changes in pharmacy practice often force community pharmacists to choose between their professional obligations to counsel patients and business objectives. State and federal legislatures have enacted laws that require pharmacists to counsel patients, (...) but these laws have had mixed results. This essay argues that community pharmacy's patient counseling conundrum can be solved through additional moral education and moral persuasion, not through additional legal mandates. (shrink)

Genetic counselors are on the front lines of the genetic revolution, presented with tests of varying predictive values and reliability, unfair testing distribution mechanisms, tests for conditions where no treatment exists, and companies that oversell the usefulness of their tests to physicians and nurses. Many scholars, both genetic testing task forces as well as the newly formed National Bioethics Advisory Commission, have all noted that genetic counseling programs and services are critical for adequate genetic testing. At the same time, (...) in our own work at the University of Pennsylvania we have encountered many requests for new materials for training genetic counselors in ethics and providing ethics resources for genetic counseling. One of us has noted elsewhere that it is crucial that resources from the Human Genome Project, the Centers for Disease Control, and other public agencies be devoted to providing better resources for genetic counselors facing difficult ethical issues. Although the American Board of Genetic Counseling requires that training programs include some formal coursework in ethics, many wonder whether enough is being done to prepare genetic counselors for an ever-tougher job, and in particular there has been much concern expressed about whether is an outmoded ideal that hampers this profession as it attempts to grow and identify the value of its practice. On the basis of many comments to us by genetic counselors and on the basis of our review of the current literature, we hypothesized that accredited genetic counseling training programs are poised at the turn of the century to begin planning a new approach toteaching the philosophy of genetic counseling, one that integrates philosophical, theoretical, and ethical training throughout thecurriculum in genetic counseling. (shrink)

A qualitative study was conducted with 48 Chinese counselors and psychotherapists who were interviewed in 2006 and an independent sample of 50 participants who responded to a survey in 2014. This study aims to explore how the new emerging expansion of mental health practice is related to issues and challenges of dual role relationship and how the well-engrained values and social characteristics of Chinese culture influences perceptions and resolution of ethical dilemmas. The participants identified similar dual relationships in 2006 and (...) 2014: Incidental boundary crossings, a sexual or romantic relationship, a dual social relationship, and a professional dual relationship were the most frequently reported types of dual relationships encountered by Chinese practitioners, and the socioeconomic and cultural context and the development trajectory of counseling and psychotherapy in China play a significant role in shaping practitioners’ behaviors. The comparison of the data in 2006 and 2014 indicated that practitioners in psychotherapy and counseling have an improved awareness and understanding of ethical issues, evidenced by the decreasing cases of romantic and sexual relationships and increasing cases of social dual relationships influenced by the interrelatedness of traditional Chinese culture. (shrink)

In The Virtuous Therapist, authors Elliot D. Cohen and Gale Spieler Cohen provide a systematic, philosophical approach to mental health ethics. Their comprehensive model of ethical decision making is developed to a number of difficult ethical problems counselors will experience. The issues raised in the book are timely, ethically engaging, and of practical importance to those working in the field.

The majority of women who freeze their eggs for non-medical or social reasons, commonly referred to as elective egg freezing (EEF), do not eventually utilize their frozen eggs. This would result in an accumulated surplus of unused frozen eggs in fertility clinics worldwide, which represents a promising source of donation to infertile women undergoing IVF treatment. Rigorous and comprehensive counseling is needed, because the process of donating one’s unused surplus frozen eggs involves complex decision-making. Prospective EEF donors can be (...) broadly categorized into those who have achieved motherhood and those who remained childless and have given up on motherhood aspirations. A two-step systematic counseling protocol is proposed. Firstly, it is imperative to verify and ensure that these women do not want to conceive any children with their surplus frozen eggs before proceeding with further counseling and signing of consent forms. Secondly, various motivating and dissuading factors in the donation of unused surplus frozen eggs should then be comprehensively discussed with egg freezers to facilitate informed decision-making. Key motivating factors for donation include reciprocity in wanting to share the joys of motherhood among egg freezers who already have children, goodwill to help others in need, and avoiding the wastage of surplus frozen eggs after expending so much money, time, and effort. Key dissuading factors include fear of accidental incest between natural and unknown donor-conceived offspring, as well as apprehension of unexpected future contact with unknown donor-conceived offspring due to either donor anonymity being abolished in their jurisdiction or widespread consumer DNA testing. (shrink)