Being, Doing, and Knowing: Developing Ethical Competence in Health Care

There is a growing interest in ethical competence-building within nursing and health care practising. This tendency is accompanied by a remarkable growth of ethical guidelines. Ethical demands have also been laid down in laws. Present-day practitioners and researchers in health care are thereby left in a virtual cross-fire of various legislations, codes, and recommendations, all intended to guide behaviour. The aim of this paper was to investigate the role of ethical guidelines in the process of ethical competence-building within health care practice and medical research. A conceptual and critical philosophical analysis of some paragraphs of the Helsinki Declaration and of relevant literature was performed. Three major problems related to ethical guidelines were identified, namely, the interpretation problem (there is always a gap between the rule and the practice, which implies that ethical competence is needed for those who are to implement the guidelines); the multiplicity problem (the great number of codes, declarations, and laws might pull in different directions, which may confuse the health care providers who are to follow them); and the legalisation problem (ethics concerns may take on a legal form, where ethical reflection is replaced by a procedure of legal interpretations). Virtue ethics might be an alternative to a rule based approach. This position, however, can turn ethics into a tacit knowledge, leading to poorly reflected and inconsistent ethical decisions. Ethical competence must consist of both being (virtues) and doing (rules and principles), but also of knowing (critical reflection), and therefore a communicative based model is suggested.     

Custody Evaluations: Critical Contextual and Ethical Considerations

The area of custody evaluation is fraught with anxiety and tension for parents and children as well as therapists. This article encourages the use of a set of lenses that explores individual and family members' relationships within a variety of contexts. To advance the reader's understanding, a model employing various levels and domains will be presented and described. A variety of critical ethical issues, and challenges often encountered by therapists are also examined.     

人工神经网络在临床应用中的伦理思考

现代临床医学中的海量信息具有非线性特质,人工神经网络的自我学习、记忆和归纳功能,刚好适应了医学的新发展,在医学领域有良好的应用前景。事实上,人工神经网络临床应用的理论研究成果丰富,但商业应用并不多见。本文探讨人工神经网络在临床应用中可能引发的社会伦理争议,对其临床适用范围进行初步的论述。     

Evidence-Based Practice in Psychology: An Ethical Framework for Graduate Education,Clinical Training,and Maintaining Professional Competence

Evidence-based practice is often acknowledged as the future state of psychology, yet those graduate students who will soon be applying such practices tend to hold several misconceptions about the major components within this framework. This review highlights implications for graduate education, clinical training, and professional competence in light of the movement toward evidence-based practice in psychology. These implications are discussed in relation to the close parallel between the major components of the evidence-based framework and the current Ethical Principles of Psychologists and Code of Conduct. The evidence-based framework is discussed as an ideology that promotes lifelong learning and best prepares graduate students for ethical clinical practice throughout their careers as psychologists.     

Ethical Considerations for Therapists Working With Demographically Similar Clients

The increasing emphasis on multicultural competence within psychotherapy continues to highlight the need for being sensitive to key differences between therapist and client. However, this attunement to the psychotherapeutic impact of therapist–client differences may obscure the equally critical need to evaluate ethical problems associated with therapist–client similarities. It will be argued that therapists treating clients who are demographically similar to themselves encounter a unique set of ethical challenges that warrant careful consideration and caution precisely because of therapist–client matching. The extant research on matching therapists and clients based on demographic similarities is discussed, with a particular emphasis on psychotherapeutic outcomes and client preferences. Attention then turns to the nonrational heuristics and biases that can often cloud therapists’ ethical decision making regarding the appropriate uses versus contraindications for demographically matching therapists and clients. Within the discussion of nonrational heuristics and biases, suggestions are offered for managing related challenges for ethical decision making.     

Assent and Dissent: Ethical Considerations in Research With Toddlers

In accordance with ethical principles and standards, researchers conducting studies with children are expected to seek assent and respect their dissent from participation. Little attention has been given to assent and dissent in research with toddlers, who have limited cognitive and emotional capabilities. We discuss research with toddlers in the context of assent and dissent and propose guidelines to ensure that research with toddlers still adheres to ethical principles. These guidelines include designing engaging studies, monitoring refusal and distress, and partnering with parents. Research with toddlers requires flexibility and creativity to respect toddlers in the context of their developmental capabilities.     

Ethical Considerations in Crisis and Humanitarian Interventions

The need for professionals to volunteer their time in crisis situations and to reach across time and culture in the service of humanitarian interventions will likely not abate in the near future. This article provides readers with multiple venues for considering the ethical dimensions present in crisis and humanitarian interventions. Core ethical concerns common to helping situations are magnified in crisis work. In addition, issues unique to the nature of volunteer and crisis work must also be considered. Using hypothetical case examples, bioethical principles, and ethical decision-making models, helping professionals are encouraged to go beyond their particular ethical codes in contemplating ethically and clinically sensitive volunteering.     

Ethical and Regulatory Considerations for Using Social Media Platforms to Locate and Track Research Participants

As social media becomes increasingly popular, human subjects researchers are able to use these platforms to locate, track, and communicate with study participants, thereby increasing participant retention and the generalizability and validity of research. The use of social media; however, raises novel ethical and regulatory issues that have received limited attention in the literature and federal regulations. We review research ethics and regulations and outline the implications for maintaining participant privacy, respecting participant autonomy, and promoting researcher transparency when using social media to locate and track participants. We offer a rubric that can be used in future studies to determine ethical and regulation-consistent use of social media platforms and illustrate the rubric using our study team’s experience with Facebook. We also offer recommendations for both researchers and institutional review boards that emphasize the importance of well-described procedures for social media use as part of informed consent.     

社会能力:概念分析与模型建构

社会能力是心理学领域中一个经典的研究问题,但是至今仍没有统一的概念和理论模型.总结以往的有关研究,可以归纳出社会能力概念的几个取向,如技能取向、结果取向、综合取向等.在这些概念取向尤其是综合取向的指导之下,研究者也提出了一些比较有代表性的理论模型,如成分模型、过程模型和棱柱模型等.该文对这些概念取向和理论模型进行了综述并尝试提出了社会能力的整合观点,但关于社会能力的概念和理论模型尚需进一步完善,其文化差异问题也尚需未来研究的关注.     

Financial and Ethical Considerations for Professionals in Psychology

The profession of psychology is one of many entities affected by the current economic recession. The question of what to do when clients cannot pay agreed-upon charges will need to be answered. Ethical issues related to setting the fee for psychotherapy, insurance coverage, abandonment, pro bono psychotherapy, and lack of resources are addressed in light of the 2002 American Psychological Association's Ethical Principles of Psychologists and Code of Conduct and other relevant literature. The impact of the Mental Health Parity Act on the financial complexities that professionals in psychology now face is also discussed. Several recommendations are made for psychologists, calling them to be proactive in their communities, to be advocates for their clients, and to critically evaluate their financial practices.     

Ethical and Legal Considerations for Internet-Based Psychotherapy

The provision of mental health services over the Internet is becoming increasingly commonplace as new technologies continue to develop. Evidence in support of the efficacy of many such interventions is accumulating. Given the potential global reach of Internet-based psychological services, the authors examine ethical issues relating to this growing area of practice through the lens of the Universal Declaration of Ethical Principles for Psychologists (International Union of Psychological Science, 2008). They also raise issues relating to potential liability risks and offer recommendations intended to guide mental health practitioners who are considering involvement in the provision of Internet-based services.     

Treatment of Deaf Clients: Ethical Considerations for Professionals in Psychology

Providing therapy to deaf clients raises important ethical considerations for psychologists related to competence; multiple relationships and boundary issues; confidentiality; assessment, diagnosis, and evaluation; and communication and using interpreters. In evaluating and addressing these, psychologists must consider the American Psychological Association’s Ethics Code and other relevant issues (e.g., Americans with Disabilities Act) necessary to provide ethical treatment. The current article provides background, ethical considerations, principles and standards relevant to the treatment of deaf clients, and recommendations to support psychologists, training programs, and the field. Psychologists have the responsibility to guarantee that the benefits of mental health treatment are fairly and justly provided to this traditionally underserved population.     

Including a Spiritual Dimension in Family Therapy: Ethical Considerations

The inclusion of a spiritual dimension in family therapy theory and clinical practice may well be viewed as an important professional challenge of the nineties. Following a working definition of terms, this paper explores the ethical complexities inherent in operationalizing a spiritual orientation in therapy in light of the following principles adopted from medical ethics: Respect for clients' autonomy, safeguarding clients' welfare, protecting them from harm, and treating them justly and honestly.     

Development of Social Problem Solving in Early Childhood: Stability,Change, and Associations With Social Competence

Kindergarten and 1st-grade boys were administered social cognitive interviews in 2 consecutive years to investigate the response-generation step of N. R. Crick and K. A. Dodge's (1994) social information processing model. Boys generated responses to 4 types of hypothetical social dilemmas. Responses to these situations were primarily prosocial, with a large minority of avoidant and antisocial solutions. In general, older boys provided more effective solutions than did their younger peers, and stabilities were modest but significant for subcategories of both prosocial and antisocial responses. Boys who were accepted by their peers provided more prosocial and effective solutions than did boys of lower peer status, but no status differences emerged for antisocial responses. The data also suggest that young children view aggression as an acceptable means to solving peer conflict.     

生态文明的伦理意蕴

［］生态文明是人与自然、人与人、人与社会、人与自我身心这四种关系的和谐生态的文明。它蕴含着人尊重自然、管理自然、保护环境等自然道德的根基,人尊重他人、宽容他人、与他人合作等人际伦理要求,社会尊重个人、个人认同接纳并融入社会等社会伦理精神,个体自尊、自律等自我伦理价值。     

Ethical Considerations of Multiple Roles in Forensic Services

Attorneys increasingly rely on the services of mental health practitioners. Although some practitioners lack training, the promise of professional rewards lead some to accept opportunities with resulting ethical quandaries. Due to significant differences between the objectives of traditional mental health services and expert testimony, problems occur when clinicians venture into forensic services. Attorneys and judges, unfamiliar with mental health specialties, may seek to press a mental health practitioner into multiple roles. Although not all multiple roles are ethically inappropriate, caution demands careful parsing of particular roles: (a) academic/behavioral science expert; (b) fact witness as a treating therapist; (c) expert witness based on a clinically oriented assessment; (d) pretrial and/or trial consultant; and (e) professional critic of other experts. Possible ethical issues and risks associated with accepting multiple roles are identified and strategies for avoiding or minimizing harm or exploitation are discussed.     

Ethical Considerations for the Treatment of Youth in Foster Care

Mental health clinicians treating youth in foster care face several ethical challenges, such as competence for treating youth in foster care, understanding who can provide informed consent, and confidentiality. However, few articles have addressed these ethical concerns or provided recommendations for clinicians on how to navigate these issues. This article presents a brief summary of the foster care system, an overview of the major ethical challenges clinicians may encounter when treating youth in foster care, areas of the American Psychological Association’s Ethics Code, Code of Ethics of the National Association of Social Workers, and American Counseling Association Code of Ethics most germane to the treatment of youth in foster care, and general recommendations for clinicians treating this population.     

The Ethical Implications of Social Media: Issues and Recommendations For Clinical Practice

The Internet and electronic communication technologies have taken the psychological field by storm. From the innovations of new web interventions for easier access to care to the increased ease of client scheduling and communication, these developments have greatly advanced mental health care. However, these advantages are also laced with ethical implications that warrant attention. Without judicious consideration, social media use by psychotherapists can lead to inadvertent self-disclosures to clients that risk damaging the therapeutic alliance, interfering with therapeutic processes, and placing both the client and clinician at risk. A better understanding of the ethical implications of social media use is warranted so that guidelines for appropriate use can be developed and implemented. This article highlights the potential risks associated with social media use by psychotherapists and, in absence of formalized guidelines, offers recommendations for best practices.     

When Low-Warmth Targets Are Liked: The Roles of Competence,Gender, and Relative Status

Previous research has shown that people use warmth and competence as basic dimensions to evaluate others and to interpret their behavior, but little research has examined the conditions under which low-warmth targets are liked. A series of 3 experiments involving 4 vignettes showed, in general, that low-warmth targets were better liked when they exhibited higher competence and that high-status persons displayed greater tolerance toward the low-warmth person of low status. Exceptions to these patterns were predicted and found as a function of the type of organizational context in which evaluations were made: groups that place priority on individual goals over common goals and groups that are performance oriented rather than relationship oriented. Target gender interacted with competence and relative status.     

童年中期儿童社会能力与学业成就的交叉滞后研究

本研究采用同伴提名法、问卷法,对武汉市一所小学3、4、5、6年级儿童进行6个月的追踪调查。采用交叉时序滞后设计,考察了同伴关系4个特征水平(群体水平、双向关系水平、人际互动水平和个体特征水平)的变量与学业成就的相互预测关系。结果表明,在控制了前测学业成就后,前测的社会喜好、积极友谊质量、社交领导行为可以分别正向预测后测的学业成就,而前测的攻击行为可以负向预测后期的学业成就;在控制了前测的社交自我知觉后,学业成就可以正向预测后期的社交自我知觉。