Integrating Contextual Issues in Ethical Decision Making

Many issues in ethics arise in relation to the contexts in which psychologists work. However, most ethical decision-making models reproduce the way in which psychologists tend to approach ethics by focusing on ethical dilemmas and proposing a step-by-step response to deal with them. Although these models might be useful, their emphasis on reactive approaches and their lack of contextualization constitute significant limitations on their applicability. In this article, an approach to ethical decision making that highlights the importance of the context in developing proactive strategies to solve ethical issues is proposed. This approach is further explained through its application to medical and rural settings. The implications of these suggestions to the training in ethics are finally discussed.     

The Use of Touch in Counseling: An Ethical Decision‐Making Model

Although some counselors have advocated for the limited use of touch in counseling, others have argued that touch has no place within the counseling relationship. Despite the controversy, the use of touch has been shown to have a number of therapeutic benefits; however, there are few ethical decision‐making models that are appropriate for considering the use of touch in counseling. The authors discuss the controversy surrounding the use of touch and the benefits/contraindications of touch. The 5 ethical principles of counseling are also examined; a new ordering of the principles is presented as a useful ethical decision‐making model when considering the use of touch in counseling.     

Addressing Value‐Based Conflicts Within the Counseling Relationship: A Decision‐Making Model

A growing number of legal and ethical cases have involved value conflicts between counselors, or counselors‐in‐training, and their clients. The authors examine considerations that professional counselors are encouraged to take into account when value conflicts arise within the therapeutic relationship. The authors present a strategy known as ethical bracketing and the Counselor Values‐Based Conflict Model as tools to use when facing conflicts that arise between personal and professional values.     

Moral Orientation as a Component of Ethical Decision Making

Morals are foundational to professional and ethical counseling practice. Moral orientation may play an integral role in ethical decision making. The authors review the literature regarding moral orientation and discuss the connection to ethical decision making. Implications for counselor preparation and practice are addressed.     

A Practical Account of Autonomy: Why Genetic Counseling is Especially Well Suited to the Facilitation of Informed Autonomous Decision Making

In genetic counseling, facilitation of autonomous decision-making is seen as a primary aim and respect for autonomy is used to justify a nondirective counseling approach whereby clients are free to make their own choices after being given all necessary information. However in the genetic counseling literature, autonomy as a concept appears to be interpreted variably and often narrowly. We offer a practical account of autonomy that is coherent, consistent and philosophically defensible for the genetic counseling setting. At the same time we demonstrate how nondirective counseling may serve to frustrate rather than facilitate client autonomy. We suggest that promoting purposeful dialogue rather than counseling that is nondirective is more conducive to client autonomy.     

Teaching Ethical Decision Making: Helping Students Reconcile Personal and Professional Values

Because conflicts between personal and professional values can interfere with ethical decision making, a goal of counselor education must be helping students reconcile such conflicts. This article describes one counselor educator's experience teaching ethical decision making and the effects on student learning. Growth was observed in increased tolerance for ambiguity, awareness of how values influenced decision making, use of multiple factors in decision making, and emphasis on the welfare of clients. Implications for teaching and future research directions are discussed.     

Environmental Influences on Ethical Decision Making: Climate and Environmental Predictors of Research Integrity

It is commonly held that early career experiences influence ethical behavior. One way early career experiences might operate is to influence the decisions people make when presented with problems that raise ethical concerns. To test this proposition, 102 first-year doctoral students were asked to complete a series of measures examining ethical decision making along with a series of measures examining environmental experiences and climate perceptions. Factoring of the environmental measure yielded five dimensions: professional leadership, poor coping, lack of rewards, limited competitive pressure, and poor career direction. Factoring of the climate inventory yielded four dimensions: equity, interpersonal conflict, occupational engagement, and work commitment. When these dimensions were used to predict performance on the ethical decision-making task, it was found that the environmental dimensions were better predictors than the climate dimensions. The implications of these findings for research on ethical conduct are discussed.     

Teaching Ethical Decision Making: Designing a Personal Value Portrait to Ignite Creativity and Promote Personal Engagement in Case Method Analysis

The case method approach to introducing ethical issues is a traditional tool for applying critical thinking skills to a specific dilemma (Beauchamp &; Childress, 2001 Beauchamp, T. L. and Childress, J. F. 2001. Principles of biomedical ethics, 5th, New York: Oxford University Press.  [Google Scholar]). It allows for personal reflection and clarification of an individual's conceptual framework for deciding what is and is not ethical behavior. However, it also affords the student distance from the story line and may, through providing a retrospective critique, prevent sufficient challenge to the student to articulate and defend personal value assessments in addressing the ethical dynamics reflected in the case. Providing teaching exercises that encourage the creation of language to form that conceptual framework and a comfort in using that language allows the student to not only identify ethical issues but also recognize and more effectively communicate the struggles with molding a personal values portrait to apply to such cases.     

Professional Ethical Issues and the Development of Professional Ethical Standards in Counseling and Clinical Psychology in China

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.     

我国心理咨询业的伦理学探讨

目前我国心理咨询需求日趋增加,心理咨询师培训异常火爆,但是从业者的素质良莠不齐,心理咨询工作者的伦理道德和行业规范不健全,导致了来访者和咨询师之间的伦理学困惑和问题,本文系统地分析我国心理咨询工作中的伦理学现状,结合欧美国家心理咨询伦理规范的发展历程,提出了自己的几点思考。     

Exposure to Unethical Career Events: Effects on Decision Making,Climate, and Socialization

An implicit goal of many interventions intended to enhance integrity is to minimize peoples' exposure to unethical events. The intent of the present effort was to examine if exposure to unethical practices in the course of one's work is related to ethical decision making. Accordingly, 248 doctoral students in the biological, health, and social sciences were asked to complete a field appropriate measure of ethical decision making. In addition, they were asked to complete measures examining the perceived acceptability of unethical events and a measure examining perceptions of ethical climate. When these criterion measures were correlated with a measure examining the frequency with which they had been exposed to unethical events in their day-to-day work, it was found that event exposure was strongly related to ethical decision making but less strongly related to climate perceptions and perceptions of event acceptability. However, these relationships were moderated by level of experience. The implications of these findings for practices intended to improve ethics are discussed.     

Regret in Decision Making

Decision research has only recently started to take seriously the role of emotions in choices and decisions. Regret is the emotion that has received the most attention. In this article, we sample a number of the initial regret studies from psychology and economics, and trace some of the complexities and contradictions to which they led. We then sketch a new theory, decision justification theory (DJT), which synthesizes several apparently conflicting findings. DJT postulates two core components of decision–related regret, one associated with the (comparative) evaluation of the outcome, the other with the feeling of self–blame for having made a poor choice. We reinterpret several existing studies in DJT terms. We then report some new studies that directly tested (and support) DJT, and propose a number of research issues that follow from this new approach to regret.     

Emerging Practices of Counseling and Psychotherapy in China: Ethical Dilemmas in Dual Relationships

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: (a) 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 (b) 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.     

The Challenges of Intercultural Marriage: Strategies for Pastoral Care

In this article, the author describes the unique issues associated with intercultural marriage. A case illustration provides the springboard for presenting specific pastoral care and counseling strategies that may be helpful to intercultural couples. These strategies include assessing worldview and acculturation, creating spiritual and cultural genograms, reframing cultural challenges, collaborating with indigenous healers, inventing new rituals, and developing the advocacy role.     

当前临床决策的问题及对策

随着传统生物医学模式向生物-心理-社会医学模式的转变,临床决策也应由目前以经验医学为主导的经验决策向以循证医学为基础的科学决策转变。     

信息模糊：消费决策领域中的有限理性

信息模糊（obfuscation）是行为经济学研究的重要领域,主要解释了在商品买卖过程中,销售商通过把商品信息复杂化等手段,让人们的消费过程变得更加复杂和困难,从而使消费者在购买商品时面对信息模糊做出种种不明智的选择的现象问题。本文从以往的研究成果出发,就信息模糊、有限理性和销售者的决策行为的关系进行了探讨,以期为信息模糊的跨学科研究提供可借鉴的思路和方法。     

Multiple Systems in Decision Making: A Neurocomputational Perspective

ABSTRACT— Various psychological models posit the existence of two systems that contribute to decision making. The first system is bottom-up, automatic, intuitive, emotional, and implicit, while the second system is top-down, controlled, deliberative, and explicit. It has become increasingly evident that this dichotomy is both too simplistic and too vague. Here we consider insights gained from a different approach, one that considers the multiple computational demands of the decision-making system in the context of neural mechanisms specialized to accomplish some of that system's more basic functions. The use of explicit computational models has led to (a) identification of core trade-offs imposed by a single-system solution to cognitive problems that are solved by having multiple neural systems, and (b) novel predictions that can be tested empirically and that serve to further refine the models.     

腹主动脉瘤的外科治疗决策

腹主动脉瘤破裂是最常见、最凶险的疾病之一。提高对其治疗的临床决策水平至关重要。比较传统开腹修复治疗和血管腔内修复治疗的优缺点,以最佳证据为指导,选出最佳方案应用于临床实践。以人为本,做出科学决策,从而降低医疗费用及提高疗效及患者生活质量。     

To Use or Not to Use: Male Partners' Perspectives on Decision Making About Prenatal Diagnosis

We conducted an exploratory, qualitative pilot study investigating the use of genetic counseling and prenatal genetic technologies between women and their male partners for two referral groups: pregnant women 35 years of age and over (AMA) at the time of delivery and pregnant women with an abnormal maternal serum triple screen (MSAFP3). The convenience sample consisted of 25 semistructured interviews and 50 observations of genetic counseling sessions. Male partners' styles of decision making and the way they viewed prenatal diagnosis decision making were examined. We defined three decision-making styles based on our interpretation of the data: (1) domain, (2) joint-delegated, and (3) saliency. The male partners also seemed to view prenatal diagnosis as either an information decision or an action decision and appeared to take a more active role in decision making when the decision was viewed as an action decision.     

浅析当前临床科学决策的几个影响因素

随着循证医学在我国的发展和"医疗举证责任倒置"等相关法律的实施,我国临床医生在进行诊治决策时已逐步向临床科学决策迈进。而防御性医疗、不健全的医疗制度及相关法律等却严重影响着这一科学决策的转变过程。只有有效解决了导致干扰科学决策的各种社会影响因素,如扩大基本医疗保险的覆盖率,实施医疗风险保险制度,提高医务人员认知和职业素质,保障行医安全等,临床科学决策的真正落实就大有希望。