Touch,enjoyment and health: In infancy

The paper explores Peter Lomas's influence on the author as a therapist, and in particular his idea that therapy is inescapably an ethical endeavour, however much we try to avoid this. Less persuasive, however, is Lomas's belief in therapy as a moral influence. The author sees it more as an ethical space (after Roger Poole) where people can feel free to explore, without judgement, the difficulties that have brought them there - despair, loss, inauthenticity, unfulfilled lives. The paper also explores R.D. Laing's idea of ‘fear of the soul’ which afflicts therapists (including those who do not hold much with ideas of technique) - despite our title - as well as many of those who come to see us. This fear is, it is argued, understandable as it takes us into uncharted waters, a minefield. In other words, therapy can be dangerous. The paper draws both on the author's work with individuals, and in the Philadelphia Association's community house, with which he has been involved for many years.     

Stories of crime,stories of suffering: A narrative perspective on ethical issues in criminal justice counselling

Counsellors working with prisoners often listen to stories that are both stories of crime and stories of suffering. From a criminal justice perspective, the suffering of offenders is deliberately inflicted as punishment. From a counselling perspective, however, responding to the suffering of a client and even trying to relieve it is a basic ethical concern. So counsellors, working with offenders, may face the ethical question of how to integrate a response to the suffering of offenders with a response to crime, especially when confronted with stories of cruel, violent crimes. In this paper, it is argued that a narrative perspective on counselling offers a framework in which these responses may be integrated. Here, the principle of recognizing privileged authorship of persons is crucial. The concepts of ‘double listening for implicit others’ and ‘relationally rich stories’ are developed, which are based on concepts and ideas from narrative therapy. These serve as a first step of translating the narrative ethical framework to counselling practice.     

Abuse and religious experience: A study of religiously committed evangelical adults

Two hypotheses were tested: (1) in a sample of religiously-committed evangelical adults, past experience of abuse is related to more frequent (a) religious behaviour such as prayer, church attendance and Bible reading, and (b) religious experiences, such as religious visions, healings and speaking in tongues; (2) abuse is also associated with evidence of alienation from God, as noted in more frequent reports of God as distant and more frequent religious doubting. Survey data from 3424 adults attending one of four new evangelical movement churches were analysed. Controlling for socio-economic and religious socialization variables, a series of regression equations were calculated looking at the relationship between the experience of abuse and the dependent variables of three factor scores representing conventional religious behaviour, transcendent religious experience and feelings of distance from God. Self-report of the frequency of abuse was positively associated with frequency of reported transcendent religious experiences and with feelings of distance from God. A significant relationship between abuse and more conventional religious behaviour was not found. The findings provide mixed support for the idea that abuse results in ambivalent responses toward religion and God in religiously committed adults. The lack of relationship between abuse and conventional religious behaviours is somewhat inconsistent with prior results, and likely represents a ceiling effect. The positive correlation with transcendent religious experiences and distance from God are consistent with prior studies, but may suggest alternative explanations.     

合理使用抗茵药物的伦理决策

中国是世界上滥用抗菌药物最为严重的国家之一,抗菌药物滥用会导致耐药菌株形成、不良反应发生、加重社会和患者经济负担三个主要问题。人类合理使用抗菌药物成为当今社会关注的热点问题,从临床角度阐述了合理使用抗茵药物中若干医学伦理问题,医疗政策、医院管理对抗菌药物合理使用影响的不可替代性;合理使用抗菌药物是良好医患关系的注释;合理使用抗菌药物是医患关系伦理要求。抗菌药物合理使用要求医生必须要有相应的伦理决策能力;抗菌药物合理使用要求医生要主动参与社会伦理讨论;抗菌药物合理使用是多方面共同努力的结果。     

医疗服务成本控制过程伦理范式的选择

不同伦理范式对医疗服务成本控制过程会产生不同的影响.运用经济伦理学及管理伦理学的原理和方法,结合医疗卫生服务机构的行业性质及特点,选择出现实可行的医疗服务成本控制过程的伦理范式.使医疗卫生服务机构在医疗服务成本控制过程中,从成本控制标准的确定、成本控制方法及途径的选择到成本控制结果的分析及考评等环节融入相关伦理内涵.使医疗服务成本控制更好地遵循恰当的伦理范式,更好地履行医疗卫生服务机构的宗旨和职责.     

Moral Stress in International Humanitarian Aid and Rescue Operations: A Grounded Theory Study

Humanitarian aid professionals frequently encounter situations in which one is conscious of the morally appropriate action but cannot take it because of institutional obstacles. Dilemmas like this are likely to result in a specific kind of stress reaction at the individual level, labeled as moral stress. In our study, 16 individuals working with international humanitarian aid and rescue operations participated in semistructured interviews, analyzed in accordance with a grounded theory approach. A theoretical model of ethical decision making from a moral stress perspective was developed. The practical implications of the study are discussed.     

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.     

Multicultural Incompetence and Other Unethical Behaviors: Perceptions of Therapist Practices

The present study examined nonprofessionals' perceptions of culturally based and noncultural ethical violations. One hundred seventy-four undergraduates students read 12 vignettes depicting situations in which a clinician committed either a culturally based violation (e.g., sexist or ageist behavior) or a noncultural violation (e.g., breeching confidentiality or multiple relationship). Results indicated that participants were more likely to have unfavorable views of clinicians who had committed culturally based violations. In addition, results suggested that participants would be more likely to report a clinician who had committed a culturally based violation to a supervisor or ethics board.     

Unique Ethical Concerns in Clinical Trials Comparing Psychosocial and Psychopharmalogical Interventions

In recent years, there has been a particular emphasis placed on conducting randomized controlled trials (RCTs) that compare the relative efficacy of psychosocial and pharmacological interventions. This article addresses relevant ethical considerations in the conduct of these treatment trials, with a focus on RCTs with children. Ethical concerns, including therapeutic misconception, treatment preference, therapeutic equipoise, structure of treatments, and balancing risks versus benefits, are introduced through a clinical scenario and discussed as they relate to psychotherapy versus medication RCTs. In each case, suggestions are made for researchers seeking to minimize the impact of these ethical concerns on research participants.     

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.