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Practical Ethics in Behavioral Health

Practical Ethics in Behavioral Health. One Individual at a Time Debra Burock, Ph.D., CCP Disclosure Statement: I have no real or perceived conflicts of interest that relate to this presentation. Why do we take Ethics seminars?. Licensure Requirement Interest Shades of Gray

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Practical Ethics in Behavioral Health

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  1. Practical Ethics in Behavioral Health One Individual at a Time Debra Burock, Ph.D., CCP Disclosure Statement: I have no real or perceived conflicts of interest that relate to this presentation. www.nhsonline.org

  2. Why do we take Ethics seminars? • Licensure Requirement • Interest • Shades of Gray • We’re unethical?

  3. Risks Leading to Unethical Decisions • Organizational Culture • Hierarchical pressure • Groupthink • Burnout

  4. The Evidence • Nuremburg • Dialysis ‘God Squads’ • Milgram

  5. Zimbardo – Prison Study • Discussion

  6. “Ethics change with technology.” ― Larry Niven, N-Space • Social Media • Reality Shows/Daytime TV • EHR’s

  7. Ethics – Compliance - Quality • HIPAA disclosures • Treatment Planning

  8. Ethical Decision Making • 6 Steps (Curtis, L.C. & Hodge, M. (1995) • Ethics Committees • Root Cause Analysis • Consultation

  9. 6 Steps of Ethical Decision Making(Curtis, L.C. & Hodge, M. (1995) • Identify the problem • Identify the ethical issues raised • Review relevant guidelines/regulations etc. • Obtain consultation • Identify and list possible responses and consequences • Decide on the best course of action Adapted from: Curtis, L.C. & Hodge, M. (1995). Ethics and boundaries in community support services: New Challenges. New Directions for Mental Health Services, 66, 43-60.

  10. Ethics Committees .

  11. Consultation • Form • Adjudicatory • Mediation • Consultation

  12. Root Cause AnalysisApplication for Ethics • 5 Whys • What processes allowed for the ethical dilemma? • What can be done to prevent it from happening again?

  13. Small Group Exercise • Choose 2 ethical dilemmas • ID the ethical challenges in the dilemmas • What are the compliance and quality issues related to the challenge? • How significant is the liability related to the challenge? • Who could you consult with? • What are 2 ways you could address the challenge to reduce risk to all parties?

  14. Ethical Dilemmas • Level of Care • Child Abuse Reporting • Prescribing practices • Gifts from staff

  15. Discussion • What are the signs of ethical collapse in an organization? • How can you prevent making unethical decisions? • Are there irresolvable ethical problems?

  16. Questions and Comments? Debra Burock dburock@nhsonline.org 412-214-9020

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