ETHICAL DILEMMAS ENCOUNTERED IN THE CARE OF THOSE WHO ARE DISABLED AND ALSO OLD

The aging of the population and the widespread prevalence of significant mental and physical disabilities increase the numbers of persons who are vulnerable. This creates ethical dilemmas in providing care, competing alternatives each determined by ethical principles. Such dilemmas are encountered in the Kennedy Aging Project, which teaches health professionals about the problems and care of those who are both mentally retarded and old. Two dilemmas, competency to refuse treatment and recompense for prior mistreatment, are discussed in detail as illustrative.     

Care and Responsibility in 'The Best Interest of the Child': Relational voices of ethical dilemmas in teaching

This paper discusses ethical dilemmas in early childhood education as identified by kindergarten and elementary school teachers ( n = 26). Ethical dilemmas are investigated in the theoretical framework of virtue epistemology. The moral stances of care and responsibility are identified as basic elements in teachers' professional morality. The empirical findings present conflicts between teachers and parents, collegial conflicts between teachers, and inter-institutional conflicts in the community. The method used in the study is a relational reading of teachers' narratives. Interpretative accounts are created to give room for both care and responsibility voices in teachers' written reports. The analysis of the data reveals that the ethical dilemmas in early childhood education are very relational and deal with competing interpretations of 'the best interest of the child'. Teachers have taken the moral stance of care by identifying the ethical conflict. However, the responsible professional action has been more difficult for them to accomplish. Most of the time, discussions have not produced the desired results. Ethical conflicts in teaching invite teachers to consider the moral relevance of each dilemma by taking the perspectives of the involved parties.     

Beyond Avoidance and Secrecy

Abstract

This paper describes a process-oriented approach to teaching ethical dilemmas to graduate social work students. The authors examine related empirical data and use classroom vignettes to illustrate their teaching methods. Several ethical dilemmas in different phases of clinical practice will be presented, including gift giving and receiving, flexible treatment frame and contact post termination.     

From the outside in: tutor perspectives of student transformative experiences within Indigenous Studies health education

ABSTRACT

While more is becoming understood about the effects of Indigenous Studies health curricula on student preparedness and attitudes toward working in Indigenous health contexts, less is known about how tutors in this space interpret student experiences and contribute to the development of preparedness. Reporting on a qualitative study, this article provides insight into tutors’ perceptions of tertiary first year health students’ transformative experiences in an Indigenous Studies health course. Twelve Indigenous and non-Indigenous tutors were interviewed about their teaching experiences within this context. Framed by Mezirow’s transformative learning theory, thematic analysis findings suggest tutors observe several precursor steps to transformative learning including disorienting dilemmas, critical reflection on assumptions, exploration of new roles, and trying on new roles. The content of these themes extends our understanding of how these precursor steps manifest, and the elements related to this. Findings also suggest tutors vary in their identification, interpretation and response to many of these pedagogical entry points. Within this learning context, the concept of teacher/student relationship is suggested as playing a meaningful role in the positioning and efficacy of tutors. This impacts tutors' understanding of transformative learning, the social construction of students, consequent interpretations of student experiences, and means of facilitating cognitive and affective learning. We propose a reconceptualisation of thinking around teaching in this space, with a focus on both further development of educator capabilities and student curricular opportunities to promote transformative learning appropriate to the stated goals of the Australian Indigenous Studies learning and teaching context. The findings indicate that institutional investment in the development of educators in this space remains vitally important.     

The role of design ethics in maintaining students' privacy: A call to action to learning designers in higher education

Maintaining students' privacy in higher education, an integral aspect of learning design and technology integration, is not only a matter of policy and law but also a matter of design ethics. Similar to faculty educators, learning designers in higher education play a vital role in maintaining students' privacy by designing learning experiences that rely on online technology integration. Like other professional designers, they need to care for the humans they design for by not producing designs that infringe on their privacy, thus, not causing harm. Recognizing that widely used instructional design models are silent on the topic and do not address ethical considerations such as privacy, we focus this paper on how design ethics can be leveraged by learning designers in higher education in a practical manner, illustrated through authentic examples. We highlight where the ethical responsibility of learning designers comes into the foreground when maintaining students' privacy and well-being, especially in online settings. We outline an existing ethical decision-making framework and show how learning designers can use it as a call to action to protect the students they design for, strengthening their ethical design capacity.

Practitioner notes

What is already known about this topic

• Existing codes of ethical standards from well-known learning design organizations call upon learning designers to protect students' privacy without clear guidance on how to do so.
• Design ethics within learning design is often discussed in abstract ways with principles that are difficult to apply.
• Most, if not all, design models that learning design professionals have learned are either silent on design ethics and/or do not consider ethics as a valid dimension, thus, making design ethics mostly excluded from learning design graduate programs.
• Practical means for engaging in ethical design practice are scarce in the field.

What this paper adds

• A call for learning designers in higher education to maintain and protect students' privacy and well-being, strengthening their ethical design capacity.
• A demonstration of how to use a practical ethical decision-making framework as a designerly tool in designing for learning to maintain and protect students' privacy and well-being.
• Authentic examples—in the form of vignettes—of ethical dilemmas/issues that learning designers in higher education could face, focused on students' privacy.
• Methods—using a practical ethical decision-making framework—for learning design professionals in higher education, grounded in the philosophy of designers as the guarantors of designs, to be employed to detect situations where students' privacy and best interests are at risk.
• A demonstration of how learning designers could make stellar design decisions in service to the students they design for and not to the priorities of other design stakeholders.

Implications for practice and/or policy

• Higher education programs/institutions that prepare/employ learning designers ought to treat the topics of the designer's responsibility and design ethics more explicitly and practically as one of the means to maintain and protect students' privacy, in addition to law and policies.
• Learning designers in higher education ought to hold a powerful position in their professional practice to maintain and protect students' privacy and well-being, as an important aspect of their ethical design responsibilities.
• Learning designers in higher education ought to adopt a design thinking mindset in order to protect students' privacy by (1) challenging ideas and assumptions regarding technology integration in general and (2) detecting what is known in User Experience (UX) design as “dark patterns” in online course design.

     

The Value Dilemmas of Faculty Advising; Significant Issues in a Code of Ethics for Faculty Advisors

ABSTRACT

Although frequently challenging, faculty advising continues to be a crucial component of social work education. Yet the current diversity of students, educational programs, and field placements present many ethical dilemmas to the faculty advisor. This paper explores the administrative, educational, and supportive roles of the faculty advisor, the inherent conflicts which develop and the effects of these conflicts on the ethical advising of social work students.

Similar to the classroom teacher, the faculty advisor can positively model ethical social work practice to students. Case examples from faculty advisors are used to study ethical dilemmas which arise in promoting social work values of self-determination and confidentiality. Recommendations are made to promote ethical practice among faculty advisors.     

Career Paths of Health Workers

Abstract

This article presents an evaluation of an innovative, three-year graduate program to prepare workers from educationally disadvan-taged backgrounds for professional careers in social work in an urban health care system. It analyzes the contributions to the Social Work Health Careers Opportunity Program (SWHCOP) of a course designed to provide: an overview of health care issues and policies; beginning knowledge, values and skills for social work practice in health care; and an opportunity to acquire or strengthen skills for graduate education, including oral and written communications, problem-solving, and critical thinking. This article considers the practice, policy and teaching implications of such an educational program for increasing access to professional careers in social work for members of educationally disadvantaged communities.     

Teaching Group Counseling Skills: Problems and Solutions

The authors discuss ethical and professional issues regarding group counseling and argue that it is challenging to meet or exceed the standards established by the American Counseling Association's Council for the Accreditation of Counseling and Related Education Programs for teaching principles and theories, leadership skills, and group counseling methods for effective group practice. This task is especially difficult for counselor education programs that do not have doctoral students who can provide instruction and group leadership. The authors present a model involving 2 courses that allow for mastery of skills and solve practical dilemmas of providing an experiential group experience and leadership opportunities.     

Using Movies to Illustrate Ethical Dilemmas in Undergraduate Criminal Justice Classes

Ethics education in criminal justice programs has increased in popularity, but instructors sometimes struggle to teach ethics in such a way that students retain what they have learned and apply ethical principles in the criminal justice field upon graduation. The current research highlights that there are several benefits of presenting ethical dilemmas to students through popular movies such as Mississippi Burning and Road to Perdition. Compared to the control group (Section A) that was taught in a traditional lecture format, students who were required to identify ethical dilemmas in movies (Section B) were more likely to understand the complexities of such situations, to rate unethical behavior properly, and to see how ethical principles could be applied to their everyday lives.     

Caring and Empowerment: A teacher educator's reflection on an ethical dilemma

Dealing with ethical dilemmas is part of the real, everyday life of a university lecturer. However, the literature on ethics in higher education largely focuses on the broad social agenda, academic freedom and issues connected with research. Using an auto-ethnographic case study about a 'day in the life' of a new university lecturer as a basis for discussion, the paper reports the reactions of two focus groups, representing newly appointed and more experienced academic staff, respectively. Applying Forsyth's taxonomy of ethical ideology, it is suggested that there are marked differences in approach between staff in dealing with ethical dilemmas. Experienced staff, accustomed to higher levels of professional autonomy, were more inclined to argue for a 'situationist' position, while inexperienced staff, inculcated into a more rule-bound culture, tended to adopt an 'absolutist' or 'exceptionist' stance.     

ASSESSING STUDENT PERFORMANCE USING VIDEO IN COMBINATION WITH SELF,PEER, AND INSTRUCTOR EVALUATION CHECKLISTS

Abstract

In this article, the authors propose six standards for the work of Intergenerational Specialists in an emerging field of professional practice. These standards are intended to guide students in academic settings who are preparing to work as Intergenerational Specialists in direct service roles, administrative capacities, or the supervision and training of others in the field. In addition, they might also be considered useful guidelines for program developers who want to ensure mutually beneficial interactions between younger people and older adults in any kind of organized intergenerational context. The proposed Standards for Intergenerational Practice are currently being piloted by students in a graduate degree program, and eventually will be submitted to Generations United for endorsement and widespread acceptance by the field. These basic principles are consistent with NAEYC's Developmentally Appropriate Practices for early childhood programs, and they are also consistent with ethical practices in programs for older adults.     

Comparison of the Viewing Habits and Preferences of Young Offenders and Representative Schoolchildren

In the light of the introduction of teaching standards in professional values and practice in September 2002, this study compares two sets of data from B.Ed. and PGCE primary courses, in order to examine the existing opportunities for values education within teacher education in one institution. The findings highlight a qualitative difference in the process of personal and professional development experienced by the two groups of students. Implications of the findings for university training partnerships, university tutors and professional studies programmes are then considered. The conclusion reached is that the introduction of teaching standards in professional values and practice may be the next landmark in the process vs. competence debate about teacher education, and may provide the opportunity to put human development back into the heart of teacher education.     

Let right be done: trying to put ethical standards into practice

The development of ethical standards by professional associations, boards, councils and colleges of teachers, responds in part to a moral imperative that teachers and school leaders be accountable to the wider community, and in part to a desire to enhance the overall professionalism of educators' behaviour. This article explores the conceptual and practical complexities inherent in defining ethical standards for the teaching profession with a particular focus on their questionable capacity for implementation. In combining empirical evidence from previously reported research studies with newly fabricated first person narrative responses to the evidence, the article seeks to illustrate the difficulty, if not the impossibility, of applying ethical standards to actual situations in any professionally and ethically satisfying way. It argues further that moral dilemmas facing teachers are potentially resolvable only by communities of educators internalizing and applying principles of ethics, not formalized codes or standards.     

Ethics of care in participatory health research: mutual responsibility in collaboration with co-researchers

In the field of participatory health research (PHR) and related action research paradigms, limitations of standard ethical codes and institutional review processes have been identified. PHR is highly situational and relational, part of a hierarchical health care context and therefore ethics of care has been suggested as a helpful theoretical approach that emphasises responsibilities and relationships. The purpose of this article is to explore the value of Tronto’s second-generation ethics of care for reflection on ethical challenges experienced by academic researchers. Using the design of a collaborative auto-ethnography, this article starts from a story of a researcher who deals with dilemmas in responsibility to care for co-researchers with lived experiences during a PHR study in the field of acute psychiatric care. By analysing the challenges together with all co-researchers, using a framework of ethics of care, we discovered the importance of self-care and existential safety for an ethical PHR practice. The reflexive meta-narrative shows that the ethics of care lens is useful to untangle moral dilemmas in all participatory research-related paradigms for all engaged.     

Group counseling in the schools: Legal,ethical, and treatment issues in school practice

School psychologists are interested in providing effective and efficient direct services to children. With a wide spectrum of psychological problems impacting children, group counseling represents one viable and valuable intervention. Given the complexity of group counseling, many schools and school psychologists are interested in legal and ethical issues impacting group interventions. From the attainment of appropriate consents for counseling to ethical dilemmas, the challenges involved in direct services are large. This article reviews mental health issues transforming children's mental health, considers differing group counseling models and stages of group development, and examines contemporary legal and ethical dilemmas inherent in school practice. Uniquely, a question‐and‐answer format is used to highlight legal issues for practice. © 2008 Wiley Periodicals, Inc.     

Teachers' Ethical Choices in Sociomoral Settings

This article discusses ethical dilemmas in early childhood education as identified by kindergarten and elementary school teachers (N = 26). Ethical dilemmas are investigated in the theoretical framework of moral relevance and moral conflict (Wallace 1988). Professional ethics challenges teachers to collaborate with colleagues and parents. The empirical findings present conflicts between teachers and parents, collegial conflicts between teachers, and cultural conflicts in the community. The method used in the study is a relational reading of teachers' narratives. Interpretative accounts are created to give room to different voices in teachers' written reports. The analysis of the data reveals that the ethical dilemmas in early childhood education are relational and deal with competing interpretations of "the best interest of the child". Relevance and conflict problems arise when people have to co-ordinate their actions with others. Most of the time, discussions have not produced the desired results. Ethical conflicts in teaching invite teachers to consider the moral relevance of each dilemma by taking the perspective of each party involved.     

No More Silos: Animating Integrated Health and Behavioral Health Care Practices in the Classroom

ABSTRACT

Over the last decade, there has been increased momentum to bring the worlds of physical and behavioral health care together. Instead of social work education simply reacting to this change, it is imperative that we be proactive and prepare students to be “multilingual,” that is, be able to speak and function in both the worlds of health and mental health so they can move seamlessly into the new world of integrated care. The purpose of this article is to explore curricular and pedagogical strategies needed to prepare graduate social work students for the coming shift in practice toward integrated health and mental health care.     

Chapter 9.

Abstract

Many counselors, psychologists, and social workers assist clients to take psychotropic drugs but recoil from helping clients to rethink drug use or stop taking drugs. They might fear resisting the prevailing ideology, violating “standards of care,” or contradicting physicians' advice. This article discusses withdrawal emergent reactions from prescribed psychotropic drugs and proposes a rational, person-centered approach to help adults stop taking medication. It considers assessment, collaboration with physicians and pharmacists, the client's fear of withdrawal, the importance of gradual taper, and the monitoring of withdrawal emergent reactions. For practitioners who do not personally endorse drug use, it suggests guidelines for adhering to the best standards of care and consent. It also discusses legal and ethical issues related to therapists' concerns and clients' rights. Professionals' and consumers' roles vis-à-vis medication are changing, and a large evidence base documents the risks of medications. In this context, helping clients to withdraw from medications is a corollary to ethical and legal duties to inform clients of the availability and benefits of drugs, and its limits should be framed only by the constraints of practitioner competence and informed consent.