Ethical issues in Guidance and counselling as it relates to bio-medical issues.

1. Ethical Issues in
Guidance and
Counseling
Unit Six: Ethics and Scientific Issues
Tanecia Stevens BA G&C International University of the Caribbean 1

2. What is Ethics?
• The basic
concepts and
fundamental
principles of
decent human
conduct.
Tanecia Stevens BA G&C International University of the Caribbean 2

3. Ethics cont.
• It includes study of universal values such as
the essential equality of all men and women,
human or natural rights, obedience to the law
of land, concern for health and safety and,
increasingly, also for the natural environment.
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4. What is Science?
• Science is the concerted human
effort to understand, or to
understand better, the history of
the natural world and how the
natural world works, with
observable physical evidence as the
basis of that understanding.
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5. Science
• It is done through
observation of
natural phenomena,
and/or through
experimentation that
tries to simulate
natural processes
under controlled
conditions.Tanecia Stevens BA G&C International University of the Caribbean 5

6. What are Issues?
• A point or matter of discussion,
debate, or dispute: What legal and
moral issues should we consider?
• A matter of public concern:
debated economic issues.
• A misgiving, objection, or
complaint: had issues with the plan
to change the curriculum.
• A problem.Tanecia Stevens BA G&C International University of the Caribbean 6

7. What are Medical Issues?
• The field of ethics studies principles of right and
wrong. There is hardly an area in medicine that
doesn't have an ethical aspect. For example, there are
ethical issues relating to:
• End of life care: Should a patient receive nutrition?
What about advance directives and resuscitation
orders?
• Abortion: When does life begin? Is it ethical to
terminate a pregnancy with a birth defect?
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8. • Genetic and prenatal testing: What happens if you are a
carrier of a defect? What if testing shows that your unborn
baby has a defect?
• Birth control: Should it be available to minors?
• Is it ethical to harvest embryonic stem cells to treat diseases?
Tanecia Stevens BA G&C International University of the Caribbean 8

9. Medical Issues cont.
• Organ donation: Must a relative donate an organ to a
sick relative?
• Your personal health information: who has access to
your records?
• Patient rights: Do you have the right to refuse
treatment?
• When you talk with your doctor, is it ethical for her to
withhold information from you or your family?Tanecia Stevens BA G&C International University of the Caribbean 9

10. Bio-ethics
• Bioethics is the study of
the typically controversial
ethical issues emerging
from new situations and
possibilities brought
about by advances in
biology and medicine.
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11. Bio-ethics cont.
• It is also moral discernment as it relates to medical
policy, practice, and research. Bioethicists are
concerned with the ethical questions that arise in the
relationships among life sciences, biotechnology,
medicine, politics, law, and philosophy. It also
includes the study of the more commonplace
questions of values ("the ethics of the ordinary")
which arise in primary care and other branches.
Tanecia Stevens BA G&C International University of the Caribbean 11

12. Medical ethics and Bio-ethics
• Medical ethics tends to be
understood narrowly as an
applied professional ethics,
whereas bioethics appears to
have worked more expansive
concerns, touching upon the
philosophy of science and
issues of biotechnology.
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13. Medical and Bio ethics cont.
• Still, the two fields often overlap and the distinction
is more a matter of style than professional
consensus. Medical ethics shares many principles
with other branches of healthcare ethics, such as
nursing ethics. A bioethicist assists the health care
and research community in examining moral issues
involved in our understanding of life and death, and
resolving ethical dilemmas in medicine and science.
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14. What do they have to do with
counseling?
• The integration of health care services has created a
new ethical landscape for all parties, including the
counselor who participates in the health care system.
Ethical, political, and social norms create a new
complexity within the environment for counseling
practice. Counselors who work in a health care
setting are expected to operate within the prevailing
biomedical model.
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15. Counseling
• Bioethical areas that are influential in the lives of counseling clients:
• Genetics
• Abortion
• HIV/AIDS
• Euthanasia
• Cancer
• Fertility
• Alternative
medicine
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16. Fertility Issues
• Fertility is the ability to reproduce; men who
are fertile are able to father children and
fertile women are able to get pregnant and
carry their baby to full term, with a live birth
nine months after conception. This all
happens naturally as a result of sexual
intercourse.
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17. Fertility Issues
• You may have
fertility problems
if you haven't
been able to get
pregnant after
trying for at least
1 year.
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18. Genetic Engineering
• Genetic engineering is the process of using
technology to change the genetic makeup of
an organism - be it an animal, plant or a
bacterium. The goal is to add one or more
new traits that are not already found in that
organism.
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19. Genetic engineering questions
• Does the search for a cure for specific disabilities for
individuals who
may be diagnosed
in the future
have a negative
impact on those
currently living
with a disability?Tanecia Stevens BA G&C International University of the Caribbean 19

20. Genetic question for Counselors
• What is “normal” an what constitutes a disability, and
who is to make this decision?
• What are diseases, or disabilities, and should they be
prevented or cured?
• How can we meet the financial needs of individuals
who desire gene therapy, which is beyond that many
individuals can afford?
• Who should obtain these services and at what cost?
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21. Abortion
• Counselors who work in a variety of
environments, including school,
rehabilitation, and marriage and family
practice settings, may be confronted with the
issue of abortion. Abortion is a value-laden
issue in society at large and also within the
counseling setting. Without a massive shift in
public opinion, abortion will remain one of
the most divisive health care policy issues.Tanecia Stevens BA G&C International University of the Caribbean 21

22. Abortion
Tanecia Stevens BA G&C International University of the Caribbean 22

23. Abortion Cont.
• Because of the value-laden and emotional nature of the
abortion issue, counselors must examine their own
values and understand their clients’ value systems. They
must carefully analyze all relevant empirical research to
ensure that all involved parties in the debate
appropriately characterize the scientific knowledge base.
They should encourage health care policy and
institutional policy that are based upon evidence rather
than assumption alone.Tanecia Stevens BA G&C International University of the Caribbean 23

24. Euthanasia
• Euthanasia (from Greek: εὐθανασία; "good death": εὖ,
eu; "well" or "good" – θάνατος, thanatos; "death") is the
practice of intentionally ending a life in order to relieve
pain and suffering.
• There are different euthanasia laws in each country. The
British House of Lords Select Committee on Medical
Ethics defines euthanasia as "a deliberate intervention
undertaken with the express intention of ending a life, to
relieve intractable suffering". In the Netherlands and
Flanders, euthanasia is understood as "termination of life
by a doctor at the request of a patient".
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25. Euthanasia: Think about this
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26. Ethics in Euthanasia
• Physician-assisted suicide and euthanasia are
distinguished and discussed in the context of the
counselor's role in helping terminal clients. An aging
population coupled with the proposed legislation in
many states to legalize physician assisted suicide
could mean these issues will become more
paramount to the counseling profession. Potential
ethical dilemmas are discussed using the bio-
psychosocial model, five pillars of ethics, and an
existing health-care model as guidance.
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27. Terms used with Euthanasia
• Hastened death
• Passive Euthanasia
• Active Euthanasia
• Double Effect
• Living will
• DPA: Dual Power of Attorney for heath care
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28. Elements of Ethical Procedural
Safeguards for Euthanasia
1. Requests should be made by a competent person on
several occasions and in writing.
2. A through examination should be made to rule out or
treat any prevailing psychological condition.
3. The act of assistance should be restricted to certified
physicians who will receive compensation for their
work.
4. Careful documentation with reference to alternative
treatments should be offered to the person.
5. All cases should be reported to an official body.
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29. Counseling Implication for
Euthanasia.
1. Keep current on developing legal, social, and
ethical information related to euthanasia.
2. Determine what culturally influenced moral
theory, personal biases, and persona perspectives
guide tour practice. Clarify personal beliefs and
values.
3. Become adept at the skill of self-reflection. Assess
your decision making process, understand it, and
use it to deal consistently with issues.
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30. Implication cont.
1. Examine, understand, and reconcile institutional
protocols, legal precedent, and liabilities.
2. Obtain differing professional perspectives.
3. Be knowledgeable about the potential course,
prognosis, and all treatment alternatives related to
a client’s illness.
4. Be familiar with all contextual factors that may be
influencing client. Their perspective.
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31. Implication cont.
• Try to understand client by exploring their world.
• Act as a resource person and empathic listener.
• Help clients understand the importance of various
personal and formal documents associated with the
end of life.
• Be available to comfort significant others after a
death has occurred.
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32. Counseling persons with STI (Aids)
The HIV/AIDS epidemic has presented
counselors with new ethical decision-making
dilemmas. This uncharted territory has required
counselors to carefully examine and consider
prudent action on resolved ethical issues. Legal
and professional norms of practice have
remained difficult to negotiate.
Tanecia Stevens BA G&C International University of the Caribbean 32

33. STI’s Counseling
• As counselors struggles to resolve these emerging ethical
issues; they must have a working knowledge
of the basic issues
related to working
with individuals
with touched by
HIV/AIDS and
other STIs
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34. Limitation of Confidentiality
• Counselor who receive information from clients who
may have a communicable disease known to be fatal
must disclose information to relevant third parties if,
and only if, the counselors have reason to believe
that:
a) there is medical evidence.
b) The client bears specific relation eg. Sex
c) The client have not or plan to inform third party.
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35. Limitation cont.
• In cases wherein the above conditions are met,
counselors’ general obligation to third parties is
defined by:
Within the counseling context, before disclosure,
counselors make all reasonable efforts to educate the
clients about the disease and to provide the clients
with the support, understanding, encouragement, and
opportunity to disclose the information to third
parties on their own.
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36. Limitation cont.
The counselor must make third party disclosure in a timely
fashion.
Before disclosure, counselors must inform clients of their
intention.
Counselors must disclose information only to the parties at risk
or to legal guardian.
Counselors must limit the third party disclosure to general
medical information, in earnest, communicate to the third party a
willingness to provide support in the form of counselling or to
make an appropriate referral.Tanecia Stevens BA G&C International University of the Caribbean 36

37. Counselor Implications
• Become familiar and continually update medical
information regarding HIV & STI
• Be familiar with short and long-term issues that may arise.
• Be aware of one’s own attitudes, biases, and prejudices as
they relate to individuals with HIV.
• Seek to inform and encourage all clients in high risk
groups to consider safe methods of having sex and using
drugs.
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38. Implications cont.
• Be prepared to refer clients to legal resources if
warranted to protect their right to nondiscrimination.
• Keep current regarding existing state and federal laws
concerning the caregiver role in the spread of
communicable diseases.
• Articulate early in the therapeutic relationship the
limitations of confidentiality, including the possible
use of written formats to facilitate the informed
consent process.
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39. Implications cont
• Determine mutual goals with client as part of
ongoing assessment.
• Remember that your principal duty is to your client.
• Exercise your prerogative to refer or consult with
other professional as needed.
• Maintain appropriate case notes that document
confidentiality issues, understandings with your
client, treatment goals and progress, and usual events.
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40. References
• http://www.businessdictionary.com/definition/ethics.html#ixz
z3SVbOeFcI
• http://www.gly.uga.edu/railsback/1122science2.html
• http://www.thefreedictionary.com/issue
• http://www.nlm.nih.gov/medlineplus/medicalethics.html
• http://www.counseling.org/knowledge-center/vistas/by-
subject2/vistas-professional-development/docs/default-
source/vistas/article_53#sthash.YMe4FCQE.dpuf
• Counseling Ethics and Decision Making. R. Rocco Cottone
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