Ethical Considerations in Campus Alcohol and Drug Counseling

Transcription

1 Ethical Considerations in Campus Alcohol and Drug Counseling Dorothy H. Gager, M.Div., LCSW A&D Counselor Vanderbilt Student Health Center Southern College Health Association March 6, 2009

2 American Nurses Association Code of Ethics The nurse in all professional relationships, practices with compassion and respect for the inherent dignity, work and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes or the nature of health problems. The nurse s primary commitment is to the patient, whether an individual, family, group or community. The nurse owes the same duties to self as to others, including the responsibility to preserve integrity and safety, to maintain competence, and to continue personal and professional growth.

3 ETHICAL PRINCIPLES OF PSYCHOLOGISTS AND CODE OF CONDUCT Conflicts Between Ethics and Law, Regulations, or Other Governing Legal Authority If psychologists' ethical responsibilities conflict with law, regulations, or other governing legal authority, psychologists make known their commitment to the Ethics Code and take steps to resolve the conflict. If the conflict is unresolvable via such means, psychologists may adhere to the requirements of the law, regulations, or other governing legal authority. Conflicts Between Ethics and Organizational Demands If the demands of an organization with which psychologists are affiliated or for whom they are working conflict with this Ethics Code, psychologists clarify the nature of the conflict, make known their commitment to the Ethics Code, and to the extent feasible, resolve the conflict in a way that permits adherence to the Ethics Code.

4 AMA Principles of Medical Ethics A physician shall, while caring for a patient, regard responsibility to the patient as paramount.

5 TN Licensed Professional Counselors PROFESSIONAL ETHICS. All licensees and certificate holders shall comply with the current code of ethics adopted by the American Counseling Association, except to the extent that it conflicts with the laws of the state of Tennessee or the rules of the Board. If the code of ethics conflicts with state law or rules, the state law or rules govern the matter. Violation of the code of ethics or state law or rules may subject a licensee or certificate holder to disciplinary action.

6 NAADAC Code of Ethics Principle 5: Compliance with Law I understand that laws and regulations exist for the good ordering of society and for the restraint of harm and evil, and I am aware of those laws and regulations that are relevant both personally and professionally and follow them, while reserving the right to commit civil disobedience. I understand that the determination that a law or regulation is unjust is not a matter of preference or opinion but a matter of rational investigation, deliberation, and dispute. I willingly accept that there may be a penalty for justified civil disobedience, and I must weigh the personal harm of that penalty against the good done by civil protest.

7 NASW Code of Ethics 1. SOCIAL WORKERS ETHICAL RESPONSIBILITIES TO CLIENTS 1.01 Commitment to Clients Social workers primary responsibility is to promote the well-being of clients. In general, clients interests are primary. However, social workers responsibility to the larger society or specific legal obligations may on limited occasions supersede the loyalty owed clients, and clients should be so advised Self-Determination Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals. Social workers may limit clients right to self-determination when, in the social workers professional judgment, clients actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.

8 Drug-Free Schools and Communities Act (DFSCA) and Drug and Alcohol Abuse Prevention Regulations Minimum Requirements Slide 1 The Drug-Free Schools and Campuses Regulations require at a minimum that each institution distribute the following in writing to all students and employees annually: Standards of conduct that clearly prohibit, at a minimum, the unlawful possession, use, or distribution of illicit drugs and alcohol on school property or as part of any school activities A description of the applicable legal sanctions under federal, state, or local law for the unlawful possession or distribution of illicit drugs and alcohol

9 Drug-Free Schools and Communities Act (DFSCA) and Drug and Alcohol Abuse Prevention Regulations Minimum Requirements Slide 2 A description of the health risks associated with the use of illicit drugs and the abuse of alcohol A description of any drug or alcohol counseling, treatment, rehabilitation, and re-entry programs that are available to employees or students A clear statement that the institution will impose disciplinary sanctions on students and employees (consistent with federal, state, or local law), and a description of those sanctions, up to and including expulsion or termination of employment and referral for prosecution, for violations of the standards of conduct

10 Drug-Free Schools and Communities Act (DFSCA) and Drug and Alcohol Abuse Prevention Regulations Minimum Requirements Slide 3 The law further requires an institution of higher education to conduct a biennial review of its program: To determine its effectiveness and implement changes if they are needed To ensure that the sanctions developed are enforced consistently

11 Core Institute Prevalence All Students Annual Prevalence Tobacco 41.0% Alcohol 84.5% Marijuana 30.1% Stimulants 11.3% Opiates/sedatives 5.8% Hallucinogens 3.5% Other 6.4% 30-Day Prevalence Tobacco 28.2% Alcohol 72.8% Marijuana 16.7% Stimulants 5.4% Opiates/sedatives 2.7% Hallucinogens 1.0% Other 2.5%

12 Core Institute Prevalence Underage Drinkers Drank alcohol in past year 81.1% Drank alcohol in past 30 days 68.1%

13 Core Institute Average number of drinks/week Freshman Sophomore Junior Senior Grad Male Female Total

14 Is it ethical to teach moderation drinking skills to underage students?

15 Framework for Ethical Exploration Is this moral temptation or an ethical dilemma?

16 Legal test Moral Temptation Right versus Wrong Stench test Front-page test Mom test

17 Legal test Moral Temptation Right versus Wrong Stench test Front-page test Mom test

18 Legal test Moral Temptation Right versus Wrong Stench test Front-page test Mom test

19 Legal test Moral Temptation Right versus Wrong Stench test Front-page test Mom test

20 Ethical Dilemmas Right versus Right Analysis paradigms Principles for decision-making Resolution

21 Analysis by paradigm Truth versus loyalty Individual versus community Short-term versus long-term Justice versus mercy

22 Analysis by paradigm Truth versus loyalty Individual versus community Short-term versus long-term Justice versus mercy

23 Analysis by paradigm Truth versus loyalty Individual versus community Short-term versus long-term Justice versus mercy

24 Analysis by paradigm Truth versus loyalty Individual versus community Short-term versus long-term Justice versus mercy

25 Ethical Dilemmas Right versus Right Analysis paradigms Principles for decisionmaking Resolution

26 Principles for Decision-making Ends-based Rule-based Care-based

27 Principles for Decision-making Ends-based Do whatever produces the greatest good for the greatest number

28 Principles for Decision-making Rule-based Act in a way that could become universal law

29 Principles for Decision-making Care-based Do to others what you would like them to do to you

30 Ethical Dilemmas Right versus Right Analysis paradigms Principles for decision-making Resolution

31 Resolution Make a decision The goal is a practical decision; this is not just an intellectual exercise. In group process, be sure the decision is clearly articulated.

32 Ethical Dilemmas Right versus Right 1. Analysis paradigms Truth versus loyalty Individual versus community Short-term versus long-term Justice versus mercy 2. Principles for decision-making Ends-based Rule-based Care-based 3. Resolution

33 Trooper s Dilemma Moral or ethical? Tests: legal, stench, front-page, Mom 1. Analysis paradigms Truth versus loyalty Individual versus community Short-term versus long-term Justice versus mercy 2. Principles for decision-making Ends-based Rule-based Care-based 3. Resolution

34 Counselor s Dilemma Is it ethical to teach moderation drinking skills to underage students?

35 Counselor s Dilemma Moral or ethical issue? Tests: legal, stench, front-page, Mom 1. Analysis paradigms Truth versus loyalty Individual versus community Short-term versus long-term Justice versus mercy 2. Principles for decision-making Ends-based Rule-based Care-based 3. Resolution

36 Sources How Good People Make Tough Choices by Rushworth Kidder Core Institute Southern Illinois University, Carbondale