Ethical Issues

Introduction

This paper discusses why the initial consultation is so important and what factors an ethical therapist will cover in this aspect of the therapy process. It also tackles the ethical issues besetting a therapist in the conduct of his profession dealing with psychotherapeutic counseling and hypnotherapy and counseling skills. The role of a therapist in the behaviour alteration of his or her client is so vital that it is necessary to observe some ethical considerations in the practice of his profession.

Importance of initial consultation

An initial consultation is the first of the stages of psychotherapy and generally includes a discussion of the reasons as to why the client is seeking psychotherapy help and what he is hoping to obtain from the experience. Why it is important is because it provides an opportunity to find out whether the needs, interests, and goals of the client fit with the skills of the therapist. This stage also provides the initial clarification about the limits of confidentiality, therapeutic approach, and other terms of professional services. Moreover, the initial consultation helps both the client and the therapist to gauge whether each is likely to be able to work with the other successfully (Plante, 2011). The importance of initial consultation is also found in making a formal determination of the client’s fit for a psychotherapeutic relationship and potential for meaningful change (Klonoff, 2010). Whilst informed consent is shown as important in the therapy process, with a clear description of the limits of confidentiality, full informed consent to treatment has been mandated by ethical guidelines. If for example, a client approaches a therapist for initial consultation, informed consent to treatment may involve information on behavioural therapies demonstrating effectiveness and rapid changes in the treatment of the behavioral problem that the client is complaining about (e.g. panic) (Weiner and Hess, 2006).

Further, initial consultation is important because it is where a range of decisions are in terms of whether to schedule a second session. For example, the client may evaluate whether it is adequate to have his or her needs be met by working with the therapist, as well as whether the practical terms of the therapy are acceptable to the client. In addition, considering the information thus provided during the consultation session, the therapist may ascertain whether he or she possesses the needed expertise to work effectively and successfully with the client (Klonoff, 2010).

Another importance of initial consultation is that it allows initiating a collaborative relationship between the client and the therapist and evaluating initial consultation efforts. If the therapist happens to assess a need for consultation services, then the entry stage would then initiate a consulting relationship. The value of initial consultation is seen in the establishment of a voluntary and collaborative consulting relationship between the counselor and the client. Different role expectations can lead to resistance on the part of the client, which thus necessitates a vital importance of agreement relating to role expectations to reduce such potential resistance. An initial step in evaluating a client’s condition is establishing an accurate diagnosis, which is done during the initial consultation (Boylan et al., 2011).

Much as the above are important for conducting an initial consultation, it is also because such consultation may potentially lead the client not to continue further services. The client may come to a decision that the therapist, for some reason, cannot adequately meet his or her needs. For example, he or she may find the therapist as being too direct, aloof, expensive, inexperienced, young, old, etc., and thus may conclude that the therapist’s qualities are not fit to his or her needs. The client may also feel better after the initial consultation and may no longer feel compelled to continue further sessions. Similarly, the therapist may decline from providing continued services for a variety of reasons, such as the client’s revelation of an alcohol problem, about which the therapist might decide to refer him or her instead to a specialist in the treatment of problems relating to substance abuse (Plante, 2011).

Alternatively, there are times that patients are referred by their physician right after discharge from an inpatient rehabilitation setting. Of note, the one seeking therapy for the patient is in fact not the patient himself but the patient’s family. Perceptive health care professionals are the ones who usually recognise a need for psychotherapy by the patient, with an emphasis on coping, psychoeducation, and deficit adjustment. Therefore, it must not always be assumed that it is the client who is motivated to seek psychotherapy (Klonoff, 2010). In cases of patients being considered for psychotherapy, a physician’s referral is needed, in which relevant medical records must be acquired to determine whether the patient is appropriate for therapy as well as whether he or she anticipates potential psychotherapeutic needs and challenges. It is during the initial consultation in which records are presented after being obtained and reviewed in advance in order for the therapist to thoroughly understand what the client has gone through or is going through (Klonoff, 2010).

Therefore, without the initial consultation, psychotherapeutic intervention might not be sufficient and effective enough.

Ethical issues faced by therapists

The psychotherapist is guided by ethical standards and codes that provide professional standards aimed at guiding their ethical conduct (Kohlenberg and Tsai, 2007). One ethical issue faced by a therapist in terms of initial consultation is whether to provide the consultation free of charge to the client, as some clients who have taken up this offer tended to decide to continue in counseling because of being obliged to do so. This would prompt a concern whether the therapist has violated any portion of the code of ethics (Welfel, 2013). There are some who do not charge for initial consultations, and it is important that the client is informed whether the therapist does or does not charge for the first session (Wheeler, 2014). A potential problem may ensue with the use of a free initial consultation. This is because clients may feel committed after the initial consultation and may have difficulty declining further treatment because the initial consultation was free of charge. Some might even regard this practice as taking advantage of clients and may perhaps be seen as undue influence mentioned in the code of ethics (Welfel, 2013).

Another ethical issue that may ensue during initial consultation is sexual attraction between the client and the therapist, which is identified as a boundary ethical issue (Houser et al., 2006). The client may have emotional or sex-related problems that he/she initially presents to the therapist, which the therapist must approach objectively. Albeit discussion of these feelings can foster therapeutic progress, it is still unethical and counter-therapeutic to act on them. Even when it may seem sound to become sexual with a client with sexual problems as an intervention, engaging in such unethical activity is definitely against established ethical standards and codes. Rather, the best intervention that the therapist may adopt for his/her client with sexual problems is sex therapy with the client and a significant other.The several malpractice suits filed against therapists relating to sexual relationships with their client only confirm the unethical and counter-therapeutic stance of sexual relationship between the therapist and client (Kohlenberg and Tsai, 2007). Even at the onset of the initial consultation, sexual attraction may already spark, which the therapist, being the more responsible person, must put a wall against.

Emotional tyranny is also a common ethical issue that may occur even during an initial consultation. It is a term describing abuse of power by psychotherapists to the disadvantage of their clients, caused by the power imbalance between them. For example, during the initial consultation, the therapist’s power is seen in how he establishes the therapy session, how long the session should last, how often he and the client should meet, how much the session costs, and what the permissible and impermissible behaviour must be within the session (Kohlenberg and Tsai, 2007). The realm of ethical decision-making involves the aspects of ethical dilemma, the client and the therapist’s values, race, gender, personal history, etc.; local and national laws; professional knowledge; and codes of ethics (Houser et al., 2006).

The therapist may also face violations relating to dual relationships. Such relationships are nonsexual that may involve counseling a friend, relative, or neighbour, as well as receiving referrals from people who know the client and the counseling process. An ethical dilemma of dual relationships may potentially occur when the therapist has several roles with a client; in that apart from being a client, the person is also a friend, a neighbor, a relative, etc. to the therapist. It has been suggested that accepting referrals from existing clients may constitute a boundary violation (Houser et al., 2006). Indeed, even at the initial consultation, the therapist is already face-to-face with the issue of whether to continue with the professional relationship, or terminate it right away upon seeing his or her friend across the table as a client seeking therapy.

Self-disclosure is another ethical issue besetting the therapist. Even during the initial consultation, the issue of self-disclosure may occur. Relating to this issue, it is important to determine the extent of information a therapist should share with the client and the types of self-disclosure to be made as well. Another example of ethical issue involving boundary is socialising with a client outside the counseling session and negotiating for fees (Houser et al., 2006).

One possible ethical dilemma facing the therapist during is confidentiality, which deals with maintaining privacy and non-disclosure of information to others outside the counseling relationship, unless the client expresses consent to do so (Jenkins, 2007; Houser et al., 2006). Whenever the client enters the counseling room for the first time, he or she already expects that anything being discussed with the therapist would be kept confidential. It has been found that violations of confidentiality were a common complaint made against therapists and counselors. The client, even in the initial consultation, already begins disclosing some personal matters to the therapist, which the therapist is expected to keep confidential as his legal duty. Of important note however is the fact that confidentiality is not absolute and that there are times in which the therapist may divulge certain information a necessary (Corey, 2013; Houser et al., 2006). Examples of these are those surrounding harm that may involve the client who is contemplating about suicide or is expressing thoughts about inflicting harm to others; court-involved clients; child abuse reports; and clients with medical conditions who express engaging in precarious acts relating to their condition (e.g. HIV) (Houser et al., 2006).

Further, it was found that successful outcomes ensue when clients change their personal values and take a close resemblance of that of the therapist/counselor. A relevant ethical dilemma with regard to this is in order for the counseling to be successful, how similar the client’s values must be to the counselor. Moreover, another dilemma is whether fostering such similarity is ethical and helpful enough to the client. A question for the profession is whether therapists utilise moral and ethical frameworks reflecting society’s norms as the only basis of their ethical decision-making, or whether therapists come to an ethical decision whilst taking into account the values, morality, and ethical stances of their diverse client population (O’Donohue and Fisher, 2009; Houser et al., 2006). These issues are being dealt with even upon an initial consultation.

Conclusion

This paper dealt with the importance of initial consultation and the ethical issues facing the therapist in the performance of his profession. An initial consultation is important because it forms the basis of the client’s diagnosis. It generally covers finding out the reasons as to why the client seeks help and what he or she aims to obtain as a result of the psychotherapy experience.

The ethical issues faced by the therapist in the conduct of his profession during the initial consultation are those involving a decision to charge the client for a specific fee or not for the initial consultation; potential sexual attraction between them; the issue of confidentiality and client consent; emotional tyranny; violations relating to dual relationships; and self-disclosure. Having laid down these ethical factors besetting a therapist, the conclusion being arrived at is that the therapist is bound by set standards and ethical codes through which the expected functions of his performance must be based, and that he/she should conduct the initial consultation and further sessions objectively.

References

Boylan, J. C., Malley, P. B/, and Reilly, E. P. (2011) Practicum Internship: Textbook and Resource Guide for Counseling and Psychotherapy. Third Edition. NY: Brunner-Routledge.

Corey, G. (2013) Theory and Practice of Counseling and Psychotherapy. Ninth Edition. Mason, OH: Cengage Learning.

Houser, R., Wilczenski, F. L., and Ham, M. (2006) Culturally Relevant Ethical Decision-Making in Counseling. London: Sage Publications, Inc.

Jenkins, P. (2007) Counseling, Psychotherapy and the Law. London: Sage Publications, Inc.

Klonoff, P. S. (2010) Psychotherapy After Brain Injury: Principles and Techniques. NY: The Guilford Press.

Kohlenberg, R. J. and Tsai, M. (2007) Functional Analytic Psychotherapy: Creating Intense and Curative Therapeutic Relationships. NY: Springer.

O’Donohue, W. T. and Fisher, J. E. (2009) General Principles and Empirically Supported Techniques of Cognitive Behavior Therapy. NJ: John Wiley & Sons.

Plante, T. G. (2011) Contemporary Clinical Psychology. NJ: John Wiley & Sons.

Weiner, I. B. and Hess, A. K. (2006) The Handbook of Forensic Psychology. NJ: John Wiley & Sons.

Welfel, E. (2013) Ethics in Counseling and Psychotherapy. Mason, OH: Cengage Learning.

Wheeler, K. (2014) Psychotherapy for the Advanced Practice Psychiatric Nurse: A How-to Guide for Evidence-Based Practice. NY: Springer Publishing Company, LLC.

Bibliography

Boylan, J. C., Malley, P. B/, and Reilly, E. P. (2011) Practicum Internship: Textbook and Resource Guide for Counseling and Psychotherapy. Third Edition. NY: Brunner-Routledge.

Clarkson, P. (2005) Transactional Analysis Psychotherapy: An Integrated Approach. NY: Routledge.

Cooper, J. and Alfille, H. (2011) A Guide to Assessment for Psychoanalytic Psychotherapists. London: Karnac Books Ltd.

Corey, G. (2013) Theory and Practice of Counseling and Psychotherapy. Ninth Edition. Mason, OH: Cengage Learning.

Forrest, G. G. (2010) Self-disclosure in Psychotherapy and Recovery. Plymouth: Jason Aronson.

Houser, R., Wilczenski, F. L., and Ham, M. (2006) Culturally Relevant Ethical Decision-Making in Counseling. London: Sage Publications, Inc.

Jenkins, P. (2007) Counseling, Psychotherapy and the Law. London: Sage Publications, Inc.

Klonoff, P. S. (2010) Psychotherapy After Brain Injury: Principles and Techniques. NY: The Guilford Press.

Kohlenberg, R. J. and Tsai, M. (2007) Functional Analytic Psychotherapy: Creating Intense and Curative Therapeutic Relationships. NY: Springer.

O’Donohue, W. T. and Fisher, J. E. (2009) General Principles and Empirically Supported Techniques of Cognitive Behavior Therapy. NJ: John Wiley & Sons.

Plante, T. G. (2011) Contemporary Clinical Psychology. NJ: John Wiley & Sons.

Weiner, I. B. and Hess, A. K. (2006) The Handbook of Forensic Psychology. NJ: John Wiley & Sons.

Welfel, E. (2013) Ethics in Counseling and Psychotherapy. Mason, OH: Cengage Learning.

Wheeler, K. (2014) Psychotherapy for the Advanced Practice Psychiatric Nurse: A How-to Guide for Evidence-Based Practice. NY: Springer Publishing Company, LLC.

Abstract

Studies suggest a need for further investigation in the regulation of e-business and use of systems and technologies (using e-business). The Economy of the United Kingdom is divided into two different sectors that is ever changing and fast moving Private Sector where technology and e-business is used and embraces with open arms due to the need of eliminating rivals at times without looking at the ethical issues that this my comprise or raise. The other sector consist of is organizations like Local Authorities who do not use e-Business or technology as much as they do not like the rapid change is technology and the investment in such new technology normally leads to a balancing act where cost/customer satisfaction/staff satisfaction(organizational culture) out ways the benefits. The squeeze that has been applied on the Public Sector (Local Authorities) in the United Kingdom has raised a need for more research to be taken to look at weather Local Authorities would have been better off investing in an Electronic Business system and look at saving money to try and be self sustaining without having to rely heavily on the funds provided by Central Government.

This research project proposal look at what are the ethical, privacy or security issues that may ariseThe public have lost faith in the government and local authorities’ capabilities to securely hold and preserve the public’s sensitive information due to the highly publicized loss of sensitive. What policies and procedures are in place to support a local authority looking to implement e-businessHow will these policies and procedures be in co operated in to the local authorities business plan, IS Strategy and IT/IS security policies and procedures. What are the organization culture towards change, using new technology and the uncertainty around the implementation e-business?

Background/Introduction

The Public sector who relies on government grants and national funding for business, the goals are more customer or service focused and the rights of customers or service users take a lot of presidencies. Normally Public sector organisations like Local Authorities do not use e-Business or technology as much as they do not like the rapid change is technology and the investment in such new technology normally leads to a balancing act where cost/customer satisfaction/staff satisfaction(organisational culture) out ways the benefits. The squeeze that has been applied on the Public Sector (Local Authorities) in the United Kingdom has raised a need for more research to be taken to look at weather Local Authorities would have been better off investing in an Electronic Business system and look at saving money to try and be self sustaining without having to rely heavily on the funds provided by Central Government.

If Authorities do take the step and decide to try and use new technologies (e-business), what are the ethical, privacy or security issues that may ariseThe public have lost faith in the government and local authorities’ capabilities to securely hold and preserve the public’s sensitive information due to the highly publicised loss of sensitive information as covered by Mack (2011, New Data Breach Incident at Leicester City Council, Leicester Mercury, 23/03/2011) and also by Raywood (2008, USB stick containing children’s details lost in Leicester, Leicester Mercury, 14/11/2008).

Journal

• Academy for Legal, Ethical and Regulatory Issues proceedings
• Journal of Legal, Ethical and Regulatory Issues

Research Question

1. What are the ethical and privacy issues in the public sector?
2. Have these issues have resulted in legal and information governance charges or fines?
3. What steps or procedures are in place to eradicate these issues?
4. How can these ethical and privacy issues be resolved?
5. What are the e-business related ethical issues?
6. Does these issue only arise in the public sector or do they arise in the
7. Are these issues the same in the private sector or do they differ and why?
8. Some local authorities use e-business while others do not, are there any specific reasons(Cost, size of authority, relevance, gap in knowledge, legal implications, ethical implications)
9. How do local authorities using e-business respond to any of the ethical issues with e-business?
10. Does local authority have policies and procedures to support the use of e-business systems?
11. Do local authorities feel the risk of ethical, privacy and security issue related to the use of e-business systems out way the financial benefitsIf so why and how?
12. Does local authority front line staff resist this change to technology?
13. Do organizational culture and legal policies hinder the mindset of staff and senior management with in local authorities to change in technology in particular e-business or e- marketing?

Literature Review

Public Sector working has now totally been changed since the end of 2007 and beginning of 2008, the Global Financial meltdown called the Recession that was caused due to the Big Banking Crisis has lead to a drastic change. The new Collision Government has started to put the big squeeze on public spending and local authorities have been stretched to the bone to try and save millions. These uncertain times have also in cooperated with the public loss in confidence that local authorities are able to handle the intense pressure of saving money, reducing staff, providing a good service and also abiding by the ethical and legal rules regarding information and personal data especially on e-business systems.

The Rapid change in technology with new features being developed at the speed of light, this has resulted in an increased risk in people’s privacy. ‘“Computer technology is the most powerful and most flexible technology ever devised. For this reason, computing is changing everything – where and how we work, where and how we learn, shop, eat, vote, receive medical care, send free time, make war, make friends, make love”(Rogerson and Bynum 1995, p.iv)’, (Rogerson and Bynum 2004, p.1). Technology has now helped defined how we live our life, majority of people now days spend more time using technology especially the internet.

The growth of the internet in the late 1990 and early 2000 has lead to a majority of people shopping online, banking online; e-business has slowly become a part of people’s everyday life. This does raise the issue related to security which can has drastic effects like cyber bullying, hacking, identify theft, using personal information for ones gain and to even promote cyber terrorism as identified by Rogerson and Bynum (2004, p209).

Governments do not sell products or services to customers; they perform many functions for their stakeholders. Many of these functions can be enhanced by the use of e-business. Governments also operate businesslike activities; for example buy supplies from vendors and distribute benefit payments of many kinds. Customers (general public) now have the facility to pay their council tax, get a road tax certificate, etc online using e-business. “The use of electronic commerce (e-business) by governments and government agencies to perform these functions is often called e-government” (Schneider, 2007, vol.7, page 226). There is a legal obligation for businesses that operate on the web must comply with the same laws and regulations that govern the operations of all business. If they do not, they face the same set of penalties – fines, reparation payments, court-imposed dissolution, and even jail time for officers and owners – that any business face. This legal obligation has been set by The British Computer Society Code of Conduct which states “You should not misrepresent or withhold information on the performance of products, systems or services, or take advantage of the lack of relevant knowledge or inexperience of others” as listed by Rogerson and Bynum (2004, p194). Clearly, there is scope here for a great deal more research that

• is based on empirical data of surveys done with local authority staff and the general public;
• operates with a complex understanding of concerns and barriers for local authorities to use e-business;
• looks specifically at the ways online crime, terrorism and warfare can be reduced and stopped;
• involves more work on the culture difference and change between the public and private sector;
• aims not only to describe and explain but also to change ethical and legal policies and procedure for the use of e-business in local authorities within the United Kingdom.

Research Methodologies

Local Authorities in the United Kingdom have a reluctance to use new technologies; with the current climate where LA’s are looking to reduce their outgoing cost and still tries to maintain services. E-Business is a new way forward, but LA’s are very reluctant to embrace this new technology and way forward. There may be a few ethical issues with use of E-Business within LA’s due to the issue with privacy and other factors that have undermined the image of Local Authorities due to loss of personal data and information of the general public.

Methodology:

I am look at using a positivism form of the philosophical paradigms where I can gather evidence of formal propositions and quantifiable measures to support my argument regarding the reluctance of local authorities in the United Kingdom to adopt e-business system and the ethical issues that will arise with the use of e-business systems with in local authority.

Data Collection:

I look at using a quantitative approach to collect data and comments from three different sets of audiences

• General Public
• Councilors, senior managers and staff within Local Authorities that is not using E-Business
• Councilors, senior managers and staff within Local Authorities that is using E-Business

I would look at potential trends, issues, concerns, positives and other comments from the three groups’ l have listed above.

Interviews will be my approach with Councilors and Managers to find out more from the people who take the big discussions higher up.

A series of surveys designed to look at E-Business will be distributed to staff around the different authorities.

A survey will be put to the General Public so I look at collecting quantitative data and also comments regarding E-Business in LA’s, the Ethical Issues this might cause and the concerns from the general public related to these issues.

Data Analysis:

The qualitative data analysis approach will be used in order to gain more depth and analyze underlying issues of the research question at hand. I have chosen this because quantitative data analysis approach might not necessarily capture the emotion behind the answers.

Data Analysis Software Tools:

For the analysis of my quantitative data I would use spreadsheets and statistical softwares to create

• tables,
• bar charts,
• pie charts,
• line graphs,
• scatter graphs, etc as specified by Oates (2006, chapter 17, page 250 – 253).

Spreadsheets (like Microsoft Excel) which are useful for analyses such as frequency distributions, means and cross-tabulations. Spreadsheets are also useful for graphic data from individual variables. Statistical software (like SPSS) which are useful for analyses such as multivariate analysis of variance, factor analysis and cluster analysis.For the analysis of my qualitative data I would use transcript creation, coding, data organization, hyperlink creation, etc as stated by Oates (2006, chapter 18, page 276).

Project Plan

The most important factor to with a research project is planning and effectively using the time I have to work on the research project. There are 10 useful steps which will help me make sure I am on track to delivering my proposed research project on time as identified by O’Donoghue (2006):

Stage 1 – Choosing the project

Stage 2 – Initial literature reviewThe literature review will enables me to find out what research has already been undertaken in regards to the Ethical issues with E-Business in Local Authorities in the United Kingdom. An Initial literature review acts as good starting point to help understand and decide the specific area of research you will want to undertake.

Stage 3 – Finalizing the research questions

Ideally your research questions will emerge from the literature review.

Stage 4 – Choosing and developing the methodology

At this stage you need to choose the best approach to enable you to answer your research question.

Stage 5 – Data collection

Collecting the data will be a long process which will end up taking a few months of detailed observation and recording.

Stage 8 – Data analysisData analysis includes the systematic organizing of the data and its presentation in a form that readers of your project can understand.

Stage 9 – Drawing conclusions and interpretations

It will certainly involve a critical reflection on the conclusions you have drawn and the methods you have used.

Stage 10 – Preparing the final thesis

The final stage of the project, though, is assembling the final version of the thesis..

The draft project plan attached in Appendix 1; and following the steps listed above has given me more confidence that I can prepare, plan and work to the illustrated timescales to successfully complete the research required.

Conclusion

This research project proposal illustrates that there is scope for a significant amount of research to be undertaken on this selected topic. I feel this proposal has also identifies a specific gap in the ethical issues with the use of e-business systems. E-Business systems can form the future and the possible solution for local authorities in the United Kingdom as a possible investment to help them bridge the gap at a time of uncertainty and push forward a new way to helping local authorities become more self sustaining. By in cooperating e-business in their present business policies and IS strategy, they can start planning for the future more positively. This proposal has also identified the need to look at the ethical, legal and privacy concerns which local authorities might be taking on with an e-business system. Every new system come along with its advantages and disadvantages, I feel the ethical, legal and privacy issues are the main disadvantages with using an e-business system (the other disadvantages are cost, resources and planning). There many be issues where IS/IT professionals may be unprepared to deal effectively with the ethical issues that arise in the workplace as stated by Bynum and Rogerson (2006, chapter 2, page 39).

Review and Critique of “Ethical Issues in the Social Worker’s Role in PAS (Ameda A. Manetta and Jancie G. Wells, 2001) Tracy S. Robinson September 2010 (Ameda A. Manetta and Jancie G. Wells, 2001). Ethical issues in the social worker’s role in pas. Health ;amp; Social Work/ Volume 26, pg 3 Introduction The author’s focus was on ethical issues in physician assisted suicide and the role it plays amongst social worker’s. The author’s presented results of an exploratory study of social workers views on physician assisted suicide (PAS).

In which social workers favored or not favor PAS and whether there is a difference in education or training on mental health issues, ethics, or suicide that may influenced their views as well. The involvement with PAS presents an ethical dilemma, which in this article refers to a situation in which social workers think they have no definitive guidelines for professional behavior. The article has current interest because it is important that social workers have been properly prepare and train to work with clients making end of life decision.

Summary of the author’s main points Purpose of the study. The purpose of the study was to determine social workers views on physician assisted suicide (PAS). The study involved participant from three separate workshops on suicide that were presented by the first author. The study subsamples sixty-six social workers. The social workers either had a South Carolina social work license or a bachelor’s or master’s degree in social work. The participants recruitment where given a questionnaire that contained twenty-six questions, most of which required yes or no responses.

The study focus on how these different elements guide social workers in making ethical decisions regarding intervention with clients. There were areas in the articles that mention how social workers had difficulties in doing that. Summary of literature review as presented by the author. The study found that physician assisted suicide is one of the most frequently debated issues in American Society (Bachman et al.. , 1996; Foley, 1997). The study found that people are divide on the issues.

It has brought arguments about preservation of life, autonomy, and self-determination of individual. This gives ethical and moral complicity of end life decision making. The study found that most social worker agrees that PAS should be reserved for people who are dying from terminal illness. However the other percentage that opposes argue that underutilization of narcotics for pain control leaves terminally ill patient in pain during the end of life as well. The finding for the arguments had little research conducted on the etiology of actual cases of PAS.

Most of the available data is on suicide among individuals who acted alone. It has found that when people are experiencing personal difficulties or have lowered coping capacity, they are at risk of suicide. However terminally ill people are rarely suicidal, the author’s have shown studies that the main difference between terminally ill patient who become suicidal and those who don’t is the presence of clinical depression in the patients who are suicidal. Summary of ethical issues.

There are some ethical dilemmas that occur when there is a lack of knowledge about state and federal legislation governing practice are sufficiently prepared to work responsibly with clients and family considering PAS. Some ethical issues arise when the lack of knowledge may have produced biased thinking in social workers projecting what they want in a situation onto their clients or client’s family. The instruments. The researchers used a questionnaire as their instrument in the study. The survey instrument contained twenty-six questions.

The questions included demographic information on age, race, religion, and educational degree. Sampling techniques. There were a total of ninety-eight participants, including physician, psychologists, nurses, and social workers complete the questionnaire. The finding reported here based on a subsample of sixty-six social workers who either had a South Carolina social work license or a bachelor’s or master’s degree in social work. Methods of data analysis. The researchers used the statistical program for the Social Sciences (SPSS) to analyze the data.

Descriptive statistics were calculated on demographic information. A chi-square analysis was used to determine if there were any statistical relationships between social workers who agreed and those who disagreed with PAS by whether they had universal courses, additional training, and knowledge of the PAS law of South Carolina. Data collection techniques. Participant’s recruitment occurred at three separate workshops on suicide. As attendees enter the workshop a questionnaire was administrated to ninety-eight participants. Summary of study findings.

The author’s of this article had the following major findings: (a) that social workers in South Carolina are evenly divided about who supported PAS and who did not support it. (b) circumstances under PAS would be favored for reasons other than terminal illness, were two-thirds agreed with PAS if a person had terminal illness, compared with thirty-seven percentage. (c) majority of respondents stated that they had taken university courses or had additional training in the field of mental health, ethics and suicide. Relevance of the article to social work profession.

Resolving ethical problems. The authors suggest obtaining information from social worker who works with a broad spectrum of clients would help in formulating policy. Since PAS and legacy of PAS are applicable to all populations. The authors in the article also suggest that legislation should set up some type of ethical practice by requiring that social workers be licensed in one of the three levels. And social workers only should practice in areas in which they have expertise and license in. Benefits of the article to social workers.

The social workers may benefits from this article because it makes them more aware about PAS. It also benefits by informing social workers of the accountability of their action when assist clients and their families who request information about PAS. The article helps social workers want to get more inform about the policies related to PAS and how it would affect them has social workers. The article gave them a broader view of end of life decision from the narrow biomedical and single focus on self-determination to one that incorporates the core value of human rights. Critique and Personal Opinions.

Critique. The article was relevant to social work practice. The article focused on the issues that needed to be address toward social workers roles in PAS. The authors identify the ethical dilemmas that social workers have been avoiding conflicts in the view of PAS. The research that was conducted was limited due to the fact of its small sample size, but the results of it confirm the need for more extensive research in the area of social work with PAS. Personal opinions. In my opinion I would have liked for the study to have been broader in their selection of participants.

I think that there should have been a state wide study done. South Caroline shouldn’t have been the only sate involved in their study. I believe if they had more statistics it would have capture a broader view of what they were trying to get cross. I wonder if they had given the questionnaires at the end of the workshop they would have gotten a better response in data. Improving the study. In order to improve the study what would have been done differently? I think I would have included more workshops of suicide to pull more research from the study.

The study was conducted with limitations in it. Those limitations of study did affect the calculation and results of the study. I would have liked the authors to have gone farther into the dilemmas that social workers have with avoidance of conflict. Conclusion. The article included valuable but limited information. The authors of this wanted to focus on the ethical dilemma that surrounded social workers with (PAS). The authors study did point out issues that needed to be address to help social worker want to make better ethical decision when it comes to dealing with end of life decision.

This decision should be consistence with social worker values of protection of vulnerable populations in today’s society. The study also identifies the need for NASW to disseminate its professional policy statement to the profession and to broaden their views of end of life decision. I believe this is a great start that the authors brought forth in helping social workers down the path to end the ethical dilemma presented toward PAS.

References (Ameda A. Manetta and Jancie G. Wells, 2001)