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.

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,

10. Ethics Committees .

11. Consultation
Form
Adjudicatory
Mediation
Consultation

12. Root Cause Analysis Application 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