1. The European Network for Traumatic Stress Training & Practice www.tentsproject.eu

2. Ethics and Trauma Assoc. Prof Ufuk Sezgin

3. What is “ethics”? Ethics: “the rules of conduct recognized in respect to a particular class of human actions or a particular group, culture”

4. Principles of Ethics Autonomy Beneficence Nonmaleficence Justice Fidelity Veracity (1)http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.htm (2) Goka E. Felaket Durumlarında Araştırma Etiği in Aker AT Onder ME (eds). Psikolojik Travma ve Sonuçları 219-223.

5. Autonomy The freedom to make choices Recognizing a person’s right and capacity to think, decide and act for himself according to his beliefs, values and a life plan.” Involves protection of individuals with diminished autonomy Requires truth telling and effective communication Implies informed consent Assumes knowledge, competence, and voluntariness (1)http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.htm (2) Goka E. Felaket Durumlarında Araştırma Etiği in Aker AT Onder ME (eds). Psikolojik Travma ve Sonuçları 219-223. (3) Newman and Kaloupek. Journal of Traumatic Stress, Vol. 22, No. 6, December 2009, pp. 595–602.

6. Beneficence The promotion of what is best Emphasizes moral importance of doing good Implies positive acts and clinical strategies to reduce suffering, promote growth and increase well-being (1)http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.htm (2) Goka E. Felaket Durumlarında Araştırma Etiği in Aker AT Onder ME (eds). Psikolojik Travma ve Sonuçları 219-223. (3) Newman and Kaloupek. Journal of Traumatic Stress, Vol. 22, No. 6, December 2009, pp. 595–602.

7. Nonmaleficience Primum non nocere- do no harm Avoid actions that risk hurting patients, causing unnecessary physical pain or psychological pain or suffering as during physical examinations, tests or procedures Involves protection against violation of confidentiality and coercive influences, Ensures use of evidence based practices (1)http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.htm (2) Goka E. Felaket Durumlarında Araştırma Etiği in Aker AT Onder ME (eds). Psikolojik Travma ve Sonuçları 219-223. (3) Newman and Kaloupek. Journal of Traumatic Stress, Vol. 22, No. 6, December 2009, pp. 595–602.

8. Justice Concept of fairness Distributive justice – same care for patients in similar situations Treating patients fairly Describes what patients are entitled to or can claim Respect for the law http://www.hhs.gov/ohrp/humansubjects/guidance/belmont.htm

9. Fidelity Keeping promises and commitments Adherence to organizational or systemic policies Long-term vocational planning Creativity and flexibility Effective use of referral sources for continuity of services

10. Veracity Truthfulness -Implies honesty assumes that decisions are made based on the truth Professional disclosure –Self –Colleagues –Benefits Systems

11. Do all professional ethical rules apply during any traumatic event?

12. Ethics in practice The principle of autonomy Support workers should respect to human rights and dignity. In disastrous areas any given knowledge to victims should be subjective and easy to understand.

13. Ethics in practice The principle of justice There should be no discrimination among age, sex, gender, sexual orientation, ethnicity, religion, language, political opinion, disability, identity At the time of support work defining the needs and taking resources to people who really need it is essential. While making evaluations to determine the victims who are in need, the basic principles of psychosocial first aid are put to use Support workers should mediate dealing of the social relief (goods and monetary) after a disaster

14. Ethics in practice The principle of nonmaleficience Organizations which work at disastrous areas should stay away from any action that can cause harm to disaster victims During the work culture and traditions of the served country or area should be respected Interventions should not be done if the victims are not ready Appropriate timing should be chosen in order to end services in disastrous areas

15. The principle of veracity Served people in support works should be correctly informed about the conditions, process, ending and monitoring of the services Organizations should not misuse its information and applications People should avoid from explanations regarding publicity that are beneficial to monetarily or individually Ethics in practice

16. The principle of fidelity Confidentiality of the information about the served people must be essential Forming permanent and sustainable services models should be featured Support work should stay away from undoable promises. It should be lead in realistic settings and constructive Ethics in practice

17. Ethics and professionals All professionals in the field of trauma are bonded to all ethical principle and responsibilities written or not written in their corresponding guides as well as the ones the professional group’s they are in.

18. Ethics and volunteers Having volunteers in support works after disasters besides professionals is a common application Volunteers in the field are bonded with fundamental ethical principles

19. Ethics and research Support works after traumatic events may involve research that is done in an effort to prepare for other possible events. There are some ethical principles that should be considered for planning, executing and coming out with the results of the research: –Planned research after disasters cannot be done only for curiosity and concern for scientific research. –Goals of the research should be explained clearly to all possible participants of the research. –Participation cannot be forced. –Participants are clearly informed that the help they are getting is not dependent on the research. –Data is collected afterwards as long as the pattern of the research (if it is not a study about effectiveness) is available.

20. 20 NCPTSD* Guidance National Center for PTSD Guidance for mental health providers in acute phase @ http://www.ncptsd.va.gov/ncmain/index.jsphttp://www.ncptsd.va.gov/ncmain/index.jsp