Ethics in Psychotherapy and Counseling. Kenneth S. Pope

wrote:

The creed which accepts as the foundation of morals, Utility, or the Greatest Happiness Principle, holds that actions are right in proportion as they tend to promote happiness, wrong as they tend to produce the reverse of happiness. By happiness is intended pleasure, and the absence of pain; by unhappiness, pain, and the privation of pleasure (p. 9).

      This may seem like a fairly simple, almost easy, approach to ethics. However, de Lazari-Radek and Singer (2017) emphasize that figuring out what promotes the most happiness in every situation may present more of a challenge than following a set of rules.

      The core precept of utilitarianism is that we should make the world the best place we can. That means that, as far as it is within our power, we should bring about a world in which every individual has the highest possible level of well-being. Although this may seem like mere common sense, it is often in opposition to traditional moralities. Most communities prescribe rules to be followed irrespective of whether the outcome will make the world better or worse. It is much easier to follow rules than to try to assess, each time one acts, which of the available options will have the best consequences (p. 711–717).

      Kantian Ethics

      Utilitarianism focuses on results, consequences. Kantian ethics focuses on will and intention. Kant (1785/1998) wrote:

      Nothing can possibly be conceived in the world, or even out of it, which can be called good, without qualification, except a good will. Intelligence, wit, judgement, and the other talents of the mind, however they may be named, or courage, resolution, perseverance, as qualities of temperament, are undoubtedly good and desirable in many respects; but these gifts of nature may also become extremely bad and mischievous if the will which is to make use of them, and which, therefore, constitutes what is called character, is not good …. A good will is good not because of what it performs or effects, not by its aptness for the attainment of some proposed end, but simply by virtue of the volition; that is, it is good in itself …. and considered by itself is to be esteemed much higher than all that can be brought about by it …. (p. 115–127).

      Kant believed that we must always treat others as an end in themselves and never as simply a means to an end.

      Feminist Ethics

Brabeck and Ting (2000) open a discussion of feminist ethics by quoting the striking claim that feminism itself cannot exist separate from ethics: “In 1991, the political scientist Jean Bethke Elshtain wrote, ‘feminism without ethics is inconceivable’ … According to Elshtain, all feminisms offer an ethical position that accompanies a political, activist agenda to achieve social justice and improve women’s lives” (Brabeck & Ting, 2000, p. 17). They then summarize five major themes running through feminist ethics, including:

      1 The assumption that women and their experiences have moral significance.

      2 The assertion that attentiveness and subjective knowledge can illuminate moral issues.

      3 The claim that a feminist critique of male distortions must be accompanied by a critique of all discriminatory distortions.

      4 The admonition that feminist ethics engage in analysis of the context and attend to the power dynamics of that context.

      5 The injunction that feminist ethics require action directed at achieving social justice.

      While ethics is an inextricable part of feminism, multiculturalism is an inextricable part of feminist ethics. Gartrell (2014) wrote that “any discussion of feminist ethics must incorporate diverse experiences due to race, ethnicity, class, and sexual orientation” (p. 137; see also Greene & Flasch, 2019; Hayden & Crockett, 2020; Powell et al., 2020).

      Lerman (2014) discussed the work of the Feminist Therapy Institute in creating their own ethics code based on their conclusions about traditional ethics codes. Their view that most of the current ethics codes were not a good fit for feminist therapists included:

      The recognition that most codes are reactive rather than proactive, that ethics is frequently viewed as a good-bad dichotomy rather than as a continuum of actions generated by the complex nature of human interactions, that ethics codes do not customarily teach how to make ethical decisions, that ethics codes have usually ignored issues especially pertinent to minorities and women and that complaint procedures most frequently focus on legally protecting the professional rather than displaying compassion toward the client.

      American Indian Ethics

      In a commentary on the APA Ethics Code, The Society of Indian Psychologists (SIP; Garcia & Tehee, 2014) emphasized that:

Indigenous people have a holistic and inter-relational view of health. This view means that the Western-based concepts of body, emotions, mind, spirit, community, and land cannot be separated and that an individual cannot be separated from their relationships, including the generations before them and the generations to come. There are no distinctions between physical health, mental health, and spiritual health, which also means that my physical health, mental health, and wellbeing are related to yours (“we are all related”).

      * They set forth 12 essential concepts, including:

      1 All things are sacred. Sacredness is not religiosity but a recognition that everything has an important role to play in the universe. This idea of sacredness is respectful of reciprocal relationships, of family, of the community, of the environment, of the past, present, and of the future.

      2 Life and development are understood in terms of cycles as opposed to a linear process.

      3 Everything is connected. All beings (including the Earth, the environment, and events in the past, present, and future) respond to each other’s actions. Every living system is a whole in itself, as well as part of a larger system. This explanation is an essential concept of full circle understanding.

      4 Events in life can best be understood as lessons. There is an acknowledgment that this moment is part of the lesson of whom we were, are, and whom we are to become.

      5 Respect and honoring are essential to true or long-lasting relationships. These need to be demonstrated in a way that recognizes the cultural context of the individual and the community.

      6 Relevant healing places emphasis on the social, historical, and political contexts that have shaped Indigenous experiences, lives, and perceptions.

      7 Relevant healing encourages balance and harmony within a person’s life and in relationship to others; it encourages the growth of positive elements in a person’s life and emphasizes the strengthening of resiliency.

      8 Individuality is valued by how it improves the community. Collaboration is more highly valued than autonomy. Competition should enhance collaboration.

      9 Sustainability is essential for all of us to survive and thrive. This generation is not the most important for all time. It is important to question: How can we live in a way that allows others to live? How can we live in a way that reflects respect to all those whom we impact?

      10 Mystery, awe, wonder, intuition, and miracles occur naturally in everyday life. The fact that Western culture has not yet figured out how to measure them is irrelevant.

      11 The best way to understand one’s place and identity is in the context of past, present, and future within one’s community. Any action may have broad consequences. It is important to consider how to act deliberately and thoughtfully.

      12 Compartmentalism misses the beauty of the Whole. The Whole is often much more complex and functional than the sum of each individual part. Working with the Whole acknowledges the mystery of those things still unknown and that cannot be readily observed or measured.

      CODES, ACCOUNTABILITY, AND CONFLICTS

      Difficulties defining psychotherapy with precision or agreeing on a basic philosophy of ethics do not free the profession from setting forth its own ethics. The hallmark of a profession is the recognition