Unfinished business with informed consent procedures

A Comparison of the Ethical Beliefs of Certified Rehabilitation Counselors and National Certified Counselors

Results of a national survey of certified rehabilitation counselors (CRCs) are compared with those obtained by Gibson and Pope (1993) from a national sample of national certified counselors (NCCs) to determine their beliefs about whether particular behaviors are ethical, and the degree of consensus or controversy about these behaviors. Commonalities and differences in the beliefs of these two groups are described. Implications for education and the field of rehabilitation counseling are discussed. The authors conclude that the high degree of similarity between beliefs of CRC and NCC respondents provides empirical support that these counselors share a fundamental set of ethical beliefs.

[The doctrine of free and informed consent: its ethical and legal foundations and its applications in research and practice of psychiatry]

This article briefly examines the ethical and legal foundations for the doctrine of informed consent in medical research and practice. The doctrine is based upon the importance of respecting the individual's autonomy and his right to self-determination. The article also reviews the development of the doctrine of informed consent based on its recent application. The authors cite the Nuremburg Code and the Helsinki Declarations and particularly the media denunication of several scandals in the United States during the late 1960s, when Henri Beecher's name figured prominently. The effects of informed consent in psychiatry are examined specifically, as well as the consequences for psychiatric research, on subjects who are able to give their consent, as well as those who are unable to do so. As for its effects on clinical practice, the paper discusses the right of the hospitalized patient to refuse treatment, and informed consent and the risks for patients treated with neuroleptics of developing tardive dyskinesia. The authors conclude that in psychotherapy the concept of informed consent cannot be taken for granted.

Dsm-iii-R and the family therapist: ethical considerations

DSM-III-R has gained popularity in many segments of the mental health field. Family therapists have generally not found its approach to assessing problems to be helpful in the planning of therapy, yet, are often forced to use it due to the requirements of third-party payers. This raises several ethical and practical concerns, e.g., the incompatibility of orientations between DSM-III-R and family therapy, the stigma associated with diagnosing, being asked to misrepresent diagnoses to third-party payers, and the competency of some family therapists to make DSM-III-R diagnoses. Short- and long-term strategies to deal with these ethical dilemmas are also presented.