It is important for health professionals to have an ethical framework to help take decisions regarding psychosocial interventions. Ethical challenges arise when health care intended to help is also associated with a possible negative fallout. Working with persons exposed to human rights violations, a clear awareness of ethical codes, standards and principles are necessary.

The concept of “ethics” was introduced by Socrates, and defined as a philosophical discipline by Aristotle. Today this discipline tries to set up criteria for “good” and “bad” behavior/actions, and to evaluate the motives for these actions, and the consequences.

In all health care work, and particularly in work with persons exposed to injustice and human rights violations, a clear awareness of ethical codes, standards and principles is quite necessary. The knowledge and clarity about ethical and human rights principles will strengthen the involvement of health professionals in human rights violations, and fortify their actions to prevent such violations. It is in order to strengthen knowledge about these principles, that we include a thematic page on ethics.

Here we have collected some articles and reviews, highlighting some basic definition for ethics, in connection with different other topics.

Ethics: a general introduction
BBC 2014
Ethics are a system of moral principles and a branch of philosophy which defines what is good for individuals and society.

Health Ethics, Equity and Human Dignity
This article (12 p.) discusses the necessity to review ethical principles in health, to ensure that human rights and dignity are fully respected. – Mamdouh Gabr, Cairo University.

Medical ethics: four principles plus attention to scope
BMJ 1994, 309:184, R. Gillon

The “four principles plus scope” approach provide a simple, accessible, and culturally neutral approach about ethical issues in health care. The principles: respect for autonomy, beneficence, non-maleficence, justice. The article discusses these topics, and the conclusion in personal decision making.

Applying the Four Principles
Journal of Medical Ethics, 2003;29, R. Macklin
The author reports to the article by Gillon from 1994, discussing the four principles on examples. –

Ethics of conducting research in conflict settings
Conflict and Health 2009, 3:7.

The article discusses the necessity of research in conflict areas to improve the quality of assistance, considering the ethic principles in doing research in a vulnerable population, and the harm-benefit ratio. –

Different organizations working with mental health and therapy, psychiatrists, psychologists and others, have framed some principles concerning ethics, ethical behavior etc while encountering people in need, crisis and illness. Here are some examples, the general and underlying principles are very similar.

The Principles of Medical Ethics
APA, 2013

The American Psychiatric Association has here defined Medical Ethics, with annotations especially applicable to psychiatry.

Ethical Principles of Psychologist and Code of Conduct with the 2010 Amendments
APA, 2010 – 2016 amendments

The American Psychological Association has set up in this long article the general principles, and specific ethical standards according which they are working.

National Association of Social Workers
Approved in 1996 revised in 2017
The NASW Code of Ethics is intended to serve as a guide to the everyday professional conduct of social workers.

Code of Ethics of The Institute of Australasian Psychiatrists
IAP, 1997

Also here find we ethical principles documented by a large psychiatrist organization, to provide guidelines.

The World Medical Association`s Ethics Manual
WMA, 2015

The WMA has published its ethical guidelines in different languages, the English version (140 p.) will you find here.

Canadian Code of Ethics for Psychologists
Canadian Psychological Association, 2017

Meta-Codes of Ethics
The European Federation of Psychologists` Association

Has published these meta-codes, referring otherwise to the ethical codes of their member associations.

Principles for AMHCA code of ethics
American Mental Health Counselors Association
Revised 2015

Code of ethics of body psychotherapists 
The United States Association for Body Psychotherapy (USABP) is an association of body-oriented psychotherapists, allied somatic practitioners, and interns trained in related modalities. The purpose of the USABP is to support the practice and further evolution of the field of body psychotherapy.

American Counseling Association (ACA) Code of Ethics 
The mission of the American Counseling Association is to enhance the quality of life in society by promoting the development of professional counselors, advancing the counseling profession, and using the profession and practice of counseling to promote respect for human dignity and diversity.

A variety of articles and links. The field is quite broad, so there is a range from ethics in social work/field working up to ethics in more specific mental health and treatment within general medicine and psychiatry/psychology. 

Guidelines on Human Rights Education: For Health Workers
OSCE, 2013
In the 1991 Moscow Document the OSCE participating States agreed that they will “encourage their competent authorities responsible for education programmes to design effective human rights related curricula and courses for students at all levels, particularly (…) students (…) attending public service schools.” These guidelines aim to support systemic and effective human rights education for health workers, and especially those who study to become health professionals or already carry out that important work.

Human Rights Based Approach: A Self-Assessment Tool 
Scottish Human Rights Commission, 2018
This tool is based on the PANEL principles (Participation, Accountability, Nondiscrimination, Empowerment and Legality) which form the basis of a human rights based approach. It is intended to help organisations assess their work and identify priorities for improvement towards embedding a human rights based approach.

”Do No Harm” – Training Materials
CDA 2016
The CDA has developed some training materials, aiming to sensitize helpers in “Do No Harm“. This training was the result of projects to learn more about the assistance given in conflict settings (often used and misused to pursue political or military advantage). You can download hand- and workbooks, trainers package etc.

Ethics in psychosocial interventions
Kurpad, 2018

It is important for health professionals to have an ethical framework to help make decisions regarding psychosocial interventions in patients with addictive disorders. As patients with addictive disorders are vulnerable to unethical actions in the name of treatment, therapists need to aware of their role in delivering ethical care – not just in their own clinical practice but in the setting in which they deliver the interventions. This article aims to sensitize the health professional to the various areas in which ethical challenges may arise.

Power and ethics in psychosocial counselling: reflections on the experience of an international NGO providing services for Iraqi refugees in Jordan 
Gilbert 2009
This paper reflects on some of the moral dilemmas inherent in the provision of counselling for Iraqi refugees by highlighting the day-to-day experiences of psychosocial counsellors employed by an international nongovernmental organization (INGO) in Jordan.

Journal of Ethics in Mental Health
This is an “international, peer-reviewed, web-based journal, available free online, worldwide. It aims at providing a useful forum for sharing ideas and experiences among all who are committed to improving ethical standards, behaviours, and choices in mental health caregiving”.

Ethics in Mental Health Research
This website aims to provide with resources for teaching, studying, investigating ethical issues in mental health research. Collaboration at Saint Louis Univ., Missouri Inst. of Mental Health, Nat. Inst. of Health, and the Nat. Inst. of Mental Health.

‘Stop Stealing Our Stories’: The Ethics of Research with Vulnerable Groups
Eileen Pittaway, Linda Bartolomei, Richard Hugman 2010

The article discusses the challenges and opportunities faced when integrating participatory methods into human rights-based research. It describes the development of a participatory action research approach designed to fulfil the aim of undertaking advocacy-focused research grounded in human rights and community participation.

Aiding torture
Physicians for Human Rights, 2009

Health professionals` ethics and human rights violations, revealed in May 2004, CIA inspector generals report. “Physicians for Human Rights” is discussing in this article (8 p.) the CIA report (released in 2009) about the role health professionals played in the CIA`s torture program and the level of ethical misconduct.

Ethics, Human Rights and Globalization
Univ. of Tübingen/Germany,  2002

Second global ethic lecture, held by Mary Robinson, UN High Comm. For Human Rights at that time. –

Compendium of United Nations standards and norms in crime prevention and criminal justice
UN 2006

The United Nations released in this Compendium some basic principles, see here in particular article 16 – “Principles of Medical Ethics relevant to the role of health personnel….”

American physicians and dual loyalty obligations in the “war on terror”
Jerome Amir Singh 2003
If U.S. physicians are faced with a conflict of interest between following national policies or international principles of humanitarian law and medical ethics, they should opt to adhere to the latter when treating war detainees. It is important for the U.S. medical community to speak out against possible detainee abuse by the U.S. government.

Doubtful prisoner-of-war status 
Yasmin Naqvi, 2002
The Geneva Convention relative to the Treatment of Prisoners of War regards to principles a prisoner of war cannot be prosecuted and punished for the mere fact of having taken part in hostilities, and that prisoners of war must be given humane treatment from the time they fall into the power of the enemy until their final release and repatriation. If a person is not given combatant status, he may be tried for having committed a belligerent act. Where this criminal offence may be punished by capital punishment under the domestic jurisdiction, the lack of prisoner-of-war status may be a matter of life or death.

Ethics Abandoned: Medical Professionalism and Detainee Abuse in the War on Terror 
Institute on Medicine as a Profession 2013
The report is based on two years of review of records in the public domain by a 19-member task force. The report details how DoD and CIA policies institutionalized a variety of interventions by military and intelligence agency doctors and psychologists that breach ethical standards to promote well-being and avoid harm.

In case of disaster – catastrophes, war, conflict etc – is has always been somewhat difficult to define ethic principles in providing aid, and to ensure that these principles are followed. Just basic questions (as: whom should you help first in case of disaster? And who makes the “ethical” decisions?) can be very difficult to decide.

Disaster Management Ethics
Disaster Management Training Programme DMTP, Dep. Humanitarian Affairs/UN

The Disaster Management Ethics module (65 p.) “addresses some of the ethical issues and dilemmas faced by the humanitarian assistance community as it seeks to respond to human need in the context of natural and human-caused disasters. The format simulates a discussion which aims to foster conversation and interaction. It brings together the voices of fifteen practitioners and scholars to discuss five ethical issues in humanitarian assistance”. It works as a guideline, with case-studies, and questions to answer.

Disaster Psychiatry Handbook
APA, nov 2004

The American Psychiatric Association has released this handbook (56 p.), concerning psychiatric dimensions of disaster. Especially chapter 5 – mediolegal and ethical issues in disaster psychiatry – discusses the ethic challenges in disaster situations.

World Medical Association Statement on Medical Ethics in the Event of Disasters
WMA, oct 2006

The WMA states here the medical ethics to be concerned in handling disasters and victims.

Design Ethics for Gender-Based Violence and Safety Technologies 
Zevenbergen 2017

A wide range of advocates in areas of intimate partner violence and sex work; engineers, designers, developers, and academics working on IT ethics. The objectives of the day were threefold: (1) to better understand the lack of gender considerations in technology design, (2) to formulate critical questions for functional requirement discussions between advocates and developers of gender-based violence applications; and (3) establish a set of criteria by which new applications can be assessed from a gender perspective.

WHO Ethical and safety recommendations for researching, documenting and monitoring sexual violence in emergencies 
WHO 2007
“Ethics” can be defined as a system or code of moral values that provides rules and standards of conduct. The three primary ethical principles that should guide all inquiries involving human beings (including methods used to collect information) are as follows (6): 1) Respect for persons, which relates to respecting the autonomy and self-determination of participants, and protecting those who lack autonomy, including by providing security from harm or abuse. 2) Beneficence, a duty to safeguard the welfare of people/communities involved, which includes minimizing risks and assuring that benefits outweigh risks. 3) Justice, a duty to distribute benefits and burdens fairly.

Ethical and Safety Recommendations for VAWG Interventions 
Before undertaking or supporting an intervention that aims to assist VAWG survivors and prevent re-victimization, it is paramount to ensure that ethical guidelines are followed to protect the safety of both survivors and the professionals providing services or programming. These include: respect for persons, non-maleficence (minimizing harm), beneficence (maximizing benefits), and justice.

Nine Ethical Principles: Reporting Ethically on Gender-Based Violence in the Syria Crisis 
UNFPA 2015
Gender-based violence is a complicated and sensitive subject. Reporting on gender-based violence means discussing issues that are often considered ‘taboo,’ and talking publicly about intimate and distressing matters. This can be particularly challenging in countries where tradition and religion play an important role in everyday life.

Ethical considerations in evaluating interventions against gender-based violence 
Collecting data on sensitive topics such as GBV often raises a number of ethical questions and safety concerns. This is especially the case when the survivor of violence is interviewed. The following concerns should always be taken into account when interviewing survivors: ensuring safety of respondents since they often live with their abuser; protecting confidentiality since breaching it could provoke an attack; making sure the interview process is non-discriminatory and does not cause distress.

Ethical Considerations for Researching Violence Against Women 
In many ways, researching violence against women is similar to researching other sensitive topics. There are issues of confidentiality, problems of disclosure, and the need to ensure adequate and informed consent. As the previous quote from an interviewer illustrates, however, there are aspects of gender-based violence research that transcend those in other areas because of the potentially threatening and traumatic nature of the subject matter. In the case of violence, the safety and even the lives of women respondents and interviewers may be at risk.

Violence against Women: Methodological and Ethical Issues 
The objective of this paper is to review the methodological issues that arise when studying violence against women. The paper focuses first on the history of research on violence against women, by elaborating on each perspective. Second, the paper identifies and describes methodological difficulties when researching violence against women such as methodology, operational definitions of violence, sampling frame and risk factors related to violence. The paper also elaborates on major ethical principles that should be considered and respected when researching violence against women. Finally, the paper recommends certain changes that should be made in order to improve future research on the subject.

Ethical and safety recommendations for intervention research on violence against women
WHO 2016
These recommendations have been developed to help answer questions specific to conducting research on health-based interventions to prevent and respond to VAW. Research on strategies that use health or health care as an entry point (regardless of the implementation setting, such as a clinic or community) is the focus.

Practice Dilemmas and How to Resolve Them 
Mental health law
In response to a significant problem, this website approaches professional choices from a unified perspective that views decision making as an orderly process sharing essential characteristics in all of the mental health disciplines. More than that, it invites the user to interpret professional issues from a communitarian, rather than individualistic, perspective. With these issues in mind, the system for addressing professional dilemmas is useful for practitioners and students in mental health settings. Examples of the use of this system are offered in a variety of practice dilemmas presented in links to this page.

5 Ways to teach ethics 
Handelsman and Anderson 2011
Here are five techniques which author has in his ethics courses to help students explore the ethics of psychology—and their own ethics. They give you one example of each technique; you can take it from there and apply these to ethics in your personal life and your own profession. They make no claim that these are original, and this is certainly not a definitive list.

Teaching Ethics Across the Psychology Curriculum 
Ware Balogh
The writer explains that every content area in psychology stimulates numerous teachable moments with respect to ethical issues – the raw material is there, and it is simply a matter of casting course content in terms of its ethical dimension. When ethics content is seamlessly integrated across the curriculum, students come to understand that adhering to ethical principles is the responsibility of all members of the profession and they come to expect to be confronted with ethical dilemmas in many professional contexts.

Ethical issues in undertaking research with children and young people 
Powell, M.A. 2011
This paper reviews recent literature regarding ethical issues in research with children and young people. This is a topic that has seen a significant growth in interest over recent years, in response to developments in both child research and ethics. Whilst acknowledging the clear importance of the issues related to medical and psychological research studies on children, they are beyond the scope of this review which is focused on ethical issues related to research with children, who are actively participating and expressing their views and opinions.

Ethical and safety recommendations for interviewing trafficked women 
London School of Hygiene & Tropical Medicine, the Daphne Programme, WHO 2003
In response to the rapid global rise in trafficking and growing demand for information on trafficking by policymakers, donors, service providers, and the media, women who have been trafficked are increasingly being interviewed to discuss their experiences. This article is introduces recommendations that are intended primarily for use by researchers, members of the media, and service providers unfamiliar with the situation of trafficked women. They do not explicitly discuss the different risks and obligations of interviewing females who are minors, although many of the same principles will apply.

Research Ethics for Mental Health Science Involving Ethnic Minority Children and Youths 
Celia B. Fisher 2002
The American Psychological Association, the National Institute of Mental Health, and the Fordham University Center for Ethics Education convened a group of national leaders in bioethics, multicultural research, and ethnic minority mental health to produce a living document to guide ethical decision making for mental health research involving ethnic minority children and youths. This report summarizes the key recommendations distilled from these discussions.

Frontier Ethics: Mental Health Care Needs and Ethical Dilemmas in Rural Communities 
Laura Weiss Roberts et al. 1999
Roughly 15 million of the 62 million rural U.S. residents struggle with mental illness and substance abuse. Important but little-recognized ethical dilemmas also affect rural mental health care delivery. The authors describe the features of rural mental health care and provide vignettes illustrating ethical issues encountered in the predominantly rural and frontier states of Alaska and New Mexico.

Ethics, Competence, and Professional Issues in Cross-Cultural Counseling
Paul B. Pedersen, 2007

This paper discusses the relevance of multiculturalism to professional excellence in counseling. Focus also on multicultural awareness, multicultural counselors.

Ethics and Culture in Mental Health Care 
Jinger G. Hoop et al. 2088
This article examines the complex relationship between culture, values, and ethics in mental health care. Cultural competence is a practical, concrete demonstration of the ethical principles of respect for persons, beneficence (doing good), nonmaleficence (not doing harm), and justice (treating people fairly)—the cornerstones of modern ethical codes for the health professions. Five clinical cases are presented to illustrate the range of ethical issues faced by mental health clinicians working in a multicultural environment, including issues of therapeutic boundaries, diagnosis, treatment choice, confidentiality and informed consent, and the just distribution of limited health care resources.

Ethics and Health at WHO
The World Health Organization has in 2002 launched its Ethics and Health Initiative, now carried on by the Department of Ethics, Trade and Human Rights. On this website you will find also some links to this topic, as well as information on the work the WHO is involved here.

International Global Ethics Association
It represents a “non-partisan, non-profit, global academic network, working within the new and emerging field of Global Ethics”.

The Scattergood Program for the Applied Ethics of Behavioral Healthcare 
Scattergood Ethics is dedicated to education, research, and resource development for the field of psychiatric, mental, and behavioral healthcare ethics. The program engages in scholarly research, trains and educates clinicians and scholars in mental and behavioral healthcare ethics, sponsors programs and public events, and promotes and advocates for greater attention to the ethical dimensions of diagnosis and treatment.

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