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3.4.1 Practitioners know intuitively what it means to act ethically

Many health practitioners claim they have never encountered an ethical dilemma during their practice. Is this credible, or does it suggest that some practitioners have an insufficiently developed awareness about what constitutes an ethical issue? How many people justify a hard decision simply by saying, ‘I did what felt right'? Gut instinct may currently guide practitioners through some of the complexities of therapeutic relationships, but this is not an adequate substitute for rigorous, re
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3.4 Myths about ethics

The media portray most ethical issues in highly charged terms, so it can be hard to understand what professional ethics is about, and what the full scope of ethical behaviour amounts to. In short, the media rarely explore the ‘grey’ areas of many ethical decisions. For example, the issue of abortion is viewed as either ‘pro choice’ or ‘pro life’. In this way the following myths about ethics are perpetrated.


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3.3 Why ethical behaviour is central to the health care relationship

The health care relationship is basically a relationship of trust. This implies that practitioners are motivated by the users' best interests; will not exploit the therapeutic relationship to satisfy their own ends; will behave in an appropriate manner that is conducive to the healing process; and will refrain from behaviour that could harm users, including being physically or psychologically unfit to treat them. The examples in Author(s): The Open University

3.2 Ethics and health care relationships

Activity 9: Acting ethically

0 hours 30 minutes

Write down a few sentences about what you think ‘acting ethically’ means.


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2.14 Extract 2 References

Armstrong, D. (1987) ‘Silence and truth in death and dying’, Social Science and Medicine, Vol. 24, No. 8, pp. 651–7.

Armstrong, D. (1993) ‘Public health spaces and the fabrication of identity’, Sociology, Vol. 27, No. 3, pp. 393–410.

Budd, S. and Sharma, U. (1994) The Healing Bond: The Patient-Practitioner Relationship and Therapeutic Responsibility, London, Routledge.

Busby, H. (1996) Alternative medicines/alternative knowledges: putting fle
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2.13 Conclusion

All therapeutic relationships can harm as well as heal. In orthodox medicine, the bulk of the responsibility is placed on the doctor, because healing is attributed to specific effects brought about through the doctor's diagnostic and technical expertise. In CAM relationships, where users are expected to exercise self-responsibility, it may be inappropriate to focus solely on the shortcomings of the therapist (even though the law is unlikely to recognise mutual responsibilities when therapy go
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2.12.3 Scientific advances

Advances in science may have dramatic effects on future therapeutic relationships. As specific funding becomes available for testing CAM, and as CAM practitioners start accepting the idea that their future sustainability may depend on them citing scientific research to establish their claims, more information will become available about which aspects of the therapeutic relationship are more, or less, beneficial. This may include research testing the hypothesis that elements of the CAM therape
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2.12.2 Litigation

The level of litigation against CAM therapists is currently very low, particularly compared with corresponding actions being brought against doctors and other health care professionals. This, in turn, is reflected by the low annual indemnity insurance paid by most CAM practitioners. CAM therapists tend to attribute this to CAM's safety profile compared with orthodox medicine, together with CAM practitioners’ ability to forge better therapeutic relationships with users. However, other commen
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2.12.1 Integration

One factor which is already influencing the nature of the therapeutic relationship is the move towards greater integration with orthodox medicine. Whether or not CAM practitioners welcome this development, it is inevitable. The impetus for this is partly about providing health care that gives patient satisfaction, and also stemming the tide of the spiralling costs of hi-tech, orthodox medicine and medical litigation. Stacey (1988) points out that, when the state funds parts of the nati
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2.12 The future of the therapeutic relationship

As discussed earlier in this extract, therapeutic relationships are subject to constant review and reinterpretation. As the culture changed, the predominant shift in health care was away from paternalistic forms of relationships based on professional expertise towards partnership models in which the patient has more rights but also more responsibilities. This final section looks to the future and considers some of the factors that can impact on therapeutic relationships in CAM.


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2.3.2 Responsibility for the causes of ill health

Doyal and Pennell (1979) write from the perspective of political economy and argue that there is a continual state of conflict hidden within health experiences and health care relationships. Society produces ill health through an unrelenting drive towards profit and a failure to put the health and wellbeing of individuals first. Work and everyday social life are bound up with taking risks. Many workers experience stress and some occupations involve the risk of physical injury. Social class gr
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1.10 Concepts of healing: philosophies underpinning CAM practice

Activity 5: Health beliefs in CAM

1 hour 0 minutes

Read the following accounts by individual CAM practitioners of four different modalities. These are personal perspectives, which may vary
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1.5 Models of health care delivery

In the quest to understand health and illness behaviour, social and medical researchers have developed various models to explain the different forms of health care delivery. These models emerged because, in the mid-20th century, social researchers began to question not only the position of professions in western countries but also the relationship between professionals and users. Early explorations of the patient's role in health care suggested that it was fairly prescribed (Parsons, 1951), a
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1.6.2 Alerts

Online bookshops and some of the major search engines offer ‘Alerts’ services. These work by allowing you to set up a profile once you have registered on their site, and when there are items meeting your criteria you receive an email. The good thing about alerts is that you don’t have to do anything once you have set up your profile. The downside, particularly with alerts services from the search engines, is that given the extent to which internet traffic is on the increase whether new
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1.6.1 Introduction

The process of keeping up-to-date in your chosen subject area is useful for your studies and afterwards, for your own personal satisfaction, or perhaps in your career as part of your continuing professional development.

There are a great many tools available that make it quite easy to keep yourself up to date. You can set them up so that the information comes to you, rather than you having to go out on the web looking for it. Over the next few pages, you will be experimenting with some
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1.5.2 Ways of organising yourself

How do you organise yourself?

Activity

Make a note of how you organise your:

  • emails

  • internet bookmarks or favorites

  • computer files

  • your h
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1.5.1 Why is it important to be organised?

  • 87% of items that are filed into a filing cabinet are never looked at again. STANFORD UNIVERSITY

  • In 2010, the world’s digital information output was estimated to pass 1.2zettabytes – A zettabyte is a new term which equals a thousand billion gigabytes. University of California (Berkley)

  • A new blog is created every second TECHNORATI

  • 10% of salary costs are wasted as e
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1.4.8 Summary

In this section we have introduced you to the PROMPT checklist as a useful tool for assessing the quality of any piece of information. If you use it regularly you will find that you develop the ability to scan information quickly and identify strengths and weaknesses. As a closing exercise you might like to pick one of these websites:

Diagnose-Me.com

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1.4.5 M is for Method

Method is about the way in which a piece of information is produced. This is quite a complex area as different types of information are produced in different ways. These are a few suggestions to look out for:

Opinions – A lot of information is based on the opinion of individuals. They may or not be experts in their field (see P for Provenance) but the key message is to be clear that it is just an opinion and must be valued as such.

Research – You don’t have t
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1.3.11 Choosing the right tool for the job

Before searching it is always a good idea to check what the source you have chosen covers to make sure it will unearth information that matches your search need (you will notice that all the resources we’ve covered in this guide have short descriptions to enable you to decide which to use). Some of the decision makers, depending on the context of your search might be:

  • Does it have full text?

  • Does it cover the right subject?


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