Ethics

For the trauma practitioner of any professional orientation, to study ethics would be to study the knowledge or act of deciding what is good or evil. To have ethics means to have a certain moral stance for self-regulation. In a broader sense, ethics and ethical codes give guidance to practice. One's personal ethics, to be relevant and useful, must be responsive, clear, grounded in fact not fantasy, and guide practice. Ethics therefore means standards of behavior, grounded in values. Ethical principles set the ideal, the ideal for practice and beliefs, and as such, give a sense of community to those who adhere to them. Thus, ethical principles inform and guide conduct for practitioners, clients, patients, and society and establish the “rules” of practice that dictate safe conduct toward survivors. Ideally, they become part of the practitioner's developed self, almost intuitive and innate to practice, as well.

What is unique ethically when working with trauma survivors? Donna Hardina, a professor of social work education, believes that the goal of having ethics or an ethical stance gives a practitioner directives and standards for action that are based upon specific outcomes (e.g., providing a service, counseling, consulting, researching, educating). Joyce Braak, in an ethics workshop for the membership of the Association of Traumatic Stress Specialists (ATSS) in April 2002, discussed the general mind frame of trauma survivors. She agreed with Dena Rosenbloom and Mary Beth Williams that individuals who have been traumatized frequently have impaired schemas, beliefs, and unmet psychological needs for safety, trust, personal power or control, esteem, and intimacy. They need to have these five needs met for themselves, their relationships with others, and their own relationships with the world if they are to heal. They need to restore a capacity to trust in themselves, others, and that world. Thus, according to Braak, diminished survivor trust mandates increased professional trustworthiness, and hence, the need for clear ethical standards in relating to survivors and these impaired or unmet needs.

Ethical principles help to make trauma practitioners serve their clientele appropriately within a relationship of power inequity. Both personal and professional ethics, as they are applied in practice, remind the practitioner of fallibility and the need to approach practice flexibly, using principles that seem most appropriate. Functioning within a milieu of conscience and empathy, traumatologists therefore constantly work to apply ethical principles and standards to survivors in a unique manner [Page 237]without deception, fabrication, or concealment of what Braak calls “the significant true.”

Ethical codes serve the needs and respect the rights of trauma survivors by

• providing a framework to guide actions that is based on an individual's and a profession's core values, particularly the value of doing no (more) harm to that survivor, according to therapist and author Christine Courtois;
• helping the public, including the victim, to develop expectations about and evaluate the trauma practitioner's work;
• socializing those entering the field, building a community of trauma practitioners who think or act similarly within the overall rubric of traumatology;
• managing the public's impression of the field of traumatology, thus enhancing public impressions and image of those professions working with the traumatized;
• serving as deterrents to unethical behavior;
• being sensitive and responsive to clients’ needs;
• helping to structure treatment within the limits of ideal practice, evidence-based theory, and the norms of good work; and
• reflecting the way traumatologists interpret events and the impact of those events on individuals, groups, communities, and nations.

Values may be a central part of both a practitioner's and a client's core beliefs and how to make sense of the world in which they live, according to Roy Eidelson. Frank Loewenberg and Ralph Dolgoff define values as statements of ideals that individuals try to achieve. If core beliefs and value systems are dysfunctional and/or distorted, they may be self-perpetuating and therefore impair daily functioning. Core beliefs may be held by an individual or by a group. The collective worldview and value system of traumatologists aim to reflect and operationalize shared culture and shared operating assumptions. Values are guides to action that include preferred outcomes. Professionals in the trauma field are not value free; they are not (nor can they be) neutral. As guides to action, values can be utilized creatively. Inevitably, a therapist makes professional values known directly or indirectly to clients or patients through the therapeutic process.

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