This book on ‘Practical Ethics’ is my latest (due to be published by Sage early 2019). The focus of the book is a concept called ‘relational ethics‘.
A relational approach to ethics intertwines relational sensitivity with containing ethical frameworks. In my book, I aim to explore ethics that embrace a relational attitude and acknowledge how moral and ethical horizons are ever-present in our therapeutic relationships (Gabriel and Casemore, 2009). Ethical guidelines, although useful, can never prepare us sufficiently for situations arising in practice which make our heads spin and hearts ache (Ellis, 2007; Finlay, 2012). Ethical judgements need to be made in context and it’s complicated. We can aspire to certain standards of practice but may not always meet these. The question is how to be a good enough, ethically responsive therapist.
‘Relational ethics’ sees ethics in terms of relationship rather than directives. What’s in the client’s interests and risks of harm depend on the meanings in the situation. A therapist who asks lots of questions could be seen as invasive or genuinely interested. If a therapist encourages a client to do more self-care, it might be viewed as caring or critically blaming. The holding of a time boundary may feel safe or harsh. A therapeutic challenge issued to a client could be in their interests and feel uncomfortable simultaneously; one client might feel stimulated by it, another threatened. There are few hard and fast rules.
Virtually every ethical issue and dilemma we encounter can be answered with the phrase ‘it depends’. Professional standards, personal values, legal requirements, agency policy, cultural context and relational considerations all complicate the field. At times our relational concerns may clash uncomfortably with wider professional, legal or institutional requirements. We face the unending professional challenge of marrying our personal values and wider professional and social contexts in ethically thoughtful and reflexive (critically self-aware) ways rather than rigidly following rules or defensive practices. In addition, relational ethics drive us towards collaborative, responsive, respectful, compassionate and authentic relationships as opposed to exploitative, instrumental or habitual ones. Beyond the bounds of written codes, there is an important place for professional experience and intuition. And, there is room to get it ‘wrong’ sometimes. When our behaviour falls short of the values we aspire to, we can still be a ‘good enough’ therapist.
These are the kinds of ideas which I explore in the book. I try to convey something of my own growing enthusiasm about the subject. Ethics, for me, has become lively, challenging elements of everyday life, and not those dry, philosophical principles imposed on us by professional bodies. Ethics dance and weave around us constantly; we negotiate and enact them in every relationship, whether in or out of our work as therapists. Practical ethics can only be understood and negotiated in the vibrant immediacy of the relational context concerned – a context that includes respecting the individuals involved (the values, needs, understandings of those concerned), their cultural backgrounds and the specific social circumstances of the encounter. And, if relational concerns should drive professional action, there also must be room for individual judgement, intuition and creativity.
As therapists, we strive to create safe therapeutic spaces of ‘hospitality’ where our clients can feel held, affirmed, supported, resourced, empathised with – and challenged to grow. Therapist integrity, duty of care and informed consent are key foundational relational-ethical principles, along with being open to dialogue that respects the other’s difference. But the sheer messiness, uncertainty and complexity of practice defy easy answers; there are no clear-cut ethical recipes. As practitioners, we are left with trying to exercise our professional judgement as best we can, moment-to-moment, given our knowledge, ability and the context. If we do this sensitively, thoughtfully and with caring humane intention, that – for me – is being ethical.