Question

Describe ethical challenges to treatment that might be encountered by a vocational rehabilitation clinician in a correctional facility. Explain how those ethical challenges can be addressed

Answer 1

• Vocational Rehabilitation Professionals respect the dignity, autonomy, self-determination, and rights of all persons with whom they interact in a professional capacity. They recognize the innate worth of human beings is neither enhanced or reduced by their ethnicity, religion, gender, marital status, sexual
  orientation, physical or mental disabilities, age, socio-economic status, or any other preference or
  personal characteristic, condition, or status.
• Vocational Rehabilitation Professionals have a responsibility to demonstrate respect in proactive ways. The primary ethical obligation of Vocational Rehabilitation Professionals is to their clients, or those persons who are directly in receipt of their services. Vocational Rehabilitation Professionals will endeavour at all times to promote each client’s welfare and to place the client’s interest above their own and avoid imposing values inconsistent with vocational rehabilitation.
• Ethical issues identified by rehabilitation clinicians
  Primary issues identified –
• Pressures around reimbursement
• Conflict among team members including patient and family around goal setting
• Confidentiality and exceptions to confidentiality
• Autonomy and client choice
• Client relationship
• Ways to overcome these challenges:-
• Informed Consent-Prior to entering into a professional relationship with a client, the Vocational Rehabilitation Professionals will inform clients verbally, in writing and in a manner which accommodates any limitations the client may have, the rights and responsibilities of both the client and Vocational Rehabilitation Consultant.
  
• Rehabilitation counselors will work jointly with their clients in devising and revising integrated, individual rehabilitation and counseling plans that contain realistic and mutually agreed upon goals and are consistent with abilities and circumstances of clients.
• Rehabilitation counselors will work with their clients in considering employment that is consistent with the overall abilities, vocational limitations, physical restrictions, psychological limitations, general temperament, interest and aptitude patterns, social skills, education, general qualifications, and cultural and other relevant characteristics and needs of clients. Rehabilitation counselors will neither place nor participate in placing clients in positions that will result in damaging the interest and the welfare of clients, employers, or the public.
• Rehabilitation counselors will respect the autonomy of the client if actions such as involuntary commitment or initiation of guardianship are taken that diminish client autonomy. The assumption of responsibility for decision-making on behalf of the client will be taken only after careful deliberation. The rehabilitation counselor will advocate for client resumption of responsibility as quickly as possible.
• Rehabilitation counselors will take steps to ensure that clients understand the implications of diagnosis, the intended use of tests and reports, fees, and billing arrangements. Clients have the right to (1) expect confidentiality and will be provided with an explanation of its limitations, including disclosure to supervisors and/or treatment team professionals; (2) obtain clear information about their case records; (3) actively articipate in the development and implementation of rehabilitation counseling plans; and (4) refuse any recommended services and be advised of the consequences of such refusal.
• Rehabilitation counselors will offer clients the freedom to choose whether to enter into a counseling relationship and to determine which professional will provide counseling. Restrictions that limit choices of clients will be fully explained. Rehabilitation ounselors will honor the rights of clients to consent to participate and the right to make decisions with regard to rehabilitation services.
• Rehabilitation counselors will strive to eliminate attitudinal barriers, including stereotyping and discrimination, toward individuals with disabilities and to increase their own awareness and sensitivity to such individuals.