Resolving ethical dilemmas, disputes and other problems

APPENDIX 4

The following method of dealing with such issues is a standard one used in education and training. However, the Human Givens approach sets it in the wider context of human needs and resources, and the RIGAAR process adds extra knowledge that will make problem solving more likely to succeed.

Interacting with those involved – creating rapport

In order to resolve any dispute or solve any dilemma, it is important for all those involved to focus on the need to find a solution that is good for everyone. If this is borne in mind, and all participants are treated with respect for their emotional needs, the process will move forward more smoothly. It is an obvious point that there will be some emotional arousal involved where there is conflict. Good practice with regard to creating rapport, such as talking face-to-face (or on Skype) where body language can be seen and used, is recommended. Writing can be used for summaries of discussions afterwards, and for formal records. Beware of mixed media such as texting and emails, which have the immediacy of speech but leave a permanent record afterwards – it is easy to ‘say’ things quickly in a text or email that may be regretted later.

Defining the problem – information gathering

It is important to make sure that any problem that needs a solution is clearly defined before attempting to solve it.

The most common difficulties are ambiguity, subjectivity and relativity. These can cause confusion in the minds of those involved, and for those trying to resolve the issue. This means taking a step back and asking basic questions before we rush to offer solutions: information-gathering, while accessing the observing self.

Nominalisations lead to much ambiguity (which is, of course, a nominalisation itself!). Human Givens practitioners know that words such as ‘depression’ need unpacking by asking questions as ‘How does depression affect your activities?’ and ‘when did the depression first take over?’ This effectively returns us to thinking about actions and behaviour, instead of labelling clusters of activity with a concept-word. We tend to label such words as ambiguous, because they mean more than one thing, even within one cultural setting.

The same process can be useful in defining the problems that sometimes arise between clients and therapists. For example, if a client has complained that the therapist has ‘betrayed their trust’, it is obviously important to find out what ‘trust’ means to them in this instance, and what actions constitute ‘betrayal’.

The origin of ambiguity lies in the fact that words mean different things to different people, depending on their past learning and memory. This is subjectivity – we all have a particular ‘take’ on the world, and interpret out experiences differently according to the particular pattern-matches our brains make as we take things in through our senses. However, because we are all human beings with the same basic nature, needs and resources, there is a great deal of overlap between our interpretations which in many cases allows us to reach agreement about our interpretations. In resolving dilemmas, it is therefore important to make an effort to overcome subjectivity and to agree on the definitions we are to work with. Asking questions such as ‘When you say X, what exactly do you mean? Can you give an example? Where else have you come across this sort of thing?’ can lead to understanding and agreement.

Even when we have undergone this process of defining what we are dealing with, we may find that there are still fundamental disagreements about what the facts of the case are. When these involve behaviour that is labelled ‘moral’ or ‘ethical’, people may disagree completely. For example, a female client considering an abortion believes that termination of pregnancy up to a certain point is the mother’s choice; her male partner believes that life is sacred from the moment of conception and abortion is therefore absolutely wrong. Some people believe that it is possible to identity underlying natural moral principles that will allow us to decide which of the beliefs above is right; others think that beliefs about ethics are relative, arising in particular cultures and therefore being ‘right or wrong’ in those cultures, but not absolutely right or wrong in the abstract.

As Human Givens practitioners, it is important for us to be sensitive to the culturally-specific beliefs of those with whom we work, but at the same time to use our knowledge of shared needs and resources to focus our interventions. Although it may not be possible to resolve such extreme disagreements about facts, this can provide a way forward.

Working out what the options are – setting a goal and agreeing strategies

Our overall goal is a solution that will work for everyone involved, or as close to that as possible. Before we can propose one, however, it is useful to lay out all the possible options for solution. Here we must access all the resources available before we agree on strategies.

A useful method at this stage is to establish a continuum of choices. This means literally drawing a line across a sheet of paper (landscape A4 or larger) and writing out the range of possible solutions across it, from one extreme end to the other. For example, if we were trying to involve a dilemma about continuing sessions for a needy client who was not improving, we might come up with something like this:

Stop sessions immediately without referral

Offer 3 more session, then cease

Tail off by offering monthly sessions, then cease

Refer client elsewhere now or later

Keep going 2 months and review then

Continue indefinitely until client improves

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(There might, of course, be other options or combinations than those listed.)

It is important to include the extreme solutions as well as those in the middle range that seem immediately more obvious. By doing this we gain perspective. We also open up our imaginations and allow our subconscious minds to work on resolving the issue.

Applying principles and accessing resources – the Human Givens needs criteria

In the standard model of problem resolution, it is at this stage that we would need to think about the criteria of judgement we might apply to any of the possible solutions. For this we would have to agree on the basic principles we think are of fundamental importance: for example, we might have ‘first, do no harm’ as one principle, and ‘find a solution that is fair and offers the greatest benefit to the greatest number of those involved’ as another. However, using the Human Givens approach we can first apply the fundamental principle ‘ensure that the needs of those involved are met as well as possible’. We need to think about context again too, and therefore we might add to that ‘in ways that are socially positive and consistent with law and custom’.

At this point, if we think about the security and safety, privacy, attention, autonomy and control of those involved, we will be able to see which solution may be best, as well as considering the effects of any solution on their needs for relationships at all levels, for recognition and good status, for challenges to work towards and for a sense of the meaning of their lives in the wider context.

In addition, we may be able to access the resources of those involved to help ensure that they are able to implement the solution in practical ways. Once we have laid out the range of solutions, and thought about how they might meet the emotional needs of those involved and use their resources well, it can help to take a break and switch our attention elsewhere, or ‘sleep on it’, before making a final decision. There is a good possibility that we will then be much clearer about the right solution.

Communicating the decision – rehearsing the outcome

Once a decision has been reached, it needs to be communicated to those involved in the same respectful manner as before. Where a decision involves some aspect that may seem threatening or punitive in the first instance, it will help to set it within the context of the way in which it will eventually help to meet that person’s needs, and/or those of other people. For example, if you encounter a case of sexual abuse, and need to tell a fearful client that you must disclose this to an appropriate authority, you may be able to explain how this will help to get their long-term need for safety or better relationships met, and even set the abuser on the road to help and change.

Helping those involved to imagine the results of the chosen solutions will, as we know, make it much more likely that it will be acted upon.

 

Continue to: Guidelines on the writing and use of case histories