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When conflicts arise between values, the standards must negotiate among the competing values.Ethical Standard 10.08 is an excellent illustration of how the code accomplishes this essential function.By setting forth clinically based criteria relevant to assessing whether harm is likely to occur, paragraph (b) confirms this balance of values, emphasizes the importance of avoiding harm in these relationships, and provides concrete direction in how to assess the likelihood of exploitation.Second, evidence available at the time standard 10.08 was written suggests that the significant majority of these involvements take place within two years of termination.In the alternative, the evidence may suggest that relaxing the prohibitive aspects of the standard is appropriate.In whichever direction the standard evolves, its evolution should rest upon solid clinical thinking and good research.
Note how the code settles this conflict in the case of sexual involvements with current clients and patients; harm is so likely to occur, and autonomy so likely to be compromised in the therapy relationship, that the code establishes an absolute prohibition against sexual relationships.
Analyzing this issue requires examining post-termination sexual involvements from at least two perspectives: that of our values and that of our knowledge and data about the dynamics and effects of such involvements--in short, the ethical and clinical/research perspectives.
From the ethical perspective, a conflict arises between General Principle A, Beneficence and Nonmaleficence, and General Principle E, Respect for People's Rights and Dignity.
It's totally exploitative and wrong." Also, "it is wrong to take advantage of another person.
I learned that in first grade." Further, "it will always begin with unequal power." Less than 1% of respondents said that they had no objections to having such a relationship with a patient, whereas 4.5% said that "it depends" on the circumstances.