Foundation of Ethics 

Ethical dilemmas are important struggles that occur when fact and reason support more than one conclusion in an ethical scenario. For example, a dilemma may occur when an action benefits one person but has undesirable consequences for another.

 

Unresolved ethical dilemmas can result in ethical dissonance, which is conflict or disharmony that is related to the dilemma.  Ethical dissonance can take many forms, including anger, frustration, helplessness, depression and the inability to make professional decisions. These feelings can deeply challenge our abilities to work competently and respectfully our clients, co-workers and our even own ourselves.

 

In many cases, the way we respond to the challenges of our own feelings is as important or more important, to the client, than the massage therapy we are trained to give. Understanding how and why ethical dissonance arises helps us recognize it and respect balanced, compassionate solutions.

 

Making ethical decisions requires:

 

• deliberate thought about the question or problem at hand

• rational analysis of the problem

• heartfelt consideration of all participants in the situation

• a heart and mind that are open enough to carefully weigh all of the available

 

 

It is not always possible to resolve ethical dilemmas. However, there are strategies to help us cope until the situation is resolved.

 Helpful strategies include:

 

• increased communication with all involved parties

• clarification  of issues

• examination and analysis of the arguments on all sides of the dilemma

• Being knowledgeable about your professional code of ethics

 

The following are some of the most common underlying issues to ethical dilemmas you might encounter in your practice.

 

Justice

 

Justice is fairness in the distribution of risks and benefits. There are many case scenarios you will experience that you feel are simply unfair.  For example, it’s inevitable that you will have client’s who clearly benefit from massage therapy, but their insurance does not cover the service, or their financial circumstances do not allow for it.  This does not mean that you should lower your rates to accommodate these clients.

 

Veracity

 

Veracity is respecting the client’s right to the truth. For example, imagine that you caring for a client and notice they are bruised.  When you bring it to their attention, they advise you that the bruise occurred after a massage with another therapist. They confide in you that the other therapist advised them that bruising is normal.  Bruising is not normal in massage therapy, therefore this client was denied veracity.  It is unethical to give a client inadequate or incomplete information.

 

Beneficence

 

Beneficence is providing benefits and balancing benefits against risks and it is a primary responsibility of all health care professionals. Every code of ethics addresses this issue in some form or another. For example, in massage therapy if you are working on a client with osteoporosis, there are the benefits of comfort, increased flexibility and range of motion, but those benefits must be weighed against the possibility of fracturing the bones, a clear risk.

 

Nonmaleficence

 

Nonmaleficence is avoiding harm. Most statements in a code of ethics clear on this issue.  Do no harm.  For example, ethical conflict can occur when a client requests that you work deeper than what is therapeutic.

 

Autonomy

 

Autonomy is the ability of competent persons to make independent decisions. Autonomy is protected by law, and massage therapists must respect each client’s right to decide on an alternant treatment.

 

Fidelity

 

Fidelity is keeping our promises. In the case of professionals, fidelity includes keeping both our personal and professional promises.  For example, for massage therapists, fidelity is doing what is agreed upon between you and your client during your intake process.  Additionally it involves keeping your appointments, and ultimately “being there” for your client physically and emotionally.