Understanding ethical decision-making in marriage and family therapy
Mowery, Robyn Lynn
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Using Gadamer’s ontological hermeneutics as a theoretical and methodological framework, this project explored new ways of understanding ethical decision-making as discussed in five top marriage and family therapy (MFT) journals from 1984 to 2004. Despite the field’s commitment to maintaining the highest ethical standards, only 13 articles were identified as explicitly focused on ethical decision-making processes. Although there is a plethora of articles identifying what is and is not considered ethical behavior in the MFT literature, few authors articulate the reasoning processes they used or would recommend in reaching these considered judgments. Thus, MFT practitioners have scarce guidance available for evaluating and weighing conflicting moral features when faced with ethical dilemmas. An extensive overview of ethical theory based on the moral philosophical literature is provided. This review includes discussion of meta-ethics, normative ethics (i.e., classical western, feminist, and post-modern approaches), and applied ethics (i.e., medical ethics, specifically the work of Beauchamp and Childress, 1979, 2001, and Graber and Thomasma, 1989, in press). Strengths and weaknesses of ethical decision-making models found in the extant psychotherapy literature are discussed, with particular attention given to the seminal work of Karen Kitchener (1984). Based on the understanding of ethical decision-making generated by in-depth exposure to these larger bodies of ethics literature (i.e., moral philosophy and medical ethics), the text from 13 MFT journal articles were deductively and inductively analyzed using an ontological hermeneutic approach. Results suggested that professional discourse to date about ethical decision-making processes in MFT is extremely scarce and fragmented, but that incorporating a broader understanding of ethical theory, and particularly the methods of ethical analysis presented by Graber and Thomasma (in press) offer substantial possibilities for more coherent, rigorous, and systemic approaches to ethical decision-making in MFT. Extensive discussion of the implications of and recommendations for implementing a new paradigm for MFT ethics is presented. Throughout this project, considerable attention is given to philosophy of science considerations raised by the use of Gadamer’s attempt (via ontological hermeneutics) to forge a middle path between modernist and post-modernist views of social science. Philosophical and scientific limitations of this project are acknowledged.
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