Multi‐disciplinary working in a forensic mental health setting: ethical codes of reference

Abstract

This paper reports on a small research project on multidisciplinary team-working within a medium secure forensic unit in the United Kingdom. Although multidisciplinary team working is widely accepted as an effective strategy for the delivery of healthcare services in modern society it is also recognized that interdisciplinary problems can also occur. This study developed two questionnaires, one being delivered to a number of groups and teams in the secure unit, whilst the second one was geared to individuals. A thematic analysis was employed to develop category building and concept formation. The results highlighted a three-level ethical code referencing system that was employed by both individuals and groups. Within this, three domains, or trajectories, were identified that were polarized continuums of main tensions for multidisciplinary staff working in forensic practice.

Forensic multidisciplinary perspectives of Tarasoff liability: a vignette study

“…Multi-disciplinary working in forensic settings has been studied previously with the establishment of certain areas of overlap in relation to professional ethical codes (Mason, Williams, & Vivian-Byrne, 2002). This is supported in this current study in that the professional groups appear similar in their overall perceptions of the Tarasoff case but then differ in relation to what they consider their area of responsibility to be.…”

Theory and practice in interprofessional ethics: A framework for understanding ethical issues in health care teams

“…Overall, the description and exploration of the multifaceted ethical issues confronting interprofessional teams has been restricted to teams in surgery (Bleakley, 2006), intensive care (Melia, 2001), and mental health (Mason et al, 2002). The limited literature on ethical issues in interprofessional teamwork includes discussion of the importance of recognizing the different values-related perspectives of the differing professions on the team (Childs, 1987;Clark, 1995Clark, , 1997Jormsri, 2004), the ethical basis for interprofessional teamwork (Irvine et al, 2002), the core ethical topics for interprofessional education (Aveyard et al, 2005), and the need for teams to develop shared moral language, discourse, or reflection (De Wachter, 1976;Hermsen & Ten Have, 2005;Irvine et al, 2004;Purtilo, 1988).…”

“…These approaches usually provide a set of factors or principles to be considered, along with the steps or processes to be used in reaching a decision about what to do in morally dilemmatic or clinically complex cases. At least one empirically-based ethical framework has been developed to understand the complexity of ethical issues in teamwork in the mental health setting (Mason et al, 2002).…”

“…Some work focuses on the ethical importance of conflicts between individual professions on the team (e.g., Melia, 2001;Seedhouse, 2002), of clashes between professionals and the team or the health care organizational setting within which they work (e.g., Carney, 2006;Mason et al, 2002), or of the relationships between the team and the organization (e.g., DiPalma, 2004). What is needed to move the field forward is a comprehensive model encompassing individual, team, and organizational levels that can be applied generally to teams across a wide range of health care settings and contexts.…”

“…There may be situations and settings in which these three factors overlap with each other, because they address different facets of the same issue. Further, these ethical dimensions can be analyzed at three different levels: (i) the individual, (ii) the team, and (iii) the organization (Carney, 2006;Drinka & Clark, 2000;Mason et al, 2002). In the following section we discuss each of these dimensions (also illustrated in Table I).…”