The ethics of infant and early childhood mental health practice

Abstract

Ethics is concerned with the basis for moral judgments of “right” and “wrong” and is central to the clinical endeavor. Many clinicians integrate ethical estimations into their work without much conscious awareness. However, explicit use of ethical principles and frameworks can help navigate clinical decision‐making when there is a sense of moral conflict or ambiguity about the “right” course of action. This article aims to highlight the key concepts and principles in clinical ethics as they apply to IECMH practice and stimulate a bigger conversation in the profession around how to support each other to maintain high ethical standards in working with young children and their families. Specifically, the authors consider the relevance of Beauchamp and Childress’ four principles framework (respect for autonomy, beneficence, non‐maleficence, and justice), and address some of the special ethical challenges in the field, namely, the vulnerability of the infant, the need for a competent workforce, caring for caregivers, and the problem of multiple patients. Finally, the role of infant rights is briefly explored, noting the significant interest and debate that has been generated by the publication of the World Association of Infant Mental Health's Position Paper on the Rights of Infants.

Current approaches and future directions for addressing ethics in infant and early childhood mental health

“…Further, as the workforce grows the proportion of entry level practitioners increases, reminding us of the need for a code that addresses all levels of experience. Nevertheless, as Lim et al (2023) point out, ethical decision-making sometimes occurs without much conscious awareness or without explicit attention to the ethical principles that underlie complex clinical decisions and actions. Furthermore, decisions may be based on what is most expedient or practical, driven by agency or organizational values or priorities, or by resources that are available, rather than a careful consideration of values, options, and short and longer-term implications of the decisions.…”

“…As described by Lim et al. (2023), ethics are “concerned with understanding the basis for moral judgements about what is ‘right’ and ‘wrong,’ and hence what constitutes ‘right’ action” (p. 2), namely, the essence of what a good practitioner is and how they should go about their professional work, with the ultimate intention of improving the ethical practice of individual practitioners. Ethical behavior is distinguished from behaviors determined by laws or agency policy because it is driven by individual moral reasoning, autonomy, and agency, rather than by rules or standards imposed by an external source (Kerridge et al., 2013).…”

“…Sources of social and moral authority, such as law, religion, and politics aim to provide guidance around how a person should act, but ethics involves a dual emphasis on individual moral autonomy and agency, and the use of reasoning and justification as the method for deciding what to do. By these same characteristics, ethics can (and should) be distinguished from emotional impulse or intuition (Lim, 2022). Professions have developed processes for collecting, arranging, and stating important ethical principles, duties, or values, into documents that can be used for future reference.…”