Ethical decision-making in cultural context: Implications for professional practice

Abstract

Professional codes of ethics are generally premised on self-contained individualism, the view that individuals exist independently of culture, history and time. In this article we argue that, to understand ethical decision-making in indigenous societies, it is important to come to terms with the “social reality” of the people in question. Social reality constitutes the manner in which human interactions are understood, roles defined, and transactions enacted. Due to differences in social realities, practitioners encounter multiple and overlapping health-care systems among indigenous peoples. The ethical implications of practising social work and psychology in such contexts are discussed. We argue that self-contained individualism is problematic in traditional African settings where selfhood is not only communally defined but is also distributed in space and time. Using professional codes of ethics in Social Work and Psychology as our points of departure and with reference to concepts such as professional boundaries, self-determination, and informed consent, the ethical implications of the tensions between communal and individualistic conceptions of selves are discussed. Implications for clinical practice are highlighted.