Yesterday we attended an ethics training, one of those gatherings mandated for, and, often, dreaded by, licensed professionals.
The day got off to a rocky beginning when one of the presenters outlined his, “common sense”, model for understanding ethical stances and dilemmas. He suggested a model of several overlapping circles, beginning with the individual’s ethical stance in the world, and ending with the larger societal view. All of these circles appeared to be contained within a vast circle that delineated the domain of litigation.
One concern I have with this view is that, while it fits the practice environment of many mental health clinicians in the U.S., it is disrespectful of Native people. For many of us, all ethical understanding begins in the community (people, other beings, and the landscape). My personal ethical views are secondary to those of the community, and, ideally, arise from many generations of thought about right relationship to the world and our fellow beings.
From this view, I, as the person who occupies the position of a healer (someone who engages in conversation and ceremony to alleviate suffering) must consider the person or family I am aiding as deeply embedded in a world rich in relationships and meaning, and filled with interactive spirits, including ancestors. This world is understood with an ethical worldview in which the person has a direct, personal relationship with the Creator and a unique life path, and in which each person is responsible for maintaining correct relationship to the community.
This relationship is reciprocal. The community protects, nurtures, and honors women, children, and elders, and supports and appreciates men. When warfare is necessary, returning vets are acknowledged, and ceremony performed to remove the harms of war and reintegrate them into the community. If they are disabled, they, too, are cared for by the community.
From this ethical frame, late capitalism is misguided, and it’s individual-centered ethic destructive. How can one maintain right relationships when the focus is on self?
This conflict in worldviews presents Native clinicians with a prickly problem. How are we to practice ethically in an institutionalized system governed by a worldview we may perceive to be unethical, even immoral? This is a good, even central, question. Many mental health professional organizations speak of cultural competency while simultaneously adapting culturally harmful codes and practices.
These different understandings of the world and of ethics assure Native clinicians will be subject to numerous microagressions in the course of most conferences. This is painful, and largely invisible to the vast majority of clinicians and presenters in the room. That’s a problem. Yesterday, in the second half of the conference, we began a conversation about these things. Over the course of half-an-hour, those in the room spoke together about difference and harm. This was a fine beginning, the depth of the conversation rewarding. Hopefully the conversation will continue and grow.