Clinical practice in complex contexts can be a brief but powerful encounter or a long and arduous journey. Ethical challenges may emerge at any stage in this journey, from the initial referral through to the legacy that remains long after clinical contact has been completed. Each country has ethics regulations to guide our work but these are usually only part of the story. This toolkit has been designed to provide additional opportunities for deep reflection on the ethical challenges of clinical practice in complex contexts.
To support this process, we have broken down the clinical practice journey into common stages to support further reflection on the different ethical challenges that may arise at each stage.
These stages are represented in the interactive graphic below.
To further help us identify and address ethical challenges, we have mapped the network of influences on ethical clinical conduct and distilled these into four groups: Place, People, Principles and Precedents. These considerations form interdependent threads that weave through all stages of the clinical practice journey – reflecting on each of the 4P’s can illuminate ethical challenges as well as help us locate potential solutions.
In this toolkit, we use the stages of the clinical journey as a structure for exploring ethical dilemmas and solutions across the lifespan of a clinical contact.
Visit the Templates page to request any of the 10 stages/templates in more detail, available in pdf format.
Please click on the yellow tabs for more detail about each stage of the journey and about each of the 4P’s:
*The clinical practice journey is neither linear nor predictable. The order of stages could be different. Revisiting previous stages is often required. These stages are presented to prompt our reflection on different aspects of a clinical journey and help us consider what is most relevant to our role and work.
During the development of this project, participants emphasized that ethics – doing the right thing – needs to be front of mind throughout our clinical contacts and in planning clinical services. Clinical practice ethics is about day-to-day decision making and action in all aspects of clinical services and especially during clinical contact with clients.
Given the complexity of clinical practice we can expect ethical dilemmas to emerge often. Ethical dilemmas are not limited to a specific point in time early in the journey; they may not neatly fit into ethics regulations. Additionally, things change as the clinical contact unfolds, which requires ongoing alertness and attention to ethical implications. Anticipating challenges can help us be attuned to noticing when things are going wrong or take an unexpected turn. Each ethical dilemma we face is likely to be multifaceted. In the workshops and roundtables it was highlighted that to understand dilemmas and find ethical solutions, we need to reflect on Place, People, Principles and Precedent (the 4P’s), and in doing so, we can begin to shape context-relevant solutions.
Go to Ethical Principles and Values
