The Importance of Ethical Standards
In any field that provides service to the public, there needs to be guidelines and standards in place to protect the people receiving services, the individual providing services, the public, and the profession. The first ethical consideration that influences individuals providing services is their own personal values, but this is not enough to ensure safety for people receiving services.
While it would be nice to assume that individuals who have decided to work in a helping profession just naturally know what they should and should not do, that is not always the case. In fact, even when individuals make a formal commitment to behave in an ethical way, there can still be confusion about what that means. In order to make it more likely that all peer support specialists behave in an ethical manner, specific guidelines and ways to enforce those guidelines must come into play. These guidelines and standards are specified in Codes of Ethics or practice guidelines and, when they rise to a certain level of importance, those standards may be contained in formal regulations or laws. The diagram below shows the progression of importance in ethical standards.
Some elements of ethical codes, rules or regulations indicate what a peer support specialist should or must do, while other elements describe what should not or cannot be done. Often, more attention is paid to the ethical standards that deal with forbidden behavior such as violations of confidentiality or inappropriate touch than to the prescribed behaviors such as respect for diversity, cultural competence, and maintaining personal recovery. This may be because breaches regarding what should not be done can result in greater harm to the person receiving services. Failure to act in prescribed ways that are consistent with best practices and ethical standards may also result in harm to the client. Therefore, it is important to explore all aspects of ethical standards for peer support specialists in order to ensure the greatest good for the persons receiving services, the peer support specialist, the community at large and the profession of peer support. Ethical dilemmas that arise in the course of our work must be resolved by following the guidelines of our professional ethical standards or principles rather than our own personal standards or religious convictions
Codes of Ethics
There are six general guidelines for daily ethical conduct that are contained in some form or another in most professional codes of ethics:
- provide informed consent
- operate in a competent and theoretically sound manner
- ensure confidentiality of client information
- maintain appropriate relationship boundaries
- utilize adequate consultation
- honor diverse personal and cultural values
Each of these areas is explored in detail within this module. In some states, peer support specialists may be expected to follow the code of ethics for addiction or mental health counselors, while in other states, specific codes of ethics have been developed for peer support specialists. These specialized codes of ethics recognize the unique circumstances that occur in the peer relationship. Many professional codes of ethics contain a responsibility for reporting ethical violations. This means that a professional has a responsibility to monitor not only their own ethical behavior, but the ethical behavior of their colleagues. In this way, the fundamental purpose of ethics – to protect the client – is upheld.
Module 7 Reflection Activity: Code of Ethics
Instructions: Review one state’s specific code of ethics for peer support specialists at the link below and then reflect upon the questions that follow.
Reflection: After reviewing the Nevada Code of Ethics, think about the following questions:
- What comes to your mind when the term “ethics” comes up? Do you generally have a positive or a negative response?
- Are there items in the Nevada Code that you disagree with? How would you revise the standards to be more reflective of your own values or beliefs?
- Are there things that you think are missing from the Nevada Code? What would you add?
Note: This activity is for reflection only and does not need to be submitted along with your workbook.
Laws that Govern Peer Relationships and Services
There are laws and regulations that apply to both substance abuse and mental health clients.
This is especially true in publicly-funded programs. Use of public funds creates an obligation to fulfill the public trust. When compliance with a law or policy is mandatory, failure to comply becomes an ethical issue. There may be sanctions or consequences associated with such an ethical breach. One example of this is the mandatory reporting of child abuse. In almost every state, professionals, including peer support specialists, who become aware of abuse are required by law to report it and failure to do so can result in fines and other disciplinary actions.
There are four important categories of laws that peer support specialists need to be aware of:
- Laws that govern the treatment of substance abuse and mental health clients, including laws that permit involuntary commitment to a treatment facility
- Laws that govern mandatory reporting of abuse of a child or vulnerable adult
- Federal privacy protections for health information under HIPAA
- 42 CFR, the federal law that pertains to confidentiality for substance abuse clients.
Generally, laws pertaining to treatment, involuntary commitment and abuse reporting will be contained in state statutes. These laws may also include requirements for certification for peer support specialists, limits to the scope of practice, and how peer support specialists must be supervised. State guidelines, including the state’s Medicaid handbook, will indicate whether or not services provided by peer support specialists can be reimbursed. This is an important factor in employability for peer support specialists.
Agency policies and procedures will provide peer support specialists with specific guidance that is consistent with applicable state and federal laws. More specific information about the federal laws –42 CFR and HIPPA– will be provided later in this module.