Religious freedom and healthcare
I meant to write this post about five days ago, but got caught up in a few other projects. As I've mentioned before, by trade, I'm trained as a clinical mental health counselor. This is the first time I think I've even said this in writing, but I chose to relinquish my secular counseling license in favor of pastoral counseling, even though I paid the state a lot of money for such a privilege. I did it on the basis of religious freedom.
I'll caveat this by saying that I've never turned away a client based on my moral views. In fact, I've never turned away a client, period. I've made referrals when somebody wasn't a good fit for my skills, but I've never turned anyone away. I'm a devout Christian but I believe part of that is loving all people, regardless of their choices. I don't have to accept everybody's beliefs and decisions, but I do have to honor them as fellow human beings and treat them with decency and respect.
When I started graduate school, it was easy to get caught up in the academics and not think about the practical applications of our code of ethics. Non-discrimination clauses just seem like common sense.
In the real world however, they have very serious implications, both morally and legally.
Generally speaking, the ethical thing to do is to refer any clients if you can't help them. This is based on the principle of doing no harm and not operating outside your area of expertise.
I'll give you an example, or a few of them. If someone comes to me with the following conditions, this is typically how I would respond:
Depression? Let's get to work.
Eating disorder? I think I know someone who might be able to help better. I'm not well trained in this area.
Schizophrenia? Let's make sure you're med compliant and we can talk, but I might end up setting you up with someone with more experience with your condition.
Alcohol abuse? I'm going to have to send you to someone with more expertise since I don't have much training in substance abuse.
Attachment disorder? Yeah, I've done a lot of this kind of work. I'm glad your previous therapist recommended me!
Grappling with sexual orientation? I know someone much better suited to handle this... but sorry, I can't make that referral or I might get sued.
In other words, I'm free to make referrals as I deem necessary to make sure the client gets the best care, but only if it doesn't stem from my personal beliefs. Here's where it gets weird, though: I can make referrals if I have excessive negative feelings for the client that I can overcome. For example, if I have a client who is repeatedly hostile and makes me uncomfortable time after time, I can suggest that another therapist might be a better fit... but not if it comes from my religious views.
In graduate school, we were taught to check our prejudices and privileges. This is a good thing in many ways. There's absolutely no reason and no sense in allowing yourself to hold on to racism, sexism, and the like.
At the same time, to or talk to ask clients about their faith and religion and to integrate it is necessary for good therapy. Nonetheless, we're expected to check our own moral beliefs at the door, even if it means compromising on our core values.
That's a bad predicament to be in one that so convoluted that I don't know that it can be logically reconciled. I can't see how keeping a client whose values are in complete contradiction is yours, and two might bring up strong, negative feelings could you anything but ultimately cause harm to the client. You can talk about it with a colleague or supervisor all day, but when you're talking about somebody's fundamental value system, asking them to change that for a job is an acceptable, in my opinion.
This is the point were many people would say that religion is doing more harm than good. Empirical, psychological evidence doesn't support that, however.
These are the reasons that I've decided to pastoral counseling only.
It's also one of the reasons that I'm moving away from something that I love, I have a passion for, and have a talent for, in favor of doing public health research.
I think this is an issue that the mainstream, secular profession is going to have to address at some point or another.#fopp religion