Ethical Issues in Counseling

Introduction

I remembered that several years ago I have read the news on newspaper about a father who raped her daughter then her daughter become pregnant, and it’s too late to terminate the pregnancy. I feel quite uncomfortable after reading this. If we want to talk about incest with other people, we can expect that very few of them are willing to discuss it in detail or try to avoid this topic, as incest is a taboo subject in our culture; it is invariably associated with child abuse and its horrific, long-lasting, and often irreversible consequences. May be people who have studied this topic in the college are less reluctant to this controversial topic. As a counselor, if we have to deal with the incest victims, what should we pay attention to? What should we consider if the victims become pregnant?

We need to identify the ethical problem faced by the therapist working with family in which child sexual abuse is suspected or has occurred. The primary focus is paternal incestuous abuse, with the recognition that siblings, extended family, and stepparents may also be perpetrators. The abuser usually wins the trust of the victim first, and then violates that trust in order to commit the abuse. The abuser may use force, the threat of force, a bribe, the offer of special attention, or a gift to make the victim keep the abuse secret.

According to Thompson (1990), ethical dilemmas arise for several reasons. Behavior may be unethical and yet illegal, e.g. choosing not to report suspected sexual child abuse due to the risk of physical reprisal for the child, unethical and illegal e.g. failure to report or pursue suspected child abuse, based on a lack of knowledge regarding reporting procedures, or unethical yet outside legal jurisdiction, e.g. working with families in which abuse has occurred, without specific training in sexual abuse intervention.

I’m going to begin by discussing the preliminary countertransference reactions a therapist brings into the relationship unintentionally at the outset of psychotherapy with an incest victim. There are a wide range of intense affective reactions the therapists may feel in response to their knowledge of a patient’s incest history, which may include horror, anxiety, outrage, protectiveness, guilt, disgust, blame, denial, arousal, retaliatory wishes, powerlessness, and grief. The common countertransference reaction that we bring to the therapeutic relationship when we know or suspect that incest is involved is the response to the taboo against incest and to the destruction of our personal and cultural parental images. Incest is a disturbing event, and we are all influenced by the cultural taboo against it accompany with the denial of the existence of incestuous relationships. Incest stories are difficult to hear, painful to believe, and hard to know the way one must know a patient’s early environment and childhood experience in order to help her reconstruct a comprehensible, affectively accurate understanding of her personal context. The reality of incest involves exploitation, tyranny, betrayal of trust, crossing generational boundaries, and the violation of deeply held cultural values of maternal and paternal caregiving and protective functions. In additional, it is difficult to imagine and visualize the details of adult-child sexual intercourse and the images of the actual bodily contact are disturbing and painful. We may probably try to show our empathy to incest victims, because we always view the event of incest as a tragedy. It is good to do so but we need to be alert to our reactions to the victims in order to maintain a therapeutic position. Also we must know that it is critical in counseling with incest victims to protect their confidentiality.

Incest is listed as one of the classic two reasons to get an abortion (another is rape). In my point of view, that a woman be forced to have a baby that was conceived out of rape by stranger is easier to be accepted than by a father. It seems that every time the mother were to look upon her child, he or she would be a constant reminder of the horrible act that brought about that child's creation into this world. Also, incest can raise issues of mental retardation and handicaps. Undoubtedly, the following circumstances in which abortion should have been allowed: