Mental health ethics principles and frameworks

Mental Health Ethics

The author of this report is asked to pick from several example scenarios and discuss the mental health and other ethics surrounding how to react to that particular situation and why. The scenario selected by the author of this report asks the author to evaluate a Catholic father that admits to having urges and attractions towards adolescent boys and he has gone so far as to even engineer opportunities to be around them. He has apparently not acted them yet and has thus not violated any laws. However, the amount of further disrepute this would bring on the church and of course the overall risk that he will act in the manner of a child predator eventually seems like a foregone conclusion if something is not done. While the role and job description of a counselor typically precludes a breach of confidentiality, the concept of "imminent danger to one's self or others" is clearly in play here and there is never a situation where engaging in sexual acts with an adolescent boy under the age of consent is acceptable and this is even without including the moral repercussions and implications, both Catholic-oriented and not.

Analysis

Catholic priests and other personnel acting in a predatory nature towards young boys and girls, usually the former, has been a pervasive problem within the Catholic Church over the years and decades. The problem is certainly not limited to Catholics or even churches in general but the Catholic Church has certainly been one of the flashpoints and epicenters of the problem (Lueger-Schuster). The problem with child pornography, child molestation and child abuse in general has become so entrenched and elaborate that virtual child porn is created and disseminated and there is even a national organization, albeit a group of pariahs, known as the National Man-Boy Love Association, or NAMBLA for short (DeYoung).

Even so, the cases above are rather clear-cut and the example cited for this particular report is very much shades of gray, and for a few different reasons. First, irrespective of the history with other offenders and the admissions of the priest in question, no crime has actually occurred unless the priest is obfuscating that. Second, counselors are almost never at liberty to divulge the transcript or subjects of a counseling session to anyone, whether it be police, family members or colleagues that the person works with or otherwise knows. There is always an exception for situations where a crime has definitely and provably occurred. For example, if a counselor finds out that a child is being abused and the police and/or Child Protection Service (or equivalent) agency is not always involved, reporting that to the police is not just allowed, it is often required under the "mandated reporter" provision (Henderson). There is no opaqueness or ambiguity to what is going on here except the fact that no offense has occurred yet, except that it is not known for sure if even that is true given that the priest may have simply not revealed that as of yet.

However, given that a crime has not technically happened yet, there are really three options that exist and none of them are all that clear-cut or easy to make. The first is to notify the police. This is probably the most ethical and prudent thing to do but very hard to justify from a counselor standpoint because no crime has occurred yet and thus there is not really something for the priest to be held on other than perhaps a mental hold due to the danger of himself or someone else getting hurt, with the "someone else" being the obvious provision in play. Notifying the church is another option but is also not a clear option for the same reason. However, so long as the counselor is clear about what has and what has not happened, then the church can make a choice that protects the children while at the same time does not violate the privacy of the people involved. The final option is to implore the priest himself to step out of his position so as to protect the children from being victimized. Of course, children are not able to consent to sex and it is never right for this to happen no matter who is involved. Also, as mentioned before, the level of trust and stature of the position demands that the priest step down so that no one gets hurt.

There are several ethical principles involved in this matter. The first general principle is the aforementioned principle of the fact that a crime has not technically occurred. Couple this with the fact that all of us have some sort of urges every day that we consider but discard. However, this principle is fairly easy to dismiss given that no normal person has sexual urges towards children and anyone that does and actually admits it, with an expectation of privacy or not, needs to get some help and should be removed from the situation so as to not allow someone to be victimized (Jones) (Tjersland).

This leads to the next principle in question as far as ethics goes and that is to act in the best interest of the children even if a crime has not yet occurred. As already stated, it is not normal, natural or safe if a person that is around children at all, let alone as much as a priest would be, to have these feelings and they need to be removed from that situation immediately so that no one gets hurt. It would be bad enough if the priest said nothing to anybody about the urges but it is clear that he has and there is no guarantee that he is being completely honest about not acting on his urges yet. There is a rather thin line between manufacturing a chance to victimize a child and actually acting on it. Just because a victim has not come forward does not mean there is not one. Children in particular are less likely to come forward as a victim when they are attacked and this is doubly true when they think they will in trouble for saying something and/or the person doing the victimizing is a person of authority or stature such as a parent, other family member or member of the church.

Another principle to keep in mind is that the priest is probably coming forward due to some modicum of guilt. This could just be because he is feeling these feelings and not because he actually acted on them but it could also be that he has indeed acted on them and just has not reached the point where he can admit it fully. Regardless, he needs stronger attention to fully address the problem. In the meantime, he needs to be removed from having access to children. A related principle could probably be called the "junkie" or "alcoholic" principle. In short, having a person be exposed and surrounded by what triggers and has allure to him or her is less than wise because the possibility of offending or reoffending in such a situation is almost a certainty at one point or another. For example, a current or prior addict of alcohol around a bar or other place where alcohol flows freely is not a good idea because it is tempting to the person. The same thing can be said of drugs in general, with the harder drugs like heroin, crack and methamphetamine being the worst (Strickland, and Smith).

The "junkie" principle is proven even more when it refers to situations where likeminded people are involved and surrounded by the same general stimuli. In other words, being in the situation is bad but so is being around people that are like-minded and/or are doing the same thing (or are thinking about it). It is unlikely that there is another priest doing the same thing in this situation but if there is, the chance of both/all of them eventually offending is nearly certain due to the comfort and validation, however sick it may be, that the person may get because someone else feels the same sick urges as they do. However, the other side of that coin is when people know of this sickness, even if it is just one person that is potentially doing it, and nothing is being done about it. When speaking of drugs and alcohol, this applies more to people that drink casually around a drug addict or that gives money freely to a drug user. Even if the addict is not being directly urged to imbibe in alcohol or to use their drug or choice, they are still being urged in one way or another to reoffend and give into their urges. The same basic thing as the latter is being done here. Allowing a man that has these urges, which are always illegal to act on and never moral in any sense of the word, to continue to have exposure to what tempts him is bad enough. Given this priest is able to coax and created situations where boys are with him alone is even worse. In short, the counselor in this situation has no choice but to step in and say/do something.

To make a final decision, it would normally be wise to do some information gathering and to truly find out for sure whether or not this man has offended or not. However, the only real way to do that is to prod the priest even more and/or to ask the children and/or parents what is going on, if anything, and that would probably not be the best idea, at least in the latter case. Any querying of children would have to be done with the full knowledge and consent of the parents, and this is true both ethically and legally, and even if such permission was not garnered it would get back to them eventually. It is a certainty that when (not if) that happens, the parents will immediately figure out why the children are being questioned and that will unleash a firestorm. However, telling the parents in some form and at some point should probably happen because not only should this man be removed immediately it has to be known for sure whether anything did happen, when it happened and how many children were affected. The problem is that while it is not known for sure if something did indeed happen, it would be fairly impossible to be discrete about figuring out whether it happened. If this broke in the local (or national) media and it is found that nothing really did happen, then a lot of damage would still be caused.

Given the above, there is really no other choice here but to notify the church of what is going on. Going straight to the police would probably be the safer step but the fact that there is not a complaining witness (yet) probably precludes that from being a safe option. However, the notification of the church would need to have more "stick" than "carrot." Basically, the counselor should go to the church and tell them that the priest has divulged his urges to the counselor and that he needs to be removed for the safety of the children. If it is clear, or it otherwise comes to pass, that the priest does ANY more services or work with children, it should be stated in no unclear terms that the police will be notified immediately and the church not only will be forced to comply with their orders, the likelihood of this immediately blowing up into full-blown scandal goes without saying.

If the church dawdles or refuses to comply, the police and child protective services need to be notified. The latter might not be able to do much given that is not a child/parent relationship, but this can obviously vary by city and county and the definition "best interest of the children" certainly comes into play. The next step is to make sure that no victims are present. However, the church needs to be careful to not stain the potentially offending priest unless he actually acted on his urges. The way to favor both sides of the argument would be to have a program and class whereby children are told what "good touch" is and what "bad touch" is and that no one, not even parents or priests, are allowed to violate those rules and that the children should tell someone if/when it happens to them.