Ethical Absolutism, Ethical Relativism, and Ethical Multiculturalism
The movement known as multiculturalism is reshaping moral dialogue in psychology through its emphasis on inclusion, social justice, and mutual respect (Fowers & Davidov, 2006).
Psychologists with high levels of ethical commitment and awareness are often stymied by moral complexities that surface when psychological activities are conducted in diverse contexts, cultures, or communities. For example, when applied to ethical decision making across different contexts, the universal perspective of the deontic position is indifferent to particular persons and situations. It therefore rejects the influence of culture on the identification and resolution of ethical problems in a manner that can lead to a one-size-fits-all form of ethical problem solving (Fisher, 1999). In sharp contrast, ethical relativism, often associated with some forms of utilitarianism and communitarianism, denies the existence of universal or common moral values characterizing the whole of human relationships, proposing instead that the identification and resolution of ethical problems are unique to each particular culture or community.
Ethical contextualism (Fisher, 1999, 2000, in press; Macklin, 1999) blends the two approaches assuming that moral principles such as beneficence and respect for autonomy are universally valued across diverse contexts and cultures, but the expression of an ethical problem and the right actions to resolve it can be unique to the cultural context. From this perspective, universal moral principles can mediate our understanding of ethical meaning across diverse contexts without placing a priority on the principles themselves over the moral frameworks of others (Walker, 1992).
Culture and Informed Consent: A Case Example
Take the example of the ethical challenge of obtaining informed consent for mental health treatment for women suffering from posttraumatic stress disorder (PTSD) in war-torn countries where cultural mores require that permission is obtained from fathers, husbands, or brothers before a practitioner can offer services to women.
A psychologist who is an ethical absolutist might refuse to obtain permission from a male relative prior to obtaining consent from a female living in this culture on the grounds that any action that privileges the opinion of a third party in a treatment or research decision is a violation of a universal principle of respect for individual autonomy. The cultural relativist, on the other hand, might interpret the cultural mores dictating male privilege as evidence that respect for individual autonomy is not a moral value in this particular culture; consequently, any action consistent with the cultural norm (e.g., obtaining the male relative’s permission) is ethical.
The ethical contextualist would see the problem as one that requires consideration of both a universal valuing of individual autonomy and its traditional expression within this particular culture. A psychologist adopting this position would seek to resolve the ethical problem in a manner consistent with both. For example, examining the cultural meaning of this tradition, a psychologist might find that women in this culture value the male gatekeeper role and see it as beneficial to themselves and/or the stability of their families and communities. In this scenario, principles of justice and respect for personhood might result in an ethical resolution in which psychologists seek permission from a male relative before they obtain informed consent from potential female clients/patients—at the same time making it clear to both parties that the psychologist would respect the woman’s right to refuse treatment irrespective of male permission.
Alternatively, the ethical contextualist might find that women living in this particular cultural community view this tradition as repressive and fear harsh retaliation if they disagree with the decision of their husbands or other male relatives. In this scenario, drawing on the principles of beneficence and nonmaleficence and respect for personhood, the psychologist might create a safe and confidential opportunity for women to learn about and then consent or refuse the treatment on their own without male involvement. For further discussion of these and related issues, readers are referred to the Hot Topics in Chapter 5, on multicultural ethical competence, and in Chapter 13, on the integration of religion and spirituality in therapy.