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The "Rational Suicide" Question
In short for example, for a severe burn patient in constant pain whose self-determination is an all consuming wish to die, where do you draw the ethical boundary concerning your ethic responsibility to protect your client from harming him or herself? Thus, the ethic of self-determination is at odds with the ethic to protect one from harming him or herself.
A boundary is set because the relationship is time limited. This seems pretty obvious. When the purpose is served and the goal achieved, the specific relationship is terminated. It is also an unequal relationship, as I mentioned earlier, in which the therapist and client or patient have differing roles and responsibilities - the therapist to give and the client to receive help. Therapy is directed to meet the needs of the client through provision of the needed help by the therapist.
However, in this unequal relationship regarding the boundary of time, unnecessarily prolonged therapy tends to become sterile and meaningless, and can create client dependency. As you know, the therapist's role demands teaching clients how to use help, how to use their own capabilities, and where to turn when future assistance is needed.
It is a basic fact in setting boundaries that a helping relationship is geared to meet the needs of clients and not that of the therapist. Yet, as we discussed earlier, if the needs of therapist are not met, for example regarding conflicting feelings toward the client, the therapist will not be able to function to his or her fullest potential.
Your Paycheck vs. Your Principles
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