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The SGA Ethics Code

Adopted by the SGA Meeting Resolution
as of 20 May 2016

Chairperson of the meeting:  V. Shamov
Secretary of the meeting:  D. Britvina

Ethics (in Greek ‘ethos’ means moral, custom) is a philosophic research of morality.  The term is also used to denote moral norms within a certain social group.     
This code is a set of rules to regulate the activity within the Community (SGA) and to provide a dialogue within the international framework, as well as interaction with other organizations.  
While developing this document the working group considered the circumstances and the needs of the Community (SGA) and the existing Ethics Codes in some other professional organizations.

Introduction

Every professional community follows the Ethics Codes (further referred to as EC) which regulates its life.  The Community EC does not contradict the democracy principles, the Constitution and the laws of the Russian Federation.  The aim of this EC is to facilitate the development of professional activity of the SGA members, i.e. of candidates for group analysts, group analysts, training analysts, supervisors (further referred to as ‘group analysts/candidates’).  The community members must observe the EC in their professional activity.  
It is important for a specialist to realize the necessity of self-enquiry and to have an opportunity to discuss ethics issues with colleagues.  
The principles and standards of ethics make it possible to maintain the identity of a group analyst.  They also set professional boundaries, define and regulate interaction with (a) patients, (b) analysants, colleagues, professional communities and other organizations.  

A. Main EC Principles

1. Professional competence.
2. Respect for persons and absence of discrimination.
3. Mutuality and informed consent.
4. Confidentiality.
5. Truthfulness.
6. Prohibition of exploitation.
7. Scientific responsibility.
8. Safeguarding the professional community and its members from incompetence.
9. Social responsibility.
10. Professional responsibility.  Integrity. Identity.

B. Standards applicable to the principles of ethics

The standards reflect the forms of practice accepted in psychotherapeutic communities as time-tested and morally appropriate for the professional service.

1. Professional Competence

A group analyst/candidate must practice within the range of their professional competence and to refuse to assume responsibilities which they cannot fulfill.  If necessary, they should make appropriate use of consultations in allied fields (psychiatry, narcology, psychoanalysis, etc.).  
Group analysts/candidates should follow the group-analytic approach based on democratic principles.  As it is impossible to be a group analyst outside professional relationships, group analysts/candidate must participate regularly in intervisionary groups and/or systematically supervise their work, develop their knowledge and skills.

2. Respect for persons and absence of discrimination

The Community members practice is based on the respect for persons.  Professional ethics is inconsistent with discrimination based on ethnic identity, nationality, gender, race, religion, sexual orientation, disability or social and economic status.  
The group analyst/candidate must not participate in political movements where people are discriminated on these grounds.

3. Informing

Group-analytic process/therapy exists by virtue of mutually accepted agreement between group participants and the conductor.
Group-analytic relations are based on trust and informed consent.  All aspects of the group-analytic contract should be discussed with a client/patient during the initial interview.
The group analyst/candidate must agree with group participants upon the time, fee and other rules (confidentiality, completion of analysis, charging for missed sessions and other) in a correct form, as well as agree with those who are in charge of minors or wards.  
If the analysis is paid for by the third party or some of group participants are minors or wards, the issues with the persons who pay or with guardians must be discussed early on before the beginning of the group.

4. Confidentiality 

Confidentiality is an important element of group-analytic process, being the main right of the patient/analysant and a constituent part of effective treatment and research.  The group analyst/candidate must take measures to provide confidentiality regarding the current or former patients and has no right to discuss the material received during group-analytic treatment outside the therapeutic, consultative, research or educational context.
If the group analyst/candidate uses materials in talks having consultative, educational or scientific aims, patients/clients/analysants personal data must be disguised to avoid identification.
The information about the patient must be protected.  All information about patients’ life, including their names and facts which have been revealed during the treatment are strictly confidential.  Any disclosure of confidential information, which the group analyst/candidate is responsible for, must be impeded.
The group analyst/candidate should never share confidential information about patients/clients with non-clinical third parties (e.g. insurance companies) without the patients/clients consent.  However, confidentiality is not violated if the information is shared with a group analyst colleague (supervisor, intervisor) or an attending psychiatrist in the patient’s best interest, as all of them must also observe confidentiality.
If a third party or a patient demands that the group analyst/candidate does not observe confidentiality, it is ethical to refuse such demands even if the patient violates confidentiality.
If the patient is a minor or a ward, the group analyst/candidate must seek to preserve the patient’s confidentiality while keeping parents or guardians informed of the course of treatment.  The ways to preserve confidentiality depend upon the patient’s age, level of development, clinical situation.
It is important to preserve confidentiality when handling the records of group participants and other documents regarding the group-analytic process.
Supervisors, consultants and students participating in supervisions, clinical presentations and scientific talks must protect confidentiality.  It is acceptable to remind those participating in such events about the confidentiality of information.

5. Truthfulness

Therapeutic relations are based on truthfulness.  The group analyst/candidate should speak candidly with a prospective patient or the parents/guardians if the patient is a minor about the benefits and burdens of group-analytic treatment.  The group analyst/candidate should avoid misleading patients/guardians and their relatives with statements about the group-analytic treatment that are knowingly false and reinforce unrealistic expectations.  
The candidates who are in training may inform their patients that they are in training and supervised.  The candidate must not deny that supervisions are a requirement of training, in case this interests the patient.
It is unethical for a group analyst/candidate to use their position in the group-analytic community, professional status or special relationships with a patient/client to force treatment.  
It is unethical to distort information about their professional status.

6. Prohibition of exploitation

As clients/patients are quite vulnerable and in unequal relations, the group analyst/candidate should avoid any form of exploiting patients or their families.  
It is unethical to use the professional status, relationships or position in the organization while exploiting patients because this violates their boundaries.
It is unethical to become involved in any financial dealings with patients beyond reimbursement for treatment.
The group analyst/candidate should aim at establishing and maintaining an equal attitude towards group participants and therefore has to examine constantly countertransference relationships.
The sexual relations between the specialist and the patient, the parents (guardians) of minors are beyond the professional ethics regardless of who initiated them.

7. Scientific responsibility and professional development in theory and technique of group analysis

The group analyst/candidate should raise their professional competence in theory and technique of group analysis and facilitate the increase of the educational level of students and colleagues.
It is unacceptable to falsify material:  to make public presentations or submit for publication in scientific journals that does not refer to reality.  To preserve confidentiality, it is necessary to exercise caution in disguising clinical material lest it becomes misleading for colleagues.

8. Safeguarding the professional community as well as its members and patients from incompetence

The group analyst/candidate should safeguard patients/clients/analysants from colleagues’ incompetence that can cause harm.
The group analyst/candidate must recommend its colleagues who demonstrate incompetence to turn for professional help.  Cases of serious violations, refusal to accept help or harm being caused a patient/client/analysant must be discussed at the Ethics Committee.
If a group analyst is formally notified by the Ethics Committee that their clinical conclusions and working abilities are inconsistent with the required level, then he/she should consult with no less than two colleagues, one of whom may be a doctor – not a group analyst – to evaluate his/her condition.
If impairment is found, it is necessary to take remedial measures in order to protect patients from harm and to prevent degradation of the standards of care in the profession.
The community (organization) should take care about increasing the professional ethics competence of its members. If professional ethics is breached the Ethics Committee investigates the facts.
The Community shares the existing democratic principles which imply participants having equal rights.

9. Social responsibility

The Ethics Code does not contradict the Constitution and the Russian Federation legislation.
The group analyst/candidate invests their time and abilities into the therapeutic, consultative and educational activity which aims at enhancing the quality of patients’ life.  Rendering help to those affected by natural and anthropogenic calamities and military action is a valuable contribution to improving the psychic health of people and strengthens the Community authority. 
If a patient may seriously injure himself/herself or commit a suicide, the group analyst/candidate should take appropriate steps.  A breach of confidentiality is possible to the extent to which it is necessary to prevent harm, if other measures are impossible. 
If the patient is a minor or a ward and the group analyst encounters the potential danger of their self-injury or suicide, appropriate steps must be taken.  This may include notification of parents/guardians, even if a breach of the patient’s confidentiality is required.  Under these circumstances, any breach of confidentiality should be restricted to the minimum necessary to prevent harm of the minor or the ward.
When the group analyst/candidate becomes convinced that abuse is occurring and it threatens the patient’s or other people’s life and health, the group analyst/candidate may report  the abuse to the appropriate bodies.  
Should patients be minors/wards,  parents/guardians and/or the appropriate bodies are notified.  In such circumstances the confidentiality breach must be as minimum as possible. The group analyst/candidate may also refuse to report to the relevant agencies if he/she believes that to do so would seriously undermine the treatment or damage the patient.  
Taking into account the difficulty of making a decision in such a situation, the group analyst/candidate who encounters such facts should turn for a consultation and/or supervision to determine the optimal therapeutic strategy.

10.  Professional integrity.  Identity

The professional integrity of the group analyst implies certain personal and social maturity, stability and humanistic beliefs corresponding to the principles of democracy.  The group analyst/candidate must be capable for self-inquiry, empathetic, thoughtful and honest in relationships, maintain the honour of the profession.  The ability to reflex enables to realize their own problems and if it necessary, to turn for consultative and supervisory help to the competent colleagues.  If there is a need, group analysts/candidates participate with colleagues of the same profession and specialists in other fields within their abilities.  It is unacceptable to take for analysis a patient who is undergoing analysis in another analyst’s group without the latter’s consent.
The group analyst/candidate accepts professional limitation and aims at maintaining the high standards of professional practice.  
The group analysts/candidates who are in training must be familiar with and follow this Ethics Code.
Group analysts should join the research of ethical behavioral procedures which correspond to implementing the principles and standards of the psychoanalysis ethics.

C. Maintaining the ethical principles and standards

The Ethics Committee (SGA EC) ensure that the SGA ethical principles and standards are maintained. 

1. Structure and purpose

The Ethics Committee consists of five people who must be the SGA members and have a qualification status no lower than the group analyst.  The Ethics Committee members are elected by the common assembly or, if necessary, by the SGA CC.  Each Committee member works for one or two years.  
The Ethics Committee forms the board of three SGA members (priority given to the Ethics Committee members) to consider each inquiry to the Ethics Committee.  It is recommended that the SGA members who are in the board should not be involved in any conflict and should not have analytic or any other relevant relationships with each other and those involved in the conflict.

2. Responsibilities

The Ethics Committee is intended to:
1) facilitate informing the SGA members and other interested persons about the Principles and Standards of the professional ethics and implementing them in professional service;
2) continue developing standards of the professional ethics and to recommend additions and amendments in the SGA Ethics Code;
3) consider inquiries relating the organization members’ unethical conduct and to take appropriate decisions following the procedure below.

As a result of considering an inquiry, the Ethics Committee:
1) develops recommendations on regulating the conflict and solving the ethical problem;
2) takes a decision about the possible SGA membership.

3. Procedure for the EC handling of unethical conduct inquiries

Upon receiving an inquiry, the EC:
1. Forms a board of three SGA members (priority given to the EC members) to consider every inquiry to the Ethics Committee.  It is recommended that the SGA members who are in the board should not be involved in any conflict and should not have analytic or any other relevant relationships with each other and those involved in the conflict.
2. The Committee considers the inquiry and develops recommendations on solving the conflict, which are submitted to the EC.
3. The EC informs those involved in a conflict about its decision.
4. If necessary, the EC takes a decision about who and how should be notified about the EC decision.
5. The Committee controls its implementation.

The Committee resolution should include the answers to the following questions:
- Have the facts mentioned in the inquiry taken place?
- Has there been violation of the professional ethics?
- What has been violated?
- What are the consequences of the professional ethics violation for the person who appealed to the EC, the SGA and for other persons?

In accordance with the report the board can take one of the following resolutions:

1. To admit the absence of the professional ethics violation due to the absence of the incident mentioned.
2. To admit the absence of the professional ethics violation as it is impossible to ascertain the veracity and character of events (the appropriate decision cannot be taken due to the absence of reliable data or due to other procedural defects).
3. To admit the absence of the professional ethics violation (the mentioned events happened but did not violate the professional ethics).
4. To admit the professional ethics violation.
5. To admit the professional ethics violation and make an admonition.
6. To admit the professional ethics violation and recommend the TC to temporarily disqualify the specialist and/or deprive them of the right to practice fully (or partially) on behalf of the SGA within a specified time limit, or recommend the CC to temporarily prohibit occupying certain positions in the SGA within a specified time limit.
7. To admit the professional ethics violation and to recommend the SGA General Assembly to suspend from the SGA and deprive of the right to practice on behalf of the SGA within a specified time limit. 
8. To admit the professional ethics violation and recommend the SGA General Assembly to expel from the SGA and deprive of the right to practice on behalf of the SGA.
9. To postpone the final decision till fulfilling the SGA members’ recommendations for settling the conflict and to reconsider the case (always with specific recommendations and time limits).
The board can also give the SGA members additional recommendations regarding the case considered in order to minimize the consequences of violating the professional ethics in any type of resolution which are also included in the resolution.
The board resolution is based on an impartial evaluation by the members during the closed (without the board members) voting.  The adopted elaborate written resolution is given:
- to the complainant, 
- to the SGA members whom the appeal concerns,
- to the remaining EC members.
While processing an inquiry, forming the board and working in the board all specialists involved and the SGA members must preserve confidentiality.
The Ethics Committee informs the CC, TC and the SGA Assembly about the resolution:
- if resolution 5, 6 or 7 is taken – mandatory;
- if resolution 1 or 3 is taken – upon the wish of specialists whom the inquiry to the EC concerns;
- if resolution 2, 4 or 8 is taken – upon the EC decision.

Upon the decision taken at the general meeting or by the CC, information about disclosed violations can also be published, imparted to other communities and organizations.
The control over the activity of the EC board is carried out by the CC which observes the procedures and cannot change the resolution.  The task of the CC is to find out whether there have been factors which could have influenced the objectivity of the board making a decision (prejudice, pressure from outside, unconscientiousness, incompetence, etc.).  If the resolution has been appealed, the CC listens to the EC Chairperson’s report and either decides to confirm the resolution taken or arranges to reconsider the resolution taking into account the mistakes made.

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The Ethics Code is compulsory for all the Community members since its adoption and is certified by the signature of every Community member.