HELD

Code of Conduct

1.  Introduction

1.1   Purpose of the Code

The Code is a statement of the ethical values and principles that underpin good holistic end of life and death care practice and provides guidance about what is expected of Holistic End of Life and Death Care Australia – (hereinafter HELD) members. The Code therefore sets out the basis for safe, effective and compassionate care which safeguards and promotes the health and wellbeing of those in the member’s care. The code offers a guide to decision-making and professional behaviour and a mechanism for professional accountability. The Code may also inform the public about professional HELD services.

1.2   Applicability of the Code

The Code applies to all HELD members who are registered with HELD Australia.

1.3   Scope of the Code

The Code sets out the professional standards of conduct expected of HELD members towards those in their care: individuals, families, communities, service users, carers, staff, students, volunteers and others to whom HELD members relate as part of their duties and responsibilities. Professional standards of competence and service delivery are set out in other documents such as:

  • HELD Standards of Practice Document
  • HELD Ethics Document (When released)
  • HELD Complaints procedure
  • HELD Membership Policy (Credentialing Criteria)
  • Any competency documents published by HELD Australia
  • Acknowledgements

This document is based on the Code of Conduct of Spiritual Care Australia. It has been adopted and amended with the permission of Spiritual Care Australia and we thank them for their grace and professionalism in granting us this permission.

2.   Definitions

Code of conduct – a set of values, rules, standards, and principles outlining what we expect from members within our organisation.

Ethical – relates to moral principles.

Holistic care – to provide support in context of the whole person including their physical, emotional, social, cultural and spiritual wellbeing and needs.

Probity – the quality of having strong moral principles, honesty and decency.

Confidentiality – an expression of trust that enables people to talk about personal and private concerns relevant to their health and wellbeing.

Professional misconduct – behaviour that contravenes the professional behaviour required as set out in this Code.

 

 3.   General conduct of HELD members

As a HELD member you are professionally accountable for your decisions and conduct and you must be able to justify your practice.

In particular:

  • Promote and safeguard the interests and wellbeing of those in your care.
  • Treat those in your care with respect and dignity.
  • Respect the rights of individuals, families, groups and communities to hold their own values, traditions, beliefs and practices.
  • Act with integrity, sensitivity and understanding.
  • Develop and maintain your knowledge, skills and capabilities to practise safely, ethically, competently and legally.
  • Ensure that you are fit to practice and that those in your care are not at risk of harm because of your conduct, performance or health.
  • Comply with your terms of employment, and the policies and protocols of the institution(s) in which you provide holistic end of life and death care.
  • Uphold the reputation of HELD members and HELD Australia.

 

4.   Relationships between members and those in their care

Holistic end of life and death care involves establishing relationships and engaging in practices in situations where people are vulnerable and there is an imbalance of power. Holistic end of life and death care relationships thus have the potential to be damaging or harmful. You must therefore exercise your role with sensitivity, discernment and within ethical boundaries. Special care should be taken when relating to children, the frail elderly and all other vulnerable persons. The only appropriate relationship between you and those in your care is a professional relationship committed to promote the good and best interests of individuals. Moving the focus away from meeting the particular needs of those in your care towards meeting the member’s own needs is unprofessional and an abuse of your role.

Ethical relationships will include the following qualities:

  • Speak and act in ways that honour the dignity of the individual and/or group or family.
  • Demonstrate respect for the cultural and religious values of those you serve and refrain from imposing your own values and beliefs on them.
  • Safeguard the confidentiality of clients in all settings and/or in any documents or publications.

 

4.1   Personal and Professional Boundaries

Professional boundaries enable the effective functioning of caring and supportive relationships in which HELD members can respond to the needs of those in their care. Boundaries frame behaviour and practice so that relationships are consistent and their limitations clear to all parties involved.

In particular:

  • Observe personal and professional boundaries in your practice that sustain the integrity and rights of those in your care.
  • Recognise and work within your personal and professional limits and where necessary refer to another appropriate professional.
  • If you have other qualifications e.g. nursing, you cannot attend a client as both a nurse and an end of life doula/advocate etc at the same time. It is important to avoid confusion of your roles in your presentation to the client or community.
  • Do not behave in ways which exploit, manipulate, intimidate or which may cause distress, pain or harm.
  • Do not impose your values, beliefs or practices on those in your care; or fail to respect their beliefs, values or spiritual interests.
  • Do not display sexualised behaviour towards those in your care.
  • Do not misuse a person’s assets or money while having legitimate access to them.

 

4.2   Maintaining Trust

When engaged in holistic end of life and death care, you must only practice in ways that enable trust and safeguard ethical relations with those in your care.

In particular:

  • Ensure that none of your actions or omissions could be detrimental to the wellbeing of those in your care.
  • Maintain clear professional and personal boundaries in the relationships you establish with those in your care.
  • Respect the decisions about the support and care you provide and facilitate.
  • Respect the autonomy of those in your care, including their freedom to make decisions contrary to your beliefs, practices or advice.
  • Avoid any conflicts of interest. However, in the event that you have to withdraw your involvement on the grounds of conscience, faith or ethical principles, refer the client to a colleague or appropriate professional to enable the continued provision of care.

 

4.3   Respecting Confidentiality

Holistic end of life and death care cannot be provided without access to and the use of personal and confidential information.

You must therefore respect and promote confidences, and in particular you must:

  • Respect the right of individuals to control the disclosure of their own personal information.
  • Establish the boundaries of confidentiality with those in your care and respect as far as possible the limitations of disclosure that an individual can reasonably expect or request.
  • Treat information about those in your care as confidential and use it only for the purposes for which it was given.
  • Guard against breaches of confidentiality at all times by protecting information from improper disclosure.
    • Ensure that confidential information is not disclosed to a third party unless there is a clear justification which may include:
      1. The valid consent of the individual
      2. Where there is a risk of serious harm to self or others
      3. The prevention, detection or prosecution of a serious crime
      4. And when required by law or by order of a court or other public body that has jurisdiction.
  • Discuss with those in your care reasons why disclosing confidential information to other Members or other professionals may be in their best interests and facilitate good care.
  • Only disclose confidential information about those in your care who are not capable of consent (for example because they are unconscious) on the grounds of necessity if it is clearly in the individual’s interest and the disclosure is not contrary to the individual’s known values and beliefs.
  • De-identify personal information to protect the identity of individuals when discussing cases in supervision, professional development and or any educational purpose.

 

4.4   The use of touch and physical contact

Holistic end of life and death care members may use touch informally as a gesture of care and formally within rituals and therapeutic practices. However, because the use of touch can be misunderstood or misinterpreted, or it may be unwanted, it must always be used with sensitivity and permission must always be obtained. The use of ritual or therapeutic practice that involves touch should be clearly explained and permission obtained.

Where an individual does not have the capacity to consent to touch, a member may act on the grounds of necessity if it is:

  • A matter of safety; or
  • Not contrary to the individual’s known values and beliefs; or
  • A case of a person lacking capacity and is not contrary to the wishes of a person with legal responsibility.

Physical contact must cease immediately if there are any signs of discomfort or at the person’s request.

 

5.   Working with colleagues

Holistic end of life and death care involves Members working effectively with other members such as palliative care teams, doctors, nurses, other doulas, allied health members, psychosocial professionals, volunteers, ministers of religion and representatives of faith communities and/or belief groups.

Members should:

  • Respect the skills, contributions and integrity of colleagues.
  • Work in a collaborative and cooperative manner with colleagues and multidisciplinary teams and communicate effectively with them within the limits of confidentiality.
  • On the occasion of a member taking leave and being unable to attend a client, a replacement alternative is to be sourced.
  • Work within professional protocols and boundaries of confidentiality when receiving or initiating referrals and liaising with colleagues.
  • Challenge colleagues who you consider have behaved unethically or in contravention of this Code (and or any other relevant code), and act to bring your concerns to an appropriate authority. E.g. Police, Medical Member, Nurses, AHPRA.

 

6.   Probity in professional practice

Holistic end of life and death care Members require the highest standards of integrity.

In particular:

  • Be honest in representing your professional affiliations, qualifications, and experience, and do not make unjustifiable claims about your competence.
  • Provide transparency about your fees. Have a price list available on request or available via your website/socials.
  • You must not write or sign documents that are false or misleading e.g. contracts
  • Distinguish between holistic end of life and death care and medical or clinical care (including formal counselling) and ensure that those in your care understand the type of support you are offering.
  • Do not encourage those in your care to give, lend or bequeath money or gifts which will be of a direct or indirect benefit to you, or put pressure on those in your care to make donations.
  • Manage any finances for which you are responsible with diligence and for the purpose for which they are intended.
  • Declare any conflicts of interest that may compromise your impartiality or the interests of those in your care.

 

7.   Ethical principles in research

HELD members engaging in research should follow guidelines and applicable laws that seek to protect the dignity, privacy and wellbeing of all participants.

Therefore HELD members should:

  • Engage in research within the boundaries of their competence.
  • Seek approval of the relevant ethics research committees within their institutions and or field of endeavour.
  • Adhere to the notion of informed consent, which includes framing all communication in a manner that is understandable to the participants and or their proxies.
  • Inform all participants of their right to withdraw consent at any time, without consequence to their ongoing care and support.
  • Seek to make all efforts to carry out research in a culturally appropriate manner.
  • Maintain confidentially of the participants (as in 4.3 respecting confidentiality).
  • Use any information obtained through the research for appropriate professional purposes only.

 

8.   Dealing with misconduct

Professional misconduct is conduct that contravenes the professional behaviour required of HELD Members as set out in this Code.

HELD Australia operates a register of members who have committed to meet the standards and who agree to work within the Code of Conduct.

Complaints regarding a member’s behaviour may be lodged with HELD Australia for contravening the standards of professional behaviour set out in this Code.

See the complaints procedure document on the HELD web site https://held.org.au.

HELD Australia will process the complaint appropriately, giving consideration to suitable action that may be taken regarding the status of the member’s registration e.g. be subject to condition/s, suspended for a set period or removed from the register depending upon the level and type of misconduct.

8.1   Disciplining HELD Members

Where a complaint alleging misconduct is received about a HELD member – the HELD board will instigate an investigation.

8.2   The capability of a member

Misconduct should not be confused with issues of competence or capacity – where there is a clear failure by a member to meet an adequate standard of practice through lack of knowledge, ability or consistent poor performance. The current standards of professional practice for a HELD member are defined in the following documents:

  1.  This document
  2.  HELD Australia Standards of Practice (once developed)
  3.  Any other relevant documents published by HELD Australia

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