title: Applied ethics in mental health in Cuba: part II--power differentials, dilemmas, resources, and limitations.
abstract: This article is the second one in a series dealing with mental health ethics in Cuba. It reports on ethical dilemmas, resources and limitations to their resolution, and recommendations for action. The data, obtained through individual interviews and focus groups with 28 professionals, indicate that Cubans experience dilemmas related to (a) the interests of clients, (b) their personal interests, and (c) the interests of the state. These conflicts are related to power differentials among (a) clients and professionals, (b) professionals from different disciplines, and (c) professionals and organizational authorities. Resources to solve ethical dilemmas include government support, ethics committees, and collegial dialogue. Limitations include minimal training in ethics, lack of safe space to discuss professional disagreements, and little tolerance for criticism. Recommendations to address ethical dilemmas include better training, implementation of a code of ethics, and provision of safe space to discuss ethical dilemmas. The findings are discussed in light of the role of power in applied ethics.
authors.affiliation: Department of Psychology, Victoria University, P.O. Box 14428, Melbourne, MC 8001, Australia.
authors.forename: Isaac
authors.initials: I
authors.lastname: Prilleltensky
authors.forename: Laura Sanchez
authors.initials: LS
authors.lastname: Valdes
authors.forename: Amy
authors.initials: A
authors.lastname: Rossiter
authors.forename: Richard
authors.initials: R
authors.lastname: Walsh-Bowers
mesh_terms: D032781:Codes of Ethics; D003220:Conflict, Psychological; D003462:Cuba; D004651:Employment; D004995:Ethics, Professional; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D008605:Mental Health Services / Q000941:ethics*; D028681:Moral Obligations; D028743:Professional Misconduct; D011369:Professional-Patient Relations; D011584:Psychology