Trying to manage and respond to ethical dilemmas can, initially, seem overwhelming and can cause anxiety!
Ethical dilemmas can arise in any/many situations such as:
• Social, online, mobile media & communication
• How to manage a ‘cause for concern’
• When to disclose or not disclose
• Issues relating to confidentiality
• Issues relating to professional boundaries
• Issues that may challenge our own moral standing
To help work through ethical dilemmas, it is important to consider the ethical framework you work with. The moral principles of National Counselling Society’s (NCS) Code of Ethics are:
1) Working towards the good of clients and doing no harm – (Beneficence and Non-maleficence)
Practitioners hold the welfare of clients central to their work and so commit to avoiding harm.
2) Being trustworthy and responsible – (Fidelity)
Practitioners endeavour to establish trust with their clients and the community in which they work. Therefore, practitioners not only honour the trust placed in them by their clients and the community but also act in a respectful, professional and ethical manner when representing their profession.
3) Respect for the dignity and rights of the client – (Autonomy)
Clients have the right to self-determination and to be shown dignity and respect for making their own lawful decisions.
Practitioners are aware of their own judgements based on their own experiences and need to take precautions (supervision) to provide a service that is not restricted by their own prejudice and limitations of experience. This also means showing respect for diversity of persons, without prejudice to colour, race, belief, gender, sexuality, social context, and mental and physical abilities.
5) Integrity and self-responsibility
Practitioners work to be as honest, truthful and accurate as possible. They are also responsible for looking after their own needs and health. So, a practitioner will only commit to a practice that they can offer being aware of own expertise, training, health and wellbeing and let the client know if anything changes.
These principles cannot (and do not) always exist side by side. E.g. being trustworthy (fidelity) and offering confidentiality may conflict with duty to keep a client safe from harm (non-maleficence).
It is important to consider how to manage a situation when these principles compete with one another.
Working ethically does not also mean sticking rigidly to the rules and regulations of a professional organisation but it does mean working with a Code of Ethics that supports us and enables us to be professional, considered and responsible for the way we work whilst always consider the moral principles that guide our role as a Therapist.
So, what do we do when faced with an ethical dilemma?
When faced with an ethical dilemma, it can be helpful to use a practical, systematic model to help guide the decision-making process.
Using a ‘Stepped Approach’ model for ethical decision making can help to work through any potential issues/problems in an organised way (which hopefully can start to reduce any anxiety initially triggered by the presenting dilemma!?)
An example of the practical steps that can be followed is:
1) Identify ethical problem, situation or issue
2) Look at your options and evaluate
3) Refer to the NCS Code of Ethics – note what values may be/are in conflict?
4) Consult with your supervisor – assessing possible consequences of all viable options
5) Re-evaluate, re-assess options, choose an option that has least damaging consequences and best outcome and plan the implementation
6) Implement decision and record the process (Including dates and supervisor recommendations)
7) Review and reflect on outcome of the decision (include review notes in process records)
Where necessary, and before making any decisions, it may also be advisable to check legal requirements/constraints (e.g. when working with children, young people and/or vulnerable adults)
Once implemented, more information may emerge, perhaps in an unexpected form. All information can offer further insight and will help you manage ethical decisions in the future. This experience will be valuable and will need reflecting on in supervision.
It is important to note that dealing with ethical dilemmas may not be as linear as the above staged model suggests. There may be lots of ‘going back and forth’ through the initial stages before a decision can be made - so bear this in mind when embarking on this process. The staged approach is merely a guide to help you ensure you’re considering important key aspects of the decision-making process.
Further information about Working Ethically can be found in the following online workshop:
This short online course is free of charge to all NCS members until the 31st May 2018 (£15 thereafter) and will give you 4 hours of CPD.
Please check the members area of the website under ‘Benefits’ for further details:
The cost to non-members is £15.
This course is well worth doing even if it just refreshes the extensive knowledge you may already have on this topic.
References & Further reading:
• National Counselling Society (NCS) Code of Ethics - Code of Ethics
• GDPR - https://www.nationalcounsellingsociety.org/blog/general-data-protection-regulation-gdpr-and-data-protection/.
• Bond T (2015) Standards and Ethics for Counselling in Action 4th Edition London Sage
• Carroll M. & Shaw E. (2013) Ethical Maturity in the Helping Professions – Psychoz Publications
• Kitchener, K. S. (1984). Intuition, critical evaluation and ethical principles: The foundation for ethical decisions in counselling psychology. Counselling Psychologist, 12(3), 43-55.
• Kitchener K. S. and Anderson S.K. (2011) Foundations of Ethical Practice, Research, and Teaching in Psychology and Counselling 2nd Ed Routledge Hove
• West W (2002) Some Ethical Dilemmas in Counselling and Counselling research. British Journal of Guidance and Counselling 30(3): 261-268