A Framework for Ethical A Framework for Ethical Decision MakingDecision Making

Presented byPresented by

• Nyla McCarthy, President• Catalysts for Change Consulting• 1460 Evergreen Ave NE• Salem, Or 97301• Email: nyla@teleport.com• Website: www.nylamccarthy.net

Materials copyrighted. Please contact me for usage.

The Framework The Framework OverviewOverview

• Step One: Describe the problem• Step Two: Determine whether there

is an ethical issue or an ethical dilemma

• Step Three: Identify and rank the key values and principles

• Step Four: Gather your information

The Framework, The Framework, continuedcontinued

• Step Five: Review any applicable Code of Ethics

• Step Six: Determine the options• Step Seven: Select a course of

action

The Framework, The Framework, continuedcontinued

• Step Eight: Put your plan into action.• Step Nine: Evaluate the results

Don’t forget!Step Ten: Submit cases to your ethical

review team or board regularly for review

Step One: Describe the Step One: Describe the ProblemProblem

• Ethical problems are always embedded in a context.

• Circumstances impact upon the problem definition (for whom does the problem exist? What is the setting?)

• Beware of the tendency to look toward the clinical or purely legal perspective for guidance.

Step Two: Determine Step Two: Determine Whether There Is an Whether There Is an Ethical DilemmaEthical Dilemma

• “Dilemma”– greek origindi- twolimos-horns,

“Two horned”

Step Two: Determine Step Two: Determine Whether There Is an Whether There Is an Ethical DilemmaEthical Dilemma

• X versus Y• ____ versus ____• “good” versus “bad” options• “good” versus “good” options• “bad” versus “bad” options

Step Two: Determine Step Two: Determine Whether There Is an Whether There Is an Ethical DilemmaEthical Dilemma

• Dilemma becomes ethical when the good or bad options seem to have a moral component

(eg. confidentiality vs. prevention of harm, self determination vs. worker’s perception of client’s best interests, freedom vs. safety)

Step Two: Determine Step Two: Determine Whether There Is an Whether There Is an Ethical DilemmaEthical Dilemma

• Terms of an ethical dilemma must be ethical in nature, not legal.

• If something is a law, you then have the ethical choice to follow the law or not.

Step Two: Determine Step Two: Determine Whether There Is an Whether There Is an Ethical DilemmaEthical Dilemma

• If you find it easy to articulate the perceived best interest as being on one side, you might ask, “who determines what is in the best interest?” You? Courts? Client? Family?

• Remember, most individuals will probably perceive their own preferences as being in their own best interest.

Step Three: Identify Step Three: Identify and Rank the Key and Rank the Key Values and PrinciplesValues and Principles

• What reasons can you provide for prioritizing one competing value over another?

• Understand that a resolution to a dilemma which goes against an individual’s personal set of values has very little chance of success.

Step Four: Gather Your Step Four: Gather Your InformationInformation

• Do you have all the known facts?• Do you understand the applicable laws or

legalities?• Do you have all relevant policies

available to review?• Are you clear about the individual’s views

and personal values?* Don’t hesitate to seek out consultation.

Step Five: Review Any Step Five: Review Any Applicable Code of Applicable Code of EthicsEthics

• Not legal documents, but professionals are bound to tenets and can be sued for breach

• Look for the following:-- mission statement-- values base of the organization-- ethical principles to guide practice-- ethical standards

• Codes can be revised or updated as needed

Step Five: Model CodeStep Five: Model Code

• The Napsa Code of Ethics is an excellent model. Let’s take a look…..

Step Six: Determine Step Six: Determine the Optionsthe Options

• List all possible actionable options• Weigh the cost/benefits of each

option• Seek out additional points of view

Step Seven: Select a Step Seven: Select a Course of ActionCourse of Action

1) Discard the least desirable option.2) Discard any which you can not put

into action.3) Discard any options which violate

the values systems of those affected.4) Recognize that your final choice will

be impacted by your personal values.

Step Eight: Put Your Step Eight: Put Your Plan Into ActionPlan Into Action

• Reflect on the outcomes with a sense that you have truly approached this ethical dilemma with the best of intentions and to the best of your ability.

Step Nine: EvaluateStep Nine: Evaluate

• Evaluate the consequences for each person involved (client, family members, co-workers, agency, etc.)

• Consider submitting your most difficult cases to an ethics review board or peer consultants for feedback.

Step TenStep Ten

• Discuss the case with your ethical review committee or board

• Don’t have one? Create one.• Need help? Give me a call and we

can design one which will work for you

ActivityActivity

• Small group case study review• Debrief

Case Study Small Case Study Small GroupsGroups

• Select a recorder/reporter• Read the case together• Follow the framework steps as possible• Discuss and define the primary ethical

dilemma within each case• Discuss the steps as a group• Come up with a plan of action• Present findings and discuss process

The Bird in the HandThe Bird in the Hand

• A new take on an old fable…

Thank you!Thank you!