Ethics are based on philosophical principles and these guidelines assist a practitioner in making the best possible decisions for the welfare of the clients and the practitioner himself. Ethics are normative or critical in nature and concern human conduct and moral decision. Morality describes decision making and judgement by an individual concerning an incident or human behaviour. This is greatly influenced by the values he or she has acquired or formed as a result of external influence or indoctrination. Value is an enduring belief that a specific that a specific end-state of conduct is desirable (McLeod, 1998). Terminal and instrumental values are two types of values where the former refer to the desired end-state of existence, for example wisdom and the later refer to the mode of conduct that leads to it, for example broad-mindedness .Values then influence and determine the decisions we choose to make in our daily lives.
In providing an effective, therapeutic therapy, a practitioner helping a client encountering dilemma in decision- making may adopt the eight – step model approach to think through the ethical problems (Corey, Corey & Callanan, 2007). The steps of the model are described as follows:
Step 1- Identify the problem or dilemma.
In the first step the existence of the problem must be recognised. The nature of the problem has to be ascertained. Identify if it is an ethical, legal, moral, professional or clinical problem. The practitioner’s and the client’s insights regarding the problem must be examined. Consultation with the client can begin at this stage as problems are being identified. Looking at the problem from different perspectives is useful as most ethical dilemmas are complex.
Step 2 – Identify the potential issues involved.
From the collected information, irrelevant ones must be discarded. The critical issues must be noted and described. The welfare of those involved; their rights and responsibilities must be evaluated. Ethical principles relevant to the problem must be identified and examined with the client. In doing so the moral principles namely, autonomy, non-maleficence, beneficence, justice and fidelity must be considered and applied to the situation. The safety and welfare of the client and practitioner cannot be compromised while potential issues are being sorted out.
Step 3- Review the relevant ethics codes.
The practitioner must seek guidance that can be found from the professional codes of ethics. They provide a basis for accountability, and through their enforcement, provide protection for clients from unethical practices (Corey, 1997). Practitioner must also examine the agreeability of his values with the relevant codes. Should they be in conflict, he must have a rationale to support his stance. It is essential to consider congruency of these values and ethics with those of the client’s. The practitioner must ensure clarity of the ethical codes and if they are applicable with the state laws of the region.
Step 4- Know the applicable laws and regulations.
The practitioner should be up to date with the specific and relevant laws that apply to the ethical issue. This is particularly critical in situations which deal with keeping or breaching of confidentiality, reporting of child or elder abuse, record keeping, assessment, diagnosis, issues pertaining to dangers to self or others and the grounds of malpractice.
Step 5- Obtain consultation.
Consulting with colleagues to obtain different perspectives on the problems is generally considered to be helpful. Seeking legal counsel for legal questions is prudent along with consulting a person with an expertise in an unfamiliar culture to serve a client from that culture. In addition the practitioner must understand current rules and regulations of the agency or organization that he or she is working for. It is wise for the nature of the consultation and suggestions provided to be documented. These records would illustrate the practitioner’s attempt to adhere to the community’s standard practice.
Step 6- Consider possible and probable courses of action.
At this point a list of a variety of courses of action may be identified through brainstorming. The practitioner could discuss with the client as well as other professionals the available options. The possibilities could be identified for probable courses of actions and these should be documented.
Step 7- Enumerate the consequences of various decisions.
From the various possible courses of actions, implications of each course must be examined. The questions of who will be affected and to what extent will the client’s decision to pursue the actions affect them must be carefully examined. Again using the fundamental moral principles as a framework, the client must collaborate with the practitioner to ascertain the probable outcomes and consequences. If new ethical issues arise from the selected course of action, a re-evaluation of the action must be pursued.
Step 8- Decide on what appears to be the best course of action.
Careful consideration of all information received from different sources deliberately and with sensitivity to cross cultural issues is critical before making the best decision. Once making the decision, informing the supervisor, implementing and documenting the decision follows. Reflecting on the experience considering any follow up action could result in finding a solution for the client.
While the procedural steps may help in resolving ethical matters, some implications may be noted. Firstly, the client enters a collaborative relationship with the practitioner. The implication is that the client with the practitioner’s help must draw out the details of the problem. This implicates that the client should refrain from coveting relevant information to enable an accurate analysis of the issue. This is to ascertain the true nature of the problem whether it is an ethical, legal, moral, professional, or clinical one. The different perspectives of the problem must be explored. What are the insights the client and practitioner have regarding the problem? (Corey et al., 2007). Failing which the consequence is an unnecessary delay in resolving the problem as there will be an inaccurate analysis of the situation.
Secondly, in identifying the potential issues, all the persons involved in the problem must be identified. The implication of failing to identify any one individual who may be affected by the decision of the client would be unethical. The welfare, rights and responsibilities of those affected by the decision might create a different set of problems. The decision would then have to be reversed and a new course of action would have to be pursued. It is to therefore necessary to explore to what extent the course of the action will affect the client and the others (Corey et al., 2007).
Next the values and ethics of the client and the practitioner must be evaluated and the degree of congruency noted. This implicates that the relevant ethical principles that are identified to the problem should not be in conflict with those of the client and the practitioner. If there are disagreements, then they must be supported with a rationale. If necessary, guidance must be sought from the relevant organization to clarify the professional codes to the particular problem. Otherwise consequently, the client’s decision may violate the ethical codes relevant to the issue.
The client must be informed of the relevant and most recent laws or regulations that apply to the situation. He must look out for any law or regulations that have a bearing on the situation. The implication of his ignorance is that he may run into problems with the law. The practitioner too must abide by the rules, regulations and policies of the workplace. When in doubt practitioner must seek professional advice. The client must be informed of legal issues related to confidentiality, abuse of the vulnerable, record keeping and grounds for malpractice. If the practitioner discovers a criminal act by a client for example, sex with an under-aged girl he has the moral responsibility to report him. The practitioner has the ethical responsibility to discuss with the client on the implications of his actions before reporting the incident. The client must understand the implications of his actions that violate the law.
The fundamental moral principles may be considered as framework for evaluating the consequences of the given course of action. The client must decide the principles that apply to the situation specifically and prioritise them. By thinking through these ethical principles, professional can better evaluate their options in such complex situations. Prioritising the principles can help the client and practitioner to work through the steps of the decision-making model (Elizabeth, 2010). There are implications however when prioritizing one over another. The practitioner encourages the client to exercise autonomy i.e. making a free choice. In doing so, the client must have the concept of doing no harm or non-maleficence and acting in justice (Elizabeth, 2010). Conflict can arise when subscribing to justice which may result in the necessity of treating an individual differently. Though not easy to apply equal weightage to all the principles, it will help to explore an ethical dilemma and resolve it with the least damage to the welfare of those affected.
The model may be useful when clients seek help in making decisions in their life regarding relationship issues. A client may be caught in a loveless marriage and be involved in an extra-marital affair and seek advice to take the next step in his life. The dilemma of whether to dissolve his marriage and move on with his life or stay in the marriage to fulfil his duties towards his wife and children is one that needs careful consideration. A divorce would mean breaking up of his family and causing a disruption in the relationship with his children. Staying in the marriage would mean the sacrifice of his love life. Analysing his situation using the model can shed light to clarify the implications of his actions and weigh the consequences.
The model may help clients to make decisions at their place of work regarding conflicting work practices. An office worker may be tormented by the wrong practices of her fellow colleagues. She may be facing a dilemma as to whether to report her colleagues to the management or turn a blind eye to the situation. The model can help the client to analyse the situation and evaluate her moral values. She would then be able to make an ethical decision that would do least harm to those involved in the situation.
In conclusion, the eight – step model can be a useful tool in helping a practitioner to guide clients to make sound decisions that do not have conflict with their ethics and are aligned with the laws and regulations of the region. In doing so the practitioner must ensure that he or she is operating in the best interest of the clients.
Courtney from Study Moose
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