Counselling Ethics

Categories: Moral

On 1st March 2010, Dr Susan Lim sent a letter to Mr George Yeo, then Minister for Foreign Affairs. In the letter, Dr Susan mentioned that her disciplinary proceedings will bring light to certain information which will bring embarrassment to her late patient, Pengiran Anak Hajah Damit Pg Pemancha Pg Anak Mohd Alam (“Dr Susan Lim handed 3-year suspension,” 2012) and her immediate family. She hopes that with the letter sent, the disciplinary proceedings will not be pursued further.

Dr Susan faced allegations and disciplinary proceedings with regards to overcharging a patient.

Dr Susan wrote a letter to George Yeo which are threatening in nature stating that sensitive information would be divulged by her if disciplinary proceedings were to continue. Her letter further threaten that the proceedings will bring embarrass the Brunei family as well as potentially upsetting Singapore’s bilateral ties with Brunei. Dr Susan also threaten to pursue civil action against the Brunei Government if her settlement amount does not cover the fees and disbursements which are still outstanding (“Dr Susan Lim’s threatening letter to Foreign Minister George Yeo”, 2011).

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Dr Susan additionally added that “some of the facts that may cast a negative light on Brunei”. Such information will include the medical condition of her patient and the varying relationship between the Ministry of Health, the Royal Family and the patient’s family. Dr Susan also mentioned that the Royal family had been unreasonable and outlandish with their demands on Dr Susan. An example was that she had to bear out-of-pocket expenses together with the cost of a private air-charter to transport her patient.

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The Ministry of Foreign Affairs later replied that they had taken note of Dr Susan’s letter and they are not in a situation to mediate in the ongoing legal process (Torrijos,2011). The billing included the specialized upkeep and any additional expenditures such as transferring her to Brunei. According to (Salma Khalik, 2015), there was two hearings before Justice Woo Bih Li. The first hearing was about the fee for the legal assessor in the Singapore Medical Council’s (SMC). The second hearing was about the appeal to the Law Society to set up an investigation team to hear rights of professional wrongdoing against SMC’s counsel for overpricing in its bill. Dr Susan’s husband Mr Sharma was looking for consent from Justice Woo to appeal against two of his previous judgements in presenting the SMC higher cost.

Deontology is an ethical theory that employ guidelines to differentiate between right from wrong. Philosopher Immanuel Kant is often related with the application of Deontology. This theory involves people to follow the guidelines and do their part in responsibility. The approach of Deontology will generally fit well with our characteristic instinct on what is or moral or not. Deontology does not require gauging the expenses and advantages of a particular circumstance. Additionally, it avoids partiality and doubt as one can only follow a certain set of rules. Many people may find the outcomes unacceptable. Deontology recommends not to disrupt the rule. It makes it easier to use deontology by following the rules given. But it also means that there is a possibility to forget the consequences of our actions when defining what Is right or wrong. In deontological ethics an act is morally decent because of some characteristic of the act itself, not because the invention of the act is moral. Deontological ethics focuses on the point that some acts are morally mandatory unrelatedly of their values for human well-being. With reference to Kant, morality is not the doctrine of how we may make ourselves happy, but rather how we may make ourselves worthy of happiness. According to Kant, the only thing unqualifiedly good is a good will (Kant 1785). The limitation that deontology theory has is the illogicality of us having responsibilities or consents to make the world ethically is the worse. Deontologists need their own, non-consequentialist model of rationality, which is practically different to the naturally reasonable, “act-to-produce-the-best-consequences” model of rationality that encourages consequentialist theories. It will be inconsistent till this is done.

With reference to Dr Susan’s case the moral theory of deontology is applicable because Dr Susan has a moral and ethical dilemma with potential ramifications. Dr Susan’s allegations and disciplinary hearings will bring to light several compromising infomation thus the moral theory of deontology can be applied. As mentioned by Dr Susan, the refusal of her wanting to divulge infomation on her patient despite the disciplinary hearing fits in with her character and moral fabric. As part of the need to follow guidelines and do their part as supported by deontlogy, Dr Susan would still need to divulge the infomation during the proceedings.

The theory Normative ethical relativism guarantees that there are no all-around valid good standards. This theory says that the moral appropriateness and unfairness of actions differs from culture to culture and that there are always no total worldwide moral standards binding on all human. This theory supports that all rational about the straightforward values of morality (Ethics) is constantly relative. Each culture begins the basic values and principles that help as the groundwork for morality. The theory supports that this is the circumstance now, has always been the case and will always be the case. Moreover, the theory expresses that assorted cultures have distinctive points of view and that it is inconceivable for there ever to be a private arrangement of moral standards for the entire world in light of the fact that there are no general rules that could apply to all society of the earth. The theory supports that all such reasoning about moral standards is only an impression of the power holders of a specific culture, therefore an individual’s culture does and constantly follow its ethical principles. The thought of imposing ones culture and principles to others of differing cultures can be said to be a political move and an assertion of power. In most cases, going with what you call morality will keep you safely within the range of cultural acceptance for your specific time and place. But that’s all that it really reflects the cultural understandings that formed it (D Thane).

The limitation of normative relativism compared to ethical relativism is that normative views that moral norms depend on social organizations on their being and nature because there is no precise and balanced morality or set of values for all cultures. Metaethical relativists may argue that the meaning of moral standings such as ‘good’ and ‘right’ have a meaning only within an assumed cultural agenda. Ethical relativism is often a consequence of epistemological relativism and postmodern skepticism that there can be no impartial or universal information in any human attempt including ethics.

With the understanding that ethical dilemmas may not necessarily be promptly settled using codes of ethics, there is a useful framework to break down and settle on ethical choices. Corey et al. (1998) founded the ethical decision-making model which is a cooperative between the client and counsellor. The steps in the framework may not always be following the actual sequence in the development. With reference to the 8 steps in making ethical decisions. Each individual step will be broken down in relation to how it may be applied to Dr Susan’s moral dilemma.

Step 1 is to identify the problem or dilemma a client may face. Using Step 1, I will firstly ask Dr Susan on whether the problem or dilemma she is currently facing actually exist. Secondly, I proceed in knowing whether the problem is an ethical, legal, moral, professional or clinical in nature. From the previous line of questioning, I will probe further if the problem is a combination. I will proceed with asking Dr Susan how she can know and confirm the root cause of the problem. Using Step 1, as a counsellor, I would have to identify whether I would consult at an early stage and how I may begin the process of consultation with Dr Susan on the nature of the problem.

Step 2 is to identify the potential issues involved. Using step 2, I will firstly help Dr Susan to assess the rights, responsibilities and well-being of all those involved and will be affected by her choice of action. Considering my own welfare as a consultant, I will find ways to encourage Dr Susan to find her individuality and harness self-willpower. In addition, I will consider the actions which has minimal chances of bringing harm to Dr Susan and furthermore protect her welfare. This steps when implemented will help Dr Susan build a trusting and collaborative climate for her to find own solution. Lastly this will encourage Dr Susan in her own self to recognize and define the possible ethical matters which may arise. In step 2 I will use 2 out of the 6 moral principles such as justice and beneficence, as for justice I will have to be fair by giving equal fairness to everyone who are involved in the case. And for beneficence It is my responsibility to do good, to the best of Dr Susan’s ability and to help society in general.

Step 3 is to review the relevant ethical guidelines. The guidelines can be looked from Dr Susan’s professional codes. In addition, I will check if the morals in agreement with the specific ethical code in question. Furthermore the relevancy the professional codes on the specific area that Dr Susan has a dilemma in. Moreover, a check will be conducted on whether the codes are liable and valid legally.

Step 4 is to know relevant laws and regulations. Firstly, know if there are any laws and regulation that have a behavior on the condition beneath consideration. Next is to see what are the specific and pertinent state and federal laws that apply to the ethical dilemma. Consider what are the rubrics, regulations and policies of the agency or organization where Dr Susan work. Following the Fees Act (chapter 106) in Dr Susan’s case I should consider the facts whether she has charged her patient with the right amount of fees and whether it is justifiable.

Step 5 is to obtain consultation. As for obtaining consultation in Dr Susan’s case it should be done with professionals who are well known of ethical issues and to know what they would expect from this consultation. What are the types of questions that can be asked from who I consult. Furthermore, I can find out ways that I can test to justify of a course action that I am inclined to take. I should also choose wisely when I should make use of the consultation process and whether it can be told to Dr Susan. Lastly, I should consider if there are any possible ways that I can include Dr Susan in the consultation process.

Step 6 is to consider possibilities and probable courses of action. I could help Dr Susan to find out the numerous ways that we can brainstorm as many probable progressions of action. As a counseller I will need to have an orderly method for examining ethical obligations and likely courses of action. Considering if I should involve Dr Susan in the discussion of the several courses of action.

Step 7 is to list the consequences of the probable courses of action. In Dr Susan’s case I should find out how I can best assess the possible consequences of respective course of action. I should also consider if I want to involve Dr Susan in the discussion of the implications of each course of action for the client. Lastly examine the consequences of different decisions for Dr Susan, as a counselor, and for the occupation over-all.

Step 8 is to decide on what appears to be the best course of action. After cautiously taking into consideration of all the information gathered know what seems to be the best action to take. Decide if I solicit the involvement of Dr Susan in making this decision at that stage. Once I express a plan of action, I can ask for comments from a colleague or supervisor. Once the course of actions has been done, what are some ways that you might evaluate the course of action. Lastly in Dr Susan’s case if I am willing to follow up to determine the consequences and see if additional actions are essential.


  • Dr Susan Lim’s threatening letter to Foreign Minister George Yeo. (n.d.). Retrieved from Susan Lim handed 3-year suspension. (2012, August 24). Retrieved from E. (2011, March 29).
  • Top surgeon ‘threatened’ MFA: Counsel. Retrieved from S. (2016, January 19).
  • Susan Lim case back to the courts again next week. Retrieved from Kant Quotes. (n.d.). Retrieved from (n.d.). Retrieved from
  • Ethical Decision-Making Model. (n.d.). Retrieved from Doda Follow. (2015, June 26).
  • Ethical decision making (corey et al). Retrieved from P. A. (n.d.).
  • Normative Ethical Relativism. Retrieved December 2, 2018, from 8 Ethics/Normative_Ethical_Relativism.htmJ. G. (2015).
  • Limits of Moral Relativism. Retrieved December 2, 2018, from within Legislation. (n.d.). Retrieved from

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Counselling Ethics. (2019, Nov 27). Retrieved from

Counselling Ethics

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