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Running head: ETHICAL DECISION MAKING

Ethical Decision Making:


An Example Using the Canadian Code of Ethics for Psychologists
Kimberley Kiefuik
University of Calgary

ETHICAL DECISION MAKING

The Canadian Code of Ethics for Psychologists (Sinclair & Pettifor,


2001) was developed to help ensure the ethical behaviour and attitudes of
psychologists. This is done through the presentation of four ethical
principles, value statements, and ethical standards that demonstrate how
these standards, statements, and principles can be applied by psychologists
(Truscott & Crook, 2004). When principles conflict, the Canadian Code of
Ethics for Psychologists includes an Ethical Decision-Making Process (Sinclair
& Pettifor, 2001) which is used to assist psychologists in the resolution of an
ethical issue. The following is an example of how the ten steps of the Ethical
Decision-Making Process included in the Canadian Code of Ethics for
Psychologists may be used, and is applied to vignette I.1.
Step One
This step requires the identification of the individuals and groups
potentially affected by the decision. The primary individuals I see being
affected by the decision I make are the staff at the young offenders center as
this decision could determine their potential safety or physical harm.
Secondly, the adolescent client, and the therapeutic relationship we have
built, will be affected regardless of the decision I make. Moreover, the youth
potentially involved in the attack, other youth in the center, and myself could
all be affected by my decision.
Step Two
The second step in this decision making model asks for the
Identification of the ethically relevant issues and practices, including the

ETHICAL DECISION MAKING

interests, rights, and any relevant characteristics of the individuals and


groups involved and of the system or circumstances in which the ethical
problem arose (Sinclair & Pettifor, 2001). Using the chart that outlines the
Canadian Code of Ethics for Psychologists (The Four Ethical Principles with
their Respective Values and Standards), I identified thirteen ethical values
related to my current ethical problem: six under Respect for the Dignity of
Persons, four under Responsible Caring, two under Integrity to Relationships,
and one under Responsibility to Society. See table 1.
Table 1
The Four Ethical Principles with their Respective Values and Standards
(Personal thoughts added).

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Principles/Values

4
Personal Thoughts

Principle One: Respect for the


Dignity of Persons.
Value: General Rights
I.5 Avoid or refuse to participate in
practices disrespectful of the legal,
civil or moral rights of others.
I.8 Respect the right of research
participants, clients, employees,
supervisees, students, trainees, and
others to safeguard their own
dignity.

It is my moral and legal obligation to


alert the young offender center staff
of this situation.
My client is in a vulnerable position
(incarcerated), and has the right to
privacy.

Value: Non-Discrimination
I.9 Not Practice, condone, facilitate,
or collaborate with any form of
unjust discrimination.

I cannot discriminate against, or


allow the age and status of my client
to influence my decision.

Value: Informed Consent


I.16 Seek as full and active
participation as possible from others
in decisions that affect them,
respecting and integrating as much
as possible their opinions and
wishes.

My client should be made aware of


any decisions that I make that affect
them, and I am obligated to respect
his opinion.

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Principles/Values

5
Personal Thoughts

Value: Confidentiality

I.43 Be careful not to rely


information about colleagues,
colleagues clients, research
participants, employees,
supervisees, students, trainees, and
members of organizations, gained in
the process of their activities as
psychologists, that the psychologist
was the reason to believe is
considered confidential by those
persons, except as required or
justified by law.

I.45 Share confidential information


with others only with the informed
consent of those involved, or in a
manner that they persons involved
cannot be identified except as
required or justified by law, or in
circumstances of actual or possible
serious physical harm or death.

The therapeutic relationship


between my client and myself is
based on trust, therefore this
information was relayed to me in
perceived confidence.

There is possible serious physical


harm or death at stake here.

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Principles/Values

6
Personal Thoughts

Principle Two:Responsible
Caring
Value: General Caring
II.1 Protect and promote the welfare
of clients, research participants,
employees, supervisees, students,
trainees, colleagues, and others.

II.2 Avoid doing harm to clients,


research participants, employees,
supervisees, students, trainees,
colleagues, and others.

By not saying anything I may


increase the trust of my client and
foster the therapeutic relationship
which could increase his personal
welfare. However, the physical
welfare of the staff at the center is
at stake if I do not report this
information.

Value: Risk/Benefit Analysis


II.17 Not carry out any scientific or
professional activity unless the
probable benefit is proportionately
greater than the risk involved.

If I do not report this information I


am not preventing potential harm.

I must weigh out the risk/benefit


analysis on the staff at the center
being physically harmed and the
therapeutic relationship being
harmed.

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Principles/Values

7
Personal Thoughts

Value: Offset/Correct Harm

II.39 Do everything reasonable


possible to stop or offset the
consequences of actions by others
when these actions are likely to
cause serious physical harm or
death. This may include reporting to
appropriate authorities, on intended
victim, or a family member or other
support person who can intervene,
and would be done even when a
confidential relationship is involved.

To offset the consequences of


actions by others I must report this
information.

Principle Three: Integrity in


Relationships
Value:
Straightforwardness/Openness
III.16 Fully explain reasons for their
actions to persons who have been
affected by their actions, if
appropriate and if asked.
III.38 Seek consultation from
colleagues and/or appropriate
groups and committees, and give
due regard to their advise in arriving
at a responsible decision, if faced
with difficult situations.
Principle Four: Responsibility to
Society
Value: Beneficial Activities
IV.10 uphold the disciplines
responsibility to society by
promoting and maintaing the

If I report this information I must


fully explain to the client why I
chose to do this.

Consulting with co-workers and/or


supervisors is a good option in the
decision making process.

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Principles/Values

Personal Thoughts

highest standards of the discipline.

In order to maintain and promote


high standards I must protect others
from harm

Step Three
This step asks the decision maker to consider how personal biases, stresses, or selfinterest might influence the decision made. My initial reaction is torn between concern for my
client and the relationship that I have formed with him, and concern for the safety of the staff at
the young offenders center. My concern for my client is one of the primary reasons why I am in
the field that I am in. I have worked with youth for a number of years, developing safe and
trusting relationships with them. This type of relationship is paramount in a young persons life
and my client, along with many other youth in his position, may have had a tough and unfair
upbringing, without many trusting adults to role model for him. As an adult whom this youth has
recently begun to trust, I do not want to take this trusting relationship away from him.
My concern for the safety of the staff at the young offenders center is fueled not only by
concern for their well-being, but also by my ten years of experience, prior to becoming a
counsellor, working as a front line staff member in a variety of youth residential and non
residential facilities. In particular, I started off my career working with violent and unpredictable
youth in a center where restraints and confinement rooms were often used. In this position I had
my life verbally threatened, and was injured a number of times by angry youth acting

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impulsively. This type of job can be very difficult to return to every day, and I admire and
empathize with these staff members.
Step Four
Based on step two of this decision making process, I can rule out the action of doing
nothing and not warning the staff at the young offenders center. However, when making this
decision I need to be aware that timing is important, and the faster the staff are made aware of
this potential situation, the better chance there is at ensuring their safety. I also need to be aware
that the way I handle this situation will influence the relationship between myself and this youth,
and must proceed with this in mind.
Alternative One
I act quickly by notifying the supervisor of the young offenders center who will then
proceed to notify the staff and take precautions as necessary. I will keep the name of the youth
confidential to ensure the anonymity of my client, therefore protecting him from potential
retaliation from his peers.
Next, I bring the youth in for an appointment where I explain to him my course of action,
and most importantly, why. During this time I will clarify to the youth that it was my moral and
ethical obligation to report this information as this attack on staff could potentially result in
serious injury. Moreover, in an attempt to foster the therapeutic relationship, I will explain that
there are various ways that trust may manifest and while it is very important that he feels
comfortable speaking candidly with me, that his safety, and the safety of other youth in the
center, are a very serious concern for me, and he must trust that I made this decision with this in
mind. Further, I will ensure that this youth understands that he made the right decision to tell me
the plan of attack by his peers as this shows that he understands the possible negative outcomes

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of such an attack and decided to tell an adult that he trusts. I will reassure my client in
understanding that his name has been kept confidential to prevent retaliation from his peers.
Alternative Two
Before notifying a supervisor about this planned attack, I will bring my client in for an
appointment. During this time I explain to him that I am very proud of him for deciding to tell
me about the plan of attack by his peers as this shows that he understands the possible negative
outcomes of such an attack. I will tell him that as a professional I have an ethical and moral
obligation to report this information to the young offenders center supervisor to prevent the
serious injury of staff or youth, and that I will be notifying the centers supervisor. In an attempt
to foster our therapeutic relationship I will explain to him that trust can be manifested in various
ways, and that his safety, as well as the safety of the other youth in the center, are a serious
concern for me. By making the decision to tell the center supervisor I am protecting his safety
and that he must trust that this decision was made with this in mind. Moreover, I will be clear
with this youth that confidentiality is a priority, and his name will remain anonymous when I
report this information to the center supervisor.
I will then act by notifying the supervisor of the young offenders center who will then
proceed to notify the staff and take precautions as necessary. I will keep the name of the youth
confidential to ensure the anonymity of my client, therefore protecting him from potential
retaliation from his peers.
Step Five
Table two
Negative and Positive Outcomes of Both Alternatives

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Possible Positive Consequences

Possible Negative Consequences

Alternative One
-Acting quickly to report the
situation will minimize the
potential physical injury to staff
and clients involved.

-Acting quickly may result in


thoughtless actions and less care
being taken to ensure the
confidentiality of my client.

-My client may see the value in my


quick actions in trying to minimize
the harm to others and the
therapeutic relationship may be
strengthened.
-My actions may be perceived as
being preventative, and I may be
commended for my quick
response.

-My client may be hurt or angry that I


acted without speaking with him first
which may result in a weakened or
broken therapeutic relationship.
-My actions may be perceived as
being rash, reactive, and at breach of
client confidentiality.

Alternative Two
-By taking some time before I
-Waiting to report the situation could
speak to the center supervisor I
result in the attack to happen, and
am able to speak to my client first.
serious physical injury of staff and
clients to take place.
-My client may feel valued that I
spoke with him before acting,
-My client may feel hurt or angry that
fostering his trust in me and
I am reporting this situation which
strengthening the relationship.
may result in a weakened or broken
therapeutic relationship.
-My actions may be seen as
showing respect and protecting
-My actions may be seen as
the dignity of my client by
dismissive to the safety of the staff
speaking with him first.
and other youth in the center.

Step Six
I will proceed with the first alternative because a quicker response may ultimately
prevent the serious physical injury of staff or other youth in the center. In this situation standard
I.45 allows me to share the confidential information obtained in the session with my client

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without his prior consent. During the follow up conversation with my client I will explain
thoroughly why I acted in the manner that I did, and praise him for being honest with me to
convey respect to my client. With both alternatives there is still the possibility that my client will
be hurt and angry with me reporting the potential attack to the center supervisor, however I will
utilize empathy and genuineness to minimize the harm to the client and the therapeutic
relationship.
Step Seven
With the physical safety of the staff and clients as my primary concern, I will carry out
alternative one.

Step Eight
With the physical safety of the staff and youth of the young offenders center no longer in
immediate risk, I will focus on minimizing the harm to my client, adjusting the conversation with
him as needed. Debriefing with the client and having discussions regarding this situation may not
be resolved in one session, and I am prepared to allow the client the time he needs to feel
comfortable with the outcome of the situation. Further, I am aware that the client may feel it
necessary to terminate our sessions if he thinks that the therapeutic relationship has been broken,
and we are not able to repair any damage sustained. In this case my client will be referred to an
alternative psychologist.
Step Nine
I believe that I have accounted for any negative consequences of my course of action. If
any unaccounted negative consequences arise I will deal with them in an ethical manner,
utilizing the ethical decision making process as needed.

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Step Ten

Unfortunately, given the nature of the counselling relationship, there is not a lot that can
be done to prevent future dilemmas of this manner from occurring. It is important that the client
feel safe in the counselling relationship, ensuring them the ability to speak openly. It is also
necessary for the counsellor to report any possible or actual harm to the client or to others. In this
situation the counsellor must ensure that the client understands the confidentiality standards
involved which are to be discussed during the first session under informed consent to services.

References
Sinclair, C., & Pettifor, J. (Eds.). (2001). Companion manual to the Canadian
code of ethics for

psychologists (3rd ed.). Ottawa: Canadian

Psychological Association.
Truscott, D., & Cook., K.H. (2004). Ethics for the practice or psychology in
Canada. Edmonton,

AB: University of Alberta Press.