Ethical Decision-

making Model
Resolving Ethical Dilemmas
 • The following are general ethical
principles that social work
professionals recognize:
• Autonomy: The duty to maximize
the individual's rights to make
his/her own decisions
Ethical • Beneficence: The duty to do good
• Confidentiality: The duty to respect
Principles privacy and trust and to protect
information
• Fidelity: The duty to keep one's
promise or word
• Gratitude: The duty to make up for
(or repay) a good
 Justice: The duty to treat all fairly, distributing risks
and benefits equitably

Non-maleficence: The duty to cause no harm

Ethical Ordering: The duty to rank the ethical principles that one
follows in order of priority and to follow that ranking in

Principles resolving ethical issues

Publicity: The duty to take actions based on ethical
standards that must be known and recognized by all who
are involved
Reparation: The duty to make up for a wrong
 Respect for persons: The duty to
honour others, their rights, and their
responsibilities

Universality: The duty to take actions

that hold for everyone, regardless of
Ethical time, place, or people involved

Principles Utility: The duty to provide the

greatest good or least harm for the
greatest number of people

Veracity: The duty to tell the truth

 Occur when there is a conflict between two or more
ethical principles.

The most beneficial decision depends on the

Ethical circumstances.

Dilemmas
“What makes ethical dilemmas particularly difficult is
that they often involve conflicts between two or more
deeply held beliefs.” (…http://biggsuccess.com/bigg-
articles/3-steps-to-solve-an-ethical-dilemma/)

9-5
Ethical Dilemma Video
 • There are at least four benefits to
putting a framework in place for
making ethical decisions:
The benefits – Efficiency – decisions can be made more
quickly
of an – Consistency – results in more systematic
established outputs
– Payback – builds emotional goodwill with
framework your constituents
– Self-respect – you feel good about
yourself when you look in the mirror
 – Informed Consent
Frequently – Refusal of Treatment
Occurring – Use of Scarce Resources
Ethical – Cost-Containment Initiatives that
Negatively Affect Client Well-Being
Dilemmas – Incompetent Health Care Providers
Approaches to Resolving Ethical Dilemmas

Two major approaches The first school of

The second claims that
that philosophers use thought basically
some actions are
in handling ethical argues "no harm, no
simply wrong.
dilemmas. foul“.

One approach focuses

the other
on the practical
concentrates on the
consequences of what
actions themselves.
we do;
 Approaches to Resolving Ethical
Dilemmas

It is assumed that if there

are any laws involved, you But, the laws generally
plan to obey them. establish at least a bare
Although, it’s not always minimum for how you
morally wrong to break should act.
laws.
 1. Analyze the consequences:
who will be affected by
your action (negative and
3 – Step positive effects) both in
long run and short run?
Process of 2. Analyze the actions:
Resolving consider all options from a
different perspective,
Ethical which option offers actions
that are least problematic?
Dilemmas 3. Make a decision
 • Ethical dilemmas may
involve social worker’s:
– delivery of services to
Social individuals, families, couples,
Work and and small groups.
– disclosure of confidential
Ethical information without a client’s
Dilemmas consent (for example, when
a client threatens to harm
himself, herself, or someone
else);
 – limiting a client’s right to self-
determination against his or
her wishes (for example,
Social when a social worker pursues
Work and involuntary psychiatric
hospitalization of a troubled
Ethical client);
Dilemmas – social contact with a former
client.
 • Other ethical dilemmas
pertain to
– agency administration,
Social – community work,
Work and – social policy, and
– research.
Ethical
(Frederic G. Reamer,
Dilemmas 2002)

Examples include:
• administrators’ decisions about the
allocation of scarce or limited agency
resources,
• conflicts of interest among staff, and
• the use of ethically questionable
marketing strategies to solicit clients.
Social Work and Ethical Dilemmas
Still other ethical dilemmas involve
relationships among professional
colleagues.
• E.g., a social worker’s response to a
colleague who has behaved
unethically or who is impaired or
incompetent (the ethics of “whistle-
blowing”).
(Frederic G. Reamer, 2002)
Steps to Help Making Ethical Decision - 14 Guiding Steps
 • Three conditions must be present for a situation to be
considered an ethical dilemma.
1. The first condition occurs in situations when an
individual, called the “agent,” must make a decision
about which course of action is best. Situations that
Ethical are uncomfortable but that don’t require a choice,
are not ethical dilemmas. E.g., students in their
Dilemmas internships are required to be under the supervision
of an appropriately credentialed social work field
instructor. Therefore, because there is no choice in
the matter, there is no ethical violation or breach of
confidentiality when a student discusses a case with
the supervisor.
 2. There must be different courses of
action to choose from.
3. Third, no matter what course of
action is taken, some ethical
Ethical principle is compromised. In other
Dilemmas words, there is no perfect solution.
(http://www.socialworker.com/feature-
articles/ethics)
 • Allen (n.d.) further states that in
determining what constitutes an ethical
dilemma, it is necessary to make a
distinction between ethics, values, morals,
and laws and policies.
Approaches – Ethics are prepositional statements
to Resolving (standards) that are used by members
of a profession or group to determine
Ethical what the right course of action in a
situation is.
Dilemmas – Ethics rely on logical and rational
criteria to reach a decision, an
essentially cognitive process
(Congress, 1999; Dolgoff, Loewenberg,
& Harrington, 2009; Reamer, 1995;
Robison & Reeser, 2002).
 – Values, on the other hand,
describe ideas that we value or
prize. To value something means
that we hold it dear and feel it has
worth to us. Often, values are
Approaches ideas that we aspire to achieve,
to Resolving like equality and social justice.
– Morals describe a behavioural
Ethical code of conduct to which an
Dilemmas individual ascribes. They are used
to negotiate, support, and
strengthen our relationships with
others (Dolgoff, Loewenberg, &
Harrington, 2009).
 • Finally, laws and agency
policies are often involved in
complex cases, and social
workers are often legally
Approaches obligated to take a particular
course of action.
to Resolving • Legal obligations may require
Ethical social workers to share
Dilemmas confidential information (such
as in cases of reporting child
abuse) but requires that we
protect confidentiality to the
“extent permitted by law.”
 • Conflicts between personal and professional values
should not be considered ethical dilemmas for a
number of reasons.
Approaches – Because values involve feelings and are personal,
to Resolving the rational process used for resolving ethical
dilemmas cannot be applied to values conflicts.
Ethical – Further, when an individual elects to become a
Dilemmas member of a profession, he or she is agreeing to
comply with the standards of the profession,
including its Code of Ethics and values.
 1.  An “absolute” or “pure” ethical dilemma only occurs
when two (or more) ethical standards apply to a
situation but are in conflict with each other. For
example, a social worker in a rural community with
Two limited mental health care services is consulted on a
client with agoraphobia, an anxiety disorder involving
Types of a fear of open and public spaces. Although this
problem is outside of the clinician’s general
Dilemmas competence, the limited options for treatment,
coupled with the client’s discomfort in being too far
from home, would likely mean the client might not
receive any services if the clinician declined on the
basis of a lack of competence (Ethical Standard 1.04).
 Denying to see the patient then would be
potentially in conflict with our commitment to
promote the well-being of clients (Ethical Standard
1.01). This is a pure ethical dilemma because two
ethical standards conflict. It can be resolved by
looking at Ethical Standard 4.01, which states that
Two social workers should only accept employment (or
in this case, a client) on the basis of existing
Types of competence or with “the intention to acquire the
necessary competence.”
Dilemmas The social worker can accept the case, discussing
the present limits of her expertise with the client
and following through on her obligation to seek
training or supervision in this area.
•  
 2. Some complicated situations require a decision but may
also involve conflicts between values, laws, and policies.
Although these are not absolute ethical dilemmas, we
Two can think of them as “approximate” dilemmas. For
example, an approximate dilemma occurs when a social
Types of worker is legally obligated to make a report of child or
domestic abuse and has concerns about the releasing of
Dilemmas information. The social worker may experience tension
between the legal requirement to report and the desire
to respect confidentiality.
 • However, because the NASW Code of Ethics
acknowledges our obligation to follow legal
requirements and to intervene to protect the
vulnerable, technically, there is no absolute ethical
Two dilemma present.
• However, the social worker experiences this as a
Types of dilemma of some kind and needs to reach some kind of
resolution.
Dilemmas • Breaking the situation down and identifying the ethics,
morals, values, legal issues, and policies involved as well
as distinguishing between personal and professional
dimensions can help with the decision-making process
in approximate dilemmas.
 Models for Resolving Ethical Dilemmas

• A number of models for resolving ethical dilemmas

have be put forward such as
– Congress’ Ethic model and
– Kenyon’s Ethical Decision-making Model.
• In both Kenyon's and Congress's ethical decision-
making frameworks, there are five fundamental
components to this cognitive process. They encompass:
– naming the dilemma,
– sorting the issues,
– solving the problem, and
– evaluating and reflecting
 Congress ETHIC Model
• E- Examine relevant, personal, societal, agency, client and professional values. Look at
your own personal values as it relates to family, education, marriage, divorce, money, etc,
to avoid transference as far as these are concerned.
Examine:
– Agency values
– Professional values
– The client’s responsibility and right to self-determination
– Societal values
• T- Think about ethical standards , e.g., promote the rights of clients to self-determination
and assist in their efforts to identify and clarify their goals.
• H- Hypothesize about different courses of action or consequences
• I- Identify who would be helped and who would be harmed
• C- Consult with supervisors and colleagues
 1. Describe the 2. Consider the 3. Examine the
issue ethical guidelines. conflicts.

KENYON'S 5. Generate all 6. Examine and

ETHICAL
4. Resolve the
possible courses of evaluate the action
conflicts.
action. alternatives.

DECISION-
MAKING
7. Select and
9. Evaluate the
evaluate the 8. Plan the action.
outcome.
preferred action.

MODEL
10. Examine the
implications.
 • As perfect ethical decisions are seldom possible, it is
important to evaluate and reflect. Social work professionals
KENYON'S can learn from past decisions and try to make them better
ETHICAL in the future, particularly when they lead to policy making.
To do this:
DECISION- – Review the ramifications of the decision.
– Review the process of making the decision. For
MAKING example, ask yourself if you would do it in the same way
the next time and if the appropriate people were
MODEL involved.
 KENYON'S ETHICAL DECISION-MAKING MODEL
– Ask whether the decision should become policy or if more cases and
data are needed before that step should occur.
– Learn from successes and errors.
– Be prepared to review the decision at a later time if the facts or
issues change.
 • It is important to remember that
Kenyon's and Congress's ethical
KENYON'S decision-making frameworks are
based on a rational model for ethical
ETHICAL
decision making.
DECISION- • One of the criticisms of rational
MAKING decision-making models is that they
MODEL do not take into account diversity
issues .
 1. DETERMINE whether there is an ethical issue
or/and dilemma. Is there a conflict of values,
or rights, or professional responsibilities? (For
Essential example, there may be an issue of self-
determination of an adolescent versus the
Steps for well-being of the family.)
Ethical 2. IDENTIFY the key values and principles
involved. What meanings and limitations are
Problem- typically attached to these competing values?
(For example, rarely is confidential
Solving information held in absolute secrecy;
however, typically decisions about access by
third parties to sensitive content should be
contracted with clients.)
 3. RANK the values or ethical principles
which - in your professional
judgement - are most relevant to the
Essential issue or dilemma. What reasons can
Steps for you provide for prioritizing one
Ethical competing value/principle over
another? (For example, your client's
Problem- right to choose a beneficial course of
Solving action could bring hardship or harm to
others who would be affected.)
 4. DEVELOP an action plan that is consistent
with the ethical priorities that have been
determined as central to the dilemma. Have
Essential you conferred with clients and colleagues, as
appropriate, about the potential risks and
Steps for consequences of alternative courses of
action? Can you support or justify your action
Ethical plan with the values/principles on which the
plan is based? (For example, have you
Problem- conferred with all the necessary persons
Solving regarding the ethical dimensions of planning
for a battered wife's quest to secure secret
shelter and the implications for her teen-aged
children?)
 5. IMPLEMENT your plan, utilizing the
most appropriate practice skills and
competencies. How will you make use
Essential of core social work skills such as
Steps for sensitive communication, skilful
negotiation, and cultural competence?
Ethical (For example, skilfull colleague or
supervisory communication and
Problem- negotiation may enable an impaired
Solving colleague to see her/his impact on
clients and to take appropriate
action.)
 6. REFLECT on the outcome of this ethical
decision-making process. How would you
evaluate the consequences of this process for
Essential those involved: Client(s), professional(s), and
agency(ies)? (Increasingly, professionals have
Steps for begun to seek support, further professional
Ethical training, and consultation through the
development of Ethics review Committees or
Problem- Ethics Consultation processes.)
• From discussion by Frederick Reamer & Sr.
Solving Ann Patrick Conrad in
Professional Choices: Ethics at Work (1995)
An Ethical • Given the fact that ethical dilemmas
Decision- may not always be readily resolved
through the use of codes of ethics, it
Making might be useful to have a framework
Model in which to analyze and make ethical
decisions.
 • The following ethical decision-making
model comes from the work of Corey
et al. (1998).
Step 1: Identify the problem.
An Ethical
Decision- Step 2: Identify the potential issues
involved.
Making
Model Step 3: Review relevant ethical
guidelines.
 • Step 4: Know relevant laws and
regulations.

Step 5: Obtain Consultation.

An Ethical
Decision- Step 6: Consider possible and probable
courses of action.
Making
Step 7: List the consequences of the
Model probable courses of action.

Step 8: Decide on what appears to be the

best course of action.
 • Allen, Karen (ND). What is an ethical dilemma?
retrieved on October 20, 2014 fro
http://www.socialworker.com/feature-
articles/ethics-
References articles/What_Is_an_Ethical_Dilemma%3F/
• Congress, Elaine. (nd.). Real cases project: Social
work ethics. Retrieved on October 18, 2014
from
socialwork.adelphi.edu/realcases/pdfs/teach
ing_guides/Social%20
 • Syracuse University school of Education. (nd.) An
Ethical Decision-Making Model
http://soe.syr.edu/academic/counseling_and
human_services/modules/Common_Ethical_I
References ssues/ethical_decision_making_model.aspx
• Reamer, Frederic G (2002). Making Difficult
Decisions in Social Work Today retrieved from
http://www.socialworktoday.com/news/eoe
101402.shtml
 • http://www.netce.com/
References coursecontent.php?courseid=923