1. A Framework for Ethical Decision Making

2. Presented by Nyla McCarthy, President Catalysts for Change Consulting 1460 Evergreen Ave NE Salem, Or 97301 Email: nyla@teleport.com Website: www.nylamccarthy.netMaterials copyrighted. Please contact me for usage. 3. The Framework Overview Step One: Describe the problem Step Two: Determine whether there isan ethical issue or an ethical dilemma Step Three: Identify and rank the keyvalues and principles Step Four: Gather your information 4. The Framework, continued Step Five: Review any applicable Codeof Ethics Step Six: Determine the options Step Seven: Select a course of action 5. The Framework, continued Step Eight: Put your plan into action. Step Nine: Evaluate the resultsDont forget!Step Ten: Submit cases to your ethicalreview team or board regularly forreview 6. Step One: Describe the Problem Ethical problems are always embeddedin a context. Circumstances impact upon theproblem definition (for whom does theproblem exist? What is the setting?) Beware of the tendency to look towardthe clinical or purely legal perspectivefor guidance. 7. Step Two: Determine Whether There Is an Ethical Dilemma Dilemma greek origindi- twolimos-horns,Two horned 8. Step Two: Determine Whether There Is an Ethical Dilemma X versus Y ____ versus ____ good versus bad options good versus good options bad versus bad options 9. Step Two: Determine Whether There Is an Ethical Dilemma Dilemma becomes ethical when thegood or bad options seem to have amoral component(eg. confidentiality vs. prevention of harm, selfdetermination vs. workers perception ofclients best interests, freedom vs. safety) 10. Step Two: Determine Whether There Is an Ethical Dilemma Terms of an ethical dilemma must beethical in nature, not legal. If something is a law, you then have theethical choice to follow the law or not. 11. Step Two: DetermineWhether There Is an EthicalDilemma If you find it easy to articulate the perceivedbest interest as being on one side, you mightask, who determines what is in the bestinterest? You? Courts? Client? Family? Remember, most individuals will probablyperceive their own preferences as being intheir own best interest. 12. Step Three: Identify and Rank the Key Values and Principles What reasons can you provide forprioritizing one competing value overanother? Understand that a resolution to adilemma which goes against anindividuals personal set of values hasvery little chance of success. 13. Step Four: Gather YourInformation Do you have all the known facts? Do you understand the applicable laws orlegalities? Do you have all relevant policies available toreview? Are you clear about the individuals viewsand personal values?* Dont hesitate to seek out consultation. 14. Step Five: Review AnyApplicable Code of Ethics Not legal documents, but professionals arebound 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 15. Step Five: Model Code The Napsa Code of Ethics is anexcellent model. Lets take a look.. 16. Step Six: Determine the Options List all possible actionable options Weigh the cost/benefits of each option Seek out additional points of view 17. Step Seven: Select a Course of Action1) 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. 18. Step Eight: Put Your Plan Into Action Reflect on the outcomes with a sensethat you have truly approached thisethical dilemma with the best ofintentions and to the best of yourability. 19. Step Nine: Evaluate Evaluate the consequences for eachperson involved (client, familymembers, co-workers, agency, etc.) Consider submitting your most difficultcases to an ethics review board or peerconsultants for feedback. 20. Step Ten Discuss the case with your ethicalreview committee or board Dont have one? Create one. Need help? Give me a call and we candesign one which will work for you 21. Activity Small group case study review Debrief 22. Case Study Small Groups Select a recorder/reporter Read the case together Follow the framework steps as possible Discuss and define the primary ethicaldilemma within each case Discuss the steps as a group Come up with a plan of action Present findings and discuss process 23. The Bird in the Hand A new take on an old fable 24. Thank you!