Ethical Decision Making Beneficence

ETHICAL DECISION-MAKING

Ethical Decision-Making

In the subsequent sections of this text, I will be seeking to deploy the ethical decision-making model in an attempt to determine how best to resolve the ethical dilemma presented in the scenario. The model, as presented in this case, is largely based on the work of Forester-Miller and Davis (2016) titled, Practitioner’s Guide to Ethical Decision Making. This is just one of the many ethical decision-making models. Indeed, according to Cottone and Claus (2000), “there are many practice-relevant models that can be chosen as guides for ethical decisions in particular practice settings...” (281).

1. Identification of the problem

Joe is concerned that Carla, his client who is undergoing counseling for depression and anxiety, will end up having sex with the said classmate whom she is interested in dating. Carla is in her first year of campus. In his opinion, such an act would not only be illegal (because the two are not married), but also unethical (citing the ‘Do no harm’ principle). Carla has already attained the age of the majority. In the scenario presented, Joe has essentially embraced a moral stance in his asking of Carla not to date her classmate.

2. Application of the ACA Code of Ethics

A review of the ACA Code of Ethics indicates that the standard of relevance on this front happens to be:

C.2.e. Consultations on Ethical Obligations: In which case Joe has consulted with his supervisor

3. Determining the dilemma’s nature as well dimensions

To a large extent, seeking to implement a decision contrary to Carla’s wishes would be going against the principle of autonomy. However, owing to the fact that Carla is undergoing counselling for anxiety and depression, an unstable romantic relationship would likely worsen her symptoms – a pointer to the need for Joe to discourage her from dating at this point. This would be in line with the principle of beneficence.

It would be prudent to note that as Proctor (2014) points out, in counselling scenarios, it is not uncommon to encounter situations in which case the counselor’s beneficence comes into conflict with the patient’s autonomy. The author argues that in such a scenario, there is need for a determination to be made as to the competence of the client. In the author’s own words, “the principle of respect for patient autonomy overrides the principle of beneficence in a competent patient” (109).

4. Possible Courses of Action (COA)

COA 1: Respect Carla’s decision to date her classmate – with no attempt whatsoever to advise her on possible downsides

COA 2: Refer Carla to another counselor

COA 3: Involve Carla in the exploration of the downsides of her decision, and advise (not coerce) that she considers dating later on. Ultimately respect Carla’s final decision.

5. Potential Consequences of the Selected COAs

COA 1: Respect Carla’s decision to date her classmate – with no attempt whatsoever to advise her on possible downsides. In this case, Joe would essentially be respecting Carla’s self-determination and independence as a mature young adult. In so doing, however, he would be failing in his obligation to remove or notify her of conditions that could cause her harm (i.e. in line with the principle of beneficence). This could worsen her situation going forward.

COA 2: Refer Carla to another counselor. In this case, Joe would effectively be avoiding the need of having to confront and address the conflict between the two principles. This would, however, mean ending the counseling relationship abruptly – which could have a negative impact on the intended therapeutic outcomes.

COA 3: Involve Carla in the exploration of the downsides of her decision, and advise (not coerce) that she considers dating later on. Ultimately respect Carla’s final decision. This would involve meeting Joe’s duty as a counselor to act for the benefit of Carla, while at the same time ensuring that he does not violate the autonomy principle.