Ethical Decision Making

Ethical Decision Making
Guadalupe Ornelas University of Phoenix
PSYCH545
April 30, 2012
Christi Moore, Ph.D.

Ethical Decision Making
In a modern environment where cost cutting procedures drive modern procedures to cutting-edge levels of competition ethical decision making is more than ever relevant in the field of psychology. Complex ethical dilemmas are likely to appear camouflaged with our own personal emotions. Today’s fast paced and competitive environment requires that psychologists make ethical decisions that entail profound legal and moral implications. The field of psychology is a field where theories are challenged and superseded continuously. For example Pope and Vasquez (2011) highlighted the results of the Boulder Task to define therapy, as an undefined technique applied to unspecified problems with unpredictable results. Given the professional challenges and the fast environment typical in the field of psychologists ethical competency is an inherent requirement. Although there are numerous guides to address ethical behavior, it would be impossible for any given ethical guide to cover every possible situation (Pope and Vasquez 2011). Therefore, psychology requires an active awareness of the ethical aspect beyond the surface of the situation (Pope, & Vasquez, 2011). Situational training is an effective method of analyzing the aspect of given situations and their ethical implications. The purpose for this paper is to present a hypothetical situation and to analyze its ethical aspects, and to apply the 14 steps of the ethical decision making process proposed by Pope and Vasquez (2011).

The Following Situation is Considered
Mary, a young mother 34 years of age requests psychological counseling. Her son John, 14 years of age had a terrible sports accident and he is in a state of coma. She is a single parent and has sole guardianship of her son. Her son’s prognosis is bleak. The physicians predict that if her son survives he will highly likely live in vegetative state for an unpredictable length of time. The physicians strongly recommend that Mary prepares to disconnect life support for John and allow him to die. Mary’s is extremely distressed and requests that the male psychologist comes to her house to provide her with therapy and companionship through her crisis.

The Ethical Dilemma
Ethical dilemmas often arise accompanied by other mitigating circumstances that appeal to our personal emotions. Psychologists are human being and consequently likely to be motivated by their personal emotional feelings. The field of psychology is closely related to the medical field and therefore their professional practices are expected to uphold a high moral standard (Pope, & Vasquez, 2011). Psychologist practitioners because of the high standards of the discipline of psychology enjoy authority and respect among the community (Pope, & Vasquez, 2011). It is because this respect and authority that bind psychologists to put the rights and needs of clients and cohorts at the top of the priority list.
The scenario presented is emotionally charged. Mary is clearly in emotional distress because of her son’s accident and the prognosis given by the physicians. The request to seek counsel at her place of residence has ethical implications in several dimensions. First, the psychologist is not medically certified to give counsel regarding medical conditions. Second, the request for the psychologist to provide the treatment at her residence raises the question of dual relationship. The scenario is complicated given the emotional appeal of the situation for the psychologist.

Apply the 14 Steps of the Ethical Decision Making Process
Circumstance factors cannot be effectively predicted in every situation. The Boulder Conference clearly recognized the subjectivity in the field of psychology and therefore recommends rigorous training (Pope, & Vasquez, 2011). How can ethical training be effective given the fluidity of theories and extenuating circumstances? Acceptable codes of conduct are designed with the objective of upholding certain moral principles. Therefore ethically responsible psychologists are required to subscribe to upholding high moral principles.
Pope and Vasquez (2011), further recommend that ethical training emphasizes in establishing a set of steps for psychologists to apply in situations where ethical dilemmas arise. Effective ethical training requires psychologists to focus in the decision making processes in the field of psychology. The authors recommend the “the steps in ethical decision making” (Pope & Vasquez, 2011, p. 117). The following is an analysis of the case scenario presented through the 14 steps in the ethical decision making process.
Step 1: Clearly State the Question, Dilemma, or Concern as Clearly as Possible
In the case scenario the fundamental question is the nature of the request for counseling. The place and nature of the intervention are of a more personal nature than professional. The therapist lacks qualification training to making a significant recommendation regarding the son’s health. Providing companionship is not an activity supported by professional psychology. Although, it may indirectly be part of therapeutic intervention, companionship exclusively is not a form of treatment.
Step 2: Anticipate Who Will be Affected by the Decision
The decision that the psychologist makes will directly affect the emotional stability of the mother. Indirectly, the psychologist’s decision will affect the mother’s decision in regards to her son’s health.
Step 3: Figure out if Anyone is the Client
The mother is the potential client. At this point in the situation the psychologist has not committed to a client-therapist relationship, therefore a client is not yet established.
Step 4: Assess Whether Our Areas of Competence-and of Missing Knowledge, Skills, Experience, or Expertise-are a Good Fit for this Situation
The situation is properly fit for therapist to intervene in the distressful nature of the situation. However, the psychologist cannot provide assistance with the physician’s medial prognosis of her son. Alternately, a ministry counselor may provide comfort, relief, and spiritual guidance.
Step 5: Review Relevant Formal Ethical Standards
The American Psychology Association’s (APA), Ethical Principles of Psychologists and Code of Conduct (2010), clearly address these topics. Ethical standard number two of the APA (2010) code of ethics addresses the topic of competence. Additionally, ethical standard number three of the APA’s (2010) code of ethics addresses the issue of multiple relationships.
Step 6: Review Relevant Legal Standards
The APA’s ethical principles and standards is not a legally binding standard, it serves to indicate approval of the association for the purpose of self-government (Pope & Vasquez, 2011). Additionally, governments at all levels have established statues that describe in detail acceptable standards for professional care (Pope & Vasquez 2011). Medical insurances also serve to set acceptable standards for research and therapeutic procedures (Pope & Vasquez, 2011).
Step 7: Review Relevant Research and Theory
The APA reported that between the years of 2005 through 2008, dual relationship in the form of sexual misconduct ranked consistently higher than any other category (Pope and Vasquez, 2011). Malpractice and non-sexual relationship scored second and third correspondingly (Pope and Vasquez, 2011).
Step 8: Consider Whether Personal Feelings, Biases, or Self-Interests May Affect our Ethical Judgment
The case presented is highly emotional. Personal emotions cloud objective judgment. Both the mother and the psychologist are at risk of allowing their feelings dominate their decision.
Step 9: Consider Whether Social, Cultural, Religious, or Similar Factors Affect the Situation and the Search for the Best Response
Pope and Vasquez (2011), highlight the fact that not all situations necessarily lead to dual relationship. However, the therapist would take on considerable risk of being perceived as unethical by not restricting himself to a more professional setting for consultation and therapy. Religious counseling is a strong factor to be considered. Perhaps, the client can be assisted by a ministry counselor alone.
Step 10: Consider Consultation
The psychologist can benefit from his support network (Pope & Vasquez, 2011). Consultation with peer psychologists is beneficial. A closer analysis of the situation from someone else’s perspective is beneficial.
Step 11: Develop Alternative Courses of Action
There are several courses of action that can be developed in the situation. One is refuse the client and do nothing. Two, work with the client to find another therapist. Three, kindly refuse the client and suggest religious counseling. Four, explain the reasons for the refusal to the client and work with them to find suitable care.
Step 12: Think Through the Alternative Courses of Action
The first option does not relieve the psychologist from responsibility. By refusing the client the client counselor relationship is not established, however the therapist risks accusation of abandonment. The second option is better, however without explaining the reason with the refusal will cause ambivalence on the client. The third option is ethically acceptable. The fourth option is the optimum course of action. Disclosing the reason for the refusal is not an easy thing to do but it will have the best effect in the situation. Working closely with the client to find alternate support is the most ethically and morally course of action.
Step 13: Try to Adopt the Perspective of Each Person Who Will be Affected
Both the mother and the son depend on the mother’s decision. The mother needs the best quality care to make the best decision. Eliminating the possibility of dual relationship enables the mother and the psychologist to look for the best possible care for her.
Step 14: Decide What to do, Review or Reconsider it, and Take Action.
In the present case scenario the best decision is to disclose the potential complication for the client therapist relationship. The therapist will be required to work closely with the client to find alternative care provider.

Explain the Importance of Ethical Decision Making Process in Psychology Psychological therapists operate in a competitive and dynamic environment. It is impractical to try and predict every situation that professional psychologists may confront. Psychologists are exposed to emotional feelings which camouflage the underlying ethical implication of situations. The ethical decision making process is important because it focuses in a process which is adaptable to every situation that a psychologist may find. Ethical decision making is important to keep the psychologist from litigation, to maintain positive public relations between the psychologist community and the public, and to guide the psychologist through the process.
Conclusion
Upholding high moral principles is an inherent responsibility in the field of psychology. Given the fluidity of situational factors the most effective approach to ethical decision making is to review the guiding principles and by adopting an effective decision making process. Situations in the field of psychology are dynamic. The commitment to upholding a high moral set of principles by adopting an effective decision making process will enable psychologists to make the best ethical decisions in the field.

References
Pope, S., & Vasquez, T. (2011). Ethics in psychotherapy and counseling (4th ed.). San Francisco, CA: Jossey-Bass/Wiley.

References: Pope, S., & Vasquez, T. (2011). Ethics in psychotherapy and counseling (4th ed.). San Francisco, CA: Jossey-Bass/Wiley.