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.net
Materials copyrighted. Please contact me for usage.

3. The Framework Overview
• Step One: Describe the problem
• Step Two: Determine whether there is
an ethical issue or an ethical dilemma
• Step Three: Identify and rank the key
values and principles
• Step Four: Gather your information

4. The Framework, continued
• Step Five: Review any applicable Code
of 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 results
Don’t forget!
Step Ten: Submit cases to your ethical
review team or board regularly for
review

7. Step One: Describe the
Problem
• Ethical problems are always embedded
in a context.
• Circumstances impact upon the
problem definition (for whom does the
problem exist? What is the setting?)
• Beware of the tendency to look toward
the clinical or purely legal perspective
for guidance.

8. Step Two: Determine
Whether There Is an Ethical
Dilemma
• “Dilemma”– greek origin
di- two
limos-horns,
“Two horned”

9. 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

10. Step Two: Determine
Whether There Is an Ethical
Dilemma
• Dilemma becomes ethical when the
good or bad options seem to have a
moral component
(eg. confidentiality vs. prevention of harm, self
determination vs. worker’s perception of
client’s best interests, freedom vs. safety)

11. Step Two: Determine
Whether There Is an Ethical
Dilemma
• Terms of an ethical dilemma must be
ethical in nature, not legal.
• If something is a law, you then have the
ethical choice to follow the law or not.

12. Step Two: Determine
Whether There Is an Ethical
Dilemma
• If you find it easy to articulate the perceived
best interest as being on one side, you might
ask, “who determines what is in the best
interest?” You? Courts? Client? Family?
• Remember, most individuals will probably
perceive their own preferences as being in
their own best interest.

13. Step Three: Identify and
Rank the Key Values and
Principles
• What reasons can you provide for
prioritizing one competing value over
another?
• Understand that a resolution to a
dilemma which goes against an
individual’s personal set of values has
very little chance of success.

14. Step Four: Gather Your
Information
• Do you have all the known facts?
• Do you understand the applicable laws or
legalities?
• Do you have all relevant policies available to
review?
• Are you clear about the individual’s views
and personal values?
* Don’t hesitate to seek out consultation.

15. Step Five: Review Any
Applicable Code of Ethics
• Not legal documents, but professionals are
bound 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

16. Step Five: Model Code
• The Napsa Code of Ethics is an
excellent model. Let’s take a look…..

17. Step Six: Determine the
Options
• List all possible actionable options
• Weigh the cost/benefits of each option
• Seek out additional points of view

18. Step Seven: Select a Course of
Action
1) 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.

19. Step Eight: Put Your Plan
Into Action
• Reflect on the outcomes with a sense
that you have truly approached this
ethical dilemma with the best of
intentions and to the best of your
ability.

20. Step Nine: Evaluate
• Evaluate the consequences for each
person involved (client, family
members, co-workers, agency, etc.)
• Consider submitting your most difficult
cases to an ethics review board or peer
consultants for feedback.

21. Step Ten
• Discuss the case with your ethical
review committee or board
• Don’t have one? Create one.
• Need help? Give me a call and we can
design one which will work for you

22. Activity
• Small group case study review
• Debrief

23. Case Study Small Groups
• Select a recorder/reporter
• Read the case together
• Follow the framework steps as possible
• Discuss and define the primary ethical
dilemma within each case
• Discuss the steps as a group
• Come up with a plan of action
• Present findings and discuss process

25. The Bird in the Hand
• A new take on an old fable…

26. Thank you!