4.1 Introduction to Ethical Dilemmas
Throughout a career in counseling, one will be privy to numerous multifaceted and diverse ethical dilemmas. As humans, we are complicated beings that continually create even more complex systems within which we reside and interface. Due to interactions between values, individuals, organizations, and governmental institutions, discrepancies may develop for which solutions are not forthcoming. These discrepancies necessitate more than snap judgments or a reliance on knowledge alone to resolve, but rather a nuanced and well-thought-out approach that emphasizes respect for the values and well-being of all parties involved. Within the counseling profession, this process is called Ethical Decision Making.
Ethical decision-making is an integral part of ethical and professional practice mandated by the ACA (2014) and NAADAC (2021) codes.
According to the ACA (2014) Code of Ethics:
“When counselors are faced with an ethical dilemma, they use and document, as appropriate, an ethical decision making model that may include, but is not limited to, consultation; consideration of relevant ethical standards, principles, and laws; generation of potential courses of action; deliberation of risks and benefits; and selection of an objective decision based on the circumstances and welfare of all involved” (Standard I.1.b.).
Similarly, the NAADAC (2021) Code of Ethics states that:
“Addiction professionals shall utilize and document, when appropriate, an ethical decision‐making model when faced with an ethical dilemma. A viable ethical decision‐making model shall include, but shall not be limited to: (a) supervision and/or consultation regarding the concern; (b) consideration of relevant ethical standards, principles, and laws; (c) generation of potential courses of action; (d) deliberation of risks and benefits of each potential course of action; (e) selection of an objective decision based on the circumstances and welfare of all involved; and (f) reflection upon, and re‐direction when necessary, after implementing the decision” (Standard VIII-3).
Taking the prescriptions of the codes together, a few key patterns emerge:
- Ethical decision making should be documented.
- An ethical decision making model should, at minimum, include:
- Supervision/consultation.
- An interface of ethical standards, laws, and policies relative to the case.
- The generation of multiple potential solutions, each with its own risk/benefit analysis.
- A solution supported by objective reasoning that reflects the core values of the counseling profession.
- Ethical decision making should be a continuous and evolving process. If a conclusion is reached and its implementation proves to be problematic, a counselor should return to their ethical decision making plan and revise appropriately.
Though the high-level overview of the ethical decision-making process provided by the ethical codes may prove overwhelming, scholars have translated the spirit of the ACA (2014) and NAADAC (2021) codes alongside contemporary literature on ethical practice into comprehensive and widely accepted ethical decision-making models.
In the present chapter, we present two models we find most applicable to modern practice followed by an applied case analysis for each; however, first, we consider the conflicts and issues that may arise during the ethical decision-making process.