Beyond ethics and evidence Learning to look at the intended and u.docx

Beyond ethics and evidence: Learning to look at the intended
and unintended consequences of our actions
Grant Charles
To cite this article: Grant Charles (2017) Beyond ethics and
evidence: Learning to look at the intended and unintended
consequences of our actions, Child & Youth Services, 38:2,
108-125, DOI: 10.1080/0145935X.2017.1297200
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CHILD & YOUTH SERVICES
–
Beyond ethics and evidence: Learning to look at the intended
and unintended consequences of our actions
Grant Charles
School of Social Work, University of British Columbia,
Vancouver, British Columbia, Canada
ABSTRACT
The human service professions have traditionally taken a narrow
perspective on what constitutes ethical and effective practice.
We are taught to use simplistic code-based models to judge
whether our actions are ethical and in-the-moment measures to
determine if we are being effective. If we observe no harm in

the period of our intervention, then we believe our actions are
ethical. Sim- ilarly, if we observe some positive change, then
we believe our interventions are effective. However, when we
examine our work within a broader context and over a longer
period of time we can come to different conclusions. This
article illustrates several problems with these current methods
and suggests alternative ways of examining ethics and
effectiveness.
KEYWORDS
ethics; evidence; unintended consequences
We all wish to be ethical and effective practitioners. Despite
this desire, there is no shortage of examples of unethical
behavior and poor practice in the human services sector (see
Representative for Children and Youth of British Columbia,
2013, 2014, 2015). There are numerous systemic reasons why
we see unethical practice ranging from human frailty to
overwhelmed workers with inadequate resources to antiquated
and oppressive systems of care. However, I also believe it has
something to do with how we are taught to understand ethical
behavior. I think that the current approaches to teaching and
applying ethics in professional practice are often shallow and
short-sighted. They are shallow when we focus on specific
actions as being right or wrong. Short-sightedness includes the
failure to consider a given situation within a sufficiently broad
context and failing to imagine the effect of an action taken now
beyond the term of service, our direct involvement, and the
measure of desired outcomes. The results may lead to
significant harmful unintended consequences. I believe that this
has contributed to us having wrongly shrugged off our responsi-
bility for the long-term and broad consequences of our actions.
In my 40 years of experience working in child welfare and
mental health, I have come to understand how these failures can
harm individuals, families, and communities for generations
(Charles, 2015; Charles & Degagné, 2013). I believe that we
can reduce the potential
CONTACT Grant Charles [email protected]School of Social

Work, University of British Col
for harm by learning to think about the intended and unintended
consequences of our actions, and that it is our ethical obligation
to do so.
It is widely although not universally recognized that there are
difficulties in how we currently conceptualize (Buila, 2010;
Campbell, 2015; Corvol, Moutel, & Somme, 2016; Dahnke;
2014; Stockall & Dennis; 2015) and teach ethics within many
professions (Dahnke, 2014; Martinov-Bennie & Mladenovic,
2015; Moyo, Goodyear-Smith, Weller, Robb, & Shulruf, 2015;
Pérez-García, Latorre-Medina, & Blanco-Encomienda, 2015).
Professional ethics are often taught from a narrow perspective
(Dahnke, 2014), which implies that there is a clear and
immediately knowable way to practice ethically (Sanders &
Hoffman, 2010). Even though we understand that ethical
practice is not this simple, we often teach and talk about
professional ethics using this oversimplified method (Airth-
Kindree, & Kirkhorn, 2016; Genova & Gonza, 2015; Hoffmann
& Borenstein, 2014).
A second aspect of ethics in a professional context is that to the
best of our ability, our actions must be at least be anticipated as
being effective in order to be ethical (see Paul & Brooke, 2015).
To this purpose, we use evidence to inform our decision-
making process in terms of our ethics and our interactions in the
practice world (see Kelly, Heath, Horwick, & Greenhaigh,
2015). The evidence we use can take many forms. It may be the
immediate reaction we see on a client’s face when we make a
suggestion to them. When it looks like they have just had a
revelation about their behavior, we believe that we have had an
effective intervention. If they tell us upon discharge from our
program that they have really changed their life, then we
consider the program a success. Sometimes we use standardized

outcome measures that have been scientifically declared
validated by evidence, and, if the results of these measures
indicate that the client has experienced positive change, then we
know that our work has been successful.
Although these basic approaches to ethics (what is right or
wrong action) and evidence (how do we know we have helped
and not harmed) have merit, there is also the danger that they
trap us into believing that this focus is sufficient to consider
ourselves ethical practitioners. We may believe that we truly
understand the effect of our actions because what we see in
front of us, in the moment, is the full reality of the situation.
Our self-evaluation might include these thoughts: “I am not
hurting someone in this moment; therefore, I am being ethical in
my interactions with them” or “I can see the positive outcomes
of my work in the here and now; therefore, I am being
effective.” Although there can be truth in both statements, this
may be because we examine only what we see through a narrow
perspective. It is possible that when we examine the effect of
our actions in the longer term and with a broader perspective,
we may see that we may be doing more harm than good (see
Pope, 2016).
Ethics and effectiveness are closely related, although they are
often not conceptu- alized nor taught as if they are
interconnected. As a result, we may not develop the ability to
see our practice from the broader or longer-term perspective
that I believe decreases the likelihood of potential short- and
long-term harm to clients whether they are individuals, families,
or communities. I argue in this article that, to be truly
CHILD & YOUTH SERVICES 109
110 G. CHARLES
ethical and effective, we need to look beyond our traditional
way of seeing. To illus- trate my point that we need to take a
broader approach at how we see issues, I use the example of
how the current narrative on Indian Residential Schools in
Canada, although accurate, does not capture the full story and

may therefore limit the range of response needed to address the
negative effect the schools have had on Indigenous young
people, families, and communities. I use the one-child policy in
China as an example of why we need to imagine the long-term
consequences of our actions. I also provide two frameworks that
may help practitioners assess the potential outcomes of their
actions. I suggest these frameworks are not the definitive
solution to the issues I have raised but rather a means to
stimulate thinking and dialogue in this area.
Failing at ethics
Before looking at the need to see our intentions and actions
from a broader and long-term perspective, I want to first discuss
what could be called the lower order of ethics. A common form
of ethical failure occurs when we are not sufficiently diligent in
performing seemingly small tasks related to our work with
clients. Some tasks are not viewed as crucial. The integrity of
all interactions with clients and the system we work in are not
understood as vital to the ethics and effectiveness of our
service. Shortly after any critical incident at an agency where I
once worked we would meet and see what went wrong and what
we could have done differently. We rarely found big mistakes or
clear cases of incompetence. What we found were small
mistakes, moments of thoughtless decision-making, the
repetition of unquestioned patterns of doing and being with a
young person, and moments of unintended arrogance. We
discovered a phone call that was not made, information not
passed on in a timely fashion, an assumption made about the
actions of a young person, or an absolute and unquestioned
certainty about a course of action. Often it was a series of this
type of error, where each one on its own was a minor issue, but
collectively, and over a period of time, contributed to the
dynamics that triggered the critical incident.
These are not issues restricted to the agency where I worked. I
have seen these dynamics in many organizations. It is not
unusual when reading reviews about a young person who has
died in state care to see the same dynamics described (Connolly

& Doolan, 2007; Representative for Children and Youth of
British Columbia, 2013, 2014, 2015). It is more often the small
mistakes that create the conditions for the child’s death rather
than one significant error or act of incompetence. These
patterns in practice, where we do not understand the importance
of our smallest actions as well as our tendency to view reality
as being limited to the present moment can trap us into having a
narrow perspective and to choose courses of action that may
look right in the moment but that can lead to significant
problems for our clients (Dracuo & Bryan-Brown, 2004).
To me, this is the crux of the problem. Our ethical failures are
most often not a singularly poor choice, bad judgment, or
intentionally uncaring action but rather the failure to question
ourselves and our certainties, and the failure to look beyond the
obvious to see and understand the consequences of our day-to-
day
actions. We tend to think of ethics as grand or significant
actions, but I would suggest that most of our unethical
behavior is small and in the moment. These are hard to spot and
harder to accept as being unethical. A large part of the prob-
lem is that we are not usually trained to look past the moment.
We often don’t see the small things that we do or don’t do as
being part of the big picture, and, therefore, we fail to
anticipate the potential outcomes of our actions. This is com-
pounded by our human tendency to be satisfied with a good-
enough understanding of a situation and failing to continue to
question, evaluate, and rethink our conclusions.
Looking past the obvious
This tendency to stop questioning when we have come to a
conclusion that makes sense to us can be demonstrated by
examining how we have come to understand what in Canada
were called Indian Residential Schools. These schools, similar
to the Indian Boarding Schools in the United States, were
established in part as a method to assimilate Indigenous young
people into the dominant culture. Under the guise of providing

young people with an education, there was a powerful agenda
seeking to “deculturate” them (Bombay, Matheson, & Anisman,
2011). The goal was to strip away their “inferior” native values,
beliefs, and traditions and replace them with a “superior”
European and Christian culture. The schools were a clear
manifestation of a blatant racist policy meant to destroy what
were long-standing and vibrant Indigenous cultures (Charles &
Degagné, 2013).
These schools were the means by which the dominant European
culture oppressed Indigenous people in Canada (Angeconeb,
2012; Bombay, Matheson, & Anisman, 2011). In total, over the
course of six generations, approximately 130,000 young people
attended the schools (Degagné, 2007). The children were often
forcibly or coercively removed from their families and
communities and taken to live in schools in often distant
locations. They were geographically and psycholog- ically
isolated from their families. The discipline in the schools was
often harsh and excessive. Many of the young people were
physically and sexually abused by staff and sometimes by other
young people (Bombay, 2014; Charles & Degagné, 2013). The
death rate from disease and maltreatment was very high. The
severity of the treatment these young people experienced has
had significant negative intergenerational ramifications for
Indigenous peoples and communities in Canada. The more than
1 million descendants of these children (and the rest of us) have
only recently begun to fully understand and deal with the
intergenerational effect of that treatment on individuals,
families, and communities (Bombay et al., 2011).
In Canada, when we have tried to make sense of the schools and
examine their consequences, we have focused our thinking on
the racist rationale for their estab- lishment. There is no doubt
about the racist underpinnings of the policies that created
these schools and many of the people who worked in them and
that racism is itself especially destructive. However, if we stop
our process of making sense of how this happened and what was
behind it at this point, we miss bringing in another less- obvious

contributing factor to our understanding. In fact, the residential
schools
112 G. CHARLES
were consistent with and not isolated from other similarly
devastating policies that affected Indigenous and non-
Indigenous children in Canada during the same time period. The
programs that came out of these policies were highly destructive
to large numbers of young people, including and beyond
residential schools for Indige- nous children. The results of
these practices have significant ramifications for people
throughout our society today. I would suggest that when we
miss this in our con- ceptualization of the problem, we are not
able to properly address the issues in our responses.
For example, in roughly the same time period during which the
residential schools operated, there were approximately 100,000
children called “Home Chil- dren” brought to Canada from the
United Kingdom (Neff, 2007). These young people were
ostensibly orphans; however, in many cases, the children had
living parents who were very poor. They were taken from the
inner-city slums of British cities and shipped to Canada where
the boys became farm hands and the girls became domes- tic
servants. Under the guise of providing them with a minor trade
and a proper Christian upbringing, they were in reality
societally sanctioned trafficked children torn from their homes,
families, communities, and culture to provide cheap labor to
colonial settlers in a foreign country (Charles, 2015). Their
stories of harsh and excessive punishment, as well as
experiences of physical and sexual abuse, paral- lel those of the
children in the residential schools (Charles, 2015; Harrison,
1979; Young, 2009).
In addition, similar stories of isolation, punishment, and abuse
have been docu- mented on the tens of thousands of children
who were placed in institutions for children who were labeled
“idiots,” “deaf and dumb,” and “defective” and the young peo-

ple placed in orphanages, schools for “incorrigible girls,”
industrial farms, reform schools and what became known as
“baby farms” (Cahill, 1992; Charles, 2015; Charles & Gabor,
2006; Myers, 2006; Perry, Sigal, Boucher, & Pare, 2006; Rooke
& Schnell, 1983; Sigal, Perry, Rossignol, & Ouimet, 2003). If
you were different or vulnerable as a child in Canada during
this period, you had a good chance of being removed from
family, placed in isolated settings, and being harshly treated
and abused.
When one looks solely at the residential schools to make sense
of what was happening at that time, one sees a dominant
society that imposed its racist worldview upon Indigenous
children. However, if we look at the residential schools in the
broader context of how other children were also treated, we see
a society that was not only highly racist but also what can be
called antichild. Vast numbers of children were removed from
their homes simply because they were outside of what was
considered the norm of the times. Vulnerable and marginalized
children regardless of race were at high risk of societally
sanctioned neglect, abuse, and brutality in any number of
different types of institutions. Canada is currently struggling to
deal with the ramifications of the racist foundation of
residential schools for generations of Indigenous peoples as
well as the broader Canadian society. However, we have
generally ignored the consequences of how the other children
were treated and the full picture of the rationale for the
oppressive treatment of the Indigenous young people.
In my experience, the professional and public communities
concerned with child welfare in Canada rarely, if ever,
reference the stories of the non-Indigenous children who were
brutalized in the other settings. Those stories remain as ignored
today as they were at the time the children were being isolated,
abused, and brutalized. The descendants of these children
number in the millions in Canada. Most of the descendants
would have no understanding of the early causes of the

intergenerational dys- function in many of their families. Nor
has any action been taken to address the ramifications of what
happened to these children. A number of questions arise from
this inaction. How can we deal with the residential schools if
we only seek to address the racist foundations but ignore the
antichild ones? How might this broader understanding of the
worldview that guided these historical actions inform our
response to survivors, descendants and their communities, now?
What residue of racism and antichild perspectives lives on in
Indigenous and non-Indigenous cultures? We have chosen to
deal with only one component of the issue yet hope to somehow
deal with the multifaceted ramifications. This lacks a certain
logic. The irony here is that if there was a broader discussion of
the historical treatment of all marginalized and vulnerable
children, more non-Indigenous people might begin to
understand that as the descendants of these young people they
have much more in common with Indigenous people that they
realize thus potentially decreasing the ongoing racism still
experienced by the Indigenous communities.
This case illustrates the potential for ineffective practice when
we fail to look beyond a reasonable and valid explanation
(racism) to inform our understanding and response. In this case,
if we look at only one part of what happened in Canada, we see
only one part of the story. If we look at it from a broader
perspective, we begin to see that the residential schools were
more than an attack on the basis of racism. They were also part
of a broader dehumanization of vulnerable children. This
distinction is important because our perceptions drive our
current policies, practices and interventions. It is hard to create
lasting change if we only acknowledge and respond to a part
of the story. This holds true if we are working with one person,
families, or communities. If we restrict ourselves to seeing one
truth because it seems to make sense to us without looking in
the broader context, then we may be missing the chance to
create an even deeper understanding of what is happening for
people.

In this example, there are two issues that arise. One has to do
with whether we can deal with the significant effect of
residential schools if we are not trying to deal with whole
experience. In this case focusing on only the racism means we
ignore the effect of the antichild aspects, which also provided a
justification for the horrific treatment of the children. Although
the two dynamics intersect and overlap, they are not the same
issue. This is critical to understand. We must ask ourselves
whether we can deal effectively with an issue when we pursue it
from a narrow or incomplete (but unarguably accurate)
perspective. Will we be able to make the necessary changes in
our society and the philosophies that guide us if we focus on
only one of the contributing factors (racism) to the treatment
of children in residential schools when doing so we completely
ignore the tens of thousands of other young people and the
114 G. CHARLES
millions of their descendants who were adversely affected by
the antichild attitudes and values? On an individual level, it is
similar to trying to deal with a substance misuse issue without
dealing with a corresponding mental health issue a young per-
son may have in life. Or to push the point further it is similar to
trying to deal with a substance misuse issue without even
knowing or acknowledging that the young person has mental
health concerns.
Practices that are not based on broader thinking may be
unethical and ineffective. We cannot deal with the ramifications
of antichild attitudes and policies if we don’t even acknowledge
that they existed. I am not arguing that, as practitioners, we all
must have an in-depth understanding of all historical issues at
play with our clients, their families, and communities, although
it would be helpful. I have used this example to show how
easy it is for us to accept one truth because it is obvious and
makes sense to us. To be truly effective with our clients, we
have to develop an understanding of what is happening beyond

the obvious and within the broader context of their lives. To be
ethical practitioners, we have to always be pushing our
understanding of what we believe to be true. Not doing so
reduces our ability to anticipate the consequences of our
actions with our clients in the moment and even more
importantly, over time. It is the consequences of our actions
that unfold over time that are often left unconsidered, and which
can lead to negative consequences for our clients. This means
that our well-intended interventions, which indeed look
effective and harm- less in the moment, can turn out to be
ineffective and even harmful over time. The result is that our
work is unethical, even though we thought we were doing our
best. It is important to remember that many of the people who
worked in the residential schools and the other programs I
mentioned believed that they were doing good work. At the
time, the harsh treatment of young people in the residential
schools was seen as a necessary action as part of a Christian
moral crusade to “save their souls” (Charles & Degagné, 2013;
Truth and Reconciliation Commission of Canada, 2015). This
may be difficult to believe today, but while it was happening, it
was considered by many to be a best practice, abet informed and
rationalized by the antichild, racist and xenophobic attitudes of
the time.
Looking past the here and now
It is not a simple task to consider the broad and various contexts
of an individual human life. Achieving an accurate and
comprehensive understanding is made even less likely by our
tendency to focus on the here and now of our actions. As I pre-
viously mentioned, we often think of reality as consisting of
what is happening in the present moment in front of us. We tend
to rely primarily on the evidence that is before our eyes to
evaluate if we are doing the right thing. The process for coming
to this conclusion is quite concrete. If we intervene with a client
and our intentions are honorable in that we mean no harm and
we see no harm being experienced by the client in the moment,
then we are likely to conclude that we are being ethical and

effective. Unfortunately, unconsidered consequences of our
actions play out over time in the lives of our clients, their
families, and their communities. Many of these unintended
consequences may result in significant negative outcomes.
An example of how the best of intentions can have severe
unforeseen and unintended consequences is the one-child
policy adopted in China in the early 1980s. China had an
insecure food supply for centuries of its history that have
periodically resulted in widespread famines. Although these
historical famines were precipitated by numerous and various
causes, such as natural causes (floods and droughts) and war, in
the 1980s, the government concluded that a primary cause of
famine was a result of its very large and growing population.
There was increased fear that uncontrolled population growth
would lead to ongoing large-scale famine and economic collapse
(Ebenstein, 2010). In 1982, to control population growth the
Chinese government implemented a policy restricting each
family to having one child. Although there is some debate over
the true effect of the policy on population growth, it has been
deemed a success in its home country. The size of most families
decreased significantly, as did the rate of population growth.
Although other factors may have influenced this outcome, there
have been no major famines since the implementation of the
policy.
Viewed from a narrow perspective the evidence would indicate
that the policy worked as it had the desired outcome of
decreasing population growth. However, there are considerable
unintended consequences that have a deleterious effect on
Chinese society today. One such consequence of the policy is
the breakdown in familial care for the elderly (Flaherty et al.
2007; Zhan, Liub, Guanc & Baid, 2006). The tradition of filial
piety or the belief that adult children are responsible for the
care of their aging parents was a foundation of Chinese society.
However, it is realiz- able only when there are more adult
children then aging parents and grandparents. With the one-

child policy, the population pyramid is now inverted, resulting
in too few adult children to care for elderly adults. Instead of
large numbers of adult children and their spouses to care for
aging family members there are now in many families only one
adult child and their spouse to care for four parents and possi-
bly eight grandparents at the same time they are caring for their
child (Zhan et al., 2006). This is often unworkable with the
result that many of elderly people are not receiving any or only
a limited form of support (Chang, 2008; Liu, 2008; Zhang &
Goza, 2005).
There are also concerns that a significant number of the
children born since the implementation of the policy may not
adhere to the cultural expectation of filial duty (Zhan et al.,
2006). This may be the result of a growth of a phenomenon
labeled the Little Emperors (Li, 2008). Although traditionally
parental and grandparent attention was dispersed among a
large group of children, now the single child/grandchild in the
family receives all the attention from the parents and
grandparents. This cor- responds with an increase in narcissistic
behaviors amongst young people who have been led to believe
that they are the center of the universe. This development con-
tributes to social conflict and societal strife. Although this
phenomenon is noted in other countries with low birth rates, it
is a particular issue in China because of the widespread
adherence to the One Child policy.
The title Little Emperors is descriptive in another way. One of
the consequences of the One Child policy has been a significant
change in the ratio of boys and girls being
116 G. CHARLES
born. Chinese culture has historically favored boys. In the early
days after implementation of the policy, there were widescale
reports of female infanticide (Huistendahl, 2010; McLoughin,
2005). In more recent years there, it appears that prenatal sex
selection practices, while illegal, have become more common

with the outcome that there are significant more males in China
(Ebenstein, 2010; Huistendahl, 2010; McLoughin, 2005). There
are millions of female girls and women missing from the
population due to families’ preference for a boy, which is
exacerbated by the limit to one child (Chang, 2008; Sen, 1990).
By some estimates, by 2020, there will be 30 million men of
marriageable age who will be unable to find a spouse as a result
of the gender unbalance in China (Chang, 2008). There are fears
that this many unattached men can lead to higher levels of
social unrest and instability (Isler, 2009). The gender
imbalance has also led to the kidnapping and trafficking of
women for marriage from inside China and from neighboring
countries (Isler, 2009; Zhao, 2003).
The One Child policy is a prime example of how the failure to
look beyond the intended outcomes of an intervention can lead
to significant negative consequences for a person or in this case
a society even if the initial desired results are achieved. A
policy meant to decrease the likelihood of famine and starvation
has led to a breakdown in traditional family structures, gaps in
the care of the elderly, increase in illegal sex selection
practices, increase in human trafficking, and the creation of
other forms of social unrest. A decision made with the intention
of helping a society has created the conditions by which social
stability has been undermined. This is the antithesis of the
original planned outcome.
In the case of the One Child policy the focus on the intended
outcomes and apparent lack of exploration of the possible
negative consequences by the policy makers in China has
caused significant human suffering. This historical example
illustrates an important limitation in ethical practice. Humans
tend to focus only on the intended consequences of their
actions, which essentially precludes imagining alternatives
(Ehrlinger & Eibach, 2011). The end result is that we make
decisions for all of the right reasons but end up with negative
and harmful outcomes (Dracuo & Bryan-Brown, 2004). Without
meaning for this to happen, the result is that our actions are

both unethical and ineffective.
Discussion
Ethical practice is more than doing the right thing. It is about
ensuring that the thing that is done is right. This requires
looking beyond the you-and-I-in-this-moment view of ethics. To
be ethical, we have to look past our intentions, the obvious, and
the moment. We have to learn to look at not only at our
intentions and what we are doing right now but also at the
possible consequences of our actions now and over time. Rather
than taking a linear approach to judge the ethics and efficacy of
our actions, we have to learn to anticipate the effect of what we
are doing from a more expansive and developmental viewpoint.
It is possible to move beyond our current you-and-I-in-this-
moment approach to measuring the worth of our actions to one
that helps us look at the systemic nature of our interactions with
clients.
The narrow perspective by which we view our actions is, in my
opinion, in a large part related to how we teach ethics in our
professional training programs. At present, much of our training
centers on teaching codes of conduct and moral principles of
practice (Feber & Petrucijová, 2015; Kyle, 2008; Sanders &
Hoffman, 2010; Studer & Chubin, 1977). In addition, students
might be asked to role play practice examples where role play
focus on applying ethical principles to a typical challenging
interaction (Edwards & Addae, 2015; Hugman, 2005). This
reinforces the perception that ethical problems emerge and are
resolved in a you-and-I-in-this-moment manner. Although
widely used across professions, there is a lack of agreement on
whether these methods are effective (Healy, 2003, Kyle, 2008;
Sanders & Hoffman, 2010), and there is some evidence that
once students enter practice their reported ethical standards
drop when faced with the reality of the complexity of the
workplace (Stratta, Riding, & Baker, 2016). At the very least, it
is evident that there is often a disconnect between what we learn
in our professional training and the ethical practices we see

once we enter our fields (Castro-Atwater & Hohnbaum, 2015;
Stratta et al., 2016). In fact, this approach may lead students to
believe that ethical practice is the outcome of a technical
process from which simple right and wrong answers emerge
(Hugman, 2005). When coupled with the aspirational way in
which many codes of ethics are constructed (Felderho, Hoefer,
& Watson, 2016; Pena, 2015), rather than helping them become
ethical practitioners these teaching methods may be detaching
students from their clients by encouraging them to think of
ethics as a simple intellectual inquiry (Milligan & Woodley,
2009). Ethics should not just be about adherence to a code of
conduct but also and most importantly as a beginning point for
in-depth reflection, imagination, and integrity (Akhtar, 2013).
Our understanding of ethical practice needs to move beyond a
reductionist approach where we see ethical conduct an
adherence to a prescribed moral truth (Milligan & Woodley,
2009). Instead, we need to acknowledge the complexity of our
practice and the resulting ethical demands and dilemmas this
creates (Akhtar, 2013). As part of this, we must develop the
critical thinking skills needed to think about the implications of
our actions or inactions in each given situation in the moment
and over time.
This means that we also need to examine how we use evidence
to determine whether our actions are ethical. The current way
we think about evidence con- tributes to the narrowing of our
ethical lens. At present, we use two types of evidence. The
first is an authority-based way where the evidence we see in
front of us proves to us that our interventions are effective or
not (Charles & White, 2008). The practitioner is the authority.
We see a client respond in a positive way to what we are doing,
and we conclude that we are being effective. We use our
professional judgment to assess the effectiveness of our actions.
The second conception of evidence depends on scientific
processes: the result of ostensibly dispassionate observations of
patterns of treatment and outcome (Charles, Ernst, & Ponzetti,
2003; Charles & White, 2008). This method is usually referred

to as being evidence- or science-based. If we can see it and
repeatedly and consistently measure it under similar
circumstance, then it must be a fact and therefore a truth. If
we can demonstrate the efficacy of an intervention (usually
within the
118 G. CHARLES
bounds of a short period of time), then we have scientific
evidence of our effectiveness. In the authority and scientific
forms of evidence, we fail to see that any measure of outcome—
regardless of validity and reliability—is context bound. The
measure- ment and interpretation of the evidence is always
influenced by what we choose to measure, how we measure it,
and the lens with which we view it. Evidence is never theory-,
value-, or context-free (Charles & White, 2008). This is a
severe limitation to both forms of evidence. If we look only at
what we see in the moment, then we have no way of knowing if
the desired outcomes of our work are helpful or harmful in the
long term. The decision makers and policy makers in China had
evidence of the effectiveness of the One Child policy. There
was concrete evidence that their goal of slowing population
growth and ending famine had worked. Unfortunately, the long-
term consequences of what they did have been detrimental in
unforeseen ways. Our current approaches to teaching ethics and
thinking about outcomes can trap us into having a narrow
perspective and lead us, in practice, to pursue a course of action
that looks right and effective in the moment but may lead to
significant problems for our clients and communities over time.
Ecological and consequence frameworks for understanding
ethics
There are two ways we can broaden our perspective on how we
determine the integrity and efficacy of our actions in our
interactions with clients and the broader society. The first is to
begin to look at what we do using an ecological approach (see
Figure 1). Although this approach is widely used to help us

understand our clients and the systems that affect them, we do
not as often use it to see the influence we
have on people and systems. I won’t describe ecological theory
in detail as it is well known (see Bronfenbrenner, 1979, 1995).
An ecological model lets us look at the systemic nature of our
actions in the environment in which we interact with a client.
This is a straightforward strategy. It simply requires that we ask
ourselves what are the possible effect our action or inaction
may have on the client and the systems around them not just in
the moment but also in the future.
Using this approach, we move beyond the traditional micro-
level or you-and-I method of looking at our interactions with
clients to examine the possible effect our interaction may have
on the person and others across systems and over time. This
involves giving serious thought to not only the intended
consequences of our actions but the other possible outcomes.
We can do this by asking ourselves (and our clients) what might
happen when they change an aspect of how they interact with
the world. As part of this, we would ask how their change would
affect themselves, their friends, their families, their
communities, and their societies. We also need to ask how these
changes might unfold over time.
For example, if we are working with a young woman who is
being verbally bullied at school, we can ask what would
happen if we helped her learn assertive skills. Using a narrow
way of seeing what we are doing, we could say that helping her
learn these skills is an ethical action. We could also measure to
see if she had acquired the skills. From this microperspective,
we could easily decide that our actions are ethical and
effective. However, taking a broader perspective we would need
to ask more questions to look at the potential consequences of
our actions. One outcome is that she may be able to protect
herself more effectively from the bully. Indeed, the bullying

might stop. Alternatively, the bully may escalate her aggression
and physically abuse the young person. This raises the
possibility that, although we are well inten- tioned, we may be
putting our client at greater risk for harm. By taking a broader
perspective, we might change our intervention from simply
teaching these skills to include an active monitoring of the
situation over time. As part of this process of taking on a
broader perspective, we also need to ask how a change in the
young person might influence her friends, classmates, school,
family, and community, as well as what structural changes
would be required to address the issue of bullying within the
larger environment.
It is not possible to accurately predict how change will
influence individuals and broader systems. At best, we are
making informed guesses about possible outcomes. The point is
to ask the questions so that we see the client in the reciprocal
relation- ships with the systems in her life not only in the
moment but also over time. The questions themselves do not
ensure that everything we do is ethical and effective, but they
increase the likelihood of this being the case as we broaden our
prospective of the potential consequences of our actions. We are
less likely to unintentionally cause our clients harm if we
develop practices that improve our understanding of the
potential outcomes of our actions.
In reference to the example of vulnerable children in the past,
we might reflect on the question of whether staff in the various
institutions would have used harsh pun- ishments if they had
been able to imagine the intergenerational effect their actions
120 G. CHARLES
had on those children in their care and their descendants. What
may have seemed to be an appropriate method of achieving their
immediate goals in the moment may have been viewed

differently if they had considered a broader range of potential
long-term outcomes. If they had been able to image the possible
outcomes of their actions they might have begun to challenge
the racist and antichild foundations of their work. This example
does not mean to refer to those adults who took pleasure in
hurting the children but rather those staff who were, however
misguided, trying to do a good job. Many of the people who
worked in the schools tried to do good work (Truth and
Reconciliation Commission of Canada, 2015) and as such my
guess is that many of them would be shocked at the hurt and
harm they caused over the long term.
The second way we may more accurately anticipate the integrity
and efficacy of our actions is to use a consequence framework.
This framework (see Figure 2) can be used as a method to look
past the obvious outcomes we are seeking with our clients to
also seeing what other outcomes may occur. The framework
consists of six parts: intended consequences, trade-offs,
unintended positive outcomes, unintended negative outcomes,
unknown consequences, and each of these components over
time.
The two boxes on the top left of the diagram are the easiest to
determine. In every intervention with a client we have an
intended consequence. For example, by teaching a young
woman assertiveness skills we hope to prevent her from being
bullied. However, each intervention has tradeoffs. We may have
restrictions on time, and every minute we spend with her means
that we have less time to spend with other young people in our
care. This, then, is the tradeoff. By spending time with one
young person, we have less to spend with others. We make these
decisions every
day at work. Hopefully, we take the time to think about the
consequences of working with one young person over another.
This is a relatively simple process.
It becomes more difficult to be able to see the outcomes
associated with the two boxes on the top right of the framework.

As mentioned, we can be clear on our desired outcomes and the
trade-offs we have to make to achieve them, but like the
example of the one-child policy decision makers and policy
makers in China, we may be completely ignorant of the possible
unintended consequences of our actions. Sometimes there can
be unintended positive outcomes. For example, teaching
assertiveness skills to the young victim of bullying might lead
to her sticking up to the bully and ending the harassment. This
was our intention. However, this might also lead to her
increasing her self-confidence. Being more sure of herself could
lead to higher grades in high school and a growing belief in her
that she could attend university. Although not part of the
intervention plan, this possible unintended positive could have
multiple benefits for her in the moment and in the future. It
could also have significant effects on her family in terms of
economics and in terms of role modeling of possible education
options to her siblings or future children. The contributions
she could make in her community because she had reached her
educational potential could also be significant. Although these
outcomes may or may not happen as a result of our original
intervention, we need to anticipate the possibilities so that we
can have associated interventions ready if our first action is
successful.
Likewise, we must also anticipate any possible unintended
negative outcomes. In the case of the young woman being
bullied, it is important to hypothesize what harmful actions may
occur as a result of our intervention. If the intervention were
unsuccessful, her self-confidence could significanly decrease,
potentially leading to self-harm if she felt that there was no
hope of an end of the victimization. If she com- mitted suicide,
this would affect not only her but also her friends, family, and
community. If the intervention was successful and she
acquired the intended assertiveness skills, the bullying might
escalate. Thus, we need to anticipate the many possible
unintended consequences.
The trick is to make the top-left boxes as big as possible and the

others as small as possible. We want to become as aware as
possible of the potential positive and negative consequences of
our interventions overtime as well as decreasing the potential
unknown consequences as we can be in any situation. By asking
ourselves what else could happen if we do or don’t do
something in our interactions with clients, we can begin to
increase our sense of the obvious and less obvious outcomes in
our work with people. By taking the time to broaden our
understanding of the possible outcomes of our actions, we
increase the likelihood that we can be ethical and effective
practitioners in the moment and, just as important, over time.
As we learn to see ourselves not just as individuals in the
moment but also as having influence across systems and over
time, we can begin to see ourselves as part of the big picture.
This is a critical step in becoming truly ethical and effective
practitioners.
122 G. CHARLES Conclusion
All practitioners want to be ethical and effective. We want to
believe that we are helping rather than hurting people. However,
it can be difficult to be the practitioner we want to be. There
are constant forces at play that push us to our limits. The limits
to our knowledge, the high and varied needs of our clients,
increasingly large caseloads, stretched and insufficient
resources, and a lack of support in many workplaces hinder our
ability to achieve our goal to be competent and contributing
practitioners. However, who we are and how we work is not
simply about the environment in which we work. We are also
influenced by how we learn about ethics and evidence in our
professional training and how we apply them once we begin to
practice in our respective professions.
We have traditionally taken a narrow perspective on what
constitutes ethical and effective practice. We often evaluate the
correctness of our actions within the moment we are interacting
with our clients. If we don’t see harm and we do see change

then we believe we are being ethical and effective. I have
provided large-scale historical examples of social practices as a
means of demonstrating these points. These examples are
analogous to our work with individuals in a professional role.
We often fail to consider the effect of our work on our clients
and systems in the present and over time. We risk harming
others by limiting our perspective to short-sighted
considerations and simplistic measures of outcomes. This is
ulti- mately an issue of professional ethics, and we need to
adopt methods of deepening and broadening our perspectives to
truly meet our goal for ethical and effective practice.
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