Model for Ethical Dilemmas


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Model for Ethical Dilemmas

  1. 1. How to Solve Ethical Dilemmas1. Model for Ethical Dilemma—Taken from Practitioner’s Guide found in Course Documents 2. Ethical Dilemma—School Records 3. Ethical Dilemma—GLTB 4. Ethical Dilemma—To Warn or Not to Warn 5. Ethical Dilemma—The Case of the Former Client
  2. 2. Model for Ethical Dilemmas Taken from Practitioner’s Guide found in Course DocumentsStep Information to be considered CompletedIdentify the problem Gather as much information as you can that will illuminate the situation. In doing so, it is important to be as specific and objective as possible. Writing ideas on paper may help you gain clarity. Outline the facts, separating out innuendos, assumptions, hypotheses, or suspicions. There are several questions you can ask yourself: Is it an ethical, legal, professional, or clinical problem? Is it a combination of more than one of these? If a legal question exists, seek legal advice. Other questions that it may be useful to ask yourself are: Is the issue related to me and what I am or am not doing? Is it related to a client and/or the client’s significant others and what they are or are not doing? Is it related to the institution or agency and their policies and procedures? If the problem can be resolved by implementing a policy of an institution or agency, you can look to the agency’s guidelines. It is good to remember that dilemmas you face are often complex, so a useful guideline is to examine the problem from several perspectives and avoid searching for a simplistic solution.Apply the ACA, ASCA, STATE THE SPECIFIC SOURCE OF YOUR GUIDELINESor Federal Guidelines After you have clarified the problem, refer to the Code of Ethics (or pertinent source) to see if the issue is addressed there. If there is an applicable standard or several standards and they are specificfor Special Education and clear, following the course of action indicated should lead to a resolution of the problem. To be able to apply the ethical standards, it is essential that you have read them carefully and that you understand their implications. If the problem is more complex and a resolution does not seem apparent, then you probably have a true ethical dilemma and need to proceed with further steps in the ethical decision making process.Determine the nature There are several avenues to follow in order to ensure that you have examined the problem in all itsand dimensions of the various dimensions. Consider the moral principles of autonomy, non-maleficence, beneficence, justice, andproblem fidelity. Decide which principles apply to the specific situation, and determine which principle takes priority for you in this case. In theory, each principle is of equal value, which means that it is your challenge to determine the priorities when two or more of them are in conflict. Review the relevant professional literature to ensure that you are using the most current professional thinking in reaching a decision. Consult with experienced professional colleagues and/or supervisors. As they review with you the information you have gathered, they may see other issues that are relevant or provide a perspective you have not considered. They may also be able to identify aspects of the dilemma that you are not viewing objectively. Consult your state or national professional associations to see if they can provide help with the dilemma.
  3. 3. Generate a potential course Brainstorm as many possible courses of action as possible. Be creative and consider all options. Ifof action possible, enlist the assistance of at least one colleague to help you generate options.Consider the potential Considering the information you have gathered and the priorities you have set, evaluate each optionconsequences of all options and assess the potential consequences for all the parties involved. Ponder the implications of eachand determine a course of course of action for the client, for others who will be affected, and for yourself as a counselor.action. Eliminate the options that clearly do not give the desired results or cause even more problematic consequences. Review the remaining options to determine which option or combination of options best fits the situation and addresses the priorities you have identified.Evaluate the selected Review the selected course of action to see if it presents any new ethical considerations. Stadlercourse of action. (1986) suggests applying three simple tests to the selected course of action to ensure that it is appropriate. In applying the test of justice, assess your own sense of fairness by determining whether you would treat others the same in this situation. For the test of publicity, ask yourself whether you would want your behavior reported in the press. The test of universality asks you to assess whether you could recommend the same course of action to another counselor in the same situation. If the course of action you have selected seems to present new ethical issues, then you’ll need to go back to the beginning and re-evaluate each step of the process. Perhaps you have chosen the wrong option or you might have identified the problem incorrectly. If you can answer in the affirmative to each of the questions suggested by Stadler (thus passing the test of justice, publicity, and universality) and you are satisfied that you have selected an appropriate option.Implement the Course of Taking the appropriate action in an ethical dilemma is often difficult. The final step involves You will not addressAction strengthening your ego to allow you to carry out your plan. After implementing your course of this step unless you action, it is good practice to follow up on the situation to assess whether your actions had the actually follow anticipated effect and consequences. through.
  4. 4. Ethical Dilemma—School Records Dilemma #1Step Information to be considered CompletedIdentify the problem. Joe Bob is a 12 year old whose primary caretaker is his father. He very seldom has contact with his mother. One day his mother calls and wants to see Joe Bob’s academic record, including his TAKS scores. The secretary sends the call to you. Before I can give out any information, I will need to have her come in and produce a picture id to verify her identity. From a legal standpoint I need to know the status of the family unit. I would need to know if the parents are legally separated or divorced, and if there is any legal reason, such as a court order, that would prevent the release of school records. Ethically, I need to consider whether or not I should notify the father that the mother is requesting the information. Since the child in question is only 12, the father will determine whether or not he tells his son what his mother is up to. I know that professionally I may share the information with others on a need-to-know basis when working with the student, but does the mother fall into this category? Does it matter why or what she wants the information for, and is that my concern? I do not believe there is a clinical reason to withhold the information because I am not counseling the student at this time.Apply the ACA,ASCA, Texas Family Code (TFC) §153.377or Allows a nonparent who is appointed as the possessory conservator (the parent with visitationFederal Guidelines for rights) the same right of access to medical, dental, psychological, and educational records ofSpecial Ed. the child as the managing conservator (the one with custody), without regard to whether the right is specified in the court order (Walsh, Kemerer, & Maniotis, p. 369). Texas Education Code (TEC) §26.001 Parents are considered “partners with educators, administrators, and school district boards of trustees in their child’s education.” TEC §26.004 & §26.006 Parents are entitled to “all written records” in regards to their child. These records include attendance records, test scores, counseling records, reports about behavioral patterns, and teaching materials. Page v. Rotterdam-Mohonasen Central School District Unless a court order is in place, non-custodial parents enjoy the same rights as custodial parents.
  5. 5. Determine the nature When considering the moral principles of autonomy, non-maleficence, beneficence, justice, andand dimensions of the fidelity, only fidelity is removed from the equation. There is no therapeutic relationship between theproblem. counselor and the student, so fidelity is a non-issue. Autonomy involves the right for the client to choose a course of action, but the client in question is only 12. Parents have the right to choose for their child until they are 18, when FERPA transfers that right from the parent to the child at that time. The father has a right to choose for the child but so does the non-custodial mother. I do feel that some damage could be done to the child if the mother is seeking information to use against the father to gain custody or visitation rights since she has been nonexistent for some period of time. Non-maleficence does appear to be an issue because there is a potential harm to the child if the information is released to the mother. If the mother uses the information to separate the child from the primary caretaker, then I believe beneficence is also a concern in this situation. If the child’s welfare is in danger with the release of the information, then I must take that into consideration. Should I treat the mother the same as the father, or does the father have a bigger stake in the situation? Justice does not mean equal, so if I treat the mother and father differently, I must be able to explain why I have done so. The biggest issue that I see is the combination of non-maleficence and beneficence. If the release of the information could possibly hurt the child, as a counselor, I could possibly have to counsel the child, which could lead to the possibly of more release of information questions. If I go strictly by the law and use the TFC, the TEC, and recent court cases, I have no choice but to release the information to the mother.Generate a potential There seems to be only two choices of action in this case. I can give the mother the information she iscourse of action. asking for, or I can deny her access to the information.Consider the potential If I release the information to the mother, she may be satisfied, and no further action will be required. It isconsequences of all possible that she truly is interested in her son’s education and is seeking the information because she cares. Ifoptions and determine a the child is doing well in school, she may be satisfied that the current situation is best for the child. However, ifcourse of action. the information shows that he is struggling, she may feel she could do a better job in her son’s education than the father. If this were the case, the whole situation could become very messy. If I deny her access to the desired information, she may seek legal action to compel the release of the records. Again, under current federal law, she has a legal right to the educational records of her child. I believe that weighing all the options available, I would give her the information she is requesting, but I would contact the father before I released the records to her. Mrs. Sarah Morrison, the Smyer Counselor, advised me to give no information over the phone. Mrs. Morrison advised me to ask the mother come to school and show proof of identification, such as a drivers’ license. While I am waiting for the mother to come in with the information I need from her, I should notify the father of the mother’s request for academic information and TAKS scores. At this time I need to ask the father if there is any legal reason I should not give the mother the information. I could release the information to her after I have obtained information as to any legal reason to withhold the student information and when I have verified identification.
  6. 6. Evaluate the selected After reviewing all the facts, the law, and visiting with a certified counselor, I would release thecourse of action. information to the mother after I have no legal documentation to deny her the information and when she in fact comes in in person and verifies her identity and legal right as the parent of the child. I would treat someone else in the exact situation the same as I did in this situation. I would have no problem with my behavior being reported in the press. Given the same circumstances, I would recommend to another counselor to follow the same procedure as I did in this situation.Implement the Course After careful consideration, some investigating of the situation, proof of identity, and no legalof Action. documentation to deny release of academic and TAKS information, I would release the desired information to the mother in this case. ReferencesPage v. Rotterdam-Mohonasen Central School District 109 Misc.2d 1049, 441 N.Y.S. 2d 323 (1981). Retrieved from Constitution and Statutes, Texas Education Agency.(n.d.).Texas education code Retrieved from Constitution and Statutes, Texas Family Code. Retrieved from http://www.statutes.legis.state.tx/Docs/FA/htm/FA.261.htmWalsh, J, Kemerer, F, & Maniotis, L. (2010).The educators guide to Texas school law: seventh edition. Austin, Texas: Univ of Texas Pr.
  7. 7. Ethical Dilemma—GLBT Dilemma #2Step Information to be considered CompletedIdentify the problem. You have a student who comes to you and tells you he is gay. He says some other students are teasing him constantly and one has even pushed him around in the locker room. What are your obligations? This could be an ethical problem if the counselor has trouble separating his/her own views about homosexuals or has difficulty working with a homosexual student. Legally, not acting on behalf of the student being harassed could result in the public school official being sued for not protecting the student (42 U.S.C. 1983). Professionally, counselors are directed under Competency 002 (Student Diversity) of the Texas Educator Certification as follows: The school counselor understands human diversity and applies this knowledge to ensure that the developmental guidance and counseling program is responsive to all students. This could possibly become a clinical problem because I do believe I would need to counsel the student on healthy ways to handle problems that may arise due to his sexual orientation. As far as the students teasing him and pushing him around, I would need to discuss the situation with the school principal, who will handle the discipline of the students causing this young man distress.Apply the ACA, ASCA position—Professional school counselors recognize the need for all studentsASCA, or Federal who attend school in a safe, orderly and caring environment. To promote this type ofGuidelines for environment, comprehensive school counseling programs include anti-Special Ed. bullying/harassment and violence-prevention programs along with comprehensive conflict-resolution programs to foster a positive school climate. ASCA position—Professional school counselors promote equal opportunity and respect for all individuals regardless of sexual orientation/gender identity. Professional school counselors work to eliminate barriers that impede student development and achievement and are committed to academic, personal/social and career development of all students. 14th Amendment to the United States Constitution--All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside. No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.
  8. 8. Determine the nature Autonomy does come in to play in this situation. The student is allowed and encouraged toand dimensions of the choose freely, make his own decisions, and act on his own values. The counselor is not toproblem. impose his/her values on the student or to imply that what he is doing is morally or ethically wrong, based on the counselor’s values. The concept of non-maleficence is also an important part of this situation. The student does have a right to attend school without the fear of being singled out for not conforming to the norm. The principle of do no harm applies to the counselor not making the student feel guilty about his sexual orientation. Beneficence reflects the counselor’s responsibility to be actively involved in the situation to do good, to protect, and to prevent harm if possible. Since the student has been pushed around in a locker room, something has to be done to keep him safe. I am not sure how justice is a part of this equation. The student does not deserve special treatment because he is homosexual but does not deserve to be treated differently because he is homosexual. Both the homosexual student and the boys who are teasing and shoving him have expectations to attend school without fear. Since I could possibly be counseling the homosexual student, he would expect me to keep his confidences and place his interests as my priority. When counseling with him, I should make him aware of the exceptions to confidentiality and encourage openness and honesty. If he is under 18, I will communicate with him the possibility of bringing his parents into the discussion to help him deal with his sexual orientation. They too may have a need to discuss their son’s sexual orientation and how they can help him deal with his choice. Mrs. Morrison, the Smyer counselor, advised me to work closely with the homosexual student to help him better deal with the problem and suggest healthy ways to handle to the situation. She also advised me that the actions by the boys were a discipline issue, not a counseling issue. Mrs. Morrison said I should contact the principal and let him deal with that part of the situation.Generate a potential I believe the course of action is to work closely with the student who has offered up the factcourse of action. that he is homosexual. I believe he may need to talk about it and could possible need help in confronting his parents if they are unaware. He will need to develop coping skills because people may always judge him or treat him differently because of his sexual orientation. I am not saying that his sexual orientation will always be a source of ridicule, but he will need coping skills to deal with insensitive people. As a counselor, I need to provide opportunities for all students to learn acceptable alternatives to treating others. It is not acceptable to tease someone about their sexual orientation or push them because you do not approve of their lifestyle, hair color, or clothes. Students need to be allowed to practice how to treat one
  9. 9. another in various situations. Respect for one another should be a goal for the student body to learn as a whole. As far as the boys in question, the principal should handle the discipline and hand out punishment appropriate for their actions. They should be made aware of the fact that what they are doing could be construed as harassment, and the consequences could have legal implications. Wisconsin, 1996: Jamie Nabozny was awarded $962,000 for injuries he suffered while at Ashland Middle School and Ashland High School. This was the first time a federal jury found school officials responsible for anti-gay harassment committed by students. In addition to verbally abusing him, Nabozny said other students kicked him, urinated on him, and in one incident, pretended to rape him. One attack left him in need of surgery. Illinois, 1996: the Riverside-Brookfield School District settled a lawsuit filed by the family of a gay student who alleged that school officials did not act on his complaints of abuse from other students. Washington, D.C., 1997: The U.S. Department of Education issued guidelines spelling out that gay and lesbian students are covered by federal prohibitions against sexual harassment. Arkansas, 1998: Following a complaint from a gay student who said he endured two years of abuse from other students, the Fayetteville School District signed an agreement with the U.S. Department of Education to hold sexual harassment workshops for teachers and students, take disciplinary action against any student “reported and confirmed to have engaged in sexually harassing behavior.” Doing nothing is not an option. As a school official, I could be sued for failing to protect the student under the theories of negligence, gross negligence, strict liability, or failure to supervise. Ingraham v. Wright (1977), the U.S. Supreme Court held that students’ right to their bodily integrity is a liberty interest that is protected by the Constitution.Consider the potential If I work with the student on ways to deal with his choice of lifestyle, I believe I can betterconsequences of all help him deal with insensitive people that he will encounter for the rest of his life. If I dooptions and determine nothing to help him, then I will have failed in my obligations as a counselor. If I ignore thea course of action. boys who have been teasing and shoving him, then I could be prosecuted for not protecting him. I must hand that part of the situation over to the principal. As the counselor, I need to
  10. 10. provide all students opportunities to learn how to approach situations in which they feel threatened. If I do not address that problem with the students as a whole, the situation could possibly get worse, and someone could be seriously injured. All students need to be given opportunities to respect one another, regardless of ones differences.Evaluate the selected After considering the pros and cons of the situation, I feel I must offer my services to thecourse of action. student who is being bullied. I must also take steps to work with the students as a whole on ways to treat those who are different than us. Teasing and physical contact are not acceptable ways to react to someone we view as different or unacceptable. The world is made up of a diverse population and so is the school setting. Learning to accept those differences without prejudice is something we all can benefit from. I would make the principal aware of the boys that have been picking on the student and let him assign an appropriate punishment for their behavior. I believe I would treat any other student with the same respect and try to remedy the situation. Every student is entitled to attend school without the threat of fear or bodily harm. If the incident were reported to the newspaper, I would have no problem defending my position. A person’s sexual orientation does not give another person the right to pick on them, tease them, or do bodily harm. As a counselor and an educator, I have a duty to protect the students in my charge. I would take the same steps again under the exact same circumstances, offer to counsel with the young man who has come forth with the confession of homosexuality, and turn the boys in who were mistreating him to the principal.Implement the Course Meet with the student who presented the problem and begin counseling sessions if he isof Action. willing. I will give the principal an opportunity to handle the discipline of the boys responsible for inappropriate behavior. I will implement opportunities for the student body to grow and accept people from diverse backgrounds. ReferencesDunklee, D, & Shoop, R. (2006). The principals quick-reference guide to school law: reducing liability, litigation, and other potential legal tangles. Thousand Oaks, California: Corwin Pr.Stone, C. (n.d.). Case studies legal and ethical issues in working with minors in schools. Unpublished manuscript, College of
  11. 11. Education and Human Services, University of North Florida, Jacksonville, Florida. Retrieved from States government, (n.d.). The constitution of the united states, Washington, DC: Government Printing Office. Retrieved from
  12. 12. Ethical Dilemma—To Warn or Not to Warn Dilemma #3Step Information to be considered CompletedIdentify the problem. Demarcus is a 14 year old student under the special education umbrella as “emotionally disturbed.” He is generally non-violent but lately has been having “meltdowns.” His teacher refers him to you because, during one of his meltdowns, he said, “I hate my father. I’d like to choke him.” This situation appears to combine ethics, a legal obligation and professional obligations all together. Ethically, I feel a need to alert the father of the threat because of the emotionally disturbed component of the student’s disability. Legally, I do not have to share this information with the father because Texas does not have a duty to warn clause, but I am allowed to share if the student or someone else is in danger. Professionally, I feel compelled to share this information because the student is under 18 years of age, and the parents are in control of their child’s educational direction as well as counseling services. The parents have a right to know if they or someone else is in danger and to take appropriate steps to avert the situation. Under the clinical obligation, I need to be proactive and get the bottom of the threat. I will probably be treating the student, provided he and/or his parents agree to the counseling sessions. I do not believe that because Demarcus is emotionally disturbed that his declaration should be dismissed, but because of his situation, action should be taken to keep the event from happening. Even if he is blowing off steam, the threat should be dealt with in a timely manner.Apply the ACA, The student’s Individualized Educational Plan (IEP) needs to be checked to verify anyASCA, or Federal special needs he may have concerning his mental capabilities.Guidelines for The ACA Code of Ethics (2005), allows a counselor to release confidentialSpecial Ed. information under the following circumstances: danger and legal requirements (harm to self to others), contagious or life threatening diseases (harm or self to others), and court-ordered disclosure. Texas state law also provides release of confidential information in cases of abuse or neglect to Child Protective Services or to law enforcement personnel. Counselors should consult other professionals when in doubt of the validity of an exception (ACA Code of Ethics, 2005). Texas Family Code (TFC) §32.004 (b) (2), which allows for release “with or without the consent of a child who is a client, advise the child’s parents or, if applicable, manage conservator or guardian of the treatment given to or needed by the child.”
  13. 13. Determine the nature The principle of autonomy, of allowing the client (Demarcus) to choose for himself, seems toand dimensions of the be out of the question. Since he has been identified as emotionally disturbed and under theproblem. age of 18, I believe his parents should be given the opportunity to decide if they want him to receive counseling services or not. He too should be included in the conversation, but ultimately, his parents should make the final decision. The concept of non-maleficence is perhaps the main concern in this situation. Demarcus had indicated that he would like to choke his father and would be causing harm to others. Protecting the object of Demarcus’s frustration (his father) has to be taken into consideration. As a counselor, I need to work with Demarcus to help him understand that harming oneself or others is not a healthy way to handle any situation. The principle of beneficence requires the counselor to work toward the welfare of the client, Demarcus, and at the same time prevent harm to oneself or others. I would need to help Demarcus develop coping skills on a level that he can understand. Since the concept of justice does not require a counselor to treat everyone the same, I will have some leeway in the approaches I use to help Demarcus confront his anger issues. I believe that his emotional disturbed “label” allows me to treat him differently than someone else who does not carry that label. I believe his individual situation requires me as the counselor to approach his treatment with an understanding that I may need to seek outside help in his treatment. Demarcus should expect me to keep his confidences or fidelity, just as I would with any other client. The duty to disclose confidential information is given by the Texas Family Code (TFC) §32.004 (b) (2), which allows for release “with or without the consent of a child who is a client, advise the child’s parents or, if applicable, manage conservator or guardian of the treatment given to or needed by the child.” The ACA Code of Ethics (2005), allows a counselor to release confidential information under the following circumstances: danger and legal requirements (harm to self to others), contagious or life threatening diseases (harm or self to others), and court-ordered disclosure. A wise woman, Dr. McGlamery, added the following comment to this course of action: “I would like to go to Paris. Does that mean I am buying a ticket? Probably not. I would like to choke my father. Does that mean I would actually do it, or I am just frustrated with some aspect of my life? Dont know. Why dont you just ask him why he said it? What if I had said that DeMarcuss father was a known meth dealer? Would that have changed your answer?” It is always wise to consult with someone with more experience than yourself when facing a dilemma.
  14. 14. Generate a potential As the counselor, I feel I must counsel Demarcus and work on his anger issues. I will workcourse of action. closely with Demarcus and his parents to help defuse the situation. I would confer with the teacher who notified me of the threat to see if she has noticed any change in his behavior since the incident was reported. If I am unable to make adjustments in his coping skills, I will need to seek help from an outside source. I would, of course, discuss the matter with Demarcus and his parents. I do not believe his threats should be dismissed as a child blowing off steam or not take the threat seriously. Given his emotionally disturbed impairment, I think the threat carries more weight. If he has trouble with reality, he may be confused with right and wrong. He needs to be shown coping mechanisms on his level to handle difficult situations. I visited with Mrs. Sabrina Murphy, a special education teacher, about this situation. She advised me that since Demarcus is emotionally disturbed, he should have a Behavioral Intervention Plan (BIP) on file, and I should become familiar with it before acting. She also informed me that more needs to be known about the student’s background, for instance: Socioeconomic situation-homeless, free or reduced lunch, etc. Family situation-parents married, divorced, deceased, living with grandparent, etc. How the student arrives at school-walks, parents bring him, bus Other siblings-living at home, with someone else, or only child Cultural background Mrs. Murphy also indicated that I should consider individual, group, and family counseling in order to better serve the needs of the student.Consider the potential It is hard to determine what should be done without knowing all the information aboutconsequences of all Demarcus’s emotional condition. If I do not involve his parents in the counseling sessions oroptions and determine make the aware of the situation, then things could become progressively worse. By makinga course of action. his parents aware, they are free to determine what course of action they wish to pursue. His parents may be more aware of what caused the outburst and are better equipped to handle the situation. They may not know how to help their son and be appreciative of the help that I could offer. I would consider individual counseling with Demarcus, group counseling with other students, and family counseling to help alleviate the tension within the home. As with most dilemmas, doing nothing as in this case is not an option. I would continue to confer with the teacher who first brought the problem to me to verify if there is any change in Demarcus’s behavior.
  15. 15. Evaluate the selectedAs I evaluate my course of action, which is to counsel Demarcus and involve his parentscourse of action. about the situation, I have no problem doing the same thing if the occasion were to rise again. Given the same information on a different case, I would take the same measures: counsel the student and make the parents aware of the situation. I do not believe I would have a problem with my actions plastered all over the newspaper. My actions could prevent someone from being harmed, and if the danger is not really present, it would allow the parents to choose their own course of action or non-action. Given the same situation, I would have no problem advising a colleague to do the same. I would feel less guilty if this were all a mistake than I would if Demarcus acted on his threat toward his dad. I believe the law would be more forgiving if I divulged confidential information and a situation was averted, than if I ignored the threat and harm was done.Implement the Course Begin counseling Demarcus and keep his parents abreast of the progress or lack thereof. Iof Action. would follow up with the teacher who referred Demarcus to me in the first place to verify if progress is showing up in the classroom. ReferencesAmerican Counseling Association.(2005). Code of ethics and standards of practice. Retrieved fromhttp://www.counseling org/Herbert, J. D. (2002). The duty to warn: a reconsideration and critique. Journal of American Academy Psychiatry Law, 30(3), 417-424. Retrieved from, D. L. (2009, March 10). [Web log message]. Retrieved from Constitution and Statutes, Texas Education Agency.(n.d.).Texas education code.
  16. 16. Retrieved from S. Department of Education, Family Policy Compliance Office. (Nod). Family educational rights and privacy act (20 U.S.C. 1234g; 34 CFR Part 99). Washington, DC:Government Printing Office. Retrieved from
  17. 17. Ethical Dilemma—TheCase of the Former Client Dilemma #4Step Information to be considered CompletedIdentify the problem. You saw Sandy for marital issues and childhood abuse for some two years. She terminated counseling some 18 months ago and is now employed as the secretary at your doctor’s office. You see her after a recent appointment there. She has been divorced for a year. Sandy invites you to her apartment for a drink after your appointment to “catch up” on what’s been happening. I do believe this is an ethical dilemma and possibly a professional dilemma. This is an ethics problem because it involves interaction with a former patient. I think it also presents itself as a professional dilemma because of the prior patient/counselor relationship. Perhaps the ethical and professional dilemmas are only ethical; should I or should I not change the relationship with Sandy from professional to personal? I do not believe that this is a clinical problem since I am no longer counseling Sandy. As far as beginning a friendly relationship with Sandy affecting those around her or what they are doing or not doing, I do not believe it would. However, I would find it awkward knowing what I know about her, so it is possible her family members or friends might find the relationship uncomfortable. I would need to check the institution in which I work to see if there are any rules concerning relationships with former clients.Apply the ACA, ACA Code of Ethics:ASCA, or Federal A.5.c. Nonprofessional Interactions or Relationships (Other Than Sexual or RomanticGuidelines for Interaction or Relationships) Counselor-client non-professional relationships with clients,Special Ed. former clients, their romantic partners, or their family members should be avoided, except when the interaction is potentially beneficial to the client. A.5.d. Potentially Beneficial Interactions-When a counselor-client non-professional interaction with a client or former client may be potentially beneficial to the client or former client, the counselor must document in case records, prior to the interaction (when feasible), the rationale for such an interaction, the potential benefit, and anticipated consequences for the client or former client and other individuals significantly involved with the client or former client. Such interactions should be initiated with appropriate client consent. Where unintentional harm occurs to the client or former client, or to an individual significantly involved with the client or former client, due to the non-professional interaction, the counselor must show evidence of an attempt to remedy such harm. Examples of potentially beneficial interactions include, but are not limited to, attending a formal ceremony (e.g., a wedding/commitment ceremony or graduation); purchasing a service or product provided by a client or former client (excepting unrestricted bartering); hospital visits to an ill family
  18. 18. member; mutual membership in a professional association, organization, or community.Determine the nature As a counselor, I will be encouraging my clients to become independent, thus autonomy isand dimensions of the something to consider. Sandy is becoming independent, moving on, and reaching out toproblem. make new friends. However, I do not believe I should become a personal friend based on our previous counselor/client relationship. I think Sandy is capable of making rational decisions, but I do not feel comfortable in becoming a friend, as her invitation to “catch-up” might lead. Being acquaintances at the doctor’s office may be as social as the relationship should be. The only way I see non-maleficence being as issue is if I did accept her invitation to “catch-up” and a friendly relationship developed; she might view my insights as professional suggestions instead of friend to friend. I do not believe I would suggest anything that might cause her harm, but if she misinterpreted something I said, I would feel responsible. Whether I was Sandy’s counselor or friend, I would not wish her ill will, or harm of any kind. If I am going to show beneficence toward Sandy, I think the best avenue would be to just be friendly acquaintances. As far as justice in this situation, as long as I would do the same thing concerning other former clients, I do not have a problem. Sandy should know that I would never reveal any information that was learned in any counseling session provided that information fell under the confidentiality guidelines. Whether we become friends or not, fidelity would be honored. I consulted Sarah Morrison, the Smyer ISD Counselor, and she advised me that this was not a good idea. She said, “Absolutely not, it is unethical and could cause problems down the line.”Generate a potential One course of action would be to tell Sandy that I do not think it would be a good idea for uscourse of action. to have drinks and catch up. I would explain to her that since our prior relationship was as counselor/client, I did not think changing that relationship would be beneficial to either one of us. Another possibility would be just to agree to go to her apartment, have drinks, and catch up on everything that has happened since I last saw her. I really do not feel comfortable with this option. I could just tell her that I am very busy, and I do not know when I would have time to stop by, but I am glad that she is working and doing well.Consider the potential If I chose to just tell Sandy up front that I cannot in good conscience accept her invitation, sheconsequences of all might be hurt. I do not want to hurt her, but I do not want to put either of us in an awkwardoptions and determine situation. I feel I would know too much of her background and trying to switch froma course of action. counselor to friend would be uncomfortable for us both. I have no problem talking small talk when I see her at the doctor’s office or out in public, but drinks and friendly conversation is
  19. 19. not an option for me. If I did agree to meet with her for drinks and catch up as she said, I do not think it should be at her apartment. Her apartment suggests friends getting together, and up until this point, we have not been friends. If I were to agree to meet her for drinks, I think it should be in a public place. If I chose the last option, and just told her I am really busy and do not know when I would have the time, she might forget about it or just ask me the next time I am at the doctor’s office.Evaluate the selected I think I am most comfortable with the first option. I do not feel that under the circumstancescourse of action. of our prior relationship that I can accept her invitation for drinks at her apartment to catch up. I think accepting her invitation just opens up too many unknown problems. It is possible that she does not want anything other than an ear to listen, but I feel she should confide in a close friend. She is apparently well enough to commit to a job and feels confident in herself to reach out to a former counselor, but I just feel it is an awkward situation. I do not see any benefit to her for me to accept her invitation. Ethically, this type of relationship is not recommended between a former counselor and client. I do feel that I have selected the best course of action by explaining to her the ethics that are involved in this type of relationship. I believe I would do the same thing given the same circumstances no matter who the former client was. As a coach, I do not sit with parents of my athletes because I do not want any one saying that my friendship with that parent is why their child plays all the time. I do think it is fair to say no to former clients when the previous relationship of counselor/client is involved. I do not think anyone would fault me for not accepting Sandy’s invitation. In the world of public opinion, I think more would be said if I did accept the invitation than not. I would have no problem recommending this course of action to another colleague. If I read the Ethical Code correctly, this type of relationship does not benefit the former client and should be avoided.Implement the Courseof Action. ReferencesAmerican Counseling Association.(2005). Code of ethics and standards of practice. Retrieved fromhttp://www.counseling org/