Running Head: EDPS 604 ETHICAL DECISION-MAKING

Ethical Decision-Making Process Model

Christina P. Majcher
University of Calgary

EDPS 604 ETHICAL DECISION-MAKING

Ethical Decision-Making Process Steps

Step 1. Identification of Individuals and Groups Potentially Affected by the Decision
The primary individuals that I see being affected by any decision I make are the two
women, the two accused therapists, the accused therapists current clients, all of the women in
the current study, the womens current therapists and previous therapists of all other women
involved in the study, the university, my supervisee, society in general and psychology as a
discipline. I believe that my greatest responsibility in this situation is to the two women (Respect
for the Dignity of Persons, Responsibly Caring, Integrity in Relationships).
Step 2. Identification of Ethically Relevant Issues and Practices
I can identify many ethical values that I think are key to this dilemma:
Table 1.
Principle/Value
Principle I: Respect For The Dignity Of Person
I.1 Demonstrate appropriate respect for the

My Thoughts
I need to respect the expertise of the

knowledge, insight, experience and areas of

therapists currently working with the

expertise of others.

women as well as the knowledge and

insight of the women.

I.8 Respect the rights of research participants,

I need to convey respect for the women. I

clients, employees, students, trainees, and others

need to ensure that I know the complete

to safeguard their own dignity.

story. In addition, the women may not

want to have the therapists reported and I
need to respect their feelings, personal
interests and dignity.

I.11 Seek to design research, teaching, practice

Not including the previous therapists in my

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and business activities in such a way that they

research has perhaps unfairly excluded

contribute to the fair distribution of benefits to

them as part of the process.

individuals and groups, and that they do not

unfairly exclude those who are vulnerable or
might be disadvantaged.
I.16 Seek as full and active participation as

It is imperative that I involve the women

possible from others in decisions that affect them,

and perhaps their current therapists with

respecting and integrating as much as possible

my decision. The current therapists who

their opinions and wishes.

made the referral and the other women in

the study may be impacted by whatever
decision I make. I should take their points
of view into consideration, but not feel
bound to follow their wishes.

I.20 Obtain informed consent for all research

I need to ensure that I was very direct with

activities that involve obtrusive measures,

the women of the potential consequences

invasion of privacy, more than minimal risk of

of sharing the names of their previous

harm, or any attempt to change the behaviour of

therapists and my limits to remaining

the research participants.

confidential.

I.24 Ensure in the process of obtaining informed

Have I been completely open with the

consent, that at least the following points are

women to ensure that they know the

understood: purpose and nature of the activity;

purpose of my research as well as

mutual responsibilities; confidentiality

confidentiality protections and limitations?

protections and limitations; likely benefits and

Did I document these conversations?

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risks; alternatives; the likely consequences of

non-action; the option to refuse or withdraw at
any time, without prejudice; over what period of
time the consent applies; and, how to rescind
consent if desired.
I.37 Seek and collect only information that is

Does knowing the names of the individuals

germane to the purpose(s) for which consent has

affect or influence the intent of my

been obtained.

dissertation? Is this relevant information

that should be recorded?

I.39 Record only that private information

What is the intent of my research? The

necessary for the provision of continuous,

names of the therapists do not pertain to

coordinated service, or for the goals of the

my research question.

particular research study being conducted, or that

is required or justified by law.
I.43 Be careful not to relay information about

I need to be careful with relaying this

colleagues, colleagues clients, research

information to colleagues when consulting

participants, employees, supervisees, students,

to help protect the clients and therapists

trainees, and members of organizations, gained in

privacy.

the process of their activities as psychologists,

that the psychologist has reason to believe is
considered confidential by those persons, except
as required or justified by law.
I.45 Share confidential information with others

I need to be aware that the information that

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only with the informed consent of those involved,

the women shared with me is not my

or in a manner that the persons involved cannot

information to share with others, without

be identified, except as required or justified by

everyones informed consent. It might be

law, or in circumstances of actual or possible

helpful to know if the therapists are aware

serious harm or death.

of my research.

I. 46 Encourage others, in a manner consistent

Does encouraging the women to report the

with this Code, to respect the dignity of persons

relationships support their right to dignity

and to expect respect for their own dignity.

Principle II: Responsible Caring
II.1 Protect and promote the welfare of clients,

and respect?

research participants, employees, supervisees,

interest of the women? Is it in the best

students, trainees, colleagues, and others.

interest of everyone else involved? How

Is sharing this information in the best

can I care responsibly for all of the people

involved? I feel that the women are the
most vulnerable people in this situation as
the therapist held the power in this
relationship. I need to protect them first
and foremost.
II.2 Avoid doing harm to clients, research

Sharing this information or encouraging the

participants, employees, supervisees, students,

women to report their previous therapists

trainees, colleagues, and others.

might cause more harm to the women or

their current therapists.

II.13 Assess the individuals, families, groups, and

I must ensure that I have a good idea of

communities involved in the activities adequately

whether or not the women could handle

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enough to ensure that the will be able to discern

reporting the therapists. Im not sure about

what will benefit and not harm the person

the intent and degree of harm at this stage.

involved.
II.40 Act to stop or offset the consequences of

Are the therapists engaging in this type of

seriously harmful activities being carried out by

relationship frequently with other clients?

another psychologist or member of another

How much harm did the relationships with

discipline, when there is objective information

previous therapists cause the women?

about the activities and the harm, and when these

activities have come to their attention outside of a
confidential client relationship between
themselves and the psychologist or member of
another discipline.
Principle III: Integrity In Relationships
III.1 Not knowingly participate in, condone, or be

If the allegations are false or have been

associated with dishonesty, fraud or

misinterpreted in any way, I could seriously

misrepresentation.

damage the careers of the therapists.

I need to ask myself if I am affected by

III.10 Evaluate how their personal experiences,

knowing this extra information. Am I

attitudes, values, social context, individual

filling a personal need by not letting them

differences, stresses and specific training

get away with this type of behaviour? I

influence their activities and thinking, integrating

need to remain unbiased.

this awareness into all attempts to be objective

and unbiased in their research, service and other
activities.

I need to ensure that I have all of the facts

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III.11 Take care to communicate as completely

before I proceed to share with all parties

and objectively as possible, and to clearly

involved if requested to do so. Is that

differentiate facts, opinions, theories, hypotheses,

breaking confidentiality?

and ideas, when communicating knowledge,

finding and views.

I will have to justify my course of action to

III.16 Fully explain reasons for their actions to

all parties affected and involved. Perhaps I

persons who have been affected by their actions,

can share aspects of this process?

if appropriate and if asked.

I have promised confidentiality to the

III.17 Honour all promises and commitments

women. However, sharing the names of

included in any written or verbal agreement,

the therapists was an unexpected and

unless serious and unexpected circumstances

serious circumstance.

intervene.

I need to ensure that knowing the names of

III.19 Carry out, present and discuss research in a

two of the therapists does not affect my

way that is consistent with a commitment to

research in any way. Have I been

honest, open inquiry, and to clear communication

completely clear what this research is about

of any research aims, sponsorship, social context,

and for? Does it deter me from my original

personal values, or financial interests that might

project?

affect or appear to affect the research.

I need to ensure that the women were clear

III.23 Not engage in incomplete disclosure, or in

with the intent of my research. If I had the

temporarily leading research participants to

women fill in a questionnaire, would it

believe that a research project or some aspect of it have avoided the sharing of the names of
has a different purpose, if there are alternate

the therapists? Was the sharing of

procedures available or if the negative effects can

information a result of how I collected my

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not be predicted or offset.

information?

III.24 Not engage in incomplete disclosure, or in

If the women knew that I would feel the

temporarily leading research participants to

need to report the therapists behaviour as

believe that a research project or some aspect of it unethical, would they have shared their
has a different purpose, if it would interfere with

story with me in the first place?

the persons understanding of facts that might

clearly influence a decision to give adequately
informed consent.

I need to speak with all of the women who

III.26 Debrief research participants as soon as

have provided me with information for my

possible after the participants involvement, if

paper if I am going to act on my concerns

there has been incomplete disclosure or

in regards to the two therapists.

temporary leading of research participants to

believe a research project or some aspect of it has
a different purpose.

If I share this information with all of the

III.28 Act to re-establish with research

women in the study are they going to still

participants any trust that might have been lost

trust me to share their whole story or will

due to the use of incomplete disclosure or

they edit the information for fear of being

temporary leading research participants to believe

reprimanded or having someone that they

that the research project of some aspect of it had a potentially cared about reported?
different purpose.

I need to talk to my supervisor/professor to

III.36 Familiarize themselves with their

determine the best course of action. I will

disciplines rules and regulations, and abide by

also review the codes and standards to

them, unless abiding by them would be seriously

refresh myself on the rules and regulations.

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detrimental to the rights and welfare of others.

I need to ensure that I am following the

III.37 Familiarize themselves with and

rules and regulations. My concern is that if

demonstrate a commitment to maintaining the

I report the therapists, it may be

standards of their discipline

detrimental to the welfare of the women. If

I dont report the therapists, I may be
putting other women at risk. Also, if I
dont report the therapists, am I condoning
behaviour not in keeping with the standards
of our discipline?
I have the time and resources to check with

III.38 Seek consultations from colleagues and/or

my supervisors/professors about my

appropriate groups and committees, and give due

concerns with this situation and possible

regard to their advice in arriving at a responsible

courses of action. Hopefully this can help

decision, if faced with difficult decisions

Principle IV: Responsibility To Society
IV.10 Uphold the disciplines responsibility to

me ensure objectivity of the situation.

society by promoting and maintaining the highest

upholding the disciplines responsibility to

standards of the discipline

society? What if these therapists are

By not reporting the therapists am I

making a habit of entering into sexual

IV. 13 Uphold the disciplines responsibility to

relationships with their clients?

society by bringing incompetent or unethical

The Standard suggests that my

behaviour, including missuses of psychological

responsibility goes beyond the women

knowledge and techniques, to the attention of

sharing the names of the therapists. It

appropriate authorities, committees, or regulatory

brings up the concern that I have a

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bodies, in a manner consistent with the ethical

responsibility to society to do what I can to

principles of this Code, if informal resolution or

ensure that other psychologists are not

correction of the situation is not appropriate or

harming their clients. However, whatever

possible

choice I make, I need to make sure that it is

ethical and well thought through.

IV.16 Convey respect for and abide by prevailing

The role of a therapist is to help and not

community mores, social customs, and cultural

intentionally harm their clients. Even if it

expectations in their scientific and professional

was a consenting relationship it, does not

activities, provided that this does not contravene

condone it? Due to the unequal balance of

any of the ethical principles of the Code.

power and influence of a therapist, it is

impossible for a client to give meaningful
consent. If my role is to only collect
information for research purposes, is it my
place to get involved?

IV.30 Encourage others, in a manner consistent

Would it be helpful for me to encourage the

with this Code, to exercise responsibility to

women to report the therapists to act in the

society

best interest of future clients working with

these therapists? How will that affect my

relationship with them?

Step 3. Consideration of How Personal Biases, Stresses, or Self-interest Might Influence
the Development of or Choice Between Courses of Action
My initial reaction was frustration, confusion and anger: frustration that the women
shared the information with me as it puts me in a difficult position; confusion with my role and
whether or not it is my place to report these therapists; and anger at the therapists for acting

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unethically with their clients. I feel that it is therapists like this that give the entire profession a
bad reputation. I have high expectations for how therapists interact with their clients and get
frustrated when people in a position of power take advantage of people (particularly women).
However, I understand that I only know one part of the story and that I have not heard the other
point of view. Two grown adults entering into a sexual relationship is not ethically appropriate
with a therapist-client relationship, however, these situations do happen. I am not sure if these
were one time occasions or if the client attempted to sexualize the relationship (even though the
obligation to not reciprocate would still be with the therapist). Do these differences make the
situation less ethical? The therapists should have maintained appropriate boundaries. I also have
to remember that I am not in the role of a therapist to these women and that I asked for the
information (with the exception of the names) for research purposes. If I am not counseling
these women, how can I support them through the process or affects of reporting their previous
therapists? That is not my role and I have limited experience. I need to gather more information
and speak with my supervisor/professor before jumping to conclusions as well as before I decide
on my course of action.
Step 4. Development of Alternative Courses of Action
After going through the Ethical Principles and Respective Values and Standards, I have
decided that I have ruled out some courses of action: a) do nothing, just collect the data I need
for my research and forget about the names, or b) report the therapists immediately to their
regulatory body. There are two courses of action that I think I should explore further to
determine if they are appropriate given this situation.
Alternative 1. First, I will phone my supervisor/professor to better understand my role in
this situation. I will share my concerns and my thoughts on a course of action. They will be able

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to guide me and help me understand if there is any information or part of the process that I may
be missing. If they feel that it is within my role to continue with this course of action, I will
phone the women and get more information from them in regards to the sexual relationships. I
can explain my position and concern for what they experienced, but also my concern for future
clients who work with these therapists. I need to ensure that the women were clients of the
therapist at the time of the sexual relations or how soon after they were clients (ie determine if it
was less that 2 yrs). I can state that I am having a hard time turning a blind eye as it is
unethical for therapists to get sexually involved with their clients. I can also explain that I want
to honour my promise of confidentiality, but I feel that it is in conflict with my duty to report
unethical behaviour. I will review the limits to confidentiality that I have previously discussed
with them. I can outline sections of the Code to help the women understand that there are no
circumstances in which sexual activity with a client is okay and that it is always considered
detrimental regardless of what a therapist may say to justify this type of relationship.
If it does sound as though these therapists did not act in the best interest of their clients, have
caused harm to the women and are at danger of potentially harming other women, then I will
report them to their respective regulatory bodies.
Alternative 2. As with the first course of action, I will call or meet with my
supervisor/professor to discuss my concerns and thoughts for a course of action. I will also seek
guidance to better understand my role and duties in this situation. If my supervisor feels that I
am on the correct track then, I will contact the women to speak with them first, but also to get
permission to speak with their current therapists. In addition, I will ask my supervisor to provide
me with any psychologists familiar with supporting women who have been in sexual
relationships with their therapists to learn strategies on how to support the concerns of the

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women. When speaking with the women, I will explain that I am in a difficult position knowing
the names of the therapists that they had sexual relations with and I am concerned about their
well being as well as the well-being of future women who work with these therapists. First, I
will get an idea of how they feel about what happened. Is it a case where they are fine with the
situation and it is over and they want to forget about it and move on from it? If so, will
encouraging them to report the therapists cause more damage? Or, is it the case where they have
unresolved feelings, anger, resentment or feelings of mistrust? I will share the information from
the Code that indicates that under no circumstance is a therapist to engage in sexual relations
with their clients. I will also review the limits to confidentiality that I originally shared with
them. Next, I will call their current therapist to discuss my concerns and explain my situation. I
will also discuss the situation with them to help determine the best course of action as well as the
possibility of the women needing support throughout this process. I can also determine whether
or not their current therapist have already reported the therapist. If I feel that it is in the best
interest of the women, I will encourage them to report their previous therapists to their regulatory
bodies.
Step 5. Analysis of Likely Short-term, Ongoing and Long-term Risks and Benefits of Each
Course of Action on the Individual(s)/group(s) Involved or Likely to be Affected
Table 2.
Possible Positive Consequences

Possible Negative Consequences

Alternative 1

Engaging and discussing concerns with

supervisor will help ensure that I am

following protocol as a student, but also

The women could be very upset or even

angry with me and not want me to precede

any further.
The women could be confused as I

EDPS 604 ETHICAL DECISION-MAKING

reinforce the importance of collaboration

promised confidentiality in the beginning

and guidance.
Obtain a better understanding of the

and perhaps didnt understand the limits to

womens perspectives of the situation,

14

therefore ensuring that I am acting in their

the women and not the therapists, it could

best interest.
Ensure that I have all of the correct

be skewed from their perspective and if

their allegations are not true, I could

information before jumping to

my ability to uphold confidentiality.

As the information is only coming from

conclusions.
I am providing the women with

seriously damage the therapists careers.

I could compromise my current research.

The women could be upset with me for

information to help prevent future

situations.
Alternative 2

Engaging in conversation with my

asking to speak with their current

supervisor as well as the current therapists
therapist. They may be concerned that we
working with these women will help
will psychoanalyze the situation that is
ensure that I am not overstepping
boundaries or my role, and reinforce the

importance of consultation.
Obtaining more information from the
current therapist will help me determine a

me for stirring up old or dealt with

suitable course of action.

Encouraging the women to report the
therapists is helping to empower them and
move past the situation.

truly about them.

The current therapist could be upset with

emotions of interfering with their client.

My role was to collect information for
research, not to council or advise their

clients.
The women could tell me that they do not
want to report the therapists and could be

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15

angry with me for suggesting that they do.

The women could ask to be withdrawn

from my research.
Step 6. Choice of Course of Action after Conscientious Application of Existing Principles,
Values, Standards
Alternative II is the best choice. It is respectful to all parties involved. It includes my
supervisor, the referring therapists and the women in the discussion of the dilemma as well as the
decision-making. It also includes consulting with another psychologist. Even if the women
disagree with my views, I will do everything in my power to ensure that they understand my
reasoning and my ethical responsibilities. The rationale is to help these women as well as protect
other women from being taken advantage of unethical therapists in the future.
Step 7. Action with a Commitment to Assume Responsibility for the Consequences
I need to act and monitor the results. I need to be aware that there will likely be
consequences for my actions. I also have to consider the consequences for my supervisor.
Step 8. Evaluation of the Results of the Course of Action
In evaluating the results of my decision, I may focus on the way that I set-up and
collected consent for my research paper. Next time, I need to ensure that I share all of the
potential scenarios with individuals before we get started. I will discuss the limitations to
confidentiality.
Step 9. Assumption of Responsibility for the Consequences of Action, Including Correction
of Negative Consequences, If Any, or Re-engaging in the Decision-making Process if Ethical
Issue is not Resolved
I will address any unanticipated negative consequences immediately. I will maintain an
open dialogue throughout this process to be able to address issues as they arise. This scenario

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will have a much larger impact on others. It is not about me. I will adjust as needed based on
the feedback that I receive throughout the ethical-decision making process. As the process
proceeds, I will consider any remedial actions that may need to take place.
Step 10. Appropriate Action, as Warranted and Feasible, to Prevent Future Occurrences of
the Dilemma
I need to provide more information, open communication and clarification of the intent of
my research. I must ensure that I am clear with the ethical implications of sharing personal
information and if that does occur, how ethical issues will be addressed. It is important that I am
extremely clear on informed consent, confidentiality, and my role and responsibility with
collecting information for research purposes. I also need to make sure that I discuss any future
research concerns and potential problems with my supervisor/professor to ensure that I am
implementing the most effective procedures to collect information in a manner that helps prevent
the sharing of too much information.
REFERENCES
Sinclair, C., & Pettifor, J. (Eds.) (2001). Companion manual to the Canadian Code of Ethics for
Psychologists (3rd ed.). Ottawa, ON: Canadian Psychological Association.
Truscott, D., & Cook, K. H. (2004). Ethics for the practice of psychology in Canada. Edmonton,
AB: University of Alberta Press.