Ethical Concerns: Working Ethical Concerns: Working with More than One with More than One Member of a SystemMember of a System

Thorana S. Nelson, Ph.D.Thorana S. Nelson, Ph.D.

OverviewOverview

Decision Making PrinciplesDecision Making Principles Working with More than One PersonWorking with More than One Person ExamplesExamples ResourcesResources

Ethical Decision Making PrinciplesEthical Decision Making Principles

Kitchener Model (Zygmond & Kitchener Model (Zygmond & Borhem)Borhem)

Two levelsTwo levels• IntuitiveIntuitive• Critical evaluativeCritical evaluative

Kitchener ModelKitchener Model

FactsFacts Moral SenseMoral Sense

Intuitive LevelIntuitive Level

RulesRules Critical-Evaluative Critical-Evaluative PrinciplesPrinciples Level LevelTheoryTheory

Intuitive LevelIntuitive Level

FactsFacts Ordinary moral senseOrdinary moral sense ProblemsProblems

Problems at Intuitive LevelProblems at Intuitive Level

May not result in ethical decisionMay not result in ethical decision Situation may be very uniqueSituation may be very unique Does not allow critical evaluationDoes not allow critical evaluation

Critical-Evaluative LevelCritical-Evaluative Level

Ethical rules (code)Ethical rules (code) Ethical principlesEthical principles Ethical theoryEthical theory

Ethical PrinciplesEthical Principles

AutonomyAutonomy NonmaleficenceNonmaleficence BeneficenceBeneficence FidelityFidelity JusticeJustice

Ethical Theory: Ethical Theory: UniversalizabilityUniversalizability

Act is ethical only Act is ethical only if it can be generalized if it can be generalized

to similar situationsto similar situations

Ethical Theory: Balancing PrincipleEthical Theory: Balancing Principle

Do the least amount ofDo the least amount ofavoidableavoidable

harmharm

Personal Model (tsn)Personal Model (tsn)

Intuition (my “itch”)Intuition (my “itch”) Code of ethicsCode of ethics LawLaw Consult with colleague (consultation Consult with colleague (consultation

group)group) Consult with client (optional)Consult with client (optional) AAMFT ethical or legal consultationAAMFT ethical or legal consultation

Personal ModelPersonal Model

ActionAction DocumentationDocumentation EvaluationEvaluation

Working with More than One Working with More than One Person: IssuesPerson: Issues

Confidentiality/privilegeConfidentiality/privilege Informed ConsentInformed Consent Confidentiality/privacy/secrecyConfidentiality/privacy/secrecy ReportingReporting Duty to Warn/ProtectDuty to Warn/Protect Keeping recordsKeeping records Release of recordsRelease of records

ExamplesExamples

CouplesCouples Family Family Minors in therapyMinors in therapy Non-custodial parentsNon-custodial parents Non-related othersNon-related others

• Single sessionSingle session

Additional ResourcesAdditional Resources

State or Provincial LawsState or Provincial Laws

Google search: Utah LawsGoogle search: Utah Laws