Running head: ETHICAL DECISION-MAKING

Ethical Decision-Making Assignment

EDPS 604
Alison Lessard
University of Calgary

ETHICAL DECISION-MAKING

Ethical Dilemma
You are a graduate student doing your doctoral dissertation on the experiences of women
who have been sexually involved with previous therapists. The women have been referred to the
project by the current therapists, have consented to share their experiences, and have been
assured of confidentiality. In conducting your interviews, you are told the names of two of the
previous therapists who had become sexually involved. You had not asked for this information
and, in fact, had asked that the women not reveal the identities of the therapists with whom they
had been sexually involved. You now wonder what your responsibilities are. Should you report
the two therapists to their respective regulatory bodies? Should you persuade and assist the
women to make formal complaints themselves? Assuming this issue is outside your research
mandate, should you do nothing?
(Companion Manual Vignette Research #38)
Step 1. Identification of the Individuals and Groups Potentially Affected by the Decision
The individuals most affected by a decision I make will be the women who disclosed the
names of the therapists with whom they had been sexually involved. Also, any current or past
clients of the named therapists as there may have been similar involvement. My own credibility
could be affected negatively and my doctoral dissertation could be at risk. Obviously the two
psychologists who were identified will be personally and professionally affected by the process.
Public trust in the discipline of psychology could be negatively impacted, particularly if the
situation is covered by the media.

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Step 2. Identification of the Ethically Relevant Issues and Practices, Including the
Interests, Rights, and Any Relevant Characteristics of the Individuals and Groups Involved
and of the System or Circumstances in Which the Ethical Problem Arose.
I used the Canadian Code of Ethics for Psychologists to assist me and I can identify fifteen
ethical values that are impacted by this issue. Six under Respect for the Dignity of Persons, four
each from Responsible Caring and Integrity in Relationships and one under Responsibility to
Society.
Principle I: Respect For The Dignity of Persons
Value: General Rights
I.7 Make every reasonable effort to ensure that psychological knowledge is not
misused, intentionally or unintentionally, to infringe upon human rights.
I understand my research participants have the right to privacy. This essential human
right is important in this case as the womens sense of autonomy and self-determination are key
elements. They chose to disclose their private information to me and it is my duty to ensure that
my knowledge of their situation is not misused.
Value: Informed consent
1.24 Ensure, in the process of obtaining informed consent, that at least the following
points are understood: purpose and nature of the activity; mutual responsibilities;
confidentiality protections and limitations; likely benefits and risks; alternative; 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 think I need to evaluate whether all of my research participants fully understood
informed consent related to this study. In particular, whether they comprehended the limitations
of confidentiality when dealing with sexual involvement of therapists, and my duties surrounding

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their disclosure of the names of therapists. I specifically asked participants not to reveal any
identities. However, it is possible that the participants fully understood informed consent but
trusted me with the information because they wanted to report the involvement with their
psychologists.
Value: Protections for Vulnerable Persons
1.31 Seek an independent and adequate ethical review of human rights issues and
protections for any research involving members of vulnerable groups, including persons of
diminished capacity to give informed consent, before making a decision to proceed.
I need to request a review of my research procedures to ensure that my participants rights
are adequately protected. The women whom I am studying could be considered a vulnerable
group.
Value: Privacy
I.40 Respect the right of research participants, employees, supervisees, students and
trainees to reasonable personal privacy.
Again, the privacy of my research participants is highly concerning to me. I need to
weigh the significance of their disclosure to me against my responsibilities to protect their
privacy. Reasonable privacy in this situation has been impacted because of the disclosure of
therapist identities.
Value: Confidentiality
I.43 Be careful not to relay information about colleagues, colleagues clients,
research participants, employees, supervisees, students, trainees, and members of
organizations, gained in 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.
The confidentiality of my participants is paramount, however sexual contact between a
psychologist and client is considered to be assault according to Canadian law whether or not it

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was consensual. Once the women provided me with the names of therapists, the law may take
precedence over their confidentiality. However, I need to strive to ensure that their
confidentiality continues to be protected as much as possible regardless of my decision.

Principle II: Responsible Caring

Value: General Caring
II.1 Protect and promote the welfare of clients, research participants, employees,
supervisees, students, trainees, colleagues and others.
I need to be concerned about protecting all of my research participants. The welfare of
participants who disclosed therapist names, current clients of the aforementioned therapists, as
well as the therapists themselves.
Value: Risk/Benefit Analysis
II.16 Seek an independent and adequate ethical review of the balance of risks and
potential benefits of all research and new interventions that involve procedures of unknown
consequence, or where pain, discomfort or harm are possible, before making a decision to
proceed.
My research practices may need to be reviewed in order to determine if my study will be
beneficial and not cause harm to my participants. I want to know if I have anticipated all possible
negative consequences and any further harm that may result from my interviews and questions.
Value: Minimize Harm
II.36 Act to minimize the impact of their research activities on research participants
personalities, or on their physical or mental integrity.
I realize the impact this dilemma may have on my research participants. I may not have
considered this enough in-depth before beginning my research. Sexual involvement with

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therapists could be a traumatic event for some of the women. Possible effects could be
depression, difficulty trusting others and anger. My interview process could increase the
likelihood of harm or distress of the participants by discussing their experience. I may also need
to address their mental health needs after our interview and make arrangements for follow-up
support if it is needed. Since they were referred to the study by the current therapists, there is
some assurance that their needs in this area will be addressed.
Value: Offset/Correct Harm
II.40 Act to stop or offset the consequences of seriously harmful activities being
carried out by an other psychologist or member of another discipline, when there is
objective information about the activities and the harm, and when these activities have
come to the attention outside of a confidential client relationship between themselves and
the psychologist or member of another discipline. This may include reporting to the
appropriate regulatory body, authority, or committee for action, depending on the
psychologists judgement about the person(s), or body(ies) best suited to stop or offset the
harm, and depending upon regulatory requirements and definitions of misconduct.
While the information was given to me within a confidential client relationship, any
action I take action needs to prevent any further harm. According to the Standards of Practice, I
am allowed to disclose confidential information regarding a client if I believe there is a
possibility of harm to them or another person. Sexual involvement with clients is considered to
be assault, which is obvious harm.
Principle III: Integrity in Relationships
Value: Accuracy/Honesty
III.1 Not knowingly participate in, condone, or be associated with dishonesty, fraud,
or misrepresentations.
If I do nothing and do not report I would be at risk of condoning not just unethical but
illegal behavior.

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Value: Straightforwardness/Openness
III.14 Be clear and straightforward about all information needed to establish
informed consent or any other valid written or unwritten agreement (for example: fees,
including any limitations imposed by third-party payers; relevant business policies and
practices; mutual concerns; mutual responsibilities; ethical responsibilities of
psychologists; purpose and nature of the relationship, including research participation;
alternatives; likely experiences; possible conflicts; possible outcomes; and, expectations for
processing, using, and sharing information generated.
I think I may not have been careful enough ensuring my research participants completely
understood the nature and purpose of my work. Perhaps I should have informed them of my own
ethical and legal responsibilities if they disclosed specific information to me during interviews in
addition to requesting that they not provided me with any names.
Value: Avoidance of Incomplete Disclosure
III.24 Not engage in incomplete disclosure, or in temporarily leading research
participants to believe that a research project or some aspect of it has a different purpose, if
it would interfere with the persons understanding of facts that clearly might influence a
decision to give adequately informed consent (e.g., withholding information about the level
of risk, discomfort, or inconvenience.
As I reflect, I am considering that when designing my research I should have anticipated
the fact that my participants might disclose information to me. While I didnt purposefully avoid
incomplete disclosure I am not sure they fully understood the consequences regarding disclosure
to me or another psychologist and may not have been adequately informed of the outcome of
their actions.
Value: Reliance on the Discipline
III.37 Familiarize themselves and demonstrate a commitment to maintaining the
standards of their discipline.

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Understanding the complexity of my current dilemma and following this process of

ethical decision-making, is evidence that I am committed to the standards of the discipline of
psychology.
Principle IV: Responsibility to Society
Value: Beneficial Activities
IV.13 Uphold the disciplines responsibility to society by bringing incompetent or
unethical behavior, including misuses of psychological knowledge and techniques, to the
attention of appropriate authorities, committees, or regulatory bodies, in a manner
consistent with the ethical principles of this Code, if informal resolution or correction of the
situation is not appropriate or possible.
Sexual relationships with a client are professionally prohibited in Alberta and sexual
contact between a psychologist and client is considered to be assault according to Canadian law
(Truscott & Cook, 2004). If the accused therapists are in fact guilty, they have violated the
principles of the ethical and criminal code. They have also grossly misused their power in a
professional relationship. Regulatory bodies need to be involved as an informal resolution is not
appropriate here.
IV.18 Consult with colleagues, if faced with an apparent conflict between abiding by
a law or regulation and following an ethical principle, unless in an emergency, and seek
consensus as to the most ethical course of action and the most responsible, knowledgeable,
effective, and respectful way to carry it out.
I definitely need to consult with trusted colleagues regarding this dilemma. The conflict
between legal and ethical obligations is a difficult one to navigate without the input of other
experienced and knowledgeable persons. My research participants, the accused therapists,
clients of the accused as well as my interests are all in conflict. Also, I need to fulfill my
commitment to society in return for their trust and respect and must act responsibly.

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Step 3: Consideration of How Personal Biases, Stresses, or Self-Interest Might Influence

the Development of or Choice Between Courses of Action
Initially I was upset that the women disclosed the names of therapists to me. I was
researching their experiences and did not anticipate that I would be dealing with such a complex
situation. I also specifically asked them not to divulge names to me. My dissertation and
research could be postponed which affects my pursuit of my doctoral degree. I am also
concerned that I didnt explain the specifics of confidentiality and informed consent adequately
with my participants. I am worried about causing undo harm to my participants by reporting, but
if I do nothing my own credibility and that of the profession is at risk.
Step 4: Development of Alternative Courses of Action
It is obvious to me that continuing my research is not appropriate at this point. I need
support to review my procedures to ensure that they are appropriate and can avoid future
difficulties. Delaying reporting or not reporting are not appropriate options. I have arrived at
two alternatives that both involve reporting, but differ slightly in how they are carried out.

Alternative 1
First, I will contact the research participants who provided the names of therapists to me
and inform them that as a result of their disclosure I am legally and ethically bound to act on
their behalf. I will report the two therapists to their respective regulatory bodies. I will arrange
counseling support for the participants as I am very concerned for any distress they may
experience as a result of the reporting process. I need to discuss the dilemma with my supervisor
and I realize I may have to postpone my research indefinitely.

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Alternative 2
First, I will consult with trusted colleagues to verify that I have considered all the factors
of this dilemma. I will then contact the research participants who provided the names of
therapists to me and encourage them to make a formal complaint against the therapists and state
that I will assist them through the process. If they are not comfortable initiating the process with
my help, I will tell the participants that I will report on their behalf. I am sure they will be
concerned about confidentiality. I need to assure them that I will do whatever I can to protect
their privacy and confidentiality as much as possible during the process of reporting. My other
main concern is the participants mental health and level of distress as a result of the reporting of
the incident. It might be important for their current therapist to be aware of the situation, but I
will need the womens consent to do this. I will also arrange a variety of support agencies that
are available to my participants such as womens support groups, religious or spiritual assistance.
I feel it is my responsibility to ensure that the women are supported in any way necessary
throughout the process. I will request a review of my research practices and re-evaluate the
benefit to society of such a study.
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 (e.g.,
Client, Clients Family or Employees, Employing Institution, Students, Research
Participants, Colleagues, the Discipline, Society, Self)
Alternative 1
Possible Positive Consequences
The regulatory bodies and the legal system will investigate and if the therapists are guilty,
they will not be harming other clients. The women could feel empowered and relieved that while

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the process was difficult, their coming forward will assist others. I will feel satisfied that I have
proceeded appropriately.
Possible Negative Consequences
The women could be very upset and suffer emotionally. They may also feel they had no
choice in the reporting process as I took matters into my own hands. My research could be
canceled or postponed.
Alternative 2
Possible Positive Consequences
The women feel more in control of the process as I offered them the opportunity to report
with my assistance. The report will still proceed whether they agree to initiate the process or not.
I have also planned more carefully for any detrimental effects on the women as a result of the
report. There will be follow up by a psychologist and referrals to outside agencies for additional
support if necessary. My research will be reviewed independently and if necessary improved
upon. I also consulted with colleagues before taking any action. I will have acted professionally
and ethically and my own credibility will remain intact.
Possible Negative Consequences
The women could be upset and suffer emotional distress. They may refuse psychological
or outside agency support, which could result in further harm. My research could be cancelled or
postponed.

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Step 6. Choice of Course of Action After Conscientious Application of Existing Principles,

Values, and Standards.
I feel that the second alternative is a better choice. Providing the women with the
opportunity to report is more respectful. The first alternative is the correct thing to do, but rather
than including the women in the process I take matters into my own hands. They are already in a
vulnerable situation and removing an opportunity for empowerment is not a good choice.
Furthermore, I want to ensure that my research practices are appropriate and ethically sound. I
think an independent review is necessary. I believe the additional levels of support for the
women is important and is another reason I would choose Alternative 2. The process could be
lengthy, however reporting the therapists is the correct thing to do according to Canadian law.
Step 7. Action with a Commitment to Assume Responsibility for the Consequences of the
Action.
I need to respond and act immediately. The first step is to contact the women and begin
the process.
Step 8. Evaluation of the Results of the Course of Action.
Before continuing my research, I need to carefully evaluate my process of gaining
informed consent. My research participants must fully understand my legal and ethical
responsibilities regarding disclosure of names and the effect this has on their right to
confidentiality.
Step 9. Assumption of Responsibility for the Consequences of Action, Including Correction
of Negative Consequence, If Any, or Re-engaging in the Decision-making Process if Ethical
Issue is Not Resolved.

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I will take on the responsibility to ensure that any negative impact on the women is
reduced and that they are monitored and supported appropriately.
Step 10. Appropriate Action, as Warranted and Feasible, to Prevent Future Occurences of
the Dilemma (e.g., Communication and Problem Solving with Colleagues, Changes in
Procedures and Practices)
As previously mentioned, I can identify flaws in my research design. Specifically, I must
determine whether my participants fully comprehend the limitations of informed consent. I will
consult with my supervisor and evaluate whether continuing my research is appropriate and
make any recommended changes where necessary. I do not want this to happen again, but I need
to be aware that disclosure is still a possibility when dealing with such a sensitive issue.

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References
Canadian Psychological Association. (2000). Canadian code of ethics for psychologists (3rd ed.).
Ottawa: Author.
Truscott, D., & Crook, K.H. (2004). Ethics for the practice of psychology in canada.
Edmonton, AB: The University of Alberta Press.