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Tutor: Please be very detailed. 1. Demonstrate all the steps…
Tutor: Please be very detailed.
1. Demonstrate all the steps from the Ethical Decision-Making Model by Mary Alice Fisher to apply and work through the ethical dilemma A Suffering Caregiver .
Ethical Decision-Making Model by
Mary Alice Fisher, Ph.D., 2005; 2015
The Center for Ethical Practice
I. ASSESS
A. Identify the problem and determine whether the matter is an ethical one. Use your Ethics Code and other professional guidelines to identify the specific ethical issues. Name them.
B. If this involves a clinical issue, describe and clarify the relevant clinical components.
C. Consider whether there are any legal requirements, contractual obligations or agency considerations that might influence your decision or limit your options.
D. Consider, as clearly as possible, any relevant personal values (or other personal factors) that might affect your objectivity, introduce bias, or otherwise influence your decision.
E. Evaluate the rights, vulnerabilities, and responsibilities of all parties involved. Determine your relationship (if any) and obligations (if any) to each of these parties.
F. Obtain consultation. Consult with a trusted colleague or supervisor about the ethical, legal and personal issues involved. If needed, obtain a formal consultation with an ethics consultant or with the ethics office of your professional association. If necessary obtain legal consultation and/or medical consultation.
G. Consider whether members of your team or practice group should be engaging in this decision-making process with you. If so, begin discussing the issue collaboratively.
II. PLAN
A. Generate a list of possible decisions/solutions. (At this stage, do not censor; consider all possible courses of action, no matter how wild/crazy/inappropriate they seem.)
B. Using this list, eliminate any options that are clearly unethical, illegal, or clinically inappropriate, using the assessment above as a guide.
C. Enumerate, consider, and weigh the consequences of each of the remaining options.
III. IMPLEMENT
A. Make a decision. Decide how to best act on (carry out) your decision..
B. Carry out the decision you have made.
IV. EVALUATE
A. Document your decision-making process and your actions.
B. Evaluate the process, your decision, and its outcome.
A Suffering Caregiver
A colleague of yours, Dr. Solomon, contacts you for advice regarding a new client she has just seen. The client, Mr. Don Tellanyone, is a 47-year-old man who is seeking services for depression. During the initial phone contact, he asked repeatedly about privacy and wanted assurances that information discussed in session was confidential. The patient repeated this line of questioning during the first face-to-face session.
As the session progressed, he revealed that the source of his depression was the death of his mother one year ago. His mother had suffered from a combination of severe respiratory problems and Alzheimer’s. Mr. Tellanyone had been caring for her and his father in his home for 6 years prior to her death. During the last two years, she required total care. He revealed that she had been suffering greatly and, out of compassion for her, he gave her an excess dose of her sleeping and pain pills. Medical personnel never questioned the death as the woman had been quite sick and “It was only a matter of time.”
Mr. Tellanyone goes on to explain that he is now caring for his father in similar circumstances, although there is no dementia. His father has declined rapidly since the death of his wife and now requires total care. Mr. Tellanyone reveals that recently he had a conversation with his father in which the father commented how peaceful his wife’s death was and how he hoped for a similar passing.
Mr. Tellanyone is feeling quite guilty about his mother. Simultaneously, he strongly believes he made the right decision. He would like help to work through the issues. He is also very concerned about confidentiality and wants assurances from Dr. Solomon.
Dr. Solomon, feeling uncomfortable with the situation, contacts you for a consultation about the potential ethical issues for this case.
