Thinking it through: models of ethical decision-making

Transcript

RyanA psychologist is seeing a woman in her seventies for grief counseling after her husband's death. One afternoon her adult son is in the waiting room. He wants to join the session, and he wants regular updates.

SoheeAnd the client, when she's asked, says quietly, whatever he thinks is best. Which is not quite a yes.

RyanNo clear rule is being broken yet. It's a situation that needs thinking through. Welcome to EPPP Prep, the podcast. I'm Ryan.

SoheeAnd I'm Sohee. Today's knowledge statement is short: models of ethical decision-making. Not the rules themselves, but how a psychologist reasons when the rules don't hand over an answer.

RyanLet's start with something the Canadian Code says that's quietly reassuring. Some ethical decisions happen very rapidly, especially when clear-cut standards exist and nothing is in conflict.

SoheeBut others, particularly when principles, values or best interests conflict, are not easily resolved. The Canadian Code says they might be emotionally distressful, and might need time-consuming deliberation.

RyanSo feeling torn isn't a sign you're doing it wrong. It's a sign you've found a real dilemma. For those, the Canadian Code lays out ten basic steps that typify a good process.

SoheeLet's walk our grief client through them. Step one: identify the individuals and groups potentially affected by the decision.

RyanThe client, obviously. Her son. Possibly other family members. And the therapy relationship itself.

SoheeStep two: identify the ethically relevant issues. That includes the moral rights, values, well-being and best interests of everyone involved, and the cultural, social, historical, economic, institutional, legal or political context.

RyanHere, the client's privacy and her right to make her own choices are front and center. So is her well-being in grief. And context really matters. The Canadian Code notes that definitions of what's private vary across communities and cultures, as does the role of families in personal decision making.

SoheeSo a family's involvement might be welcome and expected for one client, and intrusive for another. You find out; you don't assume.

RyanStep three is the one people skip. Consider how your own biases, external pressures, personal needs, or self-interest might influence the options you develop or the choice you make.

SoheeMaybe the psychologist dislikes conflict, and the son is insistent. Maybe she has her own feelings about how adult children should treat a grieving parent. Step three asks her to notice that before it steers her.

RyanStep four: develop alternative courses of action. Turn the son away entirely. Let him in today. Meet with the client alone first to learn what she actually wants. Or plan a joint session, if she freely chooses one.

SoheeStep five: analyze the likely short-term, ongoing, and long-term risks and benefits of each option, for each person affected, with the context in mind.

RyanLetting him in today might ease the moment, but cost her a private space and her trust. A flat no might feel protective, but cut off support she'd actually welcome. Meeting with her alone first keeps her choice at the center.

SoheeStep six: choose a course of action after conscientious application of existing principles, values and standards, which includes relevant laws and regulations.

RyanAnd our confidentiality episode already covered the rule that matters here. Sharing information with the son rests on the client's consent.

SoheeStep seven: act, with a commitment to assume responsibility for the consequences. Step eight: evaluate the results.

RyanStep nine: take responsibility for the consequences, which includes correcting negative ones, or going back into the process if the issue isn't resolved.

SoheeAnd step ten: take appropriate action, as warranted and feasible, to prevent the dilemma from happening again. The Code gives examples like problem solving with colleagues and changes in procedures and practices.

RyanFor our psychologist, that might mean asking every new client, at intake, how they'd like family involved. Next time, the answer is already on record.

SoheePause and think. Why does a decision-making model bother with step three, your own biases and needs, at all? Aren't the facts of the case what matter?

RyanBecause the Code recognizes that biases, pressures, personal needs and self-interest can shape which options you even consider, and which one you pick. A model that ignores the decision-maker misses a real source of error.

SoheeNow, where does consultation fit? The Canadian Code says psychologists in time-consuming deliberation are encouraged and expected to consult with the people affected, when appropriate.

RyanAnd to consult colleagues or relevant others, including advisory bodies, when they can add knowledge or objectivity. But the decision for action remains with the individual psychologist.

SoheeThat's a classic trap. An answer where the consultant decides, or where you simply follow what most colleagues would do. Consultation informs the decision; it doesn't make it for you.

RyanThen there are the dilemmas that stay hard even after all of this. The Canadian Code asks for a process explicit enough to bear public scrutiny.

SoheeAnd it allows that some resolutions might be a matter of personal conscience. But even those decisions are expected to come from a process based on a reasonably coherent set of ethical principles.

RyanHere's the reassuring part. If a psychologist can show every reasonable effort was made to apply the Code's principles, and the conflict could only be resolved by personal conscience, that psychologist would be deemed to have followed the Code.

SoheePause and think, number two. A colleague says, I just go with my gut on ethics, it's my conscience. Does the Canadian Code accept that?

RyanNot on its own. Conscience is respected, but it has to be the end of a deliberate, principled process that could bear public scrutiny, not a replacement for one.

SoheeAnd that process matters if a complaint is ever filed. The Canadian Code says an adjudicating body judges whether the psychologist conscientiously engaged in an ethical decision-making process and acted in good faith, or showed negligent or willful disregard of ethical principles.

RyanThe Canadian Code also says it advocates both proactive and reactive ethics. Reactive is solving the dilemma in front of you. Proactive is everyday conduct, thinking and planning, so fewer dilemmas arise.

SoheeWhich is exactly what step ten does. Now let's look at the APA side. The APA Code's Introduction describes how psychologists make decisions about their professional behavior.

RyanThey must consider the Ethics Code, plus applicable laws and psychology board regulations. They may also consider other guidelines adopted or endorsed by psychological organizations, the dictates of their own conscience, and consult with others in the field.

SoheeAnd the Introduction adds something important for gray areas. The Ethical Standards are not exhaustive. Conduct not specifically addressed by a standard isn't necessarily ethical, or unethical.

RyanSo no standard on it, doesn't mean anything goes. You reason from the principles. And the Preamble frames ethics as a personal commitment and lifelong effort, which includes consulting others about ethical problems.

SoheeOne more model worth knowing is principle-based reasoning. A 2025 review by Pillay synthesized the ethics codes of counseling, psychology, medical and social work organizations into a small set of shared principles.

RyanAutonomy and informed consent. Beneficence and avoiding harm. Confidentiality and transparency. Justice, fairness and inclusiveness. And fidelity, professional integrity and accountability.

SoheeRun our grief case through those and you land in the same place. Autonomy says it's her choice. Confidentiality says the son needs her consent. Fidelity says keep faith with the person who came to you.

RyanSo how does a model help on test day? When a question hands you a messy situation and asks for the best next step, look for the option that fits where the psychologist is in the process.

SoheeIf she hasn't yet found out who's affected or what the client wants, an answer that jumps straight to a final action is usually premature. Gathering that information, or widening the options, comes first.

RyanAnd remember the back half of the list. Acting isn't the end. Evaluating the results is its own step, and so is correcting what went wrong and preventing the next one.

SoheeLet's recap. The Canadian Code's ten steps: identify who's affected; identify the ethical issues and context; examine your own biases and pressures; develop alternatives; weigh risks and benefits.

RyanThen choose by applying principles, standards and laws; act and take responsibility; evaluate; correct or re-engage; and act to prevent it happening again.

SoheeConsult the people affected and your colleagues, but the decision stays with you. Make your reasoning explicit enough to bear public scrutiny. Conscience is honored when it follows a principled process.

RyanFrom the APA side: consider the Code, laws and board regulations, other guidelines and conscience, and consult. The standards aren't exhaustive, so reason from the principles.

SoheeIf ethics questions have ever felt like guessing, this is your antidote. You now have a process, and a process is something you can practice.

RyanTry walking one practice question through the steps this week. Slowly is fine. You're learning to think like the psychologist you're becoming. Thanks for listening to EPPP Prep.

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