FOCUS Newsletter - July 1996
When thinking about a particular dilemma, it is helpful to ask and formally answer the following questions. This can be done individually or in a group process such as a multidisciplinary team or a department:
What personal and professional values are involved with the dilemma? (Be sure to include the personal values of the client or client system and the professional values of the involved parties.)
What are the selected values or moral principles which are in conflict? Is there any way to "rank" order the values or principles? What moral philosophy pertains?
Who are the key players? Who is involved? Who is or will be affected?
What are the proposed actions which need to be evaluated as ethical or unethical? Are there relevant legal issues to be considered? Are there relevant clinical issues?
What is the context of the proposed action?
What is the purpose of the proposed action? What is expected to be achieved?
What are the alternatives? What are the consequences (benefits, limitations, harms) of each alternative?
Who has the responsibility to make the decision? Who has the right to make the decision? Who should participate in the decision? Why?
What are the viable resolutions (must include at least two, if there is only one, the decision is made)?
Choose your resolution of choice and act accordingly.
Note: The resolution of choice may be limited by what the person responsible for the decision is willing to accept. Generally, this should be worked out, individual or personal values, may alter the outcome of the resolution process.
* These steps are a modified form of those found in; Lowe-Phelps, K. Truthtelling: An ethical dilemma. Carina. VII(1):4-12, 1988.
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