Ethical Dilemmas and a Decision Making Model Case Study

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Counseling -- Ethical Dilemma -- Case Study

A 17-year-old Jewish female student advises a counselor that she went to a party last weekend with an African-American 17-year-old boy, and ended up passed out in an upstairs bedroom. She was awakened by the boy forcing himself on her. She protested loudly, but said that no one came to help her. The client claims the counselor is the only person she has told that she was raped. For the past five days, she has endured the snickering and sneering of Derrick and his friends in the hallways "as they smugly march around with their worlds intact" while she "dies a little more inside each day." She says she has been having trouble focusing on school, and she blames herself for the incident, saying she drank way too much even though she doesn't think she had very much to drink that night. She wonders aloud to the counselor if she could have been drugged. She begs the counselor not to tell anyone, especially her parents. How should the counselor proceed?

B. Body: Corey, Corey and Callanan's Decision-Making Model

The decision-making model chosen is Corey, Corey and Callanan's eight-step model, which employs the six essential moral principles for ethical decision-making: autonomy; non-maleficence; beneficence; justice; fidelity; and veracity (Corey, Corey, & Callanan, 2011, p. 24). Their model is acknowledged as an effective tool for ethical decision-making because it does not leave the counselor adrift in his/her own values and sometimes arbitrary assessments (Cottone & Claus, 2000, p. 279). The influences of those six moral principles are highlighted in the following employment of the eight-step model: identify the problem or dilemma; identify potential issues involved; review the relevant ethics codes and sections; relevant laws; consult with colleagues; consider possible and probable options; list the implications of the various options; choose the apparently best course of action (Corey, Corey, & Callanan, 2011, pp. 24-6). In addition, the counselor must document his/her work in every step, for at least two reasons: to be more effective as a counselor; to document for other colleagues and professionals, both to assist them and to avoid any negative outcomes in malpractice issues.

1. Identify the Problem or Dilemma

At this step, the counselor gathers as much information as possible and determines whether the situation poses a dilemma that is ethical, legal, clinical, professional and/or moral (Corey, Corey, & Callanan, 2011, p. 24). Briefly, a 17-year-old Jewish female student claims she was sexually assaulted by a 17-year-old black male student while she was in various states of incapacity at party: first passed out; then unable to effectively stop the attack due to consumption of alcohol and possibly being drugged. Her cries for help were ignored and now that she is back in school, the alleged perpetrator and his friends have reportedly been snickering and sneering at her in the hallways "as they smugly march around with their worlds intact" while she "dies a little more inside each day" and has trouble focusing in school. I am the only person she has told, she does not want me to tell anyone else and she at least partially blames herself for drinking alcohol, though she asserts she did not have much to drink and may have been drugged prior to the assault.

This situation poses: an ethical problem regarding confidentiality; a possible legal problem of professional reporting requirements for a sexual assault and possible illegal drugging. and a professional problem, as I'd like to observe the alleged perpetrator and his friends in the halls and if they are snickering and sneering at his victim, I'd like to at least slap each of them in the head and "read the riot act" to them to stop the snicker and sneering.

2. Identify Potential Issues Involved

By examining the information, involving the client as much as possible, list the critical issues and shed the irrelevant ones (Corey, Corey, & Callanan, 2011, pp. 24-5). Here as much as anywhere else in the process, diversity is an important facet, as the counselor considers the rights, responsibilities and welfare of everyone involved in the situation. Diversity issues are woven into the situation because the victim is a Jewish-American teenaged girl whose culture may impose and advance certain attitudes about teenaged sex, sexual assault, a teenaged girl's responsibilities in exposing herself to possible harm by attending a party and drinking alcohol, and attitudes toward African-American teenaged males. In addition, diversity issues are presented by the alleged perpetrator, who is an African-American teenaged male, whose culture may have differing attitudes about teenaged sex, sexual assault, the girl's responsibilities in exposing herself to possible harm by attending a party and drinking alcohol, and attitudes toward Jewish-American teenaged girls.

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The critical issues are: client confidentiality, as she has asked me to tell no one else about a criminal assault and drugging; and my legal responsibility as a mental health professional to report certain crimes perpetrated against certain individuals. I will forego vengeance (a la Vito Corleone) and discard my wish to confront and personally punish the alleged perpetrator and his friends because my personal feelings about what they've done and what should happen to them are inconsequential.

3. Review the Relevant Ethics Codes and Sections

In this step, the counselor finds and considers the applicable ethics code(s) and specifically pertinent sections for the defined issues (Corey, Corey, & Callanan, 2011, p. 25). The American Counseling Association (ACA) is a not-for-profit professional/educational organization that exclusively represents professional counselors and periodically issues a code of ethics to guide professional counselors (American Counseling Association, 2016). The most recent revision of the code is the 2014 Code of Ethics (American Counseling Association, 2014). Several applicable code sections are:

a) Section A -- The Counseling Relationship

i. A.1.a - Primary Responsibility

Throughout the entire counseling process, the counselor must be mindful that his/her primary responsibility is to respect the client's dignity and promote her welfare (American Counseling Association, 2014, p. 4);

ii. A.2.d -- Inability to Give Consent

The client is a minor and is legally incapable of giving consent; in addition, the counselor must consider the rights and responsibilities of her parents/family to protect her and make decisions in her behalf (American Counseling Association, 2014, p. 4).

b) Section B -- Confidentiality and Privacy

This Code section, several provisions of which are applicable, guides the counselor regarding confidentiality of client information (American Counseling Association, 2014, pp. 6-8). In this situation the counselor especially must:

i. B.1.a - Respect her rights, taking into consideration cultural meanings (here, Jewish-American) of confidentiality and privacy, repeatedly discussing with the client how and to whom information is shared in the course of her treatment (American Counseling Association, 2014, p. 6);

ii. B.1.c - protect the client's confidential information and disclose it only with appropriate consent or sound legal/ethical justification (American Counseling Association, 2014, p. 7); iii. B.1.d -- explain the limitations of confidentiality and the situations in which confidentiality would have to be breached (American Counseling Association, 2014, p. 7);

iv. B.2.e -- Advise her ahead of time about any required disclosure and then disclose only essential information (American Counseling Association, 2014, p. 7);

v. B.3.c -- If disclosure is required in consultation with colleagues and other professionals, ensure that the confidential information is disclosed in settings that ensure as much privacy and preservation of confidentiality as possible (American Counseling Association, 2014, p. 7);

vi. B.5.a -- since this client is legally a minor, she lacks the capacity to give voluntary, informed consent to release confidential information; consequently, the counselor must be guided by law, written policies and ethics (American Counseling Association, 2014, p. 7); vii. B.5.c -- particularly in view of disclosure laws that will be addressed below, and since the client is a minor, the counselor must seek permission from a third party to disclose, inform the client of that requirement and continue to safeguard her confidentiality as much as possible (American Counseling Association, 2014, p. 7); viii. B.7.a -- Since consultation with other colleagues may be necessary, the counselor must limit disclosure to only information relevant to the consultation and continue safeguarding the client's identity and other information as much as possible (American Counseling Association, 2014, p. 7);

ix. B.7.b -- The counselor must reveal only the information covered by consent, only that which is germane to the consultation and continue to safeguard the client's identity and other information (American Counseling Association, 2014, p. 7).

c) C.6.b -- Reports to Third Parties

If the counselor must report to third parties per the law, for example about the sexual assault and drugging, the counselor must ensure his/her report is accurate, honest and objective (American Counseling Association, 2014, p. 9).

4. Relevant Laws

The counselor must make it his/her business to stay current on applicable laws, using them as part of the process, though not as the end point of counseling (Corey, Corey, & Callanan, 2011, p. 25). The applicable law is found in the Florida State Statutes:

a. §743.07 - Rights,….....

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