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Common Ethical Issues: Case Studies and Test Your Knowledge

Case Studies

What follows are three case studies taken from Bernard and Goodyear (1999). Try analyzing the cases from the perspective of a trainee and a supervisor. How does the ethical decision-making model presented in this module apply to the case? You might also want to talk with your supervisor, classmates, professors, or other practitioners about these cases. After the three cases are presented there are some questions that might guide your discussion.

Case #1

Vanessa has been a marriage and family therapist at an agency for six months. Gary, one of the other three therapists in the agency and the only other single therapist, is her clinical supervisor. It will take Vanessa 2 years under supervision to accrue the experience she needs to be eligible to sit for the state licensing examination for her LMFT. One evening Gary calls Vanessa to inquire whether she would like to go to a day-long workshop with him. The speaker for the workshop specializes in a kind of therapy in which Vanessa has expressed interest. Vanessa accepts and the workshop turns out to be an excellent professional experience. On the way home, Vanessa and Gary stop for dinner. Vanessa picks up the tab to thank Gary for including her. The following day Vanessa is sharing some of the experiences of the workshop with Camille, another therapist at the agency. When Camille asks, “Isn’t Gary your supervisor?” Vanessa feels defensive and misunderstood. Later that day, Vanessa decides to go to her agency director and ask his opinion of the situation. He tells her not to be concerned about it and that Camille “worries about everything.” During her next supervision session, Vanessa chooses not to mention either conversation to Gary (pp. 191-192).

Case #2

Margaret is a school counselor who has been assigned a trainee from the local university for the academic year. As she observes Noah work with elementary school children, she is increasingly impressed with his skills. She asks him to work with Peter, a nine-year-old, who has not adjusted well to his parents’ recent divorce. Again, she is impressed with Noah’s skill, his warmth and understanding, and ultimately, with the success he has in working with Peter. Margaret is a single parent who is concerned about her nine-year-old son. She decides to ask Noah to see him. Noah is complimented by her confidence in him. Margaret’s son attends a different school, but she arranges to have Noah see him after school hours (p. 192).

Case #3

Ruth has been assigned to a local mental health hospital for her internship to work with patients who are preparing to be discharged. It is her first day at the site and she is meeting with her site supervisor. He gives her a form to fill out, which asks for information regarding her student malpractice insurance. When Ruth tells her supervisor that she does not carry such insurance, he advises her that it is their policy not to accept any student who does not have insurance. The supervisor also expresses some surprise because this has always been the hospital’s policy and Ruth is not the first student to be assigned to them from her training program (p. 186).

Questions for Case Studies

  1. What are the main issues in the case?
  2. What ethical issues are of concern in the case?
  3. Are there particular breaches of ethical principles? What are they?
  4. What can the supervisor do, if anything, to resolve the ethical problem(s) presented in the case?
  5. What can the trainee do, if anything, to resolve the ethical problem(s) presented in the case?
  6. Is there other information that might have been helpful in the resolution of this case?
  7. What could have been done to prevent the ethical problem from occurring in the first place?

Test Your Knowledge

What follows are 15 multiple choice items designed to test the knowledge that you have gained as a result of completing this module. Answers are provided at the end. Good Luck!

  1. The branch of philosophy that seeks to understand and to determine how human actions can be judged as right or wrong:
    1. epistemology
    2. eschatology
    3. pragmatism
    4. ethics
    5. teleology
  2. Which of the following is not a classification of ethical theories?
    1. Kantian Deontologism
    2. Consequentialism
    3. Pragmatism
    4. Virtue ethics
    5. Natural Law
  3. Are all of the following ethical theories and their brief definitions correct?
    Natural Law: Reflection on nature can lead one to discover principles of good and bad.
    Kantian Deontologism: An act must be performed because the act is approrpiate for everyone or conforms with moral law.
    Virtue Ethics: Certain character traits are appropriate and praiseworthy. They can be integrated into “practical wisdom” or “right reason.”
    Consequentialism: The rightness or wrongness of an action must be judged according to the effects that it produces.

    1. Yes
    2. No
  4. What ethical principle assumes the three standards of impartiality, equality, and reciprocity?
    1. Respecting autonomy
    2. Doing no harm (Nonmaleficience)
    3. Benefiting others (Beneficence)
    4. Being just (Justice)
    5. Being faithful (Fidelity)
  5. Your clinical supervisor shares his or her disclosure statement with you, giving you the opportunity to see the types of interventions that will be used in clinical supervision. You are given the opportunity to decide which, if any, of the interventions are uncomfortable to you. This process best complies with which ethical principle?
    1. Respecting autonomy
    2. Doing no harm (Nonmaleficience)
    3. Benefiting others (Beneficence)
    4. Being just (Justice)
    5. Being faithful (Fidelity)
  6. Your clinical supervisor shares information with others about your disclosures during supervision. The information shared was “personal” and had little if any bearing on your work with clients. What is the primary ethical principle violated by your supervisor?
    1. Respecting autonomy
    2. Doing no harm (Nonmaleficience)
    3. Benefiting others (Beneficence)
    4. Being just (Justice)
    5. Being faithful (Fidelity)
  7. Which of the following is not a purpose served by professional codes of ethics?
    1. They provide protection to consumers and further the professional stance of organizations.
    2. They provide a vehicle for professional identity.
    3. They provide a framework to resolve all ethical issues that might face a profession.
    4. They provide some means of defence for those who conscientiously practice within the ethical guidelines laid down by a particular profession.
    5. They provide evidence that a particular profession has a body of knowledge and skills that it can proclaim.
  8. Because ethical code development is a process driven by concensus and the fact that problematic issues developed outside of this process may have to be addressed within a code of ethics, we may view codes of ethics as “reactive” documents.
    1. True
    2. False
  9. An ethical decision-making model provides you with a set of guidelines for making ethical decisions. If you were facing a difficult ethical dilemma, after identifying the problem and the potential issues involved, what would be, using Corey’s model, one of the first places that you would look for assistance in the resolution of the dilemma
    1. Ethical guidelines
    2. Ethics scholarship
    3. supervisor and respected colleagues
    4. practicum class
    5. internship class
  10. Substantive due process
    1. Covers the relationship between supervisor and trainee. Trainees are made aware of their responsibilities and those of the supervisor during the clinical supervision process.
    2. The extent to which interactions between supervisor and trainee can be disclosed to others.
    3. Your clinical supervisor is also the instructor for one of your classes.
    4. Addresses the extent to which fair and consistent application of the criteria that governs your training program has been followed.
    5. Addresses the rights that you have as a participant in a training program.
  11. Dual relationship
    1. Covers the relationship between supervisor and trainee. Trainees are made aware of their responsibilities and those of the supervisor during the clinical supervision process.
    2. The extent to which interactions between supervisor and trainee can be disclosed to others.
    3. Your clinical supervisor is also the instructor for one of your classes.
    4. Addresses the extent to which fair and consistent application of the criteria that governs your training program has been followed.
    5. Addresses the rights that you have as a participant in a training program.
  12. Informed consent
    1. Covers the relationship between supervisor and trainee. Trainees are made aware of their responsibilities and those of the supervisor during the clinical supervision process.
    2. The extent to which interactions between supervisor and trainee can be disclosed to others.
    3. Your clinical supervisor is also the instructor for one of your classes.
    4. Addresses the extent to which fair and consistent application of the criteria that governs your training program has been followed.
    5. Addresses the rights that you have as a participant in a training program.
  13. Procedural due process
    1. Covers the relationship between supervisor and trainee. Trainees are made aware of their responsibilities and those of the supervisor during the clinical supervision process.
    2. The extent to which interactions between supervisor and trainee can be disclosed to others.
    3. Your clinical supervisor is also the instructor for one of your classes.
    4. Addresses the extent to which fair and consistent application of the criteria that governs your training program has been followed.
    5. Addresses the rights that you have as a participant in a training program.
  14. Confidentiality
    1. Covers the relationship between supervisor and trainee. Trainees are made aware of their responsibilities and those of the supervisor during the clinical supervision process.
    2. The extent to which interactions between supervisor and trainee can be disclosed to others.
    3. Your clinical supervisor is also the instructor for one of your classes.
    4. Addresses the extent to which fair and consistent application of the criteria that governs your training program has been followed.
    5. Addresses the rights that you have as a participant in a training program.
  15. Should a breach of ethics occur during your clinical supervision, one of the first steps that should be taken is to:
    1. file police charges.
    2. call your professional organization.
    3. talk to the appropriate person in either your academic department or in the agency in which you are working to determine the proper procedure for filing a grievance.
    4. report your supervisor to the state licensing board.
    5. do nothing. It was probably a mistake.

Answers

1: d; 2: c; 3: a; 4: d; 5: a; 6: e; 7: c; 8: a; 9: a; 10: d; 11: c; 12: a; 13: e; 14: b; 15: c;