Foundations of Ethical Practice, Research, and Teaching in Psychology

By Karen Strohm Kitchener | Go to book overview
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Chapter 4
Beyond Ethical Decision Making

As discussed in chapter 3, sometimes decisions need to be made that violate one ethical principle in order to uphold others or when it is otherwise not possible to achieve an ethically perfect resolution. This often leaves us with a sense of moral regret, as if we failed in some way. These feelings may lead us to question our decisions, and in some cases they will lead us to try to compensate for our less-than-perfect solution or for violating one ethical principle in order to uphold another. In response to a case like Jerry's (Case 3-2), one psychologist reported that although he decided to maintain his client's confidentiality for the reasons already articulated, he had a strong emotional reaction that led him to take further action. First, he met with his "Jerry" and expressed his concerns. Although his "Jerry" agreed to examine his behavior and sign a safe sex contract, the psychologist still felt uncomfortable. His observations follow:

When I saw my first " Jerry," I struggled with finding peace with myself as I continued to provide him treatment. While his behavior did become more responsible, I was not sure when or how often he "slipped." So, I began to identify other options I could pursue that would help me feel better about what I was doing. First, I approached the local health department and asked them to post information about risky behavior and safe sex in areas of sexual activity. I also told him that I was being interviewed by a reporter who covered HIV issues in our community and that I might tell her that some people who know they are HIV positive are continuing to have unsafe sex in public places. ( Barret et al., in press)

How do we understand this therapist's actions? I suspect most of us would agree that there was something special about him. He went beyond what is typically expected in a psychologist's role and exhibited what sometimes gets called the highest standards of the profession. He exhibited compassion for his client and a responsibility to others in the community. He exhibited the kind of be

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