The five bedrock principles of autonomy, justice, beneficence, non-maleficence, and fidelity are each vital to a healthy counselling relationship. A description of each of the five foundational principles are as follows:

 

Autonomy is the principle that addresses respect for independence and self-determination. The essence of this principle is allowing an individual the freedom of choice and action. It addresses the responsibility of the counsellor to encourage clients, when appropriate, to make their own decisions and to act on their own values.

 

There are two important considerations in encouraging clients to be autonomous. First, helping clients to understand how their decisions and values may be received within the context of the society in which they live, and how they may impinge on the rights of others.

 

The second consideration is related to the client’s ability to make sound and rational decisions. Persons not capable of making competent choices, such as children and some individuals with mental disabilities, should not be allowed to act on decisions that could harm themselves or others.

  

Justice does not mean treating all individuals the same. If an individual is to be treated differently, the counsellor needs to be able to offer a rationale that explains the necessity and appropriateness of treating the individual differently. An example of justice: a counsellor working with a client that is blind would go through the form with that individual orally, instead of giving him or her a standard written form to fill out. But the counsellor would treat him the same as any other client in all other regards.

 

Beneficence reflects the counsellor’s responsibility to contribute to the welfare of the client. Simply stated, it means to do good, to be proactive, and also prevent harm when possible. Beneficence can come in many forms, such as early intervention actions that contribute to the betterment of clients.

 

Non-maleficence is the concept of not causing harm to others. Often explained as “above all, do no harm,” this principle reflects both the idea of not inflicting intentional harm, and not engaging in actions that risk harming others. Weighing potential harm against potential benefits is important in a counsellor’s efforts toward ensuring “no harm.”

 

Fidelity involves the principles of loyalty, faithfulness, and honouring commitments. Clients must be able to trust the counsellor and have faith in the therapeutic relationship if growth is to occur. Therefore, the counsellor must take care not to threaten the therapeutic relationship or to leave obligations unfulfilled. 

 

*Practitioner’s Guide to Ethical Decision Making

Holly Forester-Miller, Ph.D. and Thomas E. Davis, Ph.D.

 

The Association of Cooperative Counselling Therapists of Canada (ACCT) is dedicated to providing the highest standards of professional counselling and consulting services. ACCT Code of Ethics and Standards of Practice provides guidelines and standards for Registered Therapeutic Counsellors, RTCs/Accredited Counsellors to pursue excellence in providing their professional services.

 

ACCT Code of Ethics and Standards of Practice provide a moral framework for making decisions when ethical dilemmas arise. It is not possible to anticipate or regulate every ethical dilemma and reasonable differences of opinion can and do exist in regard to ethical decisions. Therefore, these guidelines are intended to be used as part of an ethical decision-making process, including consulting with knowledgeable resources, such as ACCT Ethics committee, trusted colleagues, research, or other reliable sources. These guidelines and standards do not take the place of legal advice, which must be obtained from a lawyer. It is also important to consider personal values and whether they may in any way unfairly bias one’s perceptions and decision-making.

 

Members of ACCT have a responsibility to ensure that they are familiar with the ACCT Code of Ethics and Standards of Practice and strive to adhere to its principles and values. In addition, the ACCT Code of Ethics and Standards of Practice provides enforceable rules and behavioural expectations with which RTCs/ACs must comply, and for which sanctions may be applied for non‐compliance. These standards address the application of ethical principles to specific areas of practice.

 

Members are accountable to the public as well as their peers and may therefore be subject to the complaints and disciplinary procedures of the ACCT. Violations of the ACCT Code of Ethics and Standards of Practice, however, do not automatically imply legal liability. Such a determination can only be made by legal and judicial proceedings. This peer review process is intended to enable ACCT to advise and to discipline its members in response to substantiated complaints originating either with peers or the public.

 

The law and professional standards usually complement each other. However, the law generally is considered to take precedence over professionally defined standards should they conflict, and should one choose to disobey the law on grounds of conscience, personal choice and risk are involved. ACCT encourages its members to carefully consider the implications of any such decisions and consult as widely as the situation demands.

 

 

ACCT Code of Ethics and Standards of Practice may require a higher standard of behaviour than required by the law. Practice guidelines, position statements, special guidelines, etc, support counsellors in providing competent and ethical practice in specific areas of practice, and while they may help to define competency they are not binding or enforceable by themselves.

ACCT Code of Ethics and Standards of Practice is based on the following fundamental principles. These principles are of equal importance.

 

- Responsible caring

- Being proactive in promoting the client’s best interests

- Integrity

- Honouring commitments to clients and maintaining integrity in the counselling relationship

- Do no harm

- Refraining from actions that risk harm

- Independence

- Respecting the rights of clients to self-determination

- Fairness

- Respecting the dignity and just treatment of all persons

- Social responsibility

- Respecting the need to be responsible to society

 

This summary of ethical decision-making is intended to offer counsellors some direction when making ethical decisions and resolving ethical dilemmas.

 

 1. Quick Decision-Making

 

A) Public Knowledge - Would I feel comfortable with this decision if it were to become public knowledge?

 

B)  Justice – Is this decision fair and reasonable for all who are involved?

 

C)  Universality – Would other counsellors make this same decision? If they did, would that be a good thing? Would I make this same decision for any of my clients?

 

 

2. Principle-Based Ethical Decision-Making

 

A)   Consider the key ethical issues in the situation.

 

B)    Consider the ACCT Code of Ethics and Standards of Practice and how those standards are relevant to this situation.

 

C)    Consider which of the six ethical principles are of major importance in this situation. Also secure additional information, consult with knowledgeable colleagues or the ACCT Ethics committee and consider the probable outcomes of various courses of action.

 

D)   Consider how the relevant ethical principles can be applied in this circumstance and how any conflict between principles could be resolved and what might be the potential risks and benefits of this application and resolution.

 

E)    Consider what your feelings and intuitions are telling you to do in this situation.

 

F)    Choose the plan of action that would be most helpful in this situation.

 

 

3. Virtue-Based Ethical Decision-Making

 

Based on the belief that counsellors are motivated to be virtuous and caring. There is no step-by-step methodology for virtue ethics. The following questions may help the counsellor in the process of virtue-based ethical decision-making:

 

A)   As I consider this ethical dilemma, what is my feelings and intuitions telling me to do?

 

B)    How can I use my values to best show caring for the client in this situation?

 

C)    How will my choice and decision affect other individuals involved in this ethical dilemma?

 

D)   If I had to publicize my decision, what decision would I make?

 

E)    What decision would my best self make?

 

 

As a Registered Therapeutic Counsellor (also includes Master Therapeutic Counsellor and Registered Counselling Supervisor) and member of ACCT I commit:

 

- To protect the welfare of my clients and make reasonable efforts to ensure my services are used appropriately.

 

- To treat all clients with respect and unconditional acceptance.

 

- To consistently complete a comprehensive assessment at the beginning of the counselling relationship.

 

- To never exploit a clients trust and to avoid dual relationships.

 

- To report the sexual or physical abuse of a child to the authorities.

 

- To avoid overt or suggested sexual contact with clients and former clients.

 

- To terminate counselling services when appropriate or requested by the client(s).

 

- To respect the right of clients to autonomy.

 

- To provide a private and safe setting for counselling.

 

- To request payment for service, only after consent for service has been given.

 

- To ensure proper self-care.

 

- To maintain healthy boundaries with clients.

 

- To obtain assistance and refer clients when appropriate.

 

- To clearly disclose confidentiality limitations, facts about services offered and financial policies.

 

- To be aware of and comply with relevant laws for the delivery of counselling services, including electronic services.

 

- To maintain client confidentiality, except where there is written consent, danger to self or others or as required by law.

 

- To carefully assess, develop a safety plan, and document the potential suicidal or homicidal behaviour by a client.

 

- To maintain accurate and adequate session and financial records.

 

- To continue to grow and develop as a professional counsellor.

 

- To avoid conflicts of interest.

 

- To avoid giving or receiving gifts of substantial value.

 

- To be aware of the influence my public statements may have.

 

- To deal appropriately with the unethical behaviour of another counsellor.

 

- To accept that I cannot realistically expect to succeed with every client.

 

 

- To promote my services professionally and accurately.