Tools for Working Through Ethical Dilemmas

BY Carole Robinson Oliver

Jason is a support officer in a Correctional Service of Canada (CSC) psychiatric facility. He works closely with the psychiatrist, who is treating a sex offender on conditional release. The offender has a history of pedophilia, but seems to be sticking to his treatment plan and never skips an appointment. One day, Jason learns from the psychiatrist that the man has re-offended, but no one else knows about it. The offender has revealed this information to the psychiatrist, knowing she is bound by a professional oath to respect confidentiality. Jason also happens to know that the offender lives with a woman who has young children. He’s worried they might be at risk.

Jason’s dilemma: Do I follow the absolute practice of confidentiality, which is sacrosanct in the medical profession, or do I do what I think is right, to ensure that these children are safe?

There are no pat answers to these and other ethical dilemmas that, daily, confront CSC staff as they go about their duties. However, there are several tools that can help people work through difficult situations and come to a decision they can live with. Since 2002, these tools have been taught to managers at the Correctional Management Learning Centre in Cornwall, Ontario. Now, they will be made more widely available to staff through a series of pilot training projects. The tools include:

A ACT

• A decision-making grid – Alternative, Consequence, Tell your story

B Bell, Book and Candle

The bell

• Do any alarm bells go off in my head as I consider my choice of action?

The book

• Does my choice violate any laws, written policies, codes, etc.?

The candle

• Will my decision stand up in the light of day or media spotlight?

C Ethical Checklist

Is it legal?

• Does my decision violate any laws (e.g., Criminal Code of Canada, civil law, Corrections and Conditional Release Act), directives or policies? Just because it is legal doesn’t mean it is ethical.

Is it fair?

• Is my decision fair to all?
• Does it promote “win-win” outcomes with all stakeholders?
• Do I have special information, because of my job, which gives me an unfair advantage over others?
• Is there a conflict between serving my interests and those of my organization or the community?

How will I feel afterwards?

• Will I be able to explain my actions so that my family, agency and others would be able to understand and support my decision?
• Would the greater community understand and agree with my choice?

D Ethical Deliberation – Decision-Making Model

1. Establish the facts.

• What are the facts of the case? What values are involved?

2. Identify values in conflict. Determine which one has the greatest authority and significance.

• What are the values which individuals involved in the case live by?
• Which ones make conflicting demands?
• Which have the greatest authority/significance in this case?

3. Identify options and consequences of each option.

• Analyse and measure the impact of each option and consider the one that is the least damaging to the organization and the individuals involved, based on the conflicting values.

4. Make a decision and take action.

• After ascertaining the facts, sorting and weighing the conflicting values and applying them to the case, make a decision based on what is right.
• Be able to explain and justify the decision.

To get back to Jason’s ethical dilemma, let’s work through it using the ACT tool (below).

A Alternative	C Consequence	T Tell your story
Tell the truth	may harm Jason’s relationship with the psychiatrist could protect the children from possible molestation or worse	Jason can tell his story
Remain silent	no impact on Jason’s relationship with the psychiatrist possible loss of respect from those higher-up, if information becomes known Jason may be haunted for years if something happens to the children.	Jason cannot tell his story
Lie: pretend you never heard about it.	no impact on Jason’s relationship with the psychiatrist possible loss of respect from those higher-up, if information becomes known. Jason is labeled as a liar. Jason may be haunted for years if something happens to the children	Jason cannot tell his story

 

If Jason is still struggling as to whether he can tell his story, he can go one step further and list all the stakeholders, all those who may be affected:

• Jason
• the psychiatrist
• colleagues in the unit
• the director/senior management
• the institution’s credibility
• the reputation of the Correctional Service of Canada
• the community
• offender’s partner; her children

“When you go through these steps,” says Donna Morrin, Director of Learning and Development at NHQ, “you realize there’s a ripple effect for whatever decision you make on your ethical dilemma. You’ll get a clearer idea of who’s affected.”

Morrin speaks from many years’ experience facilitating the Ethics and Corrections course in Cornwall. She’s eagerly looking forward to the ACT model and other tools being presented to front-line staff, through the pilot projects.

“People are going to bring their own, real-life examples to the course and work on them in groups, using the tools,” she says. “As facilitators, we try not to give our own opinion. Instead, we redirect staff back to the tools and help them work through the situation. Even if they don’t get an answer, they’ll feel better about whatever dilemma they’re confronted with and be better able to live with their decision.” ♦