Ethical Decision Making,A Ten-Step Model

By Tom Smith, Ph.D. & Ofer Zur, Ph.D.

 

A thorough ethical decision making in regard to clients with HIV/Aids often involved the following ten steps:

First, Review all of the facts of the situation leaving nothing out.

Second, identify any triggers, reactions or countertransference issues, values, conflicts and any and all personal responses to the case of a client with HIV/AIDS. Consider how they might affect judgment and treatment decisions.

Third, know the federal laws, laws in your state and the ethics that guide your profession.

Fourth, identify the different options that you may consider.

Fifth, construct a detailed risks and benefits analysis for each option.

Sixth, identify the conflicting forces and influences as well as conflicting laws and guidelines, ethics codes, and conflicting values that may be involved.

Seventh, discuss the different options with your clients and consult as necessary.

Eighth, develop a comprehensive, but open-ended, treatment plan and enlist the client’s cooperation to implement the plan.

Ninth, execute the plan, monitor and discuss outcomes and be prepared to change course if necessary.

Tenth, evaluate and asses the effectiveness or success of your plan and continue, adjust or revised the plan as necessary.

HIV and AIDS issues are extremely complex, conflictual and often emotionally charged. As a result there are many ways to go about addressing clients’ and community needs and rights. Obviously, there is not any particular skill or approach that best help the HIV client. What is helpful is up-to-date knowledge, clarity about one’s own biases, willingness and capacity to tolerate ambiguity and most importantly a willingness to engage the existential, medical, political and logistics issues that can be so intimidating and difficult.