Four steps The decision-making process involves four steps:
○ The front page test : How would you feel if what you are about to do showed up tomorrow morning on the front pages of the nation’s newspaper? What would be your response if a decision made in private suddenly became- public? This is a test of your social mores. ○ The mom test : If I were my mother, what would I do? If Mom knew about this what would she think? This is about the moral exemplar of who cares deeply about you and means a great deal to you. Put yourself in another’s shoes, and think about what you are on the verge of doing. It might well be wrong. The final important test is to determine how the Code of Ethics can inform the ethical decision-making process. How does the Code apply to the ethical issue or problem? ● Step 3: Decide the right thing to do . This step aims to re - solve an ethical dilemma where two conflicting options seem to be right. Kidder (1995) suggested three possible courses of action: 1. Rule based : Follow the rules, duties, obligations, or ethical principles in place. 2. Ends based : Weigh the consequences, good, or harm that will result for all stakeholders. 3. Care based : Resolve dilemmas according to relationships and concern for others. ● Step 4: Implement, evaluate, reassess. It is very important to take time to develop a plan for implementation . Evalua - tion and reassessment of the outcomes resulting from the de- cision are equally important. This step also requires personal and professional reflection to determine strengths, weakness- es, and need for professional growth in the four individual pro- cesses of moral sensitivity, judgment, motivation, or courage. Tips for applying the RIPS Model: ○ If there is a situation that makes the therapist uneasy, it is important to identify the ethical principles involved and determine if the situation is a problem, distress, or dilemma. Identify any conflicts that exist between ethical principles. ○ Identify the realm where it takes place. The moral conflict may be with personal, professional organizational, soci- etal, or a combination. ○ Identify resources for further information if there is confu - sion or lack of information to make a decision on an intel- lectual basis. ○ Apply the four tests from Kidder (1995) listed earlier, and test the issue against the Code of Ethics. ○ Decide on a course of action that aligns with the Code of Ethics, Model Practice Act, and any state regulatory stat- utes. ○ Analyze and reflect on the course of action to identify any barriers, potential outcomes, negative consequences, moral conflicts, and code or legal violations. ○ Review the aftereffects of the course of action to deter- mine if the outcomes and consequences turned out as expected. ○ Identify any corrections or further steps needed to address problems or unexpected consequences of the decided course of action. Are there any changes that need to be implemented to improve professional competence, insti - tutional, organizational, or societal procedures or policies to avoid future ethical issues? The FSBPT published an article on ethical decision making based on a case study presented by Annette Iglarsh and Nancy Kirsch at the 2006 FSBPT Annual Meeting (FSBPT, 2017b; Iglarsh & Kitsch, 2006).
● Step 1: Recognize and define the ethical issues . This first step includes examination of the facts of the case and an anal- ysis of the R ealm, I ndividual Process, and type of ethical S itu - ation. This step identifies the elements of the ethical situation for each of the three realms. ○ Realm : Sometimes the elements of the realm may conflict or overlap. Individual needs or rights may not always align with organizational or societal rules or expectations. ○ Individual process : In addition to the therapist evaluating the moral components of sensitivity, judgment and mo- tivation, it may also be important to evaluate the moral processes of others involved in the situation. ○ Situation : The final analysis involved in the first step of the RIPS Model is to classify the ethical situation. Is this an ethical issue/ problem, a dilemma, distress, temptation, or silence? ■ Issue/problem : Important values are present or may be challenged. ■ Dilemma : Two alternative courses of action may be taken, both of which fulfill an important duty, and it is not possible to fulfill both obligations. ■ Distress : The therapist may know the right course of action but is not authorized or empowered to perform it. Note that ethical distress may present as a later complication of any of the ethical situations. Ethical distress is often identified during the implementation phase of decision making. ■ Temptation : This involves a choice between a right and a wrong in which the therapist may stand to benefit from doing the wrong thing. ■ Silence : Ethical values are challenged, but no one is speaking about this challenge to values. This may actu- ally be the course taken by an individual who is experi- encing moral distress. ● Step 2: Reflect . Reflecting upon and interpreting the informa- tion gathered in Step 1. For example, if the individual realm seems to be most important, then the plan of action would involve direct communication with an individual or changes in interpersonal behavior or even changes in one’s personal behavior. If the organizational realm is the most important fac- tor, it may require development or revision of formal and in- formal organizational policies or procedures. Ethical issues at the societal level require an action plan to address the national legislation, policies, or values that are involved. ○ What are the relevant facts and contextual information? ○ Who are the major stakeholders? ○ What are the possible consequences (intended and unin- tended)? ○ What are the relevant laws, duties, obligations, and ethical principles? ○ What professional resources (code of ethics, guide for pro- fessional conduct, core values) speak to this situation? Apply Kidder’s steps to test right versus wrong as follows (Kidder, 1995): ○ The legal test : Is law breaking involved? If yes, the issue is one of obedience to the enforceable laws of the land, as opposed to the unenforceable canons of a moral code. If the answer is yes, it is legal, there are three other tests for right versus wrong. ○ The stench test : Does this course of action have about it an indefinable odor of corruption that makes you recoil? This is a “gut test” and a “gut level” determination. Al- ways listen to your gut because it tests your internal code of morality at the psychological level.
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