Question

After reviewing the ACA and APA Code of Ethics, how would you use the ethical principles of beneficence, nonmaleficence, autonomy, justice, and fidelity when approaching client care in a mental health and wellness program?

Answer 1

• Counselors are often faced with situations that require sound ethical decision-making ability. Determining the appropriate course to take when faced with a difficult ethical dilemma can be a challenge.
• Several foundational principles are the underpinnings of best ethical practice and are viewed as central to the process of ethical decision making within the helping professions.
• Beauchamp and Childress (1979) identified four principles that are at the core of ethical reasoning in health care:autonomy, justice, beneficence, and nonmaleficence. Kitchener (1984) added a fifth principle of fidelity. She viewed these five principles as the cornerstone of ethical guidelines for counselors.
• The five bedrock principles of autonomy, justice, beneficence, nonmaleficence, and fidelity are each vital in and of themselves to a healthy counseling relationship.
• 1.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 counselor 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 their 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.
• 2.Justice, as Kitchener (1984) points out, is “treating equals equally and unequals unequally but in proportion to their relevant differences”. Justice does not mean treating all individuals the same.
• If an individual is to be treated differently, I as a counselor need to be able to offer a rationale that explains the necessity and appropriateness of treating the individual differently.
• An example of justice is that if I as a counselor would give a person who is blind a form that is in braille, or would go through the form with that individual orally, instead of giving him or her a standard written form to fill out. But I would treat him or her the same as any other client in all other regards.
• 3.Beneficence reflects the counselor’s responsibility to contribute to the welfare of the client. Simply stated, it means to do good, to be proactive, and also to prevent harm when possible. Beneficence can come in many forms, such as prevention and early intervention actions that contribute to the betterment of clients.
• 4.Nonmaleficence is the concept of not causing harm to others. Often explained as “above all, do no harm,” this principle is considered by some to be the most critical of all the principles.
• 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 counselor’s efforts toward ensuring “no harm.”
• So,for instance,as a professional counselor,I can make an exception to my duty of keeping my client's details a secret and in order to report to the authority sometimes,if the matter is really serious regarding the health of the client, that a patient has said she/he has an immediate plan to harm someone. A desire to prevent harm to my patient’s intended victim I need to act out on this priniciple.
• 5.Fidelity involves the notions of loyalty, faithfulness, and honoring commitments. Clients must be able to trust the counselor and have faith in the therapeutic relationship if growth is to occur. Therefore, as a counselor I must take care not to threaten the therapeutic relationship or to leave obligations unfulfilled.