Ethical Decision Making Model 1
Ethical Decision Making Model: Ethical Dilemma 2 Scenario
Loralynn Wharton
Liberty University
COSC 501: Professional, Ethical & Legal Issues in School Counseling
March 1, 2020
Ethical Decision Making Model 2
Abstract
There are many ethical, professional and legal dilemmas that school counselors will face during
the course of their career. One of the biggest dilemmas is deciding when it is necessary to break
confidentiality. Students may have the ethical right to privacy, but parents also have the legal
right to be informed. This paper responds to that dilemma by applying the American Counseling
Association’s (ACA) Decision Making Model to the case scenario. School Counselors can use
this model when faced with complex ethical issues to help them determine the best course of
action.
Ethical Decision Making Model 3
Ethical Decision Making Model: Ethical Dilemma 2 Scenario
Even though priority is given to the students, school counselors also have responsibilities
with the parents/guardians and school system as a whole (Corey et al., 2019). Counselors must
be knowledgeable on state laws and school policies that regulate informed consent and
confidentiality. Above all else, the safety of students and others need to be considered. The
ACA’s Decision Making Model provides a framework for making sound ethical decisions by
addressing guiding principles, ACA Code of Ethics that are relevant, and steps to determine best
course of action for that circumstance (Forester-Miller & Davis, 1996). This model can address
complex issues that arise in a school setting.
Ethical Decision Making Model
1. Identify the Problem
By examining the facts of the situation, counselors are able to identify if there are any
ethical, legal or professional problems. In this scenario, a teacher refers a 7 grade student who
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has expressed suicidal intentions because of personal and family issues he is facing. After
meeting with the student, the school counselor determines the student is at imminent risk for
suicide, contacts the parent and provides them with a resource list of community mental health
counselors. This scenario poses an ethical problems regarding confidentiality and informed
consent since the information shared was determined to be necessary to disclose with other
parties. There is a legal problem with duty to protect and exercise reasonable care with the
student, as there is an imminent risk of harm. Simply providing a resource list to the parents is
not sufficient enough and further action to protect the student should be made to ensure
reasonable care is being made. There may also be a potential legal problem of mandated
reporting if there is suspected or reported abuse/neglect in the home.
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2. Apply ACA Code of Ethics
This step identifies ACA Code of Ethics that applies to this scenario. The following are
codes from the most recent ACA Code of Ethics (2014).
A.1.a. Primary Responsibility. The primary responsibility of the counselor is to promote
the welfare of their clients (ACA, 2014).
A.2.d. Inability to Give Consent. Since the client is a minor, he is unable to give
consent. Counselors must consider parents’ rights to make decision on his behalf (ACA, 2014).
A.11.d. Appropriate Transfer of Services. When referring to other community mental
health agencies, appropriate processes are completed and open communications is maintained
(ACA, 2014).
B.1.c. Respect for Confidentiality. Counselors keep information confidential and only
disclose what is ethically or legally justified (ACA, 2014).
B.2.a. Serious and Foreseeable Harm and Legal Requirements. Keeping information
confidential does not apply in order to protect people from harm. Imminent risk of suicide falls
under this exception. Counselors should consent with other professionals when in doubt (ACA,
2014).
B.2.e. Minimal Disclosure. Counselors only disclose essential information even when
required to breech confidentiality. Counselors should inform client and involve them in
disclosure process (ACA, 2014)
B.3. Information shared with others. Counselors make efforts to ensure privacy and
confidentiality is maintained by others when seeking consult or sharing necessary information.
B.3.c. states to make sure information being shared is done in private settings.
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B.5.a Responsibility to Clients. Since the student is a minor and unable to give consent,
the counselor must protect confidentiality and use laws and written policies as guides (ACA,
2014).
B.5.b. Responsibility to Parent and Legal Guardians. Counselors inform parents about
the role of counselor and confidential guidelines of sessions. Counselors collaborate with parents
to establish a relationship that will best serve student (ACA, 2014).
B.5.c. Release of Information. When working with minors, counselor seeks permission
from third party (parents in this case) to disclose information (ACA, 2014).
B.6.a. Creating and Maintaining Records and Documentation. Counselors maintain
records and document information for services (ACA, 21014).
B.7.a. Respect for Privacy and B.7.b. Disclosure of Confidential Information. Since
consulting is necessary in this case, counselor only shares what is relevant in order to gain
professional consultation (ACA, 2014).
C.6.b. Reports to Third Parties. Counselor will be accurate and honest with any reports
that are given to appropriate third parties (ACA, 2014).
American School Counselor Association (ASCA) Ethical Standards also align with the
ACA Code of Ethics in stating that school counselors keep information confidential unless legal
requirements demand information is revealed or to prevent serious harm (ASCA, 2016). A.2.f.
states that school counselors must balance students’ rights to make decision and parental legal
rights to make decisions on their behalf (ASCA, 2016). ASCA (2016) A.6 states that school
counselors should provide a list of referral options when additional support is needed. A plan to
transition services is made with minimal interruption of services. Counselors must inform
students or their legal and ethical obligations pertaining to confidentiality. Counselors do not
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release a student who is a danger to themselves until proper and necessary support is in place.
School counselor must follow state and federal laws in place for reporting threats to physical or
mental well-being of the student. Ohio Counselor, Social Worker, and Marriage & Family
Therapist Board (OCSWMTF) Code of Ethics states in 4757-5-02 (D.2) that counselors must
discuss with clients and authorized representatives (in this case the student and his parents) the
nature of confidentiality and the limits of clients’ right to confidentiality (2019).
3. Nature and Dimensions of the Dilemma
The ACA Practitioner’s Guide to Ethical Decision making by Forester-Miller and Davis
(1996) identifies five moral principles to consider when using the model. These principles are to
supplement the ethical guidelines that counselors must adhere to. not only Nonmaleficence
pertains to intention harm, but activities that could lead to harm. addresses the Autonomy
individual’s ability to make their own decisions and have independence when expressing their
values. is the counselor’s responsibility to prevent harm and contribute to the Beneficence
welfare of clients. means “treating equal equally and unequals unequally but in Justice
proportion to their relevant differences” (Kitchener as cited in Forester-Miller & Davis, 1996, p.
2). pertains to trust and following through with commitments. Fidelity
Autonomy is an important principle for school counselors to follow, but it is important to
consider the competence of each student’s ability to make decisions. In this case, the student who
is expressing suicidal intentions is not able to make sound decisions on their welfare. The 2
principles that take priority in this case are beneficence and nonmaleficence. The student’s well-
being and safety need to take priority over everything else. If the school counselor were to
release the student without the proper support in place, knowing there was an imminent risk of
suicide, the counselor is acting in a way that puts that student at risk. Breeching confidentiality to
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inform the parents, as well as make referrals and consult with other professionals is necessary in
this case to prevent harm and contribute to the student’s welfare.
There is a lot of literature that discusses the dilemmas that school counselors face,
particularly with suicidal students. Since school counselors only see their students briefly, any
need for further support should be discussed and outside referral need to be made. A suicidal
student needs to be seen for intensive one on one treatment. “Unless counseling takes place when
a suicidal adolescent has been identified, the probability is high that an attempt or a completion
will take place” (Capuzzi, 2012, p. 40) An article by ASCA states that suicide is the third leading
cause of death in adolescents and that school counselors often hear the first notion of it (Stone &
Zirkel, 2012) Consulting and sharing information may be necessary to reduce the risk of harm
and exercise reasonable care of the student. Lazosky (2001) wrote an article that reviewed
information collected from a study of 195 school counselors. When asked, the biggest dilemma
the school counselors faced was confidentiality issues. Most counselors stated that it was a fine
line to walk between disclosing minimal information with other school personnel while keeping
confidential. Today’s school culture promotes an open end of communication and encourages the
sharing of student information so that educators can be a strong team and better serve the student
body (Lazosky, 2001).
When dealing with a student with suicidal intentions, it is important that the school
counselor consult with another professional who had a lot of experience and training in crisis
management. This could be a school administrator or another professional counselor. Keep in
mind to only share information that was necessary to assess risk and best course of action. If the
school counselor thought there may be a legal issue with breeching confidentiality, consulting
with the school’s administrator and legal personnel would be necessary to determine what state
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laws may be applicable. In order to gain more information, the counselor may want to consult
with school educators that may be aware of the student’s history and have more knowledge about
the situation. I could also contact with the ASCA Ethics Committee if I needed further
consultation.
4. Potential Courses of Action
One course of action could be to continue assessing the risk yourself and not refer to
mental health counseling. Another course of action is to provide a list of community resources to
the parents and allow the parents and student choose a place, but not allowing the student to
come back to school until a release is signed from the mental health agency. Another course of
action is to sit down with the parents and make a referral to a particular place before the student
left the school that day. Another course of action would be to consider hospitalization of the
student after contacting the parents. Having emergency services and having them pick the
student up from school for inpatient psychiatric services. If there is suspicious of abuse or
neglect in the home, another course of action would be to contact the county’s Children Services
division.
5. Potential Consequences of Options
The consequence of assessing the risk yourself and not refer to mental health counseling
could be that that student carries out the suicidal threats. A potential consequence of sending the
student home and not allowing them to return to school until they are released from mental
health counseling is that this could increase the student’s suicidal ideation. If the student’s
suicidal intentions are a result from things going on inside the home, the student may feel that
they have no escape from their problems.
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Contacting emergency services for hospitalization does not allow the family the
opportunity to participate in outpatient therapy and takes away an easy transition. There will
likely be some trauma that comes out of the student being hospitalized. The student and family
may feel very blind-sighted by this and not agree with the decision. Contacting CPS services
could also cause distrust from the student and family if there is no abuse or neglect in the home.
This can cause the student to be fearful and not want to ever share anything personal again in the
future.
I believe the best course of action would be calling the parents into the school and explain
the results of the risk assessment that concluded there was an imminent risk of suicide. I would
go over a list of community resources, but highly encourage them to do a referral immediately.
Explain to the parents that the student should not be left alone for any length of time. If the
parents did not feel comfortable with providing the supervision that the student needed or was
unable to do so, I would suggest inpatient services at a psychiatric hospital. I would not have the
student come back to the school until there was a release from the mental health counselor and
there was no longer an imminent risk of suicide.
6. Evaluate Selected Course of Option
I do not believe there are any new ethical problems with the selected course of action. It
would be especially important to make sure when consulting with third parties, to only do so if
necessary and only share minimal information that is needed for the consultation. This meets the
justice test, as I would treat any other student that I determined had imminent risk of suicide the
same way. There is no special treatment given to this circumstance. I would have no problem
with my actions being reported publicly, as I followed ethical codes and state laws. My number
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one priority is the safety of the student and I have exercised reasonable care. I would also
recommend the same course of action to another counselor in the same situation.
7. Implement Course of Action
I would first consult with a school administrator to determine what the school’s protocol
was. I would then call the student’s parents into the office and explain what was going on. I
would make sure that everything was documented and I would have a school administrator with
me. I would make sure that the student was supervised the entire time. If the parents felt
comfortable with the student going home with the supervision and mental health counseling
needed, I would help them come up with a safety plan to support the student and provide
guidance if they needed it. If the parents did not feel like they could provide the supervision that
the student needed at that time, I would contact emergency services to come pick up the student
to get admitted to a psychiatric program. I would follow up with the mental health counseling
and I would obtain consent to share and collaborate with the third parties involved.
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References
American Counseling Association. (2014). Code of Ethics. Retrieved February 28, 2020 from
https://www.counseling.org/Resources/aca-code-of-ethics.pdf
American School Counselor Association. (2016). Ethical Standards for School Counselors.
Retrieved on February 28, 2020 from
https://www.schoolcounselor.org/asca/media/asca/Ethics/EthicalStandards2016.pdf
Capuzzi, D. (2002). Legal and Ethical Challenges in Counseling Suicidal Students. Professional
School Counseling, 6(1), 36-45. Retrieved February 28, 2020 from
www.jstor.org/stable/42732388
Corey, G., Corey, M.S., & Corey, C. (2019). Issues and ethics in the helping professions (10th
ed.). Stamford, CT: Brooks/Cole Publishing Co. ISBN: 9781337406291
Forester-Miller, H. & Davis, T. (1996). A Practitioner’s Guide to Ethical Decision Making.
American Counseling Association. Retrieved February 28, 2020 from
https://www.counseling.org/docs/ethics/practitioners_guide.pdf?sfvrsn=2
Lazovsky, R. (2008). Maintaining confidentiality with minors: Dilemmas of school
counselors. Professional School Counseling, 11(5), 335-340,342-346. Retrieved February
28, 2020 from http://ezproxy.liberty.edu/login?url=https://search-proquest-
com.ezproxy.liberty.edu/docview/213449241?accountid=12085
Ohio Counselor, Social Worker, and Marriage & Family Therapist Board; Code of Ethics.
(2019). Retrieved February 28, 2020 from https://cswmft.ohio.gov/Portals/0/pdf/10-18-
2019%20CSWMFT%20Board%20Laws%20and%20Rules%204757.pdf?ver=2019-10-
18-092339-967
Stone, C. & Zirkel, P. (2012). Student Suicide: Legal and Ethical Implications. ASCA School
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Counselor. Retrieved March 1, 2020 from
https://www.schoolcounselor.org/magazine/blogs/may-june-2012/student-suicide-legal-and-
ethical-implications
