Which is the first step to resolving an ethical dilemma?

An ethical dilemma requires a person to define right from wrong. But, as Direct Support Professionals (DSPs), we know that this is not so simple. We face difficult decisions in our daily practice. There are often many different rules, principles, and opinions at play. We are called to respond in allegiance to the individuals we support. The National Alliance for Direct Support Professionals (NADSP) Code of Ethics provides a roadmap to assist in resolving ethical dilemmas.

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How do I resolve ethical dilemmas?
RIGHT Decision Method

How do I resolve ethical dilemmas?

Ethical dilemmas can be resolved through effective decision-making. Since we are so often called upon to make independent judgments, it is important to incorporate the NADSP Code of Ethics within our daily practice. Many ethical dilemmas can be resolved easily with consultation and reflection. However, some issues cannot. Therefore, to help make it easier to solve difficult ethical dilemmas, consider a framework from which to work. The College of Direct Support has provided an approach to ethical decision-making with the NADSP Code of Ethics. This is called the RIGHT Decision Method.

RIGHT Decision Method

Recognize the ethical dilemma.
Identify points of view.
Gather resources and assistance.
Have a plan.
Take action based on ethical standards.

What is the RIGHT Decision Method?

Sometimes there really is a “right” way to make decisions under difficult conditions. The RIGHT Decision Method gives us tools to make sound ethical decisions and resolve ethical dilemmas. RIGHT is an acronym that stands for each step of the decision-making process:

R: Recognize the ethical dilemma.

The first step is recognizing the conflicting obligations and clearly stating the dilemma. It is important to recognize and use the NADSP Code of Ethics as you begin with this step. You may consider —

In what ways is the Code of Ethics applicable to this issue?

I: Identify points of view.

The second step is identifying points of view in the situation. This means considering the viewpoint of the person receiving services, your colleagues, other parties involved, and the NADSP Code of Ethics. Restating the problem clearly to someone else can also help you check out whether you have interpreted the situation accurately. It is important to understand how the person receiving supports feels. Consider —

What does the person receiving support expect? 
Then think about others who are involved in the situation and how they feel. 
What do these individuals want or need?

G: Gather resources and assistance.

The third step is gathering resources and assistance that might help you figure out what to do. Now that you have an accurate understanding for the problem and various perspectives, this step encourages you to consider other people who may be able to assist you. You may also need to find important information. For example —

Are there agency policies that could be considered? What do these documents say? Are there any laws or regulations in the state that may influence your decision-making? 
Is this a situation where legal advice is needed? Does the person have a legal representative who must be involved? 
Are there community resources that might help resolve the problem?

H: Have a plan.

The fourth step means that you are ready to make your decision. Formulating a plan will help you decide the best way to put your ideas into action. Once you have considered the following issues, write a plan down and identify step-by-step actions that you plan to take —

Whom must you speak to first? What will you say? What preparations will you make? 
What steps can you take to ensure the best possible outcome for your decision? 
How might people react?

T: Take action based on ethical standards.

The fifth and final step is implementing the plan you developed in the manner you decided. Then, it is important to monitor its success using the success indicators you identified in the planning process to help you reflect on your decision —

What worked well and why? 
What did not work well and why? 
What would you do differently after you have evaluated your outcomes?

Taylor, M., Silver, J., Hewitt, A., & Nord, D. (2006). Applying ethics in everyday work (Lesson 3). In College of Direct Support course: Direct support professionalism (Revision 2). DirectCourse.

Chapter 3: Ethical Dilemmas and the Process of Effective Resolution

With values as focal point, the National Association of Social Workers has created a framework that is used by social workers to address ethical dilemmas. The framework includes six steps:

Determine whether there is an ethical issue or/and dilemma. Is there a conflict of values, or rights, or professional responsibilities?
Identify the key values and principles involved. What meanings and limitations are typically attached to these competing values?
Rank the values or ethical principles which – in your professional judgement – are most relevant to the issue or dilemma. What reasons can you provide for prioritizing one competing value/principle over another?
Develop an action plan that is consistent with the ethical priorities that have been determined as central to the dilemma. Have you conferred with clients and colleagues, as appropriate, about the potential risks and consequences of alternative courses of action? Can you support or justify your action plan with the values/principles on which the plan is based?
Implement your plan, utilizing the most appropriate practice skills and competencies. How will you make use of core social work skills such as sensitive communication, skillful negotiation, and cultural competence?
Reflect on the outcome of this ethical decision making process. How would you evaluate the consequences of this process for those involved: client(s), professional(s), and agency(ies)?

In comparison, Evans and MacMillan (2014) have developed a framework involving 10 steps to make ethical decision-making efficient and practical. This framework is specific to law enforcement officers and addresses the consideration of laws, regulations, policy, and procedures that other frameworks assume will be followed, but in law enforcement are very important to avoid charges and allow cases against suspects to proceed. The framework concludes with a follow-up to determine the effectiveness of the course of action taken by the officer.

As a simple alternative to these frameworks, students should consider the following framework:

Establish the facts surrounding the ethical dilemma.
Facts are important in law enforcement. To investigate all cases, officers must rely on facts to guard against misinformation and cognitive biases. This is also true in ethical dilemmas that we face. If the facts are not known to us, we must investigate everything that surrounds the dilemma to ensure we are acting on the right information. Avoid acting on rumours and gossip by verifying information through factual information and evidence.
Determine your legal obligations and duties.
We must be sure what our professional and legal obligations are. Professional and legal obligations will likely allow us to easily decide on a course of action to take in an ethical dilemma. However, while professional and legal obligations may not always require a course of action that coincides with these obligations, our awareness of any professional and legal obligations must be known to allow us to be fully cognizant of the consequences of our actions should we choose to ignore professional or legal obligations.
Establish the interested participants involved.
It is important to know who will be impacted by the course of action that we decide upon. Often the primary participants are easy to identify and it is the secondary participants that are often not considered. These may include friends, families, or employees that are related somehow to the primary participants in the ethical dilemma. Knowing the impact of the decision made to secondary participants may be particularly important for a decision made with utilitarian underpinnings; where the rights of those who are not part of the majority may not be considered.
Determine the ethical values of each participant.
Determining ethical values is important to allow us an understanding of what is truly at stake. A participant in an ethical dilemma may value loyalty as the most important value. However, another participant may value equality as the more important value. When considered, the value of loyalty may not compare with equality, depending upon the ethical dilemma.
Consider normative ethical theories as an aide to determine a course of action.
When considering options, normative ethical theories may assist us in determining the consequences of actions, or the duties we may be obligated to follow that fall outside of the laws, rules, and procedures. We may also assess whether the decision we are considering is rational from another perspective we have not considered. We may also settle on an option, and rely on an ethical theory to assist us in articulating the reasoning behind the option we have chosen.
Consider options that would be ethically sound.
There may be several options to consider, and each option ought to be considered critically by determining what harm it would cause and what values the person being harmed holds. The participant should consider the positives and negatives of the decision and determine the risks and benefits associated with each option, as well as the benefits of each action, with these values in mind.
Consideration of the possible negative and positive outcomes of each possible option.
Try to predict what may otherwise be unintended consequences of your decision. These consequences may not be readily apparent, but they require a critical analysis of the consequences of your decision. To help with this, try asking the following questions:
- Would the action taken be well received if it was on the front page of a newspaper? While this should be a consideration, keep in mind that often the right decision may be the least popular in public opinion.
- If the decision is job-related, would the agency or company you work for still hire you if it knew you would make this decision? If the answer is yes, then this should give weight to the decision you are about to make.
- If the decision is not job-related, would the agency you would like to work for still hire you if it knew all the facts surrounding the dilemma and the decision you would make? If the answer is yes, then this should give weight to the decision you are about to make.