A discussion of ethical decision-making literature is overdue. In this article, we summarize the current literature of ethical decision-making models used in mental health professions. Of 1,520 articles published between 2001 and 2020 that met initial search criteria, 38 articles were included. We report on the status of empirical evidence for the use of these models along with comparisons, limitations, and considerations. Ethical decision-making models were synthesized into eight core procedural components and presented based on the composition of steps present (...) in each model. This taxonomy provides practitioners, trainers, students, and supervisors relevant information regarding ethical decision-making models. (shrink)

ABSTRACT School psychologists are frequently confronted with ethically challenging situations arising from the need to balance multiple parties’ competing interests and the challenge of serving as both student advocate and school employee. Use of a systematic decision-making model has been recommended as a way of improving the quality of school psychologists’ ethical decisions. In the present study, school psychology practitioners were randomly assigned to one of two conditions: a Critical Evaluative condition, requiring the use of a problem-solving approach to resolve (...) an ethical dilemma, or an Intuitive condition, which entailed generating a solution based solely on intuition and professional experience/judgment. Use of a formal decision-making model did not result in higher caliber ethical resolutions. Participants’ age and number of years in the field were significantly correlated with raters’ judgments that solutions considered the consequences of a chosen course of action. Most participants reported that they did not utilize an ethical decision-making model during the course of their practice, relying instead on consultation with peers/colleagues and their own professional experience. Implications of these findings are discussed in the context of school psychology practice. (shrink)

The moral distress of psychologists working in psychiatric and mental health care settings was explored in an interdisciplinary, hermeneutic phenomenological study situated at the University of Alberta, Canada. Moral distress is the state experienced when moral choices and actions are thwarted by constraints. Psychologists described specific incidents in which they felt their integrity had been compromised by such factors as institutional and interinstitutional demands, team conflicts, and interdisciplinary disputes. They described dealing with the resulting moral distress by such means as (...) silence, taking a stance, acting secretively, sustaining themselves through work with clients, seeking support from colleagues, and exiting. Recognizing moral distress can lead to a significant shift in the way we perceive moral choices and understand the moral context of practice. (shrink)