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Question: For the past two months, you have provided counselling services to Tammy, a 14-year-old girl with Type 1 diabetes. Prior to coming to see you, Tammy had been to three other counsellors in the last year, all of whom she quickly dismissed as "idiots." Although a very reluctant participant initially, the therapeutic alliance with Tammy has strengthened over time to the point where she often discloses very personal information. Tammy's parents are thrilled that their daughter has finally found a counsellor she likes and trusts. During your most recent session, Tammy hints that she drinks heavily at parties. When you probe further, Tammy quickly retracts her comments and changes the subject. Repeated attempts to get her to say more about her drinking get nowhere. You are very concerned about Tammy's medical safety if she misuses using alcohol regularly. considering the example in the image and 2. Virtue-Based Ethical Decision-Making A virtue ethics approach is based on a belief that counsellors/therapists as virtuous persons have the ability to make ethical decisions that are informed by their understanding of the interests of others, a capacity to subordinate self-interest in the pursuit of just outcomes, an acceptance of complexity, and a commitment to natural justice. Although there is no step-by-step methodology for this approach, the following questions may help with the process of context-specific, virtue-based ethical decision making : Step Five: A. What do the feelings and intuitions tell the counsellor to do in this situation? (See also Virtue-Based Ethical Decision-Making) Up to this point, decision making was mainly cognitive and rational. In this step, the task is to use emotional decision-making techniques. At this stage, counsellors can add some elements of virtue ethics, especially considering all the options below that can best help and show respect for the client. Consider the emotional response to the dilemma and answer these questions: 1. What emotions and intuition aware of as consider this ethical dilemma, and what are they telling me to do? 2. How can my values best show caring for the client in this situation? 3. How will my decision affect other relevant individuals in this ethical dilemma? 4. What decision would I feel best about publicizing? 5. What decision would best define who I am as a person? Step Six: A. What plan of action will be most helpful in this situation? B. Follow up to evaluate the appropriateness, adequacy, and effectiveness of the course of action taken. Identify any adjustments necessary to optimize the outcome. Counsellors should consider the breadth and depth of possibilities. What are all the different ways that the situation might be handled? How feasible is each possibility? Identify and follow the specific action plan, evaluate it, and provide the rationale for how to adjust any negative or neutral consequences that may occur as a result of your actions.
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