ETHICAL CONCERNS FOR THE COUSNELING PROFESSION

Ethical Concerns for the Counseling Profession

Confidentiality
At the source of the ethical dilemma regarding end-of-life decisions is that of
confidentiality. As the ACA Code of Ethics states, The general requirement that counselors
keep information confidential does not apply when disclosure is required to protect clients or
identified others from serious and foreseeable harm or when legal requirements demand that
confidential information must be revealed (ACA, 2014, B.2.a.). Therefore, some could argue
that when a client expresses interest in suicide, even completely rational terminally ill clients, it
is the counselors ethical duty to break confidentiality to protect their client from harm.
However, the ACA Code also states that if that client is terminally ill, the counselor has the
option of maintaining confidentiality (ACA, 2014, B.2.b.). So where does that leave a counselor
when they need to make their decision regarding breaching confidentiality?
Autonomy vs. Client Welfare
Additional ethical decisions need to be made regarding the debate between autonomy and
client welfare. Most obviously, the value of autonomy is one of six that make up the foundation
of the ACA Code of Ethics (ACA, 2014, p. 3). Therefore, you may assume that autonomy
trumps client welfare in an ethical dilemma. However, the Code also states that counselors will
avoid harming their clientsand to minimize or to remedy unavoidable or unanticipated harm
(ACA, 2014, A.4.a.). We are again left with two possibly contradictory ideas. An interesting
answer to this dilemma is explained by Callahan (1994). He describes self-determination as a
spectrum, not an end destination. Therefore, self-determination can be decision specific. He
argues that while a client can be seen as competent to make certain decisions, they may not be
competent to make others (Callahan, 1994). Therefore, according to Callahan (1994), it is within

ETHICAL CONCERNS FOR THE COUSNELING PROFESSION

the rights of the mental health professional to override the clients self-determination if the
professional feels that the client is not competent enough to make the decision for themselves
and the professional believes harm will come to their client (Callahan, 1994). Personally, I
believe that Callahans argument could be a slippery slope. To me, it sounds like that argument
could arguably be compared to imposing our own values on our client. According to the ACA
Code of Ethics, Counselors are aware of and avoid imposing-their own values, attitudes,
beliefs, and behaviorsespecially when the counselors values are inconsistent with the clients
goals (ACA, 2014, A.4.b.).

ETHICAL CONCERNS FOR THE COUSNELING PROFESSION

References
American Counseling Association (2014). ACA Code of Ethics. Alexandria, VA: Author.
Callahan, J. (1994). The ethics of assisted suicide. Health & Social Work, 19(4), 237-44.
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