Ethical decision-making models: a taxonomy of models and review of issues

Johnson, M. K., Weeks, S. N.,  et al. (2021).

Ethics & Behavior, 32(3), 195–209.

https://doi.org/10.1080/10508422.2021.1913593

Abstract

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.

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Here are some thoughts:

This article reviews ethical decision-making models used in mental health professions and introduces a taxonomy of these models, defined by eight core procedural components. The study analyzed 38 articles published between 2001 and 2020 to identify these components. The eight core components are:   

1. Framing the Dilemma: This involves identifying and describing the ethical dilemma.
2. Considering Codes: This includes reviewing relevant ethical codes and legal standards.
3. Consultation: Seeking advice from supervisors, colleagues, or ethics experts.
4. Identifying Stakeholders: Recognizing all individuals and parties affected by the decision.
5. Generating Alternatives: Developing various potential courses of action.
6. Assessing Consequences: Evaluating the potential outcomes of each alternative.
7. Making a Decision: Choosing the best course of action.
8. Evaluating the Outcome: Reflecting on the decision-making process and its results.    

The paper discusses the empirical evidence for the use of these models, their limitations, and other important considerations for practitioners, trainers, students, and supervisors. 

Psychiatric diagnosis: the indispensability of ambivalence

By Felicity Callard
J Med Ethics doi:10.1136/medethics-2013-101763

Abstract

The author analyses how debate over the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders has tended to privilege certain conceptions of psychiatric diagnosis over others, as well as to polarise positions regarding psychiatric diagnosis. The article aims to muddy the black and white tenor of many discussions regarding psychiatric diagnosis by moving away from the preoccupation with diagnosis as classification and refocusing attention on diagnosis as a temporally and spatially complex, as well as highly mediated process. The article draws on historical, sociological and first-person perspectives regarding psychiatric diagnosis in order to emphasise the conceptual—and potentially ethical—benefits of ambivalence vis-à-vis the achievements and problems of psychiatric diagnosis.

The entire article is here.