PRACTICE

Employing Ethical Codes

and Decision-Making Models:
A Developmental Process

EDWARD NEUKRUG
CHRISTOPHER LOVELL
RADHA J. PARKER

Counselors often encounter seemingly intractable ethical dilemmas. Toassist counselors whoface difficult
situations, thehelping professions have generated both ethical codes anddecision-making models. Because
the process of decision making seems to be related to cognitive-moral development, this article details
ethical codes and decision models and speculates on how counselor level of development may influence
use of suchcodes and models.

John, a 55-year-old gay man, is seriously depressed and feels that he has no
reason to continue living. Although he has been seeing you, his counselor, for
several months, his outlook on life has not changed, and he is determined to
end what he considers to be an "empty existence" before death overtakes him.
John's partner of 10 years, Jim, died of AIDS 2 years ago, having suffered
prolonged pain and anguish. Although John himself has lived with HN for
more than 5 years, he has recently been diagnosed with AIDS, and the reality
of his own mortality has become apparent. John, whose parents died when he
was 6, has no surviving relatives, nor any close friends. He and Jim had
isolated themselves from others, and to safeguard their privacy, had severed
all social ties years ago. As a self-employed writer who has chosen a solitary
lifestyle, John has no support system and is not interested in trying to develop
one now. He tells you that he has "lived long enough" and has accomplished
most of what he wished to do in life. He is now "ready to die" and wants only
to "get it over with as quickly and painlessly as possible." He asks you to help
him decide on the most efficient means of achieving this goal. As his coun-
selor, what should you do?
With this case and others, professional helpers are confronted routinely by
ethical dilemmas that are stressful (May & Sowa, 1992), ambiguous (Corey,
Corey, & Callanan, 1993),and complex (Welfel & Lipsitz, 1983). For guidance,

Edward Neukrug is an associate professor and Christopher Lovell and Radha J. Parker are
assistant professors, all in the Department of Educational Leadership and Counseling, College
of Education, at Old Dominion University, Norfolk, Virginia. Correspondence regarding this
article should be sent to Edward Neukrug, Counseling Program, College of Education, Old
Dominion University, Norfolk, VA 23529.

98 Counseling and Values / January 1996 / Vol. 40

helpers can tum to the codes of ethical standards widespread within profes-
sional associations. Although an ethical code can provide a useful framework
for the sometimes arduous decision-making process, such a set of guidelines
alone is often not fully adequate in helping the counselor with tough ethical
dilemmas. As a result, ethical decision-making models have been developed
as another form of assistance for the professional who must make difficult
ethical judgments (Corey et al., 1993; Kitchener, 1984; Loewenberg & Dolgoff,
1988; Smith, McGuire, Abbott, & Blau, 1991). Because it is likely that a helper's
ethical orientation or style of decision making is related to level of moral
development (Van Hoose & Paradise, 1979; Welfel & Lipsitz, 1983), the ques-
tion arises: In the face of an ethical dilemma, does a counselor's level of moral
development relate to how he or she uses the available options (i.e., code or
decision-making model)? Within the contexts of history and some contem-
porary thought about ethics, this article speculates on this question.

THE DEVELOPMENT OF AND NEED FOR ETHICAL CODES

The establishment of ethical guidelines is relatively new to the helping profes-
sions. For instance, the American Psychological Association (APA) first pub-
lished its Ethical Standards of Psychologists in 1953, the American Association
for Counseling and Development (AACD; today the American Counseling
Association [ACA]) developed its ethical guidelines in 1961, and the National
Association of Social Workers (NASW), established its guidelines in 1960.
Because ethical standards are to some degree a mirror of change in society, the
associations' guidelines have undergone a number of major revisions over the
years, which reflect society's ever-changing values (see ACA, 1988; APA,
1989; NASW, 1990).
In the development and revision of such ethical guidelines, decisions about
what might be considered ethically correct behavior were most likely a
difficult task. For instance, those who view themselves as "ethical relativists"
believe that moral rules are "preferences predominant in particular cultures"
(Brace, 1992, p. 18), and therefore, they believe that ethical judgments might
vary from culture to culture or even setting to setting. These individuals
might argue that a set of ethical guidelines such as a code should be based on
"consensus values" (Bergin, 1985). Others, such as Gert (1988), believe that
ethical judgments should be based on a set of "universal truths" with which
most rational people would agree. Such universal truths, or principles, might
include the following: not killing, not causing pain to another, and not
depriving one of freedom. Although Gert might argue that under particular
circumstances the application of certain universal truths might not be jus-
tified, he has stated that, generally, these and other truths are crucial for the
survival of society. Individuals who adhere to this orientation would argue
that ethical guidelines should be at least partly based on these universal
principles.
It is likely that in the development of ethical guidelines those charged with
the formation of such standards have separately grappled with which societal
and professional values the guidelines should reflect and whether these
values should be grounded in universal principles, consensus values, or both.

Counseling and Values / January 1996/ Vol. 40 99

Despite the likelihood of their separate promulgation, it is interesting that the
ethical guidelines of the three major helping professions-psychology, coun-
seling, and social work-all share similar values.

1. Ethical standards protect consumers and further the professional stand-

ing of the organizations (Corey et al., 1993, p. 7).
2. They serve "as a vehicle for professional identity and a mark of the
maturity of the profession" (Mabe & Rollin, 1986, p. 294). As such, the
guidelines denote the fact that a particular profession has a body of
knowledge and skills that it can proclaim and that a set of standards
can be established that reflect this knowledge (Ansell, 1984).
3. They guide professionals toward certain types of behaviors that
reflect the underlying values considered to be desirable in the profes-
sional (Corey et al., 1993; Loewenberg & Dolgoff, 1988; VanZandt,
1990).
4. They offer the professional a framework in the sometimes difficult
ethical and professional decision-making process (Corey et al., 1993).
5. They represent, in case of litigation, some measure of defense for profes-
sionals who conscientiously practice in accordance with accepted
professional codes (Corey et al., 1993, p. 6).

Although ethical guidelines can considerably assist a professional in his or

her ethical decision-making process, as Mabe & Rollin (1986) noted, such a
code has some limitations.

1. Many issues cannot be handled in the context of a code.

2. There are some difficulties with enforcing the code, or at least the public
may believe that enforcement committees are not tough enough on
their peers.
3. Often there is no way to bring the interests of the client, patient, or
research participant systematically into the construction process of the
code.
4. There are parallel forums in which the issues in the code may be
addressed, with the results sometimes at odds with the findings of the
code (e.g., in the courts).
5. There are possible conflicts associated with codes: between two codes,
between the practitioner's values and code requirements, between the
code and ordinary morality, between the code and institutional practice,
and between requirements within a single code.
6. A limited range of topics is covered in the code, and because a code
approach is usually reactive to issues already developed elsewhere, the
requirement of consensus prevents the code from addressing new
issues and problems at the "cutting edge" (Mabe & Rollin, 1986, pp.
294-295).

100 Counseling and Values / January 1996/ Vol. 40

Decision-Making Models

In view of the aforementioned practical limitations of ethical guidelines and

in search of a more flexible and comprehensive approach for resolving ethical
dilemmas, models of ethical decision making have been devised (Daniluk &
Haverkamp, 1993;Smith, McGuire, Abbott, & Blau, 1991).
For instance, Corey et al. (1993) developed a practical, problem-solving
model, which brings together both ethical-moral and pragmatic concerns. By
reviewing a number of decision-making models, he identified seven steps in
the decision-making process. These steps consist of (a) identifying the prob-
lem, (b) identifying the potential issues involved, (c) reviewing the relevant
ethical guidelines, (d) obtaining consultation, (e) considering possible and
probable courses of action, (f) enumerating the consequences of various
decisions, and (g) deciding on what seems to be the best course of action.
Although Corey et al.'s (1993) model emphasized the pragmatic aspects of
ethical decision making, other theorists have stressed the role of moral prin-
ciples in this process. For instance, Kitchener (1984)described the role of four
moral principles in the making of ethical decisions. She stated that in working
with clients, mental health professionals should promote the autonomy of the
client (e.g., independence, self-determination, freedom of choice), the
beneficence of society (promoting the good of others), the nonmaleficence of
people (avoidance of harm toward others), and justice or fairness to all (provid-
ing equal and fair treatment to all people). The counselor who employs this
model does not necessarily decline the use of codes, but refers to them as well
as using these moral principles in his or her decision-making process.
When counselors are faced with thorny ethical decisions, Rest (1984) has
suggested that they follow a critical decision-making path that begins with
interpreting the situation, continues with gauging and selecting the moral ideals
that might inform the situation, and ends with acting on the basis of the
selected ideal. At each stage in the model, Rest has pinpointed potential
counselor difficulties in employing this way of making ethical decisions. The
counselor may (a) misinterpret or fail to see the need for moral action, (b) be
incapable of making a principled moral judgment in the face of a complex
dilemma, (c) be unable to plan a course of action, and (d) lack the will to act.
As useful as models of decision making might prove, they are not immune
to criticism. Emphasis on autonomy, for example, has been questioned by
writers on female psychology who perceive that autonomy does not figure
into the ethical development of women the way it does with men (Belenky,
Clinchy, Goldberger, & Tarule, 1986; Gilligan, 1982). In a similar way, Ivey
(1991) has shown that the press toward autonomy has a cultural bias and
would not be appropriate for all clients in counseling.
An interesting critique of moral models such as those of Kitchener and Rest
has been joined by Jordan and Meara (1990), who asserted that principles
alone are insufficient to explain ethical decisions. Moral action is performed
by persons; thus, emphasis must be placed on the virtue of the actor as well
as on the principle. According to that view, training programs for professional
helpers that attend only to instruction in the use of decision-making models

Counseling and Values / January 1996/ Vol. 40 101

are seriously remiss; they neglect the character education of "virtuous
deciders" Gordan & Meara, 1990,pp. 110-112).
Finally, a third critique might be offered by those who take a multicultural
perspective (Atkinson, Morten, & Sue; Jereb, 1982;Majors & Nikelly, 1983)as
they note that individuals who are culturally different view the world from
their unique cultural and historical perspectives and subsequently act dif-
ferently in certain circumstances. For instance, in terms of moral reasoning,
Gooley (1992) noted that many White Americans view moral and immoral
behavior as dichotomous, whereas Black Americans "adhere to a unity of
opposites" when considering moral questions (p. 114). Therefore, minority
counselors might come to different conclusions in their ethical decision-
making process as compared with majority counselors. Also, when faced with
ethical dilemmas concerning culturally different clients, counselors might not
understand the uniqueness of their clients' situations.
Given such critiques, perhaps ethical decision making is a much more
complex process than one might think, for the way a counselor selects and
employs code, model, or both surely must be inflected by all of the intra-
psychic and environmental processes that are characteristic of a counselor's
world. This article concludes by considering how the counselor's level of
moral development might influence this complex ethical decision-making
process.

MORAL DEVELOPMENT AND 1HE PROCESS

OF E1HICAL DECISION MAKING

The counselor's general skill at making ethical decisions tends to increase

over time as the helper learns to reason ethically (Pelsma & Borgers, 1986;Van
Hoose, 1986) and to engage in "careful, reflective thought about which
response is professionally right in a particular situation" (Tennyson & Strom,
1986, p. 298). In programs of counselor education, counselors-in-training move
from simple, rote memorization of guidelines toward learning to integrate
"ethics with personal and professional values and identity" (Stoltenberg &
Delworth, 1987, p. 58). Such ability to integrate ethical guidelines with per-
sonal and professional values may well be influenced by the individual
counselor's level of cognitive development in the moral domain (Hayes,
1994).
Most prevalent in the literature on cognitive-moral development are studies
using the theories of Kohlberg (1984); less frequently cited, but still important,
are the ideas of Perry (Pascarella & Terenzini, 1991). Drawing on the work of
Dewey (Dewey & Bentley, 1960)and Piaget (1970),both Kohlberg (1984) and
Perry (1968) have demonstrated that a person's thought about moral and
ethical problems has distinct structural properties, and that these "structures
of knowing" change, proceeding through clearly discernable levels as the
person matures. This kind of development continues into the adult years,
though not all adults (or even all counselors, as Lovell, 1990,found) reach the
midrange described by the models. Interestingly, this development seems to
be universal across different cultures (Snarey, 1985).

102 CounSllllng and Values / January 1996/ Vol. 40

 The way helpers make ethical decisions seems to be associated with the
levels of ethical and moral development described by Kohlberg and Perry
(Magolda & Porterfield, 1988; Neukrug & McAuliffe, 1993; Van Hoose &
Paradise, 1979; Welfel & Lipsitz, 1983). In most cognitive developmental
models-including those of Kohlberg and Perry-lower level thought char-
acteristically tends toward dualism, rigidity, oversimplification, stereotyping,
self-protectiveness, and authoritarianism, whereas higher level thought is
more flexible, complex, contextually sensitive, and allocentric. Therefore, coun-
selors who are at lower developmental levels may need the supportive struc-
ture that a clearly written ethical code can provide, whereas ethical reasoning
for individuals at higher levels of development becomes a more abstract and
complex process, thus requiring less rigid adherence to codified ethical
guidelines. For those at the highest levels of moral development, ethical
guidelines might serve as but a tool in a deeply reflective decision-making
process. For "lower level" counselors, guidelines might be regarded as the
singular authority, with any further "soul searching" deemed a needless
exercise in complicating matters.
The distinctions between lower and higher level thought can be elucidated
by considering how two different counselors, Donna and Rita, might respond
to the ethical dilemma posed earlier in the case of John. Both counselors are
convinced that John has both the motivation and the means to end his life.
They do not, however, reach the same conclusions regarding what should be
done. Perceiving the severity of the situation, Donna referred to the Ethical
Standards of the American Counseling Association (1988). The guidelines
explicitly state that when clients present clear and imminent danger to them-
selves or others, counselors must take reasonable action or inform authorities.
Realizing that John has not only purchased a gun, but has also stockpiled
enough prescription pain medication to prove lethal, Donna decided that she
must intervene to save her client's life. She knew that to not do so would be
in violation of the ethical codes, and that legal action could be taken against
her if a suicide occurred. Donna therefore concluded that she had no choice.
Against his wishes, she commited John to a psychiatric facility.
Rita also understood the seriousness of John's condition but resolved the
dilemma differently. Although Rita knew that she must warn or take action
when clients endanger themselves or others, she remembered that the
guidelines equally emphasize the need to respect clients' freedom of choice.
Because the guidelines seem to offer conflicting advice, Rita resorted to higher
level reasoning. On the one hand, her knowing that John does not want to
live-the moral principle of autonomy (Kitchener, 1984)-would necessitate
allowing him to choose death. On the other hand, because helping profes-
sionals should safeguard life-the principle of beneficence (Kitchener,
1984)-would indicate that Rita should do whatever is necessary to prevent
John from destroying himself. To make her decision, Rita weighed these
principles and pondered John's situation. Judging him to be rational and
competent, she believed that he had the mental acuity to make an informed
choice. She was certain that he had carefully considered his prospects for the
future and what options exist for him. Knowing that he was intimately aware
of the probable course that the illness would take, Rita understood his

Counseling and Values / January 1996 / Vol. 40 103

preference for a dignified demise. On the basis of a primary concern for his
welfare, rather than her own liability, Rita decided to respect John's decision.
Donna's decision making exemplifies thinking that is dualistic and that
relies on external authority to distinguish between right and wrong. In con-
trast, Rita's relativistic ethical reasoning is characterized by introspection, by
a willingness to consider fully a variety of variables, and by the determination
to be satisfied that her decisions express compassion and justice in a manner
fully appropriate to the situation.

CONCLUSION

The process of ethical reasoning is complex and requires higher level thought
coupled with deep reflection. For Kohlberg, the endpoint of moral develop-
ment finds an emphasis on a life guided by moral principles (1984); for Perry,
the accent is on a person making ethical commitments while simultaneously
appreciating the truth claims of moral relativism (1968). For both, however,
whether the guiding rubric is that of principle or commitment within
relativism, the highly developed, moral person frequently acts with a sense of
incompleteness and doubt (Kohlberg, 1984, p. 303; Perry, 1968, p. 176). Thus,
in struggling toward a decision in the face of a difficult dilemma, a mature
helper may continue to question whether he or she has taken the best course
of action. It is the individual who is impulsive, nonchalant, or unduly confi-
dent about his or her ethical decision making who is probably not reflecting
deeply in the ethical decision-making process. The developmentally mature
counselor, by contrast, is cognizant of ethical guidelines, is able to use ethical
decision-making models effectively, and is the kind of person who is deeply
reflective during this process.
Emphasis is increasingly being placed on ethical issues throughout the
helping professions (Halley, Kopp, & Austin, 1992,p. 573) and in professional
counseling particularly (Daniels,1993; Gibson & Pope, 1993; Schwab & Neukrug,
1994). Furthermore, some counselor educators now view the training and
education of counselors as a process of encouraging cognitive development
(Carey, 1989; Ivey, 1991). It therefore seems important to provide experiences-
for students, beginning counselors, and even skilled counselors-that attempt to
stimulate cognitive development in the moral domain. Such attempts might
include activities that challenge counseling and support them in reasoning
slightly beyond their current cognitive level. Activities might include the use
of values clarification exercises, cross-cultural sensitivity training, peer dis-
cussion, analysis of case studies, group problem solving, self-assessment of
student's cognitive levels, the presentation of ethical dilemmas, and exposure
to others who reason at higher cognitive levels (McAuliffe, Neukrug, Lovell,
& Gaither, 1994;Neukrug & McAuliffe, 1993).
Although some efforts like these have been apparent (Kitchener, 1986;Van
Hoose, 1980), the time has clearly arrived for careful research on the moral
and ethical development of counselors-in-training, including research on the
use that counselors at various levels of development make of codes, decision
models, or both.

104 Counseling and Values / January 1996 / Vol. 40

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