Chapter 2: Ethical and Legal Issues
Chapter Overview
The author introduces the ethical codes of the American Counseling Association (ACA) and the
American Mental Health Counseling Association (AMHCA). The author discusses the application of
ethical codes and ethical decision making models in counseling practice and legal issues and concerns
relevant to mental health practice.
Key Words
Beneficence – decisions and actions that help to serve and benefit the client in the situation.
Subpoenas – document requesting your testimony or records.
Subpoena ad testificandum – request, most likely from issued by the courst, for documents.
Subpoena duces tecum – request for documents from the court or an attorney.
Informed consent – limits of confidentiality.
Multiple Choice Questions
1. The purpose of ethical codes is to provide:
a) Explicit rules and regulations for professional practice.
b) Reflect jurisprudence relating to mental health.
c) Principles to guide professional practice.
d) Provide resolution of legal issues in mental health.
e) All of the above.
2. What determines which ethical codes a practitioner falls under?
a) Professional affiliation and state law
b) Practitioner selects which codes to follow.
c) Credentialing and certification.
d) All of the above
e) a) and c) only.
3. The purpose of the ACA ethical codes is to:
a) Clarify ethical responsibilities held in common by its members.
b) Supports the mission of the ACA.
c) Provide ethical guidelines for best practice and ethical dilemmas.
d) All of the above.
e) a) and c) only
4. Ethical decision-making models are based on the principles of:
a) Trust, autonomy, justice, beneficence, and nonmaleficence.
b) Autonomy, beneficence, nonmaleficence, justice, and fidelity.
c) Autonomy, integrity, beneficence, nonmaleficence, and fidelity.
d) Integrity, justice, beneficence, nonmaleficence, and fidelity.
e) Trust, autonomy, integrity, beneficence, and nonmaleficence.
5. Ethical decision-making models are used when there is a:
a) Legal dilemma
b) Ethical dilemma
c) Professional practice dilemma
d) b) and c) only
e) All of the above.
6. A number of ethical decision-making models are available. Which one is the most effective and
preferred model?
a) Forester-Miller and Davis’s Model
b) The Beneficence Model
c) Kitchner’s Model
d) The ACA’s Model.
e) All of the above.
7. Which laws impact the counselor practitioner?
a) Confidentiality, consent, and duty to warn.
b) Criminal laws
c) Civil laws.
d) All of the above
e) a) and c) only.
8. If a counselor is subpoenaed, what should the counselor do?
a) Accept the subpoena and respond as requested.
b) Accept and consult a lawyer and supervisor
c) Do not accept and consult a lawyer and supervisor.
d) Reject the subpoena on the grounds of privileged information.
e) Ignore the subpoena on the grounds of privileged information.
9. If a counselor is subpoenaed for client records, which of the following should a counselor do?
a) Consult with client to determine which records can be released.
b) Provide only the information requested.
c) Refuse to provide any information on the grounds of privileged information.
d) All of the above.
e) None of the above.
10. A number of conditions must be fulfilled in order to ensure informed consent is ethically
administered. Which of the following conditions are NOT required?
a) A treatment plan.
b) Risks and benefits of treatment.
c) Payment policies.
d) Reviewed with client as an ongoing process.
e) Culturally appropriate.
11. The limits of confidentiality often create ethical dilemmas. Which of the following situations
create ethical dilemmas for confidentiality?
a) Multicultural populations, working with minors, and consultation.
b) Suicidal ideation, working with minors, and homicidal threats,
c) Suicidal ideation, multicultural populations, and homicidal threats.
d) Suicidal ideation, multicultural populations, and consultation.
e) All of the above.
12. According to the ACA which of the following actions would NOT be considered unethical?
a) Working with unfamiliar populations.
b) Not using evidence-based interventions.
c) Referring terminally ill clients.
d) Having multiple relationships with clients.
e) Referring clients on the basis of religious beliefs.
13. Accepting gifts can be difficult and controversial. The ACA provides some guidelines for what to
consider. Which of the following must a counselor consider before accepting a gift?
a) The therapeutic relationship.
b) The monetary value of the gift.
c) Client’s motivation for giving the gift.
d) Counselor’s motivation for accepting or declining the gift.
e) All of the above.
14. A counselor may engage in bartering with a client when:
a) A client refuses to pay.
b) A client is already doing a job for the counselor.
c) It does not affect therapy services.
d) A counselor works in a small community.
e) All of the above.
15. The ACA supports its counselor practitioners. Which of the following services will the ACA
ethical committee NOT provide for its members?
a) Represent members in malpractice suits for unethical practice.
b) Educate counselors on best ethical practice.
c) Adjudicate cases that come up before the ACA.
d) Assist members with the process for malpractice complaints.
e) Assist with ethical questions.
Activities
1. Provide a case with an ethical dilemma to a group. Ask each group member to select a different ethical
decision making model to solve the ethical dilemma. Tell each member to work independently to solve
the ethical dilemma using his or her chosen decision-making model. Then ask the group to come back
together to compare and discuss their individual outcomes. Consider the following:
• In what way were the outcomes similar or different?
• What factors influenced these results?
• Was it just the design of the model or did the individual’s personal values influence it too?
• Would they choose the same model again?
• Would they choose different models for different situations?
2. Most new counseling graduates understandably worry about the possibility of malpractice law suits.
Fortunately malpractice suits for counselors at this time still remain low compared to other health care
professionals. Nonetheless, in an increasingly litigious society they are on the rise, so it behooves a
counselor to take precautions to minimize the risk. Write a 3-4 page paper discussing the precautions a
counselor can take to minimize or avoid malpractice law suits.
3. Professional organizations, such as the ACA provide ethical codes as guidelines for ethical practice.
However, they are only guidelines and as a result leave room for individual interpretation to respond to
diverse situations. While there are ethical models to help resolve ethical dilemmas, a number of factors
influence how ethical decisions are made, such as an individual’s morality, culture, beliefs and values.
Divide the class into a group of 6-8 members and have each group explore which factors influence ethical
practice. They may consider, but not limit to:
• How would they personally define an ethical dilemma?
• How do they personally make ethical decisions?
• How do they interpret situations that create ethical dilemmas?
Discussion Questions
1. Consider the different ethical decision-making models, which model do you prefer to use?
Explain the reasons for your preference.
2. Your client is a 16-year-old Moslem and she tells you she is being forced by her parents to marry
a man she does not want to marry. She shares that having an arranged marriage at this age is
normal in her culture and her parents’ honor is at stake. Discuss the ethical issues that arise in this
case and how you might address them.
3. Research journal article(s) on ethical issues in your counseling area of interest. Discuss the
pertinent issues.
Multiple Choice Questions – Answer Key