All codes of ethics and all ethical decision making should be guided but a set of underlying values or principles. One model proposed by Thompson (1990) describes underlying tenants or virtues upon which all ethical decision making should be based. Kitchner (1988) describes similar "metaethical principles. These underlying concepts that may guide us toward ethical practice are consistent with Jordan and Meara’s (1990) discussion of virtue and principle ethics. Principle Ethics asks "What shall I do?" while Virtue Ethics asks "Who shall I be?" An understanding of these underlying virtues may help guide us in this quest of being an ethical psychologist.

Beneficence is the virtue of helping others and providing services that are in the other individual’s best interest; to do good. Nonmalfeasance is the virtue of not doing harm; ensuring that our actions do not result in harm to anyone. Fidelity is the virtue of faithfulness; being true to our commitments and obligations to others. A component of fidelity, veracity, implies we will be truthful and honest in all our endeavors. Promoting the autonomy of those we provide services to is one of our profession’s overarching goals. Justice is the virtue of providing equal access to services and equal quality of services to all those with whom we come in contact. The virtue of self-interest stresses the importance of adequate and appropriate attention to our own self-care so our competence and judgement do not become impaired.

Attention to these underlying virtues will lead psychologists to ask ourselves a number of questions which will help guide us in decision making when confronted with ethical dilemmas. For example, "Will my patient be helped by me taking this action?"; "What adverse consequences might result from acting in this way?"; "Is this course of action consistent with our informed consent agreement and with the patient’s expectations of me and of treatment?"; "Am I deceiving or being dishonest toward my patient or anyone else by acting in this way?"; "Will this action create more dependence on me or on treatment, or will it help promote my patient’s autonomy?"; "Am I treating this patient differently than others, either negatively or positively?"; and "Have I adequately addressed my self-care or could my judgement and decision making possibly be impaired?"

Still, there are many questions independent practitioners may ask themselves to help in this decision making process. Examples include "Whose needs are being met?", "What is the potential for exploitation or harm?", "What would my colleagues think if they learned about this?", "Is it possible that my objectivity, judgement, or competence are impaired or might be at risk of becoming impaired if I act in this way?", "Am I meeting the standard of care of the profession?", "Would I be comfortable having others read my clinical notes?", "Have I considered all the potential consequences of this decision for my patient as well as for any other individuals who might be affected?", "Is there a values conflict present?", "Have I weighed the relative risks and benefits of my decision?", and "Have I considered all available alternatives?" Then, monitoring for the effects of the decision is important followed by making adjustments as needed.

In addition to asking these questions as part of a model for ethical decision making independent practitioners will certainly always want to consult the APA Ethics Code for guidance. In addition, familiarity with and review of relevant state law and any applicable regulations are important as well. Then, when in doubt, consultation with an experienced colleague who will offer honest, objective feedback is recommended. Also, members of the State Psychological Association’s ethics committee or the state licensing board’s members are excellent resources. Additionally, when legal issues arise, consultation with an attorney experienced in mental health law in your state is an important step.

Other formal models of ethical decision making exist such as Gottlieb’s (1993) and Epstein and Simon’s (1990) exploitation index, which are very useful when confronting multiple relationship dilemmas. However, in general, an approach such as the one described above may prove useful for independent practitioners when confronting the many ethical dilemmas and conflicts that we regularly must address. The APA Ethics Code and state laws can only provide us with general guidelines. They can not be expected to provide the answers for all the dilemmas we face. In such situations, a strategy such as this one may prove helpful; not just for doing ethical behavior, but more importantly for being an ethical psychologist.

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