A Complex Family Situation
You have been counselling a married couple for several weeks. The couple came to you because of problems they were having in their relationship. During the process you have seen the pair separately at which time you learnt that the husband is only staying with his wife because of their two children. The wife meanwhile has confided to you that her husband is not the biological father of one of the children.
If you were confronted with this dilemma how would you deal with this couple?
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December 4th, 2008 at 3:04 pm
There are several issues for consideration in this scenario. Firstly, the wife has confided that she is hiding the true paternity of one of the children from her husband and secondly, the husband has disclosed that he is only staying in the relationship for the sake of the children.
As a counsellor I am bound by confidentiality, however, I would find it somewhat compromising to counsel the husband and wife, either separately or together, for any length of time whilst this information was being withheld.
Regardless of the ethical obligations I have as a counsellor to maintain confidentiality, should the husband become aware of the true paternity of one of the children, he may feel betrayed by me as I have withheld this information from him. Although this would only be one of the consequences for the husband on being informed, it may directly affect the counselling relationship thus further complicating his own situation.
My approach would be to talk with the wife individually, emphasising her responsibility for the information she holds and how she wishes to deal with it. I would encourage her to explore the pros and cons of either:
• Informing her husband of the true paternity of one of the children.
• Withholding the true paternity of one of the children from her husband either temporarily or permanently.
I would also see the husband individually in order to work through the relational issues he has and examine the alternative courses of action available to him.
I would then assess how the sessions to date may have affected the current situation and make a decision whether I could continue to work with the couple objectively whilst withholding critical information.
The nature of this situation highlights the importance of providing clients with clear information regarding ethical boundaries and confidentiality early in the counselling relationship so as to minimise difficulties and misunderstandings.
December 4th, 2008 at 3:05 pm
Ethical decisions inherently involve issues concerning our definition of what is ‘acceptable’ human behaviour. However, the definition of what constitutes ‘acceptable’ is neither universal nor static, but is ever-changing and evolving in a melting pot of diversity, culture, gender and nationality.
Without doubt, our sense of what is right or wrong has been influenced by our environmental and social context and our inherited traits - the unique combination of our individual identity.
There are two major theoretical perspectives we might consider - Teleology and Deontology. The main teleological theory, Utilitarianism, judges actions as good or bad, right or wrong, on the basis of the consequences they produce. Deontology, on the other hand, is concerned with ‘duty’ and the fact that some acts are obligatory regardless of their consequences.
Ethics, unlike legislation that requires an act to have occurred, is concerned with the prevention of damage or prescribing a course of action. Fortunately, there are signposts in the ‘minefield’ of ethical dilemmas, one of these signposts ‘Professional Codes of Ethics’ serves to guide us through decisions in our professional lives involving issues of honesty, fairness and justice (www.theaca.net.au).
Background
In the scenario above, all three people, wife (W), husband (H), and the counsellor (C) are presented with an ethical dilemma.
In his decision to stay ‘for the sake of the children’ H has taken a utilitarian ethical stance on this issue, that is, H is making his decision to stay based on his desire for a particular outcome i.e. ‘for the sake of the children’.
In aligning himself this way H is using the relationship with his wife as a means to get his desired end. His goals for the relationship have changed from being in a marriage with W to fulfilling his parental responsibilities until such time as his sons are able to look after themselves.
W’s contribution to child raising is the utility upon which he can fulfil his parental obligations. H’s ethical dilemma is whether it is fair and just to stay in the relationship with W without revealing to her what his new goals are and how he honestly feels about their relationship.
W too, has been setting future goals alongside H in joint counselling sessions to improve her relationship with her partner. Her reluctance to tell H that he is not the biological father of one of the children may also be based on a utilitarian ethical stance - perhaps fear of the emotional trauma that would most likely follow disclosure, and the possibility of H deciding to end their marriage, is holding W back from disclosure.
Like H, W is using her husband to maintain a secure family environment for herself and her children. Alternatively, if both H & W decided to adopt a deontological ethical stance in this dilemma, both would feel ‘duty bound’ to disclose their information to each other irrespective of the effects on their relationship.
The fact that H and W have decided to disclose their information to C indicates that as counselling sessions have progressed it has become increasingly difficult for them to withhold this information from each other. Thus, the ethical dilemma presented to W and H is about whether to be totally honest with each other and face the consequences, or to continue their deception irrespective of the potential negative effect this may have on the future of their relationship.
And what of C’s ethical considerations in this case?
C’s dilemma is primarily concerned with professional accountability to self and to W & H. In accordance with the ACA Code of Ethics counsellors must at all times:
• Establish the helping relationship in order to maintain the integrity and empowerment of the client without offering advice.
• Offer a promise of confidentiality and explain the limits of duty of care.
Thus, it is neither C’s role to advise the clients to reveal this information to each other nor to breach confidentiality and disclose to either client. The primary role of a counsellor is to facilitate the exploration of issues by encouraging clients to determine their own outcomes.
To unduly influence or direct either H or W into prematurely making their revelations to each other would be a misuse of C’s position, an imposition of C’s values onto the clients and a breach of the Professional Code of Ethics.
On the other hand, C can use feedback and influencing skills to highlight some discrepancies in W & H thoughts, actions and feelings. For example, with regard to their stated desire to improve their relationship through counselling, C can explore individually with H & W, the potential impact of non-disclosure on the future stability of the relationship.
Certainly, C is now in the unenviable (and powerful) position of being the only one in this triangle (H, W & C) who is privy to information from both partners that could significantly affect the course of this couple’s relationship. Having acknowledged this, C needs to evaluate the effectiveness of continuing to counsel this couple either on an individual or joint basis.
For example, how will C encourage this couple to explore issues and set joint goals for the future knowing that H is not committed to the relationship? And that W is withholding information from H that he may deem crucial to his ongoing commitment? Who came to counselling first? Was it H or W, or did they come together? If W came first, then should she be retained as a client if C decides against counselling the couple together?
In all aspects of working with people, it is imperative that C is aware of any legal implications that may result from a particular course of action, in this instance the rights of the child to know his biological parents. Apart from the more obvious emotional and psychological needs, the child’s future medical requirements may require immediate knowledge of his blood and tissue types.
Does C’s duty of care extend to protecting the rights of this child, who, while not in immediate danger, may become so in a medical emergency?
The very fact that W & H have requested to see C on an individual basis and that each has voluntarily made a significant disclosure directly relevant to their relationship, must surely indicate more commitment to, and potential for, the relationship that might at first have been apparent. Does this new information, handled in a sensitive, responsible and constructive manner, have the potential to resurrect this relationship rather than bury it? C would need to consider whether to continue counselling the couple under supervision, or refer either (or both) to a more experienced relationship counsellor.
March 18th, 2009 at 11:33 am
Liz - Beautifully considered. Professionally astute with enough care and warmth for all. As a student counsellor, ‘coming up through the ranks’ - I found your response to the article very helpful and insightful. Thank you for sharing your knowledge, skills and personal views on the topic. Marika
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