Praxical.Psych
ethics

Making the decision, and evidencing it

A structured process, because unstructured ethical reasoning under pressure is unreliable.

Most ethical failures are not the product of bad character. They are the product of a decision made alone, under time pressure, that seemed reasonable in isolation. A structured process slows the decision down and creates a record showing that you reasoned rather than reacted.

  1. 1Identify the problem, and separate the ethical question from the clinical and the practical.
  2. 2Identify who is affected and what each stakeholder’s interests are — including people not in the room.
  3. 3Consult the relevant code, statute, regulation and guidance, by specific section.
  4. 4Identify which principles are in tension.
  5. 5Generate at least three courses of action, including the one you are inclined to dismiss.
  6. 6Consider the consequences of each, for each stakeholder.
  7. 7Consult. Always, and document it.
  8. 8Decide, act, document the reasoning, and set a point to review the outcome.

Three tests

The publicity test
Would you be comfortable with this decision and its reasoning being read by a colleague, by your regulator, and by the patient?
The universalisability test
Would you consider this the right decision for any clinician in this situation, or are you making an exception for yourself?
The justice test
Would you make the same decision for a patient of a different class, race, gender or diagnosis?

Your notes

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Educational use only

Praxical.Psych is a teaching tool. It is not medical, clinical, psychological or legal advice, not a diagnosis, not treatment, not supervision, and not a credential. Nothing here creates a clinician–patient or solicitor–client relationship. Every patient, case, transcript and simulated session is fictional. Clinical and legal requirements vary by jurisdiction and change over time — verify anything that bears on a real decision against your own regulator, statute and current professional guidance, and consult a qualified professional.

Do not enter real patient information. If you or someone else is in crisis: US & Canada 988 · UK & Ireland 116 123 · Australia 13 11 14 · elsewhere findahelpline.com · immediate danger, your local emergency number.

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Before you begin

What Praxical.Psych is, and is not

Praxical.Psych is an educational tool. It teaches the theory, evidence base and clinical method of psychotherapy at the level of an advanced survey course, and it lets you rehearse a complete session in a simulator.

It is not medical, clinical, psychological or legal advice. It cannot diagnose or treat anyone, and it does not state the law where you practise — requirements differ by jurisdiction and change. Nothing here creates a clinician–patient or solicitor–client relationship.

  • Every patient, transcript and case in this app is fictional — a composite written for teaching. None depicts a real person.
  • Praxical.Psych is not therapy, not a substitute for supervision, and not a credential. Competence to practise comes from training, supervised hours and licensure.
  • Scores from the instruments here are for learning how they behave. They are not a diagnosis and not a risk assessment, and must not inform a decision about a real person.
  • Do not enter real patient information. Everything you type stays in this browser, but that is not the same as a compliant clinical record system.
If you are in crisis

In the US and Canada, call or text 988. In the UK and Ireland, call 116 123 (Samaritans). Elsewhere, find a local line at findahelpline.com. In immediate danger, use your local emergency number.

Read the full disclaimer