The Case of Mark
Mark is a counselor in the inner city of Toledo, Ohio, where he maintains a private practice. Mark works Monday through Thursday providing services to low-income clients. He often lets clients go without payment because he knows that they really need the help. He even lets the few who do have insurance go without paying the co-payment. Mark charges an hourly rate of $55 for the counseling services he offers Monday through Thursday.
Conversely, every Friday afternoon, Mark provides services in an upscale section of town from an office that he rents from a friend. At this site, Mark cuts no one slack with regards to payment. If a payment is not made on time that personâ??s account is sent directly to a collection agency. This policy allows Mark to make up for the money he would otherwise lose from the less fortunate clients he sees the rest of the week. Mark charges an hourly rate of $125 for the work he does from his second office.
Firstly, we need to apply Wallace's Ethical Contextualism model (WEC) to Mark's situation. The WEC is a two-element model consisting of 1) issues of relevance and 2) true ethical dilemmas (Ford, 2006). There are issues of relevance because as a counselor, Mark must abide by the APA and possibly to the codes of ethics of the National Association of Social Workers (NASW) and/or the American Mental Health Counselors Association (AMHCA). If Mark is a member of the NASW, their code of ethics specifically states that "Social workers are sensitive to cultural and ethnic diversity and strive to end discrimination, oppression, poverty, and other forms of social injustice" (NASW Preamble). Mark's fee schedule could be construed as "discrimination", and a violation of both the justice and nonmaleficence/beneficience tenets of the Belmont Report (OHSR). In addition, one of the APA's tenets is to not cause harm (physical or financial). However, it is true that Mark may have to charge the upscale clients a higher hourly rate to cover the overhead ...
Wallace's Ethical Contextualism model (WEC) is carefully applied to Mark's situation.