TPC Journal V8, Issue 3- FULL ISSUE

The Professional Counselor | Volume 8, Issue 3 257 support through her religious community. Her personal religious views do not endorse hastening one’s death, even under extreme circumstances like a terminal illness. Amy also has two young children. Amy has been meeting with Frankie, a 40-year-old woman, for about four months. Frankie was diagnosed with leukemia about six months ago and began treatment shortly thereafter. Frankie recently found out that the leukemia is not responding to treatment and her treatment options are exhausted. Frankie’s oncologist has estimated a five- to six-month life expectancy. Frankie has expressed to Amy that she wants to pursue PAD so that she does not have to be in pain for 6 more months. Frankie has a husband and 6-year-old daughter. Amy is initially shocked to hear Frankie’s desire to hasten her death. Amy is unsure how to proceed in her work with Frankie because she feels Frankie’s decision conflicts with her religious beliefs. Amy also is wondering if Frankie has considered how her family feels and if they would be okay with Frankie’s decision. Recognizing she needs to process her thoughts and feelings, Amy seeks out a helpful colleague in order to proceed in her work with Frankie. Discussion Beginning with the first step of the CVCM, Amy appears to be dealing with a complex values-based conflict. The nature of Amy’s conflict is primarily personal, but she is faced with some professional conflicts as well. Amy’s religious beliefs and values are personally driven, but the countertransference she is experiencing related to Frankie’s seeming lack of concern for her family can become a professional issue if Amy considers making professional decisions that emphasize family values over Frankie’s requests (Heller Levitt & Hartwig Moorhead, 2013). Furthermore, Amy’s personal religiously driven value conflict intertwines with the counseling profession’s value and ethical standard to respect clients’ worldviews and not impose personal beliefs onto clients (ACA, 2014, A.4.b). Understanding both personal and professional implications allows counselors to move into the second step of the CVCM. The development and context of Amy’s values may be explored through a systemic ecological lens in the second step. Beginning with the macrosystem, Amy may consider how her religious culture views death and what messages she has internalized to form her understanding of morality and autonomy (Burdette et al., 2005; Johnson et al., 2007). She also could explore how society at large influences her religious beliefs and practices and subsequently how she believes her religion views the practice of hastened death. The interaction between Amy’s religious culture and society is situated in the exosystem. Amy’s interactions with her religious community, which are a part of her mesosystem, also will play a role in her beliefs and actions. She might think about how her immediate community impacts her beliefs and influences her perceptions of hastened death; Amy’s individual perceptions and direct engagement with her religious practices play out in her microsystem. As each ecosystem is explored, Amy can develop a clear understanding of the sources of her value conflict. The same process should be repeated for her values-based conflict about Frankie’s family. Amy may value collective family decisions and could potentially struggle to meet Frankie with acceptance if she believes an isolated decision is improper. Once Amy has explored the systemic sources of her values, she is ready to seek assistance to ethically move forward with Frankie in the third step of the CVCM. Using ethical bracketing, Amy can reach out to her colleagues to consult about the issues at hand. Exploring her values with a trusted professional may enable her to bracket her values to approach Frankie’s differing beliefs and values. Amy must review the ACA Code of Ethics (2014) before creating a plan of action. Again, Code A.4.b, regarding