- Center for Ethical Practice - https://centerforethicalpractice.org -

Promises Kept, Promises Broken

Ethical Implications of Our Inevitable Loyalty Conflicts & Conflicts of Interest

This workshop explores some of the loyalty conflicts and conflicts of interest inherent in clinical work and considers ways of reducing their impact. We will explore ethical, legal, clinical and personal implications of denying them or failing to explain them to patients, as well as resources for helping us respond to them.


I. Acknowledging Potential Conflicts of Interest Among Relationships & Obligations


Colleagues; Referral Agents


Contracted Third Party Payer(s)





II. Predicting Potential Loyalty Conflicts

Issues Arising When Defining “Who Is The Client?”

Loyalty to One Client vs. Loyalty to Other Client(s)

Loyalty to Client vs. Loyalty to Agency/Organization

Loyalty to Client vs. Standards of Professional Practice

Loyalty to Client vs. Obedience to Law

Conflicts of Interest Created By Managed Care

Conflicts Created by Financial & Business Decisions

Pressures from Loyalty to Family/Friends

Importance of Loyalty to Self

III. Putting it On the Table

Personal Assessment

Clarifying Our Own Potential Conflicts

Difficulties in Recognizing/Acknowledging

Ethical/Personal/Practical Implications of Denial

Honest Discussions With Patients/Clients

Ethical Obligations About How Much to Disclose

Clinical Decisions About How Much to Disclose

Boundary Limitations on Patient/Client Discussions

Personal Risks in Being Completely Honest

Professional Decisions About Consultation

Difficult Ethical/Personal/Professional Decisions