Ethical decision-making in disability management.

A qualitative, phenomenological, exploratory study of a small purposive sample of disability management coordinators, including union representatives, explored how ethical dilemmas are identified and resolved, revealing that dilemmas arise out of interaction by the parties within the disability management environment in conjunction with professional imperatives. Key findings include the identification of preconditions, factors that facilitate ethical decisions (e.g. competency, training, balancing the parties' interests, and best practices) or predispose the accommodation process to dilemmas (e.g. dual clients and access to sensitive information), and the use of features of the Ethics of Care, Kantian Ethics, and Beauchamp and Childress' ethical principles in ethical decision-making. Based on the findings a visual model of dilemma formation and resolution, a theoretical approach to ethical decision-making combining the Ethics of Care and Kantian Ethics and a decision-making framework were developed, incorporating participants' experiences, best practices literature, ethical theories and principles and facilitating evidence based practice.