A Mixed Methods Investigation of the Effects of Ranking Ethical Principles on Decision Making: Implications for the Canadian Code of Ethics for Psychologists Jaime Williams, Thomas Hadjistavropoulos, David C. Malloy, Michelle Gagnon, and Donald Sharpe University of Regina Shannon Fuchs-Lacelle University of Regina and Regina Qu’Appelle Health Region, Regina, Saskatchewan The principles in the Canadian Code of Ethics for Psychologists (CCEP; Canadian Psychological Association, 2000) are ranked in order of importance. Although there is some support for the ranking, it is unclear whether its utilization leads to more ethical decision making. We investigated whether medical residents and undergraduate students who were given information about the ranking would provide more ethical (i.e., in accordance with the CCEP) and consistent responses to dilemmas and would be more confident in their decisions than participants not provided with ranking information. Forty-seven medical residents and 45 students were taught about the CCEP principles. Half of the participants were provided with information about the ranked order. Participants responded to 6 vignettes describing ethical dilemmas with courses of action, by rating whether the course of action was ethical and providing a by rationale. Participants, who knew about the ranking, provided ratings that were more consistent with the CCEP although the pattern varied across vignettes. Moreover, participants in the ranked condition made decisions faster than participants in the unranked condition. We found no evidence that participants were more likely to agree with each other when familiar with the CCEP hierarchy. Finally, students in the ranked condition were less confident than students in the unranked condition whereas ranking did not affect the residents’ confidence. Thematic analysis of participants’ rationales revealed that, among those who responded inconsistently with the CCEP, some had misunderstood the ethical principles, misinter- preted the relative vulnerability of the parties depicted in the vignettes, and/or provided rationales that were consistent with the code whereas their ratings were not. Specific contextual factors that affected decision making are discussed as are the implications of these findings for the CCEP. Keywords: code of ethics, ethical principles, decision making, training The Canadian Code of Ethics for Psychologists (CCEP, Cana- dian Psychological Association [CPA], 2000) was developed to reflect the “collective wisdom” of Canadian psychologists (Sin- clair, Poizner, Gilmour-Barrett, & Randall, 1987) and is consid- ered to be one of the most influential and well-respected psycho- logical codes of ethics around the world (Hadjistavropoulos, 2008). One of the objectives in the development of the CCEP was to provide “decision rules (i.e., ethical principles)” (Sinclair et al., 1987, p. 5) to aid psychologists in the process of ethical decision making. As such, the code is comprised of four ethical principles. These principles are I: Respect for the Dignity of Persons, II: Responsible Caring, III: Integrity in Relationships, IV: Responsibility to Society. These principles are not necessarily discrete; a degree of overlap may occur among them and it is recommended that “all four principles be included and balanced in ethical decision making” (Sinclair & Pettifor, 2001, p. 19). Moreover, to further guide psychologists, the CCEP also provided a ranked order of impor- tance of its ethical principles wherein Principle I is weighted more heavily than Principle II (and III and IV), which is weighted more than Principle III and so on (Sinclair et al., 1987). The ranking was This article was published Online First April 16, 2012. Jaime Williams, Centre on Aging and Health, University of Regina; Thomas Hadjistavropoulos and Michelle Gagnon, Centre on Aging and Health and Department of Psychology, University of Regina; David C. Malloy, Centre on Aging and Health and Faculty of Kinesiology and Health Studies, University of Regina; Donald Sharpe, Department of Psychology, University of Regina; Shannon Fuchs-Lacelle, Centre on Aging and Health, University of Regina and Regina Qu’Appelle Health Region, Regina, Saskatchewan. This study was supported in part through a Social Sciences and Human- ities Research Council of Canada Grant (# 402-2000-0048) awarded to David Malloy and Thomas Hadjistavropoulos. Portions of this report were presented at the 2003 annual convention of the Canadian Psychological Association. We thank P. O’Neill for granting us permission to adapt the vignette material previously used in his research. Correspondence concerning this article should be addressed to Thomas Hadjistavropoulos, Department of Psychology and Centre on Aging and Health, University of Regina, Regina, SK, Canada, S4S 0A2. E-mail: Thomas.hadjistavropoulos@uregina.ca Canadian Psychology / Psychologie canadienne © 2012 Canadian Psychological Association 2012, Vol. 53, No. 3, 204 –216 0708-5591/12/$12.00 DOI: 10.1037/a0027624 204