Carl, who is a valued employee, has a long history with the company. One day he showed up for work and got into a verbal altercation with another employee. As Carl's temper escalated, he picked up a fire extinguisher and threw it at the other employee, hitting him on the leg and bruising him. Carl was removed immediately from the floor and brought into your office. You asked him what was going on. After consultation you discovered that Carl is bi-polar and had failed to take his medication for several days. In this state, the slightest provocation will set him off. After checking with the physician, you found out that as long as Carl takes his medication, he is just fine. If he doesn’t take his meds, he can become violent or sulky. Carl apologized and said that he will be better about taking the meds and asked to keep his job.

Be Reasonable: Explore the Options: Components of the Practice. After brainstorming with the leadership team, you have identified four options:

1. Terminate Carl's employment.
2. Allow Carl to remain with no additional supervision.
3. Allow Carl to remain as long as he checks in with the plant nurse every day and she dispenses his needed medications.
4. Give Carl an automatic 2 week suspension without pay. If after returning he has another incident, his employment would be terminated. Written notice of this plan will be placed in his personnel file.

1. Expectations of the Community: Now -- what are the expectations of the community, the stake-holders, for a person who is excellent in this practice? Any option which does not meet the basic competencies is by definition an unethical option.