In this chapter, the author suggests that therapists can deal with the uncertainty of professional dilemmas by integrating ethical awareness into their practice. The integration can be achieved by viewing ethics as an active process of decision-making involving discretionary and deliberative judgement. The author illustrates and presents a formal procedure for making ethical decisions with a practical example. The discussion will be based on the professional context in Ireland, on the assumption that the approach is widely applicable. Discretionary judgement is an important defining characteristic of a profession. In addition to being discretionary, the judgement exercised by therapists should be deliberative, in the sense of systematic, taking all relevant factors into account. Ethical judgement can be improved if the deliberative process is treated as a matter of formal and routine decision-making. The first professional body to take this approach was the Canadian Psychological Association in 1986.