Clinical decision-making in infant and early childhood mental health involves various complex factors, including clinical, legal, contextual, and personal elements. An ethical dimension is central to this decision-making process, influencing all other aspects. A new multidimensional model is introduced, placing ethics at the forefront of clinical formulation. This model provides a structured yet adaptable approach to addressing the challenges faced by practitioners.

Illustrative cases highlight the model’s usefulness in different settings. For example, a Mother-Baby Unit case showcases the conflict between a mother’s mental health and her infant’s well-being. A home visiting scenario discusses balancing a mother’s autonomy with infant safety amid domestic violence. Another case examines how a physician’s personal history can affect treatment recommendations, raising consent issues. Lastly, a childcare example illustrates tensions between institutional policies and parental preferences.

These cases emphasize the importance of ethical considerations in clinical reasoning, even when they are not immediately apparent. By integrating ethics into clinical formulation, this model serves as a valuable tool for practitioners, enhancing clinical training, professional development, and reflective supervision while promoting ethical awareness in the field.