_______________________________________________________________________ Ethics for Psychologists
Technology The use of technology in psychotherapy impacts confidential- ity, privacy, privilege, and even how therapy is conducted. It is now common for therapists to have websites, and the use of search engines enables patients and therapists alike to obtain information that previously was not generally available. Some psychologists have embraced the use of technology, setting up telehealth services and offering treatment via video-conferenc- ing, e-mail, and cell phone, while others have incorporated policy statements on the use of Google, Facebook, and Twitter into their practices [29; 30]. While the APA Ethics Code is not continually revised to reflect the rapid advances in tech- nology, supplementary publications (e.g., the Guidelines for the Optimal Use of Social Media in Professional Psychological Practice and the Guidelines for the Practice of Telepsychology ) are informed by the Ethics Code and legal regulatory requirements and are available to assist providers in maintaining compliance with HIPAA laws [30; 32; 35]. While point-to-point contacts with computers may be secure, remote access and the use of video conferencing (e.g., Skype) and other Internet-based phone services or the utilization of cloud computing, email, and social networking sites may limit privacy and confidentiality. In all of these instances, patients must be advised that others may have access to their information. Well-understood protocols for all individuals using technological systems (e.g., psychologists, billing agencies, patients, support staff) should be in place to limit the risk of others obtaining data they are not entitled to. The use of laptop and tablet computers increases the risk of data being stolen or lost; password encryption is required. Up-to-date virus protection is also required to limit dissemina- tion of information or being immobilized. Clients should be informed of the risks of the use of technology prior to their use in therapy [30; 32; 35]. AVOIDING HARM AND EXPLOITATION Ethics codes for psychologists have always been concerned with preventing the infliction of harm on others. Principal A of the APA Ethics Code deals with beneficence and non- maleficence [8]: Psychologists strive to benefit those with whom they work and take care to do no harm. In their profes- sional actions, psychologists seek to safeguard the welfare and rights of those with whom they inter- act professionally and other affected persons, and the welfare of animal subjects of research. When conflicts occur among psychologists’ obligations or concerns, they attempt to resolve these conflicts in a responsible fashion that avoids or minimizes harm. Because psychologists’ scientific and professional judgments and actions may affect the lives of others, they are alert to and guard against personal, finan- cial, social, organizational, or political factors that
Geno Colello and determined he was not a threat, then the Ewing family would not have reasonably been able to assert professional negligence. The risks for notification of the victim of potential harm are not unsubstantial. In one case in which a patient made the assertion that he “could get a gun in exchange for a couple of tacos” and shoot his former employer, the patient was arrested by the police department after the former employer called them. While charges in the case were eventually dropped, the patient faced some time in jail as well as legal expenses [23]. In a similar case in Louisiana, a patient was arrested and charged with extortion after his threats were conveyed to the workers’ compensation carrier for his employer [24]. When a patient reveals he or she has harmed a child or an elder, there are state laws that may require the notification of the police or some other legal authority [25]. The same may be true of a dependent adult [26]. If a child indicates he or she is a victim of a crime, the psychologist is required under child abuse laws to report the abuse [25]. Other Exceptions Until November 1999, there was no patient-psychotherapist confidentiality for psychologists involved in treating or evaluat- ing military personnel. There is now limited confidentiality ( Appendix ) [27]. Psychologists are also allowed to breach privacy when a patient seeks psychological services to enable him- or herself to commit a crime or avoid detection for having committed a crime [1]. Under some circumstances, the holder of privilege to release information is not the patient. This is true when the court has ordered an evaluation and the psychologist is court-appointed, when there are legal proceedings to establish sanity or com- petency, or when the patient has put his or her mental state at issue in a legal proceeding, such as a malpractice claim, a personal injury claim, or a claim for disability benefits due to a mental disorder. Confidentiality is also voided in cases when a patient sues a therapist for breach of duty or a therapist sues a patient for inappropriate behavior. Patients are able to allow the release of their records by signing an authorization. The authorization must comply with state law, if any applies, and with any federal regulations, such as HIPAA. Two exceptions are if a patient requests to view his or her own clinical record and the therapist believes that such a release may harm the patient, or if a parent or guardian wishes to view the clinical record of his or her child and the psychologist believes that releasing the records would have a detrimental effect on treatment, the safety of the child, or the child’s well-being [28]. When a patient dies, a psychologist may release records concerning the conveyance of a will or deed, but clinical records generally remain confidential even after the death of a patient.
43
EliteLearning.com/Psychology
Powered by FlippingBook