Ethics for Psychologists _______________________________________________________________________
might lead to misuse of their influence. Psycholo- gists strive to be aware of the possible effect of their own physical and mental health on their ability to help those with whom they work. Harm may or may not be intentional; it may result from incompetence or lack of awareness. However, exploitation is more deliberate and consists of using someone unfairly or benefiting unjustly from someone. Some harmful relationships may not be exploitative, while other relationships are both harmful and exploitative. Incompetence that results in harm has been addressed earlier in this course. Harm from a lack of awareness may arise when the psychologist has issues that impact his or her mental or physical well-being, a lack of insight into his or her own perceptions and biases, and/or a lack of understanding of the foreseeable consequences of a course of action. Harmful and exploitative relationships generally involve boundary violations and role-confusion, such as sexual involve- ment with a patient, research subject, supervisee, or student. The involvement of third parties as payors, grant funders, or other types of relationships that include remuneration may create a conflict of interest situation. Conflicts of interest may also arise when the psychologist is acting in multiple roles, such as in providing an objective assessment in a forensic case as well as being a patient advocate in treatment. ETHICAL DECISION MAKING In many situations, psychologists need a framework for deter- mining the most ethical course of action. The theoretical orientation of the psychologist may provide some guidance, such as in how much to disclose about one’s personal life or whether or not nonsexual touch is permitted. For others, reli- gious views dictate overriding concepts of morality and values and guide ethical decision making. Models have been proposed to assist with ethical decision making in forensic cases, general ethical decisions, and health care [33; 36]. Nagy documents seven different models for ethical decision making [1; 37; 38;
COMPLAINTS AND CHARGES When psychologists violate ethical standards or state or federal laws, people who believe they were harmed can file a complaint with the state licensing authority or can institute a lawsuit against the psychologist. If the psychologist is a member of the APA, a grievance can be filed through the APA Ethics Office. The psychologist has the option to withdraw membership when contacted to begin the preliminary investigation. The process of investigation is lengthy and can take more than a year. The psychologist may seek legal advice from an attorney in responding to the investigation. The Ethics Office ultimately will make a decision whether or not to impose sanctions on the psychologist. These sanctions can range from: • Reprimand: There is a violation, but no harm came to an individual or to the profession of psychology. • Censure: There is harm to someone, but it is not sub- stantial. • Expulsion: There are egregious acts resulting in harm to another or to the profession. • Stipulated resignation: Serious violations have occurred whereby the psychologist is allowed to resign but may reapply when they comply with certain stipulations or directives. Because the APA is not a licensing author- ity, even if one resigns or is expelled, he or she is still allowed to practice unless the state licensing authority chooses to investigate and decides to suspend or revoke the license. The APA Ethics Office can also issue directives in addition to these sanctions. These include: • Cease and desist order: Requires the psychologist to stop the unethical conduct • Corrective actions: Steps to ensure that the unethical conduct will not recur, including supervision, addi- tional education, treatment, or probation and monitor- ing to ensure compliance The state licensing board is part of a regulating agency designed to protect consumers. Complaints are reviewed by a state Ethics Committee. States vary in types of disciplinary actions they may take, and the procedures differ from those of the APA. In California, complaints are reviewed through an administrative law process. The process starts when a member of the public files a complaint. At that particular stage, the professional receives a Letter of Inquiry of a Complaint requiring a response in a very short period of time. If the case is not resolved at this level, the matter may lose its confidentiality and the licensing board may file an accusation, which is a public document somewhat like an indictment. There are very precise procedures following an accusation that the attorney must know in order to properly defend the client. Cases may go to trial before an administrative law judge following a set of rules called the
39; 40; 41; 42; 43; 44]: • Worst case scenarios • Eight-step model • 10-step process • Nine questions for multiple role relationships • Five-step model
• Three-factor model • Four-factor model
Other possible frameworks include an 18-step model and the formulation of ethical issues from a feminist perspective [45; 46]. Consultation with colleagues and/or legal counsel can assist a psychologist in formulating a decision when faced with an ethical dilemma.
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