ethical standards

1. Ethical Standards American Psychological Association

2. Introduction Introduction

3. Introduction Intent of document Applicability: which psychologists are held to the code Applicability: which professional activities are included in the code Relationship of codes to the law

4. Ethical Standards and Laws Adherence to ethics code is required by all A.P.A. members Not a basis for civil liability Violation of the Ethics Code does not determine liability in court Laws regarding the delivery of psychological services and conduct of psychologists differ from state to state Ethics code and law may sometimes be in conflict

5. Preamble and General Principles Inspirational goals to guide psychologists toward the highest ideals of psychology Not enforceable rules 5 General Principles Beneficence and Nonmaleficence Fidelity and Responsibility Integrity Justice Respect for People’s dignity

6. 10 Ethical Standards* Resolving ethical issues Competence Human relations Privacy and confidentiality Advertising and other public health statements Record keeping and fees Education and training Research and publication Assessment Therapy *See “A.P.A. Ethical Principles”: a word document on the class website

7. Ethics Dilemmas: Duty to Warn Tarasoff case* Poddar told psychologist he planned to kill former girlfriend (Tatiana Tarasoff) The clinician provided oral and written warnings to the campus police Police interviewed and released Poddar Poddar befriended Tarasoff’s family and then killed her Her parents initialed a lawsuit *See “Maj, J. Health Care Provider’s Duties to Patients” on electronic reserve for a summary

8. Ethics Dilemmas: Duty to Warn (cont.) Appellate decision (first court case): no cause of action Tarasoff I (California Supreme Court or second court case): the doctor bears a duty to use reasonable care to give threatened persons such warnings as are essential to avert foreseeable danger arising form the patient condition”. Protective privilege ends when the public peril begins

9. Ethics Dilemmas: Duty to Warn (cont.) Defendant (therapist) petition for a rehearing Tarasoff II (California Supreme court reheard the same case in 1976—an unusual move) Outcome: When a therapist determines that a patient presents a serious danger of violence to another, the therapist is obligated to use reasonable care to protect the intended victim. This duty may require the therapist to take one or more steps, warning, apprising the victim of the danger, notifying the police or whatever steps are reasonable.

10. Ethics Dilemmas: ??? A 25 year old man goes to see a psychiatrist for the first time. He is accompanied by his father, who says that his son has been acting strangely for the last three weeks. He is seen on his own by the psychiatrist, and the young man describes the aural hallucinations that he has been having for three weeks.

11. Ethics Dilemmas: ??? (cont.) His discourse reveals an intense, invasive mystical delusion, with no signs of being dangerous. The psychiatrist diagnoses an acute psychotic episode and fears that it marks the beginning of schizophrenia. He wants to start neuroleptic treatment as soon as possible and tells the patient so. He explains the benefit of swift treatment and the possible side effects of the medicine. The patient refused the treatment, fearing that his intellectual capacities will be harmed.

12. Ethics Dilemmas: ??? (cont.) The psychiatrist then see the patient again in the presence of his father, to explain the situation. At this point, the patient agrees to the treatment as he thinks that his father is the “emissary of God” and he must obey him.

13. Ethics Dilemmas: ??? (cont.) Facts of Case 25 year old man Delusional but not dangerous Psychiatrist prescribes medication Patient refuses With patient present, psychiatrist explains situation to patient’s father Patient decides to accept treatment because of father’s recommendation Questions Which ethical standard is addressed in this dilemma? Should the psychiatrist treat the patient with these premises? Ethical Standard 10. Therapy Yes, because the patient did express consent Yes because the patient has a good chance of recovery Yes because if the patient does not take medication he might worsen clinically and become dangerous to himself and others No because consent was not given freely. The young man said that he was obliged to submit to his father’s wishes. Ethical Standard 10. Therapy Yes, because the patient did express consent Yes because the patient has a good chance of recovery Yes because if the patient does not take medication he might worsen clinically and become dangerous to himself and others No because consent was not given freely. The young man said that he was obliged to submit to his father’s wishes.