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Suppose that a judge or magistrate is faced with rioters demanding that a culprit be found for a certain crime and threatening otherwise to take their own bloody revenge on a particular section of the community. The real culprit being unknown, the judge sees himself as able to prevent the bloodshed only by framing some innocent person and having him executed.
A trolley (a tram or a streetcar) is running out of control down a track. In its path are five people who have been tied to the track by a mad philosopher. Fortunately, you could flip a switch, which will lead the trolley down a different track to safety. Unfortunately, there is a single person tied to that track. Should you flip the switch or do nothing?
As before, a trolley is hurtling down a track towards five people. You are on a bridge under which it will pass, and you can stop it by dropping a heavy weight in front of it. As it happens, there is a very fat man next to you - your only way to stop the trolley is to push him over the bridge and onto the track, killing him to save five. Should you proceed?
As before, a trolley is hurtling down a track towards five people. As in the first case, you can divert it onto a separate track. On this track is a single (fat) person. However, beyond that person, this track loops back onto the main line towards the five, and if it weren't for the presence of that (fat) person, who will stop the trolley, flipping the switch would not save the five. Should you flip the switch?
As before, a trolley is hurtling down a track towards five people. You can flip a switch and divert the train to run one person over instead of five, but that person is your mother. Would you flip the switch?
“So, you wouldn’t torture a terrorist to find the location of a nuclear bomb that will kill hundreds of thousands of people?”
You wouldn’t torture a member of a murderous gang to find the location of a kidnapped child?”
Why should we assume that torture will work? Will the fat man derail the trolley?
Is it always about whether or not the benefits outweigh the costs when making decisions like this? Why or why not?
Because professional relationships (especially, we have argued elsewhere, psychotherapy relationships) are different from naturally-occurring relationships in our environment, it's often helpful to do some comparisons. • Case: You are seeing a couple in therapy. One member of the couple calls you one night and tells you they're having an affair. Then they say, "Don't tell my spouse." • Do you tell the spouse?
The Analogous Relationship questions would go something like this: • Would you tell if you were not their therapist, but a close friend? A cousin? Their dentist?
How is a psychotherapy relationship is similar to, and different from, relationships between friends, teacher-student, physician-patient?
How to deal with ethical behaviors at two extremes of a continuum. • Is ethical to break confidentiality (i.e., report to authorities) when a client threatens to kill another person.
It is not ethical to break confidentiality when a client threatens to jaywalk.
When does the promise to not breach confidentiality change to breaching confidentiality? • For example: What if the client threatens to defame a person by writing a scathing blog post?
What if they threaten to embezzle a small amount of money from a bank? What if it's a large amount of money?
Think back to the couple having an affair situation • What if the couple has not paid their bills?
What if one or both members of the couple are from a different culture?
"What is your policy concerning ...?" • accepting gifts
For example, gifts might carry romantic or sexual connotations: a dozen long-stem roses is not just an expression of gratitude!
"My policy will be never to accept gifts. That way I avoid all the problems."
What if a client gives you a Christmas card or 10-cents-off coupon at Dunkin' Donuts on their last day of treatment? It might be pretty offensive to refuse such a token.
What if you were the client, student, research participant, etc.?" • For example: "If you, as a teacher, think it's OK to gossip about students, would you consider it OK for administrators (deans, etc.) to gossip about you?"
APA Ethical Guidelines for Psychology • Principle A: Beneficence and NonmaleficencePsychologists strive to benefit those with whom they work and take care to do no harm. In their professional actions, psychologists seek to safeguard the welfare and rights of those with whom they interact 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, financial, social, organizational or political factors that might lead to misuse of their influence. Psychologists 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.
Principle B: Fidelity and ResponsibilityPsychologists establish relationships of trust with those with whom they work. They are aware of their professional and scientific responsibilities to society and to the specific communities in which they work. Psychologists uphold professional standards of conduct, clarify their professional roles and obligations, accept appropriate responsibility for their behavior and seek to manage conflicts of interest that could lead to exploitation or harm. Psychologists consult with, refer to, or cooperate with other professionals and institutions to the extent needed to serve the best interests of those with whom they work. They are concerned about the ethical compliance of their colleagues' scientific and professional conduct. Psychologists strive to contribute a portion of their professional time for little or no compensation or personal advantage.
Principle C: IntegrityPsychologists seek to promote accuracy, honesty and truthfulness in the science, teaching and practice of psychology. In these activities psychologists do not steal, cheat or engage in fraud, subterfuge or intentional misrepresentation of fact. Psychologists strive to keep their promises and to avoid unwise or unclear commitments. In situations in which deception may be ethically justifiable to maximize benefits and minimize harm, psychologists have a serious obligation to consider the need for, the possible consequences of, and their responsibility to correct any resulting mistrust or other harmful effects that arise from the use of such techniques.
Principle D: JusticePsychologists recognize that fairness and justice entitle all persons to access to and benefit from the contributions of psychology and to equal quality in the processes, procedures and services being conducted by psychologists. Psychologists exercise reasonable judgment and take precautions to ensure that their potential biases, the boundaries of their competence and the limitations of their expertise do not lead to or condone unjust practices.
Principle E: Respect for People's Rights and DignityPsychologists respect the dignity and worth of all people, and the rights of individuals to privacy, confidentiality, and self-determination. Psychologists are aware that special safeguards may be necessary to protect the rights and welfare of persons or communities whose vulnerabilities impair autonomous decision making. Psychologists are aware of and respect cultural, individual and role differences, including those based on age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language and socioeconomic status and consider these factors when working with members of such groups. Psychologists try to eliminate the effect on their work of biases based on those factors, and they do not knowingly participate in or condone activities of others based upon such prejudices.
