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ROLE OF ETHICS.
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Need for ethical behavior in psychological practice.... More...
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Paper Abstract:
Need for ethical behavior in psychological practice. Bioethics. How practitioners should conduct themselves toward patients. Approach of "principalism." The four principles involved in the bioethical process. The politics of providing mental health services. Deficiencies in health care system. Principles of Beneficence, Non-maleficience. APA ethics code. Proposed revisions.
Paper Introduction:
THE ROLE OF ETHICS IN THE EDUCATION OF SCHOLARS
AND PRACTITIONERS IN PSYCHOLOGY:
DISCUSSION AND EVALUATION
Abstract
This paper reviewed the role of ethics in the education of scholars and practitioners in psychology. The review proceeded from the recognition that the essence of psychological practice is trust between provider and patient. From this recognition followed the inference that ethical behavior is crucial to effective psychological practice.
The review found that the application of ethical principles by educators and providers in psychology requires some modification in an increasingly diverse society. The American Psychological Association, recognizing this need, proposed changes to
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Elements of doing what isgood - providing treatments and medications, educating, assisting,supporting competency, kindness, and so forth - unfortunately may, attimes, conflict with one another. M. The birth of bioethics. 7). Willems, D. Christensen, R. 4), the provision in the ethicscode deals with the informal resolution of ethical violations. The proposed revision, of course, is not alaw, as it does not deal with legal liability. In February 2 1, the American Psychological Association (APA)requested comments on proposed revisions to the organization's EthicalPrinciples of Psychologists and Code of Conduct (American PsychologicalAssociation, 2 1; American Psychological Association, 1992). L. J. The principle of justice applied in health professions requiresprofessional providers to be fair and equitable to all persons. The first is the perception that something is wrong withpeople who require help because if they require help, it is likely becauseof their own failures. There arealso challenges from a variety of perspectives to the content of the fourprinciples (Wolf, 1994). This white, middle-class value structure also tends to be the majorfactor influencing the funding of access to mental health care services for(1) minority and poor families and (2) societal sub-groups, such asHIV/AIDS patients, in the United States. (1992). Fundamental modifications are evolving in the method of reasoningdownward from middle-level principles, to the content of those principles,and to the failure of bioethics to address differences associated withgender, race, ethnicity, and insurance status (Lowes & Laufer, 1994).There is a proliferation of alternatives to principlism. Background Bioethics is not a new phenomenon. Together with this value-structure, the peculiarly American linkage between religious belief andeconomic system creates additional ethical problems in the delivery ofmental health services. On the one hand, the health care system is deficient in thedelivery of healthcare services to these population segments (Montoya,Trevino, & Kreitz, 1999). 11). The contemporary approach to bioethics dates from the late-196 s.This approach has been dominated by what has come to be known as"principalism", which is an approach to reasoning about ethical problemsthat, for the most part, proceeds neither deductively from higher-ordertheory, nor inductively from a detailed attention toward the situationpresented, but, rather, "from middle-level principles down to the casepresented" (Wolf, 1994, p. C. M. The review found that the application of ethical principles byeducators and providers in psychology requires some modification in anincreasingly diverse society. Wolf, S. In the American population, minority racial and ethnic groups accountfor between 2 and 25 percent of the total population. With respect to diversity and bioethics, three perceptions are especiallysignificant. Viewing all persons to be of equal value requires that aneducator or practitioner in psychology consider the desires of familymembers and the professionals with whom they work, as well as those of thepatient in reaching decisions related to the patient. 2 in the proposed revision to the APA ethics code dealswith the provision of professional psychological services in situationscharacterized by extraordinary circumstances. (1994, January 15). The contemporary model withinwhich psychological educators and practitioners address the issues ofbioethics, however, is new. The third is the perception that white, middle-class norms shouldprovide the framework for the determination of social service needs andoutcomes in the United States (Shotter, 1985). (1999, October).Access to HIV services by the urban poor. In addition, there is in progress a rise of empiricism in bioethics,as illustrated by an increased level of attention to differences in race,ethnicity, and gender. Thesuggested revisions to the existing Code adopted in 1992 provide a basisfor assessing the role of ethics for scholars and practitioners inpsychology. The draft proposed revisions of the APA ethics code does not envisionany changes in Section 8. The result of this combination of factors is oftendetrimental to minority-group mental health care and for people afflictedwith unpopular diseases and lifestyles. Marginally effective medical care: Ethical analysis of issues incardiopulmonary resuscitation (CPR). Journal of Law, Medicine & Ethics,23(4), 382-388. The best interests of the profession dictate theretention of the existing language in the ethics code. (1994, Winter). American Journal of Law &Medicine, 2 (4), 439-455. Principle D in the proposed revision of the APA ethics code adds thejustice principle to the code. (2 1, January). The phenomenon of caring is comprised of both scientific and ethicaldimensions. Jonsen, A. 3 ofthe existing code will become Section 1. Theprinciple of justice also requires equal access to care for all persons(Willems, 2 1). From this recognition followed the inference that ethicalbehavior is crucial to effective psychological practice. Jonsen (1997)stated that contemporary bioethics is a "half-discipline" that "workswithin a larger picture that is public discourse or public policy" (p. Section 2. The politics of providing mental health care services to (1) minorityand poor families and (2) groups of people degraded by society, such asHIV/AIDS patients, in the United States have traditionally been alignedwith the perceptions of the white population majority in the United States. 3 in the revised APA ethics code. Because the application of principles such as beneficience and non-maleficence is, at times, difficult, however, does not mean that educatorsand practitioners in psychology should not observe them. Theexisting ethics code requires practitioners to intervene informally whenthey believe another practitioner may have violated the ethics code(American Psychological Association, 1992). References American Psychological Association. The principal difference between theprovisions in the Code and the suggested revisions is that the proposedrevision explicitly permits providers to adhere to the requirements of lawwhen they cannot resolve such conflicts in any other way (AmericanPsychological Association, 2 1; American Psychological Association, 1992). The review found that the application of ethical principles byeducators and providers in psychology requires some modification in anincreasingly diverse society. The four principles involved in thebioethical process are (1) autonomy, (2) beneficence, (3) nonmaleficence,and (4) justice. The additionallanguage added to the ethics code by the proposed revisions to incorporatethese principles will strengthen the APA ethics code. Therefore, ethicalbehavior is crucial to effective psychological practice. Population Reference Bureau. Medical World News, 35(1), 24-3 . In most instances, the proposed changes address contemporaryneeds. Thus, ethical performance based uponbeneficience often may be a complex process. Analyses of the healthcare experiences of (1) minority and poorindividuals and (2) individuals afflicted with HIV/AIDS suggest that twomajor problems account largely for the differential health status of theseindividuals. Shifting paradigms in bioethics and healthlaw: The rise of a new pragmatism. The proposed revision to the APA ethics code in the case ofextraordinary circumstances is, in effect, a Good Samaritan law forprofessional psychologists. (1994, Winter). B. The proposed revision statesthat they will intervene informally only in those instances where apractitioner believes an ethical violation by another practitioner occurred(American Psychological Association, 2 1). Loue, S., Lurie, P., & Lloyd, L. 2 United States PopulationData Sheet. The proposed revision to theAPA ethics code is a positive change from the perspective of patient needsand patient rights to care. (1985). Hilberman, M., Kutner, J., Parsons, D., & Murphy, D. The second is the perception that the presence ofcultural differences in the United States is wrong since everyone who livesin the United States should be prepared to adopt a single set of Americanvalues. Such attention has highlighted the fact that these individuals notonly have inadequate healthcare insurance coverage but experiencesignificantly higher modality rates for the major mental health andphysical health problems when compared to majority, white middle-classcitizens. There is no comparableprovision in the existing APA ethics code. 9). prb.org/pubs/usds2 /section1.html Shotter, A. While psychologistsmay experience tremendous inner conflicts when placed in situations whereinlegal obligations override the principles of professional ethics, it isprudent to include in the APA ethics code a professional option allowingpsychologists to obey the law without violating the APA ethics code. APA Ethics Code: Draft forcomment. The Jay Healy technique: Teaching lawand ethics to medical and dental students. the role of ethics in the education of scholars and practitioners in psychology: discussion and evaluation Abstract This paper reviewed the role of ethics in the education of scholarsand practitioners in psychology. Accompanying the problem of the delivery ofhealth care services are problems associated with some the individualsthemselves in relation to their negative attitudes towards the healthcaresystem. Beneficience requires a professional provider to do what is good(Hilberman, Kutner, Parsons, & Murphy, 1997). Ethical Principles ofPsychologists and Code of Conduct. 4) and the proposedrevisions to the ethics code (Section 1. Retrieved from theInternet 2 2- 2-25 at: http://www. American Psychological Association. In some instances, further revision appears warranted. The problem with the existing language is thatit allows organizations almost as much power as it allows public law inefforts to override principles and standards of professional ethics inpsychology. Balancing rationalities: Gatekeepingin health care. The proposed revision is,however, a special dispensation from the psychological profession thatallows a professional psychologist to provide necessary psychologicalservices in emergencies without transgressing the APA code of ethics. From this recognition followed the inference that ethicalbehavior is crucial to effective psychological practice. The existing ethic code does not directlyaddress the issue of justice (American Psychological Association, 2 1;American Psychological Association, 1992). The problem with the existing language in the APA ethics code is thatit allows psychologists to "seek to resolve the conflict in a way thatpermits the fullest adherence to the Ethics Code" (American PsychologicalAssociation, 2 1, p. The essence of psychological practice istrust between provider and patient (Friend, 2 1). Therefore, a strengthening of the ethical position of theprofession will occur through the addition to the Code of languageindicating that practitioners in psychology will accommodate organizationaldemands only to the extent that such accommodation does not establish aprecedent for breaching the Ethics Code. In part because of their distrust of the healthcare system, suchindividuals often engage in risky behaviors that lead to (1) greatersusceptibility to health problems or (2) more serious morbidity by the timethey actually receive care (Montoya, Trevino, & Kreitz, 1999). In the relatively recent past, the consideration of bioethical issuesoccurred within a framework of traditional ethics, mores of the culture,and professional practice. (1997,December). Conversely,however, the failure by a health professional to observe a patient'sautonomous desire not to prolong life through heroic efforts also could bea violation of the principle of non-maleficence in an ethical context. R. The essence of the proposedrevision to the ethics code is that, in situations characterized byextraordinary circumstances, psychological providers may be asked toprovide professional psychological services for which they have notacquired the level of competence required by the APA ethics code (AmericanPsychological Association, 2 1; American Psychological Association, 1992). Non-maleficence is the do no harm dictum (Loue, Lurie, & Lloyd, 1995). New York: St. S. (1998). D., Trevino, R. A paradigm shiftappears to have begun, however, around the mid-199 s. Conclusion This paper reviewed the role of ethics in the education of scholarsand practitioners in psychology. Whileboth the existing code and the proposed revision concern themselves withpatient welfare, the proposed revision brings the ethics code for educatorsand practitioners in psychology in line with ethics codes for other healthcare professionals through the formal recognition of beneficience and non-maleficence (American Psychological Association, 2 1). Free market economics. The review proceeded from the recognitionthat the essence of psychological practice is trust between provider andpatient. Medical Humanities Review, 2(1), 9-21. Montoya, I. Moral (normative) principles (as opposed to medical,practical, financial, religious, or legal criteria) provide the bases forethical decisions in psychology (Christensen, 1997). (2 1, February). (2 1). Washington, DC: American Psychological Association. Social Theory and Practice, 27(1), 1-18. In most instances, the proposed changes address contemporaryneeds. Martin'sPress. Suggested changesinclude a demand for even more abstract moral theory deductively applied,advocacy of specified principlism, a revival of causality, a call for aninductivism based on empirical information or ethnography, interest innarrative bioethics, and the articulation of care-based ethics. Ethical issues in communitymental health: Cases and conflicts. Washington, DC: American PsychologicalAssociation. The contemporary bioethics movement has focused greater attention onthe plight of (1) low-income and minority individuals and on (2) people inunpopular disease sub-groups in their attempts to receive adequatehealthcare coverage and medical treatment for both mental and physicalneeds. Journal of Medical Ethics, 27(1), 25-29. Community Mental Health Journal, 33(1),5-11. Friend, C. American Journal of Law & Medicine,2 (4), 395-415. Oxford, England: OxfordUniversity Press. The American Psychological Association,recognizing this need, proposed changes to the organization's Code ofEthics. Theproposed revision to the code of ethics provides protection for patients byrequiring psychologists involved in the delivery of care in such situationsto refer all patients treated in such circumstances to appropriatelytrained psychological care providers as soon as is feasible following theprovision of emergency psychological care. Consideration of these issues todayincreasingly occurs within a framework of "contemporary bioethics", whichJonsen (1997) referred to as a "demi-discipline" (p. 3 of the existing ethic code. Because the needs,desires, and informed judgments of such parties frequently diverge from oneanother, practitioners' decisions often will not satisfy all parties.While frequently difficult for practitioners in psychology to apply inpractice, the principle of justice is a worthwhile addition to the APA codeof ethics. Section 8. 11). In both the existing APA ethics code (Section 8. Empirical studies increasingly look for differencesby race or ethnicity and in relation to medical decision-making (Blechner,1994; Montoya, Trevino, & Kreitz, 1999). The review proceeded from the recognitionthat the essence of psychological practice is trust between provider andpatient. Hospitals ethicscommittees: Scope goes from end-of-life issues, in vitro fertilization andAIDS to preserving the soul of medicine. Principalism and the four principles dominated thepractice of bioethics until the early- to mid-199 s. Among the low-income segment of the overall population, however, their proportion is muchhigher (Population Reference Bureau, 2 ). (1997, February). Washington, DC: Population Reference Bureau. In some instances, further revision appears warranted. Blechner, B. Questions of how practitionersshould "conduct themselves toward patients were considered as early as thetime of Hippocrates" (Jonsen, 1998, p. Trust and the presumption oftranslucency. (1997). Jonsen, A. Similarly, HIV/AIDS patients are over-represented among all low-income persons and among minority population groups. The birth of bioethics: The origins of a demi-discipline. (2 ). Lowes, R., & Laufer, R. In both the existing APA ethics code and the proposed revision of theethics code, Section 1. Journal of Community Health,24(5), 331-337. (1995, Winter). Ethical issuesraised by needle exchange programs. Principle A in the proposed revision of the ethics code differs fromPrinciple E (which it replaces, in the existing ethics code) with respectto both the name of the principle and the content of the standard. A., & Kreitz, D. This difference is more than semantics, as it allows potentiallyserious ethical violations to continue unchallenged unless a practitionerhas some degree of proof to support a belief that an actual ethicalviolation has occurred. On average, the representationof minority racial and ethnic groups among low-income persons isapproximately 2.25 times their representation in the general population.This fact means that almost 45 percent of the nation's low-incomepopulation segment is comprised of members of minority racial and ethnicgroups. The American Psychological Association,recognizing this need, proposed changes to the organization's Code ofEthics. 2 deals with the resolution of conflicts betweenprofessional ethics and the law. L. Applying the principle of non-maleficence also can be a complex process.As an example, one interpretation of non-maleficence could mean that aprofessional provider should not act to preserve a patient's autonomy andfreedom if the patient's decision led to her or his death. 396). Journal of Medical Ethics, 23(6), 361-367. Introduction This paper reviews the role of ethics in the education of scholars andpractitioners in psychology. R.
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