Ethics Flashcards
The Preamble and General Principles are _________ and ________
Aspirational and NONenforceable
The ethical standards provide _______ and ________ rules
Specific and enforceable
If a given situation/behavior is nor specifically addressed by the ethical standards, then it is…
Either ethical or unethical
Membership in the APA requires…
You must follow the Ethics Code
The Preamble specifies that psychologists are committed to:
1.
2.
3.
- Increasing scientific knowledge, and applying that knowledge to improving the condition of individuals, organizations, and society
- Respect and protect civil and human rights
- Help the public make informed judgments and choices regarding human behavior
What are the 5 General Principles?
- Beneficence and NonMaleficence
- Fidelity and Responsibility
- Integrity
- Justice
- Respect for People’s Rights and Dignity
The General Principles are _______ in nature and, unlike the Ethical Standards, they should not _________
Aspirational
Be used to impose sanctions/they are not enforceable
General Principle A: Beneficence and NonMaleficence
Psychologists should:
- Strive to benefit those they work with
- Take care to do no harm
- Resolve conflict in ways that minimize harm
- Maintain awareness of how they may influence or mislead others
- Maintain awareness of their own mental/physical health and it’s potential impacts on those with whom they work
General Principle B: Fidelity and Responsibility
Psychologists should:
- establish relationships of trust
- conduct themselves professionally and appropriately
- accept responsibility for their behavior
- collaborate with other professionals
- be concerned with the ethical behavior of their colleagues
- Provide pro-bono services
General Principle C: Integrity
Psychologists should:
- strive to promote accuracy, honesty, and truthfulness in the science, teaching, and practice of psychology
- do not engage in fraud or deliberately mislead others
- Use deception only when benefits outweigh harm and take steps to repair any potential harm
General Principle D: Justice
Psychologists:
- recognize that fairness and justice entitle all persons to access and benefit from the contributions of psychology
- take steps to address and minimize bias
General Principle E: Respect for People’s Rights and Dignity
Psychologists:
- respect the dignity and worth of all people
- respect the rights to privacy, confidentiality, and self-determination
- are aware of and respect cultural, individual, and role differences and work to address bias related to these factors
The primary goals of the Ethics code are:
1.
2.
- The welfare and protection of the individuals and with whom psychologists work
- Education of members, students, and the public about the ethical standards within the discipline
The Ethics code applies to only to the professional roles of psychologist, with the exception that the APA may take action against a member who ______
Has been convicted of a felony
Provision of pro-bono services is __________ by the Ethics Code
Recommended but not required
Who enforces adherence to the Ethics code?
- The APA enforces adherence to the code for APA members
- An ethics violation may also lead to action from the state licensing board
(Ethical Standard 1: Resolving Ethical Issues)
If psychologists learn of misuse or misrepresentation of their work, they must…
Take reasonable steps to correct or minimize the misuse/misrepresentation
When psychologists face a conflict between their ethical principles and the law and/or organizational demands, they must:
1.
2.
3.
- Clarify the nature of the conflict
- Make known their obligation to the ethics code
- Take reasonable steps to resolve the conflict in keeping with the General Principles and Ethical Standards of the Ethics Code
Before making an attempt to resolve or report an ethical violation, psychologists must make sure that taking such action would not violate ________
the confidentiality rights of involved individuals (e.g., patients/clients)
If a psychologist becomes aware of an ethical violation by another psychologist, they should _______ so long as there is not past/future substantial harm or violation of confidentiality rights
Attempt an “informal resolution” by discussing it directly with them
Under what circumstances is a formal report of an ethical violation appropriate?
- when there is risk of substantial harm in the future, or substantial harm has already occurred
- a report would not violate confidentiality rights
- Informal resolution was attempted but was not successful
Failure to cooperate in an Ethics Investigation is itself considered…
A violation of the ethics code
Psychologists ________ discriminate (e.g., in hiring, promotion, etc.) based upon that person having made or being the subject of an ethics complaint
Can NOT; but they can consider the outcome of a resolved ethics complaint/history of prior confirmed violations
What constitutes “substantial harm” in the context of an ethical violation?
Behaviors such as:
- sexual misconduct
- insurance fraud
- plagiarism
The Ethical Standards indicate that psychologists provide services, teach, and conduct research only in areas and with populations within the boundaries of ________
Their competence
If a psychologist plans to provide services, teach, or conduct research using techniques that are new to them or a population that differs in factors known to be related to implementation/outcome (eg. age, culture, gender, SES), then they must:
Obtain the training, experience, consultation or supervision necessary to ensure competence
In order to ensure competence in forensic settings, psychologists should familiarize themselves with:
The judicial or administrative systems and rules governing their role
Psychologists should provide services outside of their training/competence only:
1) in the case of an emergency
2) until the emergency has ended and/or until appropriate services become available
When psychologists delegate work to others, it is the responsibility of the psychologist to:
1.
2.
3.
- Multiple relationships are avoided (ex. Don’t delegate interpreting to a family member)
- Only delegate responsibilities that can be expected to be completed competently by the individual’s level of education/training, etc.
- Ensure the individual completes those delegated tasks competently.
If psychologists become aware of personal problems that may interfere with their ability to perform work-related duties, they must:
Take “appropriate measures” including:
- seeking professional consultation and assistance
- consider whether they should limit, suspend, or terminate their work related duties
If a psychologist wants to change or add a new specialty (e.g., experimental psychologist wants to become a clinical psychologist), they must:
Meet the same requirements with regards to subject matter and professional skills that apply to doctoral education, training, and experience in the new area
I.e., while you wouldn’t need a whole new PhD you would need to take all the required coursework and gain the same clinical/applied training as required for the new subject area
“Vicarious liability” is a legal term which refers to:
Supervisors are legally responsible for the actions of their supervisees
Employers are legally responsible for the actions of their employees
The Ethics Code defines Sexual Harassment as sexual solicitation, physical advances, verbal or nonverbal conduct that EITHER 1) _________ OR 2) __________
1) is unwelcome, offensive, or creates a hostile workplace environment AND the psychologist KNOWS OR IS TOLD THIS
2) is sufficiently severe or intense to be abusive to a “reasonable person” in that context
Ex. If someone makes multiple comments about another person’s appearance this is not harassment until they are asked to stop and then continue the behavior.
Psychologists should avoid entering into a multiple relationship when:
1) the relationship could be reasonably expected to impair the psychologists objectivity, competence, or effectiveness
2) risks exploitation or harm to either party
Multiple relationships are ethical when:
They would not be reasonably expected to cause impairment or risk harm
When psychologists provide services at the request of a third party (e.g., court-ordered services), they should:
- Clarify….
- Identify….
- Clarify the nature of the service relationships with ALL PARTIES at the OUTSET
- Identify the use of the services and the limits to confidentiality
Psychologists must obtain informed consent before providing services. When working with an individual who is legally incapable of providing informed consent, psychologists must: 1. 2. 3. 4.
- Provide an appropriate explanation of services
- Seek the individuals assent
- Consider the individual’s preferences and best interests
- Obtain appropriate permission from a legally authorized person
_______ are responsible for _______ in the event that psychological services are interrupted unexpectedly (e.g. by the illness or death of the psychologist)
Psychologists
Making reasonable efforts to plan for facilitating transition of services
Gottlieb (1993) recommended considering these 3 factors when determining whether a multiple relationship is ethical/appropriate:
1.
2.
3.
- Power Differential (the greater the power divide, the higher the risk for harm)
- Duration (the longer the relationship the higher the risk for harm)
- Clarity of Termination (did it end cleanly? Is it likely the person will want to re-start services?)
What three conditions must be met for a legal definition of “informed” consent?
1.
2.
3.
- Capacity (individual is able to make rational decisions)
- Comprehension (individual is given adequate information and is able to understand that information)
- Voluntariness (consent is given freely, individual is not coerced)
The term “Privacy” refers to…
The freedom of individual to choose for themselves when and in what circumstances their opinions, beliefs, and behaviors are shared or withheld from others.
When a patient chooses to share information with a therapist (privacy = their choice to share or withhold) it then becomes confidential (therapist will not share with others)
The term “confidentiality” means ________ and is considered an _________
- Confidentiality is the obligation of psychologists to protect clients from unauthorized disclosure of their information
- Confidentiality is an ethical principle. It is sometimes a legal requirement.
The term “privilege” refers to ______ and is a ______ term
- The protection of a client’s confidentiality in court proceedings
- Privilege is a legal term
Psychotherapist-patient privilege was first recognized at the federal level in 1996 by the ________ Supreme Court Decision
Jaffee v. Redmond
The “duty to warn” obligation of psychologists to warn and protect identifiable third parties at risk of harm from therapy clients was established by the ______ decision
Tarasoff
If an adult client reveals they were the victim of abuse as a child, the psychologist is NOT required to make a report unless….
There is reason to suspect that the perpetrator is still victimizing a minor (e.g., that person lives with children, works as a teacher, etc)
Can psychologists compensate members of the press in exchange for publicity?
No.
Psychologists may not solicit testimonials from ____________ or other individuals who are vulnerable to ___________
Current therapy patients
Undue influence
UNINVITED, in-person solicitation of current/future therapy clients is prohibited by the ethics code. (Giving out business cards to victims at a crime scene is not okay. Providing a business card to someone who asks for it or mailing brochures is okay.)
The ethics code DOES allow:
- Attempting to implement services for _______
- Providing _______ or _______ outreach
- Collateral contacts of your own client (e.g., significant others, family members) if doing so is in the interest of your client
- Providing disaster or community outreach
Can a psychologist withhold client records (when requested for emergency treatment) if they have not received payment from that client?
No - withholding records for nonpayment is unethical
Psychologists ARE allowed to use collection agencies to collect unpaid fees (including providing necessary confidential information to contact the person) so long as:
1.
2.
- The psychologist informs the individual in advance that these measures might be taken
- The individual is given an opportunity to make a payment directly
Psychologists ARE allowed to barter for services, as long as:
1.
2.
- It is not clinically contraindicated
2. The arrangement is not exploitative
If psychologists pay/receive payment from/divide fees with another provider (e.g., referral fees), the exchanged fee must be based on ________ and not _________.
The services provided
The referral itself
For example, if a psychologist refers patients to a colleague and allows the colleague to see patients in her office, she could charge a fee for use of the office space but not just for the referral
The HIPAA privacy rule distinguishes between __(1)____ and ___(2)____.
Psychologists are required to give clients access to (1) but are not required to release (2) unless mandated by state law
Personal Health Information (PHI)
Psychotherapy notes
___________ , also called the Buckley Amendment, prohibits schools from disclosing personally identifying information from educational records AND allows students and families to inspect and challenge the contents of educational records
Family Education Rights and Privacy Act (FERPA)
Can psychologists bill insurance companies for a no-show?
No. Psychologists can only bill for services rendered.
According to the APA’s record keeping guidelines, documentation of each substantive contact with a client should include: 1. 2. 3. 4.
- Date and duration of session
- Type of service (e.g., assessment, therapy)
- Nature of service (e.g., treatment modality)
- Summary of client’s status
According to APA guidelines, records should be kept for at least _____ for an adults or ______ for minors (whichever is later)
7 years
Until 3 years after the minor reaches the age of majority
In general, psychologists should not require students or supervisees to disclose personal information in course or program related activities. They can only do so if:
1.
OR
2.
- The program clearly identified this requirement in it’s training or admission materials
- The information is necessary to evaluate or obtain assistance for student’s whose personal problems may interfere with their professional competence or may pose a threat to themselves or others
If a training program mandates group or individual therapy for students, they must ensure that:
- Students have the option of obtaining treatment with providers who are not affiliated with the training program
- Therapy is NOT provided by faculty who will be in an evaluative role
Sexual relationships between faculty/students and supervisors/supervises are specified as _____ by the Ethics Code
Unethical/not permitted.
This applies to current students, but may not apply to former students or students in different departments over whom the faculty does not hold an “authoritative or evaluative role”
When psychologists conduct research with subordinate subjects (eg students, clients, etc), they must take steps to:
Protect subjects from adverse consequences of declining/withdrawing from participation in the research study
When research participation is part of course credit, students must be given a choice of equitable alternative activities
When using deception in research, when psychologists must debrief participants?
As early as feasible
Ideally immediately following an individual’s participation
No later than the end of study data collection
Deception in research is NOT permitted when doing research that is:
Expected to cause physical pain or severe emotional distress
When therapy is provided by a trainee, the following must be provided during the informed consent procedures:
1.
2.
- Inform the individual that the therapist is in training and being supervised
- Provide the name of the supervisor
Providing therapy to an individual who is already receiving services elsewhere is _______ by the Ethics Code; the recommendation is to __________________
Not prohibited
Carefully consider the treatment issues, discuss these issues with the client, consult with the other provider as appropriate, and proceed with caution and sensitivity to the therapeutic issues
Sexual relationships with current clients are ________
Unethical
Sexual relationships with close collaterals (family members, significant others) of current therapy clients are
Unethical and prohibited
Providing therapy to persons with whom you previously had a sexual relationship is…
Unethical/prohibited
Sexual relationships with former therapy patients….
Are NOT ETHICAL in the first two years following treatment
Are discouraged and are not ethical except in the “most unusual of circumstances
May be ethical:
- if at least two years have transpired since the termination of treatment
- the therapist bears the responsibility of proving there was no exploitation
The APA General Guidelines for Providers of Psychological Services define a Professional Psychologist as _________
Someone with a doctoral degree in psychology from an organized, sequential program at an accredited institution
Regarding therapeutic-forensic role conflicts, the APA Specialty Guidelines for Forensic Psychology suggest that providing both forensic and therapeutic services to the same or closely related individuals may ______ or ______
In this situation, providers should ______________ then ______________
Impair objectivity / Lead to exploitation or other harm
Disclose the nature of these risks / refer out if possible
In forensic psychology, ________ fees pose a threat to impartiality and should be avoided
Contingent
In court mandated assessment/treatment:
- Consent is ________________
- Confidentiality _____________
Consent is not required to proceed
There may be limits to confidentiality- the psychologist to should explain the nature of the service and limits to confidentiality up front
The primary goal of child custody evaluations is to determine _____________ .
These evaluations should focus on the following:
1.
2.
3.
Child custody evaluations should focus on the psychological best interests of the child/child welfare is most important
- Parental attributes
- Psychological needs of the child
- The fit between those two factors
When conducting child custody evaluations, psychologists are strongly discouraged from _________________ which can interfere with objectivity and impartiality
Multiple relationships
Child custody evaluations should include …..
Multiple methods of data collection, evaluation of all involved parties, collection of information from collateral sources
Insanity is a __________ concept, defined as:
Legal concept
A person is not guilty by reason of insanity if, because of a mental disease or defect, the person lacks substantial capacity to appreciate the wrongness of the act or behave according to the requirements of the law
Competence to stand trial
A defendant is considered incompetent to stand trial if, due to a mental disease or defect, they lack “sufficient present ability to consult with a lawyer with a reasonable degree of rational understanding, and a rational as well as factual understanding of the proceedings against him.”
The standards for “competence to stand trial” were set in which Supreme Court case?
Dusky v. United States (1960)
Fact Witness
A person who testifies as to what he/she has seen, heard, or observed
Are NOT allowed to give personal opinions, answer hypothetical questions
Expert Witness
A person who “by reason of education or specialized training possesses superior knowledge about a subject about which persons who have no training are incapable of forming an accurate opinion or deducing correct conclusions”
Are allowed to give opinions and answer hypothetical questions
Guardianship
A legal right given to a person to be responsible for the necessities of another person legally defined as incapable of providing these necessities him/herself
Guardian ad litem
An adult appointed by the court to represent and make decisions for someone who is legally incapable of doing so on his/her own
The most accurate predictor of future violence is:
past violent behavior
In order for a client to bring a successful malpractice suit against a psychologist, the following must be established: 1. 2. 3. 4.
- The psychologist must have a professional relationship with the client that established a “legal duty of care”
- There must be a demonstrable standard of care that was breached by the psychologist
- The client suffered harm or injury
- The psychologist’s breach of duty was the proximal cause of the harm or injury
In order to receive compensation in a malpractice suit, the harm or injury to the client must be:
Able to be measured in economic terms
How can psychologists minimize risk for a charge of malpractice?
1.
2.
3.
- Be familiar with ethical/legal standards and relevant research
- Only provide services that are compatible with ones training/education/experience
- Maintain careful, well organized records
The best defense in malpractice litigation is well-organized records
According to APA guidelines, psychologists should follow these steps when responding to a subpoena for client records/information
- Determine if the subpoena is valid
- Contact the client to discuss the implications of providing the information/get consent to disclose the requested information
- If the client consents, provide the information. If the client does not consent, seek guidance from the court
If a request for confidential information arises for the first time during court testimony, the psychologist should:
Assert therapist-client privilege and refuse to provide the information until ordered to do so by the court
When there is a court order for the release of confidential information, the psychologist should:
Provide the requested information, or they will be in contempt of the court
According to the ASPPB, the six most common reasons for disciplinary actions by licensing boards are: 1. 2. 3. 4. 5. 6.
- Unprofessional conduct
- Sexual misconduct
- Non-sexual dual relationships
- Negligence
- Conviction of a crime
- Failure to maintain adequate records
Sexual relationships between psychologists and patients most often occur between __[age]__ , ___[gender]____ therapists and ___[age]___ , ___[gender]___ clients
Older, male therapists
Younger, female clients
Sexual relationships between therapists/clients seem to be declining, in a study by Lamb and Catanzaro (1993) ____% of respondents reported having had sexual relationships with clients, while a more recent study by Lamb, Catanzaro, and Moorman (2003) showed that ____% reported sexual relationships
8% in 1993
3.5% in 2003
Cost-benefit analysis
Compares the costs and benefits of an intervention using just monetary terms
Can be tricky when outcomes are difficult to measure in monetary terms
Cost-effectiveness analysis
Used to compare two interventions/programs that have similar outcomes that cannot be measured monetarily
Costs are expressed in monetary terms
Benefits are expressed in non-monetary but measurable terms (e.g., # clients who drop out, scores on symptom outcome measures)
Cost-Utility analysis
Involves evaluating outcomes by comparing monetary costs with the value of outcomes in terms of healthy years of life
Outcome is “quality adjusted life years” (QALYs) - duration accounting for quality
Cost- Feasibility analysis
Used to evaluate the feasibility of an intervention by examining the costs it would require to implement
Does NOT consider outcomes
Cost Minimization Analysis
Determines the lower cost option of two different interventions with similar outcomes
E.g., identifying where services can be provided by paraprofessionals instead of professional psychologists if the outcomes are similar
Cost-Offset Analysis
Also known as medical cost offset
Compares the medical costs of implementing intervention with the medical costs saved as a result of implementation
