Ethics Flashcards
Fee splitting aka ___
referral fees
Permissible if it is based on services provided.
Prohibited bt professionals when based on referral only
preamble and general principles - aspirational or enforceable?
aspirational
ethical standards - aspirational or enforceable?
enforceable
membership to the APA
commits members to comply with the standards of the ethics code
Beneficence and nonmaleficence
- do no harm
- avoid misuse of influence
- aware of own physical/mental health
fidelity and responsibility
- establish relationships of trust
- aware of professional and scientific responsibilities
- accept responsibility for their behavior
- consult and cooperate with other professionals
- strive to contribute a portion of prof time for little or no compensation
Integrity
promote accuracy, honesty, and truthfulness
justice
- all persons are entitled to access to and benefit from the contributions of psychology and to equal quality
- practice within your scope;
- beware of biases
Respect for ppl’s rights and dignity
respect rights of individuals to privacy, confidentiality, self-determination
-respect role differences based on age, gender, gender identity, race, ethnicity, culture, national origin
when psychologists believe another psychologist has violated the ethics code..
(informal) attempt to resolve the issue by bringing it the attention of that individual IF appropriate and IF confidentiality is not violated
when psychologists believe another psychologist has violated the ethics code.. AND there is substantial harm done…
action might include:
- referral to state or national committees, state licensing boards, or to institutional authorities
- still can not violate confidentiality
when you are the subject of an ethics complaint..
you can not be denied employment, advancement, admissions to academic programs.. etc.
providing services in an emergency
when other MH is not available, you may provide services even if you don’t have necessary training, but you must stop as soon as emergency has ended
delegation of work
1) avoid delegating work to persons with multiple relationships
2) authorize only responsibilities that they can perform competently
3) make sure they are competent
personal problems & conflicts
refrain from initiating an activity when there is a big likelihood that their personal prob will prevent them from performing competently
when psychologists become aware of personal problems that may interfere with work..
take measures to determine if they should limit, suspend, or terminate work related duties
multiple relationships are:
in professional role AND another role OR in a relationship with a person closely associated or related to the person OR promises to enter into another relationshp in the future with the person
avoid multiple relationshps when:
they could be expected to impair psychologist’s objectivity, competence or effectiveness or risk exploitation or harm to the person
otherwise, MR are not unethical..
when a multiple relationship is required by law
must clarify role expectations and the extent of confidentiality and provide updates as changes occur
guilty by reason of insanity
the person was insane at the time of the murder
guilty by reason of incompetence
the person is unable to defend himself during the court proceedings
the goals of the APA code of ethics, according to the preamble
the welfare and protection of consumers of psych services AND education regarding ethical standards of conduct
most costly and successful malpractice suits against psychologists
sexual misconduct
sex with a former client is permissible when
after 2 years and “in the most unusual circumstances”
if you are assisting with the defense, and are called upon by the prosecution to testify
you can, but only after clarifying role expectations and extent of confidentiality
can BARTER only if ___ and ___
it is not contraindicated (e.g., babysitting)
and
does not exploit pt
try to avoid testifying for child custody when
you have been a therapist to child or s/o in family
when testifying re: custody, you can serve as a ____ but not a ____
fact witness
not an expert witness
when testifying re: custody, and you have multiple roles, you ___ testify as long as you ___
CAN
clarify roles to all parties and list limits of confidentiality at outset and if they change
re: custody, if only 1 parent is participating you ___ make a recommendation as long as ___
you have multiple other sources of data AND you describe limits of recommendations
client access to records
psychologist is owner. client has access. complete access may be harmful
client testimonials
do not solicit from its vulnerable to undue influence
client welfare
1) patient 2)public 3)profession 4)psychologist as self
you __ treat clients receiving care elsewhere if you __
can
carefully consider; proceed with caution
collection agencies
1)inform pt 2)give them a chance to pay 3)can submit
competence to stand trial is associated with what case
Dusky v US
exceptions to confidentiality
1) military bases “need to know”
2) evaluating competency to stand trial - still should make effort to maintain confidentiality with regard to any info that does not bear directly on legal purpose of eval
3) if lawsuit says “psychological distress” - whole file can be opened
4) if an employer hires you to provide a service to an employee
conflict bt ethics and the law
adhere to the higher standard. make commitment to ethics code clear. attempt to resolve conflict. when conflict can’t be reconciled, adhere to the law
consultation and confidentiality
can’t disclose confidential info. that could lead to pt identification unless:
1) you have a confidential relationship
2) have consent
3) disclosure can’t be avoided
disclose only what is necessary
If you are summoned by APA ethics committee (EC)
must cooperate. have 30 days.
Deception in research is acceptable only when
1) justified by study’s value and non deceptive procedures are not feasible
2) no deception about physical harm or psych. distress
3) debrief participants @ conclusion of study or no later than conclusion of study
4) OK to record without prior consent as long as you get permission for using the tape at debriefing
Employee Assistance Programs (EAPs)
MH service program offered to employees by the employer
confidentiality with EAPs
in most cases, has to be maintained. Exception: if employee has been referred for disciplinary axn. Therapist can disclose attendance, and whether pt has accepted recommendations of the therapist. *must make employee aware of limits to confidentiality
expert witness
specialized knowledge. can offer opinions
fact witness
not allowed to offer opinions
FERPA, aka
Buckley Amendment
FERPA
schools must have ROI
providing services to diverse populations
aspirational; recognize competence, incorporate cultural issues + knowledge into practice
in person solicitation
not in uninvited forums.
informed consent for those who are legally incapable
1) provide appropriate explanation
2) seek assent
3) consider preferences and best interests
4) obtain appropriate permission from a legal authorized person
WHEN and HOW to obtain informed consent for those who are legally incapable
when: ASAP
format: written and oral
in therapy with a minor, ___ continue without assent when__
CAN
if in best interest of child
in research with a minor, ___ continue without assent when __
CAN NOT
in best interest of child
if services are court ordered, you __ need consent and you should ___
DO NOT
Inform clients of confidentiality
if services are NOT court ordered, you ___ need consent
DO
if client does not consent and services are not court ordered, but they are for the court, you should
services are postponed. take steps to put individual in contact with legal representative. if legal rep is unwilling to proceed, contact the court
you do not need IC for research when
1) no harm of distress
2) pt of educational practices
3) involves administering an anonymous survey or quetionnaire
when to get IC in therapy
as early as is feasible. inform about nature and anticipated course of therapy, fees, limits of confidentiality, provide opportunity for Qs
when is it ok to interrupt or terminate therapy
1) client no longer needs services or is not likely to benefit, or is being harmed by services
preterm counseling when therapy is interrupted or terminated
should provide + suggest alternative providers as appropriate
exceptions to need to provide preterm counseling
axns of a 3rd party payor preclude such counseling.
- if pt is in crisis - this is the responsibility of the 3rd party (managed care)
- limits to care should be discussed at outset, but don’t have to be
Larry P v Wilson Riles
restricted use of IQ tests in schools d/t unfair consequences for minorities
Goal of Managed HC
balance access, quality, and costs
1) limit services to those that are appropriate and necessary. eliminate wasteful care
2) reduce fes
3) assess quality
4) provide referrals
5) provide timely payment
when additional sessions are denied by managed care, clinicians should
appeal, if they think pt needs more sessions. if denied, discuss options with pt.
reactions to managed HC
increased paperwork re: utilization
decreased control over tx decisions and plan
client confidentiality
requirements needed for malpractice suit
1) professional relationship (not determined by $)
2) demonstrable standard of care has been breached
3) pt suffering
4) pt suffering is due to breach of standard
most common malpractice suits
sex, competence, confidentiality, fees
multiple relationships
more than 1 relationship with a client or with close others of a client
multiple relationship is prohibited when
1) impacts psychologist objectivity or performance
2) exploits/harms pt
if psychologist has a personal problem, they should ___ and ____
not initiate activity that could be impacted
take appropriate measures re: activity already in progress (consultation, limiting, suspending, terminating activity)
privilege
protects client’s confidentiality.
privilege typically belongs to the ___ unless ____
client
1) ROI, 2) mandatory reporting (e.g., client is abusive), 3) legal reasons (eg., client is suing psychologist or is in custody dispute)
pro bono services
recommended, but not required
Record keeping
adults: full records for 7 years
children: full records for 7 years or 3 years after maturity
sex with clients is ok when ___ and NOT ok when__
after 2 years and “in most unusual circumstances”
NEVER ok to provide therapy to s/o you were sexually involved with.
NEVER ok to have sex with current client
when having sex with a former client, you must take into account
1) risk of exploitation, client’s current mental state, nature and duration of therapy, circumstances of termination, and likelihood that there will be a neg impact on client
specific guidelines for forensic psychologists
does not define minimum qualifications
focuses on professional practice issues
specifies: no contingency fees
test scoring and interpretation to other psychologists
must be accurate in describing the purpose, norms, validity, reliability, and application
test scoring and interpretation
psychologists are responsible regardless of whether they scored /interpreted it or used automated scoring
timeline for complaints
pt has 5 years
colleague has 1 year
vicarious liability
sometimes supervisors can be held responsible for supervisees IF 1)disparity in training and 2) ability of supervisor to control supervisee
withholding records for non payment is ___ when
NOT ok
needed for emergency tx.
primary purpose of ethics code principles and standards
protect welfare of clients and patients AND educate educate regarding ethical standards
in what situations can psychologists refuse tx they are competent in
1) not discriminating
2) giving appropriate referral
3) not an emergency
