General Ethics Flash Cards including AHPRA

Question 1

What are laws?

Answer 1

Laws define the minimum standard society can tolerate - enforced by the government

Question 2

What is Ethics?

Answer 2

Ethics represent the maximum or ideal standards set by the profession - enforced by professional bodies

Question 3

What is Morality?

Answer 3

Morality is concerned with one’s perspective of what is right and proper conduct; often involves evaluation of actions based on culture and religion

Question 4

How can ethics be seem from your client’s point of view?

Answer 4

Ethics can be viewed as doing the right thing by your client(s)

Question 5

Give some examples of when ethics and the law are in conflict

Answer 5

*Client records are subpoenaed
*Mandatory reporting (e.g., child abuse)
*Psychologists should inform appropriate authorities
about their standards and take steps to resolve the
conflict.
*If the conflict is irresolvable, psychologists should
adhere to the law.
*Care must be taken to disclose only minimal
information necessary to satisfy the law so that ethical
violations are not heightened.

Question 6

What is Positive Ethics?

Answer 6

*The goal of positive ethics is to shift the exclusive focus
of professional ethics away from obeying rules to avoid
disciplinary action, to thinking about the ethical
standards to which one can intrinsically aspire to
achieve.
*Better personal integration of values
*Increased openness to question what is truly “right”.
*Higher ownership and investment in ethical practice.

Question 7

What is Non maleficence?

Answer 7

Non Maleficence is doing no harm

Question 8

What is Beneficence?

Answer 8

Beneficence is doing good

Question 9

How are Non-Maleficence and Beneficence different?

Answer 9

Non-Maleficence is actively doing no harm, whereas Beneficence is actively doing good

Question 10

What other general ethical principles are psychologists required to abide by?

Answer 10

*as well as Non-maleficence - doing no harm.
*Beneficence - doing good.
*Respecting autonomy.
*Being just - be fair and equitable.
*Being faithful -fidelity, loyalty, trust, honesty.
*According dignity - treat others with respect.
*Treating others with caring and compassion.
*Pursuit of excellence - quality, competent,
service.
*Accepting accountability.
*Integrity - being sincere.

Question 11

What is General Principle A in a nutshell

Answer 11

*General Principle A: Respect for the rights and
dignity of people and peoples
*Psychologists regard people as intrinsically
valuable and respect their rights, including the
right to autonomy and justice. Psychologists
engage in conduct which promotes equity and the
protection of people’s human rights, legal rights,
and moral rights. They respect the dignity of all
people and peoples.

Question 12

What is General Principle B in a nutshell

Answer 12

*General Principle B: Propriety
*Psychologists ensure that they are competent to
deliver the psychological services they provide.
They provide psychological services to benefit,
and not to harm. Psychologists see to protect the
interests of the people and peoples with whom
they work. The welfare of clients and the public,
and the standing of the profession, take
precedence over a psychologist’s self-interest.

Question 13

What is General Principle C in a nutshell

Answer 13

*General Principle C: Integrity
*Psychologists recognise that their knowledge of
the discipline of psychology, their professional
standing, and the information they gather place
them in a position of power and trust.
Psychologists keep faith with the nature and
intentions of their professional relationships.
Psychologists act with probity and honesty in
their conduct.

Question 14

What are some of the limitations to the Code of Ethics

Answer 14

• Too broad – Guide rather than provide answers.
• May contradict institutional policies.
• May clash with personal values.
• Codes can conflict with each other.
• Difficult to enforce.

Question 15

How can ethical codes be Enforced?

Answer 15

• General criminal and civil law (if warranted).
• Federal laws and regulations.
• Peers (and various ethics committees).
• Civil litigation of malpractice complaints.
• Registration boards.

Question 16

What’s the function of the Psychology of Australia?

Answer 16

The functions of the Psychology Board of Australia include:
*registering psychologists and provisional psychologists
*developing standards, codes and guidelines for the
psychology profession
*handling notifications, complaints, investigations and
disciplinary hearings
*assessing overseas trained practitioners who wish to
practise in Australia
*approving accreditation standards and accredited
courses of study

Question 17

What is involved in an Ethical dilemma?

Answer 17

An Ethical Dilemma involves a clash of ethical principles

Question 18

What is involved in a Mixed dilemma?

Answer 18

A mixed dilemma involves a clash of an ethical principle with a non-ethical protagonist

Question 19

There are 4 types of Confidentiality, name them

Answer 19

*Absolute confidentiality
*Limited confidentiality
– Content
– Recipient of information (professional or non-professional)
*Contractual confidentiality
*Discretionary confidentiality

Question 20

APS Code of Ethics A.5 explains the circumstances for disclosure of confidential information. What are the circumstances?

Answer 20

*With the consent of relevant client/s (or relevant legal
authority)
*Where there is a legal requirement (e.g., subpoena).
*If there is an immediate and specific risk or harm to
identified person/s (which can be averted only by the
disclosure).
*When consulting colleagues or in the course of supervision or professional training provided that the client’s identity is concealed & the client’s consent is obtained.

Question 21

What factors require consideration with regard breaching confidentiality?

Answer 21

Factors to consider regarding confidentiality:
– Circumstances for breaching confidentiality.
– The level of risk, harm or danger to others.
– Who to inform.
– How much to disclose.
– Is the information de-identified?

Question 22

How should I prepare my client around limitations of confidentiality?

Answer 22

*Informed written consent regarding the limits of
confidentiality needs to be obtained from the client/s.
*Discuss foreseeable uses of the information clients
disclose in the professional relationship.
*Advise the client/s if you are going to breach
confidentiality.
*All communications should be recorded
appropriately.

Question 23

There is a difference between what is legally ‘permitted’ and legal ‘duty’ to disclose confidential information in certain circumstances in Australia.

Answer 23

64% of participants reported a legal duty to
disclose confidential info. if danger eminent.
– Disclosure was likely to increase if the client had
historical risk factors (substance abuse, violence,
command hallucinations and psychosis).
*Client expectations don’t always align with practice.

Question 24

What do you know about subpoenas?

Answer 24

Subpoenas are court orders to:
– Produce documents
– Provide oral evidence in court
* Common law does not necessarily uphold the notion of professional privilege in communications between clients and psychologist.

Question 25

What do you know about the privacy act?

Answer 25

The Privacy Act operates in tandem with and essentially “over-rules” profession based privacy considerations such as APS

• Psychologists need to have read this prior to commencing practice
• Particularly relevant to psychologists: Disclosure, Health and Sensitive Information

Question 26

What do you know about the AHPRA Guidelines for Mandatory Notification (March 2014)?

Answer 26

These guidelines explain the requirements for registered
health practitioners, employers of practitioners and education providers to make mandatory notifications under the National Law to prevent the public being placed at risk of harm.

Question 27

What is the threshold to trigger a mandatory notification?

Answer 27

The threshold to be met to trigger a mandatory notification in relation to a practitioner is high.
*The practitioner or employer must have first formed a reasonable belief that the behaviour constitutes notifiable conduct or a notifiable impairment or, in the
case of an education provider, a notifiable impairment
*Making a mandatory notification is a serious step to prevent the public from being placed at risk of harm and should only be taken on sufficient grounds. The guidelines explain when these grounds are likely to arise.

Question 28

What are voluntary notifications?

Answer 28

The National Law also provides for voluntary
notifications for behaviour that presents a risk but does
not meet the threshold for notifiable conduct, or for
notifications made by individuals who are not subject to
the mandatory notification obligations such as patients
or clients

Question 29

What are the general obligations required for AHPRA Registered Practitioners?

Answer 29

The obligation is on any practitioner or employer who
forms a reasonable belief that another practitioner
has engaged in notifiable conduct to make a report
to AHPRA as soon as practicable.
*The obligation applies to practitioners in all registered
health professions, not just those in the same health
profession as the practitioner. It also applies where the
notifying practitioner is also the treating practitioner
for a practitioner

Question 30

What does AHPRA say about a clinician’s ethical responsibility?

Answer 30

In addition to their legal obligations with respect to mandatory reporting, practitioners are also under an ethical obligation to notify concerns about a practitioner, in accordance with the broad ethical framework set out
in the health profession’s code of conduct

Question 31

What is Notifiable Conduct according to AHPRA?

Answer 31

a) practised the practitioner’s profession while
intoxicated by alcohol or drugs; or
b) engaged in sexual misconduct in connection with the
practice of the practitioner’s profession; or
c) placed the public at risk of substantial harm in
the practitioner’s practice of the profession
because the practitioner has an impairment; or
d) placed the public at risk of harm because the
practitioner has practised the profession in a
way that constitutes a significant departure from
accepted professional standards.

Question 32

When would you need to notify for someone practising the practitioner’s profession while intoxicated by alcohol or drugs?

Answer 32

Only if you saw the practitioner practice their profession whilst intoxicated by alcohol or drugs

Question 33

When would you need to notify for someone engaging in sexual misconduct in connection with the practice of the practitioner’s profession?

Answer 33

Only if as a practitioner, or as an employer, I reasonably
believe that another practitioner has engaged in sexual
misconduct, e.g. (a) sexual activity with a person under
the practitioner’s care or (b) sexual activity with a
person previously under the practitioner’s care where
circumstances such as the vulnerability of the patient
or client results in misconduct
*I can make a voluntary notification if this is not the case, but I am not mandated to do so

Question 34

When would you need to notify for someone placing the public at risk of substantial harm in the practitioner’s practice of the profession because the practitioner has an impairment?

Answer 34

If as a practitioner or as an employer, I reasonably believe that a practitioner has placed the public at risk of substantial harm because of an impairment.
*I can make a voluntary notification if substantial harm is not the case, but I am not mandated to do so

Question 35

When would you need to notify for someone who has placed the public at risk of harm because the practitioner has practised the profession in a way that constitutes a significant departure from accepted professional standards?

Answer 35

If, as a practitioner or as an employer, I reasonably
believe that a practitioner has placed the public at risk or
harm because the practitioner practised the health profession in a way that constitutes a significant departure from accepted professional standards
*I can make a voluntary notification if this is not the case, but I am not mandated to do so

Question 36

When would you need to notify for an impaired student?

Answer 36

If, as a supervising practitioner or as an education provider, I reasonably believe that a student enrolled in a course of study, or for whom an education provider has organised clinical training, has an impairment that would place the public at risk of substantial harm.

Question 37

What happens if, as a registered health practitioner, I fail to Notify AHPRA?

Answer 37

Although there are no penalties prescribed under the
National Law for a practitioner who fails to make a
mandatory notification, any practitioner who fails to
make a mandatory notification when required may be
subject to health, conduct or performance action.

Question 38

In his book, Francis mentions one way of preventing an ethical problem, what is it?

Answer 38

Ensuring the client is properly informed about the limits of confidentiality, specifically, that confidentiality is not absolute

Question 39

What is one way to address an ethical conflict (where ethical principles are conflicting) according to Francis?

Answer 39

• Arrange the key principles in hierarchical order
  e. g. 1. preserve from harm; 2. respect the dignity of all persons; 3. be open & honest except where privacy & silence are clearly ethically preferred; 4. act so as to preserve the equitability of the relationship
• use professional judgemental, taking the circumstances of the case into account

Question 40

Ethical & legal obligations flow from the psychologist-client relationship. Francis enquires, when a psychologist works for an organisation, who is given a guarantee of confidentiality? Who can receive information about the client?

Answer 40

• Corporate responsibility becomes an issue
• The main complication is that more than one party may fulfil the definition (e.g., child, parent; couple in therapy)
• Francis concludes the client is the “person-across-the-desk” first and foremost.

Question 41

What are the guidelines Francis provides about when a client stops being a client?

Answer 41

• Whether or not a client retains ‘client’ status is paramount
• Particular attention should be paid to emotionally vulnerability
• No professional confidences from client or ex-clients should ever be revealed except as compelled by law
• A suitable time shall elapse before a client relationship is converted to a personal one
• If further assessment or treatment is sought, the terminating psychologist shall ensure an appropriate referral is made
• Before any relationship is converted to a personal one the advice of an independent senior psychologist colleague should be sought

Question 42

Francis provides some initial advice when first faced with an ethical dilemma, what is it?

Answer 42

• Test the case against a key principle

e. g. if client wants to become a friend - test against equity & conflict of interest

Question 43

What does Morrissey & Reddy tell us about the Commonwealth Government’s 2001 changes to the 1988 Privacy Act?

Answer 43

*Special provisions were introduced in relation to health information that regulates the disclosure of health information to 3rd parties
Note: these exceptions permit but do not compel disclosure

Question 44

What can you tell me about a psychologists requirement with regard mandatory reporting (from Morrissey & Reddy)?

Answer 44

• There is a statutory obligation to disclose client abuse
• There needs to be ‘reasonable belief’ that a child requires protection
• Psychologists who act in good faith & report suspected abuse to appropriate authorities have statutory protection from liability and are deemed not to have breached professional ethics.

Question 45

What do Morrissey & Reddy state about disclosures that are permitted, though not mandatory, i.e. discretionary disclosures?

Answer 45

Ethical codes & laws permit disclosure of confidential information:

• ‘in the interest of the client’. e.g. a suicidal client
• a ‘public interest in disclosure’ e.g. a client must be perceived to present a risk of serious harm to a 3rd party
• Both the law & the APS Code of Ethics there are some circumstances in which the public (or social) interest interest in disclosure must outweigh the duty of confidentiality to an individual client

Question 46

According to Morrissey & Reddy what does the APS say about previous criminal activity?

Answer 46

*Members must not disclose information about criminal acts of a client unless there is an overriding legal obligation to do so or when failure to disclose may result in a clear risk to themselves or others

Question 47

What are the current obligations for Victorian Psychologists with regard reporting (Morrissey & Reddy)?

Answer 47

Victorian psychologists are under the same obligations as ordinary citizens and are not compelled to report a crime except in the unusual circumstances in which the crime is a serious indictable offence and the psychologist benefits from concealing the crime or where the offence is treason

Question 48

What do Morrissey & Reddy say about the ‘duty to protect’?

Answer 48

The ‘duty to protect’ overrides the individual client’s rights to confidentiality in the relationship with his or her psychtherapist

Question 49

What poetic explanation of confidentiality do Morrissey & Reddy offer?

Answer 49

Somewhere between unthinking promises of absolute confidentiality and indiscrete disclosure of information lies the contemporary duty of confidentiality