PA Laws and Regulations: Ethical Decision Making Model

Question 1

what is the layout of PA laws and regulations

Answer 1

• General
• Licenses
• Professional corporations and fictitious names
• Qualifications
• Examinations
• Miscellaneous
• Code of ethics
• Sexual intimacies
• Notice requirements (e.g. moving, changing name)

Question 2

what are the 10 principles the PA code is organized into

Answer 2

o Responsibility
o Competency
o Moral and legal standards
o Public statement
o Confidentiality
o Welfare of the consumer
o Professional relationships
o Utilization of assessment
o Research with human participants
o Care and use of animals in research

Question 3

differences between PA ethics code and APA code

Answer 3

Preamble

Principle 2c : encouraging independent practice of unlicensed persons (clergy)

Principle 2d representation of non psychological academic degrees

Principle 3e: application of APA guidelines and standards
-Have to follow the code even if you are not a member of APA, if you are licensed you have to follow code

Principle 4 C-F: group advertisements, public announcements, personal growth groups, accurate announcements (talks at length about these things)

Principle 7c : professional relationships (provides more detail)

Principle 9c: minimal risk with human subjects

Question 4

explain PA laws that make a difference

Answer 4

• PA mandated reporter law
  -Reporting known or suspected child abuse even when not actively practicing
• Elder abuse
  -only reported when it happens in a facility
  -can be reported up to your discretion otherwise (if it is not happening in a facility)
• HIV status and reporting
  -PA does not have a specific law for HIV, the only time there could be legal action is if the person was incarcerated or the person was a sex worker; but as a psychologist we are not required to report
• PA drunk driving law
  -If someone discloses in a session that someone was drunk driving, you have to make a report, if you smell alcohol on them you have to report it as well; report to PA department of transportation and they call the police; duty to warn

Question 5

what are the five APA principles

Answer 5

–Beneficence and nonmaleficence
–Fidelity and responsibility
-integrity
-justice
-respect for people’s rights and dignity

Question 6

explain Beneficence and nonmaleficence

Answer 6

Reflects dual obligation to strive to do good and avoid doing harm
-Promoting the welfare of others
-Treating people and animals humanely
-Increasing scientific and professional knowledge of behavior and people’s understanding of themselves
-Improving the condition of individuals, organizations, and society

Question 7

explain Fidelity and responsibility

Answer 7

Faithfulness of one human being to another
-Promise keeping
-Discharge and acceptance of fiduciary (trust) responsibilities
-Appropriate maintenance of scientific, professional and teaching relationships
-Responsibility to obtain and maintain high standards of competence in their work and concern with ethical compliance
-Psychologist avoid conflicts of interest that would jeopardize trust or lead to exploitation or harm

Question 8

explain integrity

Answer 8

-Requires honest communication, truth telling, promise keeping, and accuracy in the science, teaching, and practice of psychology
-Refraining from making professional commitments that cannot be met and avoiding or correcting misrepresentations of one’s work
-Do not steal, cheat, or engage in fraud or subterfuge

What are some of the most common ways psychologists lack integrity?
-Lying, deceiving, misrepresenting work, giving false diagnoses to get someone services (time to use unspecified or other specified diagnoses)

Question 9

explain justice

Answer 9

-provide all people with fair, equitable, and appropriate access to treatment and to the benefits of scientific knowledge
-Awareness and guarding against one’s own bias

Question 10

what are the three kinds of justice

Answer 10

1) Distributive justice (fair access to benefits from contributions of psychology)

2) Procedural justice (fairness of the rules and practices applied across contexts and populations)
-Does not always mean equal

3) Interactional justice (fairness of how people are treated)

Question 11

explain respect for peoples rights and dignity

Answer 11

-Informed consent
-Respecting diversity
-Privacy and confidentiality
-Assessment

Question 12

what is a virtue and how is it applicable in psychology

Answer 12

behavior showing high moral standard; dispositional habits acquired through social nurturance and professional education to provide one with motivation and skills necessary to apply to the profession

in psychology it is developing a moral compass for psych and having an ethical commitment

-cognitive, emotional, dispositional, behavioral, and wisdom aspects of character strength, which motivates and enables one to act ethically

Question 13

what are the requisite virtues for psychologists

Answer 13

Conscientiousness
-Motivation to do what’s right

Discernment
-Being contextually and relationally sensitive; and being insight and using judgment

Prudence
-Applies practical wisdom to ethical challenges

Question 14

what are a couple of other virtues

Answer 14

Openness to others

Virtue of self care
-Identity stressors
-Recognizing the emotional toll of work related stress
-Practicing self care

Question 15

corresponding virtues and ethical awareness to beneficenence and nonmaleficence principle

Answer 15

virtues: compassion, humane, nonmalevolent, prudent

ethical awareness: psychologists should be able to identify what is in the best interest of those with whom they work , when a situation threatens the welfare of individuals and the competencies required to achieve the greatest good and avoid or minimize harm

Question 16

corresponding virtues and ethical awareness to fidelity and responsibility principle

Answer 16

virtues: faithful, dependable, conscientious, committed to professional growth

psychologists should be aware of their obligations to the individuals and communities affected by their work, including their responsibilities to the profession and obligations under the law

Question 17

corresponding virtues and ethical awareness to integrity principle

Answer 17

virtues: honest, reliable, self aware, genuine

psychologists should know what is possible before making professional commitments and be able to identify when it is necessary to correct misconceptions or mistrust

Question 18

corresponding virtues and ethical awareness to justice principle

Answer 18

virtues: judicious, fair, open to complexity and ambiguity

psychologists should be able to identify individual or group vulnerabilities that can lead to exploitation and recognize when a course of action would result in or has resulted in unfair or unjust practices

Question 19

corresponding virtues and ethical awareness to respect for people’s rights and dignity principle

Answer 19

virtues: respectful, consideration

psychologist must be aware of special safeguards necessary to protect the autonomy, privacy, and dignity of members of the diverse populations with whom psychologists work

Question 20

first two steps when dealing with a case

Answer 20

First, scan the case and determine the ethical principles and standards, law, that might be relevant for the case
-Your role and current status
-Issues relevant during intake
-Mandated reporting

Determine if there is a dilemma
-The next section will detail what to do when you believe there is an ethical dilemma present
-Might not always be a dilemma, but there are always ethical things you need to think about (a true dilemma is a conflict between multiple standards and principles)

Question 21

explain ethical intelligence

Answer 21

-An active process of continuous awareness that involves constant questioning and personal responsibility
-Depends on our ability to take care of ourselves, to recognize when fear, anger, boredom, resentment, sadness, hopelessness, or anxiety hurt our work
-Aspirational principles and standards are essential in this process, but they do not show us how to answer the question
-Looking at code to help us make a decision; what to do comes from us

Question 22

what negative and positive emotions can make an influence

Answer 22

Negative emotions
-Fear, anxiety, disgust, disrespect

Positive emotions
-Passion, calmness/centered, empathy, respect/sympathy, elevation

Question 23

what are the five factors that draw ethical judgment off track

Answer 23

cognitive commitments, authorities, groups, what you see is all there is (WYSIATI), imaginative illusions

Question 24

explain cognitive commitments and the two ways it throws off judgment

Answer 24

-Expressing a commitment to solely one approach
-Throws off judgment in 2 ways
-Logical mistake of affirming the consequent
-Inferential mistake of confirmation bias

Question 25

explain authorities

Answer 25

overly relying on our supervisors

Question 26

explain groups

Answer 26

Can potentially block sound ethical judgment

Question 27

explain what you see is all there is (WYSIATI)

Answer 27

Important to have an understanding of all of the facts because missing facts could lead us to make rash decisions

Question 28

explain imaginative illusions

Answer 28

common thinking errors

Question 29

tips for addressing common thinking errors

Answer 29

-Generative alternative explanations for clinical impressions
-Look for confirming viewpoints and disconfirming viewpoints

-Play one’s own devils advocate (or have someone play it for you)

-know Barnum effect
-Tendency to accept certain information as true, such as character assessments even when the information is so vague it could be considered worthless
-Personality descriptions apply specifically to the client rather than realizing they could apply to everyone

-Knowing that we are flawed and open to error

Question 30

explain language of ethics code

Answer 30

Always remember when we see words such as foreseeable, appropriate, or reasonable it indicates that psychologists need to use their personal decision making skills in applying the standard

Question 31

what is critical thinking

Answer 31

The objective analysis and evaluation of an issue in order to form a judgment

Question 32

due notice?

Answer 32

need to be sure that you provide forewarning (e.g. Good Faith Estimate)

Question 33

explain use of modifiers in code

Answer 33

-Appropriate potentially to the extent feasible and attempt to
-Allow for professional judgment

Question 34

explain feasible modifier

Answer 34

permits psychologists to evaluate whether factors within the specific context in which they are working justify delaying or not implementing behaviors required by a particular standard

Question 35

explain appropriate modifier

Answer 35

signals that the behaviors required to comply with a standard can vary with the psychological characteristics of the persons involved

Question 36

explain relevant modifier

Answer 36

guards against the language that would create a rigid rule that would be outdated

Question 37

explain reasonable and its two functions

Answer 37

Prevailing professional judgment of psychologists engaged in similar activities in similar circumstances, given the knowledge the psychologists had or should have had at the time

Two major functions
-Prevention of idiosyncratic ethical judgments inconsistent with the prevailing values and behaviors of members of the profession
-Guards against unrealistic or unfair expectations of responsible conduct

Question 38

explain substantial harm

Answer 38

A strong possibility that the event will happen

Use our own common sense to determine what SH means

Behaviors that are likely to cause SH include sexual misconduct, insurance fraud, plagiarism, and blatant intentional misrepresentation

E.g. client tells you they had sex with previous patient; cannot go to them without consent; have to report it to the board because it causes substantial harm; do not go right to the past therapist, go right to the state board

Question 39

explain client/patient

Answer 39

individual persons whom a psychologist is providing treatment, intervention or assessment services

Question 40

organizational client

Answer 40

refers to organizations, representatives of organizations, or other individuals for whom the psychologist providing consultation, organization or personnel evaluations, test development, research, forensic expertise, or other services that do not involve a treatment intervention, or diagnostic professional relationship with the person to whom services are provided

Question 41

important things to know when making an ethical decision

Answer 41

-When engaged in any clinical encounter, be mindful of any and all relevant ethical principles and standards
-When faced with an ethical dilemma, do not skip a step

Question 42

when is language used to reveal nad conceal

Answer 42

-Substitute the general for the specific
-Use a conditional frame for consequences
-Use denied motivation as misdirection
-Use the abstract language of technicalities
–Use the passive voice
-Make unimportant by contrasting with what did not occur
-Replace intention unethical behavior with the language of accidents, misfortune, and mistakes
-Smother the events in the language of attach

Question 43

what is risk management in terms of ethical decision making

Answer 43

-Operating using high professional ethics
-Thinking about APA/PA ethics code
-Considering state and federal law
-Does not always consider the best interest of the client

Question 44

explain principle based ethics as it relates to the five principles in the APA code

Answer 44

-Therapists avoid harming client (nonmaleficence)
-Healthcare professionals recognize the right of patients to make their own decisions (Respect for autonomy)
-Beneficence: working to promote the wellbeing of others, clients
-Justice: dealing fairly with others (nondiscrimination)
-Fidelity (integrity): being faithful to the commitments inherent in mental health services
-General beneficence: obligations that psychologists have to society in general

Question 45

when do ethical problems occur

Answer 45

-The ethical problem occurs when the guiding principles (A-E) demand or appear to demand that a psychologist adopt each of two or more alternative actions, yet the person cannot perform all of the required alternatives
-One overarching principle may temporarily override another overacting ethical principle

Question 46

what to consider when two principles/standards are in conflict with one another

Answer 46

-The reasons justifying acting on one overarching ethical principle override the justifications for acting on another
-The action has a realistic chance of success and there is no reasonable or morally preferable alternative available
-The individual tries to minimize harm to the moral principle that is being infringed upon

Question 47

BINS model of ethical decision making (what are the four bins)

Answer 47

Legal, clinical, ethical, risk management