Week 4: Ethics Flashcards

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1
Q

What is Ethics?

A

► A system of moral principles that guide human conduct in an individual or group
► Informs how people should act in a given situation or towards each other
► A branch of philosophy dealing with values relating to the rightness and wrongness of actions, and goodness and badness of motives
► Differs from morality

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2
Q

Why are ethics important in psychology?

A

► Establish a group as a profession
► Act as support/guide to individual professionals
► Meet responsibilities of being a profession
► Provide statement of moral principles that guide individual professionals to resolve ethical dilemmas

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3
Q

Who are psychologists ethically responsible for?

A
► Clients/patients
► Students
► Supervisees/Research assistants
► Research participants
► Employers, employees, colleagues
► Profession at large
► Society
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4
Q

Identify the 3 guiding bodies of Ethics.

A
  1. Code of Ethics: Core/Aspirational values - CPA and APA Code of Ethics.
  2. Professional Standards: Necessary/prescriptive for Profession - College of Psychologists in British Columbia Code of Conduct (CPBC Code of conduct)
  3. Legal Standards: Necessary/prescriptive for Society - Statutes and Case/Common Law
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5
Q

What are CPAs (Canadian Psychological Association) 4 objectives?

A

► Improve health and welfare of Canadians
► Promote excellence & innovation in psychology
► Promote psychological knowledge
► Provide services to members

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6
Q

What separates CPA Code of ethics from APA code of ethics?

A

► CPA improves upon the APA Code of Ethics
► CPA establishes psychology as a formal discipline in Canada
► CPA supports and guides Canadian psychologists in all professional activities

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7
Q

What are some features of the CPA Code of ethics?

A

► Empirically-derived: 36 ethical dilemmas, 59 psychologists participated, responses analyzed by content and categorized into groups that formed the 4 ethical principles in the CPA code of ethics.

► Differential weighting of 4 principles (some principles are more significant than others)

► Introduced the concept of “Social Contract”: society granting support for the autonomy of a discipline in exchange for a commitment by the discipline to do everything it can to assure their members act ethically.

► Includes both minimal & idealized or aspirational standards (realistic and long-term goals kinda)

► A systematic ethical decision-making model

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8
Q

What are the 4 ethical principles of the CPA code of conduct?

A

► Principle I: Respect for the Dignity of Persons and Peoples - non-discrimination, informed consent, confidentiality, privacy

► Principle II: Responsible Caring - competence, self-care, maximize benefit and minimize harm

► Principle III: Integrity of Relationships - accuracy, honesty, avoidance of conflicts of interests or deception

► Principle IV: Responsibility to Society - development of knowledge, respect for society

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9
Q

What is Confidentiality?

A
  • A professional standard of conduct to not disclose information about a client except under certain conditions.
  • An implied promise to keep information disclosed in the psychologist-client relationship private.
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10
Q

What’s the difference between Privacy and Privilege?

A

► Privacy – Right to choose information being shared

► Privilege – Right to refuse disclosing information to legal system

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11
Q

Identify 4 limits to confidentiality.

A
  1. Court Order - CanadianCriminalCode
  2. Harm or risk of harm to a child - Child, Family, & Community Service Act
  3. Unsafe to Drive - Motor Vehicle Act
  4. Risk of harm to self or others - Adult Guardianship Act, Case Law
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12
Q

What is the Infants Act?

A

► Explains legal position of children under the age of 19
► “Mature Minor Consent”
► Ensure child understands: Need for treatment, What treatment entails, and Risks & benefits.
(children may consent to a medical treatment on their own as long as the health care provider is sure that the treatment is in the child’s best interest, and that the child understands the details of the treatment, including risks and benefits.)

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13
Q

What is Duty to Protect?

A

Protect clients and others from foreseeable harm.

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14
Q

What is the Tarasoff decision?

A

In 1974, the California Supreme Court held that a therapist bears a duty to use reasonable care to give threatened persons such warnings as are essential to avert foreseeable danger arising from a patient’s condition.

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15
Q

What are The Tarasoff Principles?

A

► Tarasoff I – Duty to Warn

► Tarasoff II – Duty to Protect

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16
Q

Explain the Smith v. Jones (1999) case.

A

This case explains the public safety exception to solicitor-client privilege (criminal confidentiality from even the law).

A defense lawyer took his client who was accused of rape and other crimes to a psychologist to use the evaluation as a defense - but the client confessed to the psychologist that he was guilty and planned to hurt more people in the future.

The defense lawyer omitted this defense as a result - but the psychologist fought against this decision legally since it was clear the solicitor was a danger to society. And the psychologist ended up winning.

17
Q

What is an Ethical Dilemma?

A

A professional situation in which one or more ethical principles or laws are in conflict.

18
Q

What are the 10-Steps to the Ethical Decision-Making Model?

A
  1. (People affected) Who are the people potentially affected by decision?
  2. (Laws and Ethical values - and are they in conflict) What are the relevant ethical issues/laws? Which ethical values/laws are in conflict?
  3. (Personal bias influence) How do personal biases, stresses or self-interest affect my choice of action?
  4. (Possible plans) What are my possible plans of action?
  5. (Risks of possible plans) What are the likely short-term and long-term risks and benefits of each possible action?
  6. (What’s the Best plan) What is your best course of action?
  7. (Act and accept consequences) Act on your first-choice decision, and assume responsibility for consequences.
  8. (Evaluate outcomes of action) Carefully evaluate the outcomes of your chosen course of action
  9. (Accept responsibility and consider alternatives/correct if needed) Continue to accept responsibility, consider an alternative action if needed and correct any unforeseeable consequences.
  10. (Prevention of similar problems) Taking steps to prevent similar problems in the future.
19
Q

Vignette: What would you do?
You are a psychologist working with a 22-year-old female diagnosed with posttraumatic stress disorder, major depressive disorder, and borderline personality disorder. She regularly struggles with suicidal urges and has made multiple suicide attempts in the past. She also engages in self-harm via cutting and burning, and engages in prostitution. She does not do this for money. Instead, she uses the sex trade as a way to engage in self-harm. You have been working with her for several months to help her address these difficulties and to help her find more effective ways of coping, as it is her goal to cease all suicidal and self-harm behaviours, as well as to exit the sex trade. Unfortunately, she recently discovered she has contracted HIV. This news led to an increase in her urges to suicide and self-harm. This includes continuing to turn to the sex trade as a form of self-harm, and continuing to engage in unprotected sexual activities with the men who are paying her for sex. You have discussed the issues around infecting her clients with HIV when she engages in this high-risk behavior. Your client understands these issues and clearly stated that she does not have the wish or intent to infect others. However, she reported that when she is feeling very dysregulated, she does not think about these consequences and engages in the riskiest sexual behaviours that she can, as a way of self-harming. You are very concerned that if the police become involved to prevent the possibility of her spreading HIV to others, that her risk for suicide would increase even further, given that she has had negative experiences with the police in the past and that she has clearly states that “I can’t handle any other stressors in my life right now”.

A

I would take a 4 Aspect Approach:
1. Proactive in therapy protocol - starting off with figuring out what’s working and what’s not.

  1. Maintain the therapeutic relationship - to keep it as a safe space for the client to express any other concerning information.
  2. Risk assessment - if things are not changing, or mor concerns to her and others’ safety if brought up, I will then conduct another risk assessment.
  3. Breaking confidentiality - if the above plan does not work, then the next step would be to report the client to the police in order to protect public safety.
20
Q

How does an aspirational principle differ from practice guidelines?

A

Aspirational Principles are not obligations and should not directly force punishment if not followed - whereas Ethical Standards are.
General Principles are aspirational in nature. Their intent is to guide and inspire psychologists toward the very highest ethical ideals of the profession.

21
Q

Practice guidelines/Codes of conduct are useful but what are their limits?

A

Codes of conduct/practice guidelines offer a systematic referral and approach to practice decisions - but they cannot tell you what happens when you violate these guidelines.
The overarching ethical principles are very general and have to be fitted to each individual situation and circumstance.

22
Q

How different (or not) are the codes of ethics in different countries?

A

Comparing codes of conduct across different countries gives you an impression that psychologists do care about the same things - shows us that as a profession we have shown impressive maturation and growth.

23
Q

What specific practices and habits should clinical psychologists develop to protect themselves from complaints being brought forward against them?

A

Prevent future problems:
Good record-keeping,
Clear contracts,
Maximizing practice setups for confidentiality,
and Considering the consequences of one’s own actions.