Too often, psychologists approach ethics as an afterthought to assessment or treatment plans, research designs, course preparation, or groundwork for forensic or consulting activities. Ethical planning based on familiarity with ethical standards, professional guidelines, state and federal laws, and organizational and institutional policies should be seen as integral rather than tangential to psychologists’ work.
Ethical Knowledge and Planning
Familiarity with the rules of conduct set forth in the Ethical Standards enables psychologists to take preventive measures to avoid the harms, injustices, and violations of individual rights that often lead to ethical complaints. For example, psychologists familiar with the standards on confidentiality and disclosure discussed in Chapter 7 will take steps in advance to (a) develop appropriate procedures to protect the confidentiality of information obtained during their work-related activities; (b) appropriately inform research participants, clients/patients, organizational clients, and others in advance about the extent and limitations of confidentiality; and (c) develop specific plans and lists of appropriate professionals, agencies, and institutions to be used if disclosure of confidential information becomes necessary.
Good ethical planning also involves familiarity with guidelines for responsible practice and science. The APA and other professional and scientific organizations publish guidelines for responsible practice appropriate to particular psychological activities. Guidelines, unlike ethical standards, are essentially aspirational and unenforceable. As a result, compared with the enforceable Ethics Code standards, guidelines can include recommendations for and examples of responsible conduct with greater specificity to role, activity, and context. For example, Standard 2.01, Boundaries of Competence, requires psychologists to limit their services to populations and areas within their boundaries of competence, but as a general standard it does not specify what such competencies are in different work contents. By contrast, guidelines such as those for multicultural education, training, research, practice, and organizational change for psychologists (APA, 2003) describe the specific areas of training, education, or supervision that psychologists must have to perform their jobs competently. The Guidelines for Assessment of Dementia and Evaluation of Age-Related Cognitive Change (APA, 2012a) provides a list of necessary competencies, including memory changes associated with normative aging and the broad range of medical, pharmacological, and mental health disorders (e.g., depression) that can influence cognition in older adults. The crafters of guidelines developed by APA constituencies usually attempt to ensure that their recommendations are consistent with the most current APA Ethics Code—readers should be alert to instances in which the 2010 Ethics Code renders some guideline recommendations adopted prior to 2010 obsolete. Specific Guidelines are discussed throughout this book where their relevance to ethical standards can be applied.
Laws, Regulations, and Policies
Another important element of information gathering is identifying and understanding applicable laws, government regulations, and institutional and organizational policies that may dictate or limit specific courses of action necessary to resolve an ethical problem. There are state and federal laws and organizational policies governing patient privacy, mandated reporting, research with humans and animals, conduct among military enlistees and officers, employment discrimination, conflicts of interest, billing, and treatment. Psychologists involved in forensically relevant activities must also be familiar with rules of evidence governing expert testimony. Readers may wish to refer to the Hot Topic in Chapter 12 on the implications of case and federal law on the use of assessments in expert testimony.
As discussed in Chapter 2, only a handful of Ethical Standards require psychologists to adhere to laws or institutional rules. However, choosing an ethical path that violates law, institutional rules, or company policy can have serious consequences for psychologists and others. Laws and policies should not dictate ethics, but familiarity with legal and organizational rules is essential for informed ethical decision making. When conflicts between ethics and law arise, psychologists consider the consequences of the decision for stakeholders, use practical wisdom to anticipate and take preventive actions for complications that can arise, and draw on professional virtues to help identify the moral principles most salient for meeting professional role obligations (Knapp, Gottlieb, Berman, & Handelsman, 2007).
Ethical decision making requires sensitivity to and compassion for the views of individuals affected by actions taken. Discussions with stakeholders can clarify the multifaceted nature of an ethical problem, illuminate ethical principles that are in jeopardy of being violated or ignored, and alert psychologists to potential unintended consequences of specific action choices. By taking steps to understand the concerns, values, and perceptions of clients/patients, research participants, family members, organizational clients, students, IRBs or corporate compliance officers, and others with whom they work, psychologists can avoid ethical decisions that would be ineffective or harmful (Fisher, 1999, 2000).
Steps in Ethical Decision Making
Ethical commitment and well-informed ethical planning will reduce but not eliminate ethical challenges that emerge during the course of psychologists’ work. Ethical problems often arise when two or more principles or standards appear to be in conflict, in unexpected events, or in response to unforeseen reactions of those with whom a psychologist works. There is no ethical menu from which the right ethical actions simply can be selected. Many ethical challenges are unique in time, place, and persons involved. The very process of generating and evaluating alternative courses of action helps place in vivid relief the moral principles underlying such conflicts and stimulates creative strategies that may resolve or eliminate them.
Ethical decisions are neither singular nor static. They involve a series of steps, each of which will be determined by the consequences of previous steps. Evaluation of alternative ethical solutions should take a narrative approach that sequentially considers the potential risks and benefits of each action. Understanding of relevant laws and regulations as well as the nature of institutions, companies, or organizations in which the activities will take place is similarly essential for adequate evaluation of the reactions and restraints imposed by the specific ethical context.
A number of psychologists have proposed excellent ethical decision-making models to guide the responsible conduct of psychological science and practice (e.g., Barnett & Johnson, 2008; Canter et al., 1994; Kitchener, 1984; Koocher & Keith-Spiegel, 2008; Newman, Gray, & Fuqua, 1996; Rest, 1983; Staal & King, 2000). Drawing on these models and the importance of ethical commitment, awareness, and competence, an eight-step model is proposed:
Step 1: Develop and sustain a professional commitment to doing what is right.
Step 2: Acquire sufficient familiarity with the APA Ethics Code General Principles and Ethical Standards to be able to anticipate situations that require ethical planning and to identify unanticipated situations that require ethical decision making.
Step 3: Gather additional facts relevant to the specific ethical situation from professional guidelines, state and federal laws, and organizational policies.
Step 4: Make efforts to understand the perspective of different stakeholders who will be affected by the decision and consult with colleagues.
Step 5: Apply Steps 1 to 4 to generate ethical alternatives and evaluate each alternative in terms of moral theories, General Principles and Ethical Standards, relevant laws and policies, and consequences to stakeholders.
Step 6: Select and implement an ethical course of action.
Step 7: Monitor and evaluate the effectiveness of the course of action.
Step 8: Modify and continue to evaluate the ethical plan if feasible and necessary.