Ethical Decision Making Models and Resolving Ethical Issues

Question 1

explain what can go in the four bins of the BINS model

Answer 1

Legal
-E.g. mandated reporting, HIPAA, duty to warn

Clinical
-Implications to clinical work

Ethical
-Anything in the ethics code

Risk management
-Can hang with legal
-Do not want to harm yourself and your work in your profession

Question 2

what are the steps you should do when given a case

Answer 2

1) Acknowledge any emotions, values, and or beliefs that might impact decision making process

2) Determine if there is a dilemma

3) Scan the case and determine the ethical principles and standards, law that might be relevant for the case
-Determine BINS
-Your role and current status
-Mandated reporting
-Others?

4) Determine the stakeholders
-You, client, organization you work for

5) List all potential solutions and options

6) Determine the best plan of action and provide rationale

Question 3

what are the different standards under resolving ethical issues

Answer 3

-Misuse of psychologists work
-Conflicts between law
-Conflicts between organizations
-Informal resolution of ethical violations
-Reporting ethical violations
-Cooperating with ethics committees
-Improper complaints
-Unfair discrimination against complaints and respondents

Question 4

what are the major focuses/3 major principles of resolving ethical issues

Answer 4

-Major focus on this standard is outlining how to address ethical violations when the occur
-Major theme of beneficence/nonmaleficence, integrity, and justice
-Ignorance is not an excuse

Cannot say that you did not know, held to a different standard

Question 5

explain the standard misuse of psychologists work

Answer 5

-Focuses on corrective action that must be taken when psychologists learn that others have misused or misrepresented their work
-In some instances, psychologists may not be in a position to ensure a corrective action can be taken
-All efforts to remedy misused or misrepresented should be documented
-Write letters, speak with interested parties, request retraction or misrepresentations, or discuss with appropriate persons corrective measures etc.

Question 6

explain what “reasonable” means in reasonable steps

Answer 6

other psychologists in your position would do the same thing

Question 7

conflicts with ethics and law, when can psychologists NOT make a conscientious decision to comply with law

Answer 7

if their actions cannot be used to justify or defend violating human rights

Question 8

what is “civil disobedience”

Answer 8

-APA does not require compliance with the law either
-Cannot just waive our obligation to the code when the laws are unjust

Question 9

explain hoffman report (what it was)

Answer 9

-Responding to reports that some psychologists were actively involved in harsh interrogations post 9/11
-People were engaging in torture with interrogators to get information, APA said even if this is allowed by law psychologists cannot ethically engage in human rights violations

Question 10

what was the result of the hoffman report

Answer 10

Made clear that psychologists ethical duties supersede the legal obligations when their activities contribute in any way to violation of human rights
-However, the APA cannot hold you liable; if the court tells you if you do not break confidentiality you will go to jail; you will not lose your license in this specific instance; you still might get sued (civil not legal)
-If anything is a human rights violation we go by the code and not the law

Question 11

what laws/ethics were clarified after the hoffman report

Answer 11

-Unethical behavior involving conflicts of interest, improper handling of ethics complaints, to protect psychologists, issuing misleading statements that hid true motives, activities related to torture and violations of human rights

Question 12

what to do when keeping codes in conflict

Answer 12

Avoid dichotomous thinking (us vs. them), myth of innocence

Question 13

what to do while encouraging speaking up, listening carefully, and acting with fairness

Answer 13

think about Influence of context, slow down, increasing understanding

Question 14

how to respect the cost of betraying human rights

Answer 14

Engage in self examination, attend to conflicts of interest, make amends and apologize

Question 15

explain role in death penalty that we discussed in class

Answer 15

It depends what role we are in and what role would you even play; can I be involved in this if it is a violation of human rights?

Question 16

what is the human rights declaration

Answer 16

declares what the human rights are that cannot be violated

Question 17

what are some of the human rights

Answer 17

equality, freedom, no discrimination, life, liberty, security of person, no slavery, no torture, person before law, equal under law, no random arrests, full public hearing, innocent until guilty, freedom of movement, seek other countries, right to nationality, anyone can marry, right to property, right to thought, freedom of opinion, protest, take part in government, right to work, right to social security, right to rest, right to a good standard of living, right to education, right to participate in culture, social order, duties to community, cannot destroy rights of others

Question 18

explain psychology and human rights

Answer 18

Psychologists recognize failure to protect human rights has adverse consequences on health

However,

Mental health practices themselves may violate human rights in settings in which people are involuntarily hospitalized for mental illness based on invalid assessments and subjected to procedures that do not respect their right to personal liberty and security

Question 19

explain conflicts between ethics and organizational demands

Answer 19

-Psychologists may encounter company policies that conflict with the ethics code
-Standard requires psychologists to make known their commitment to the ethics code in communications with the organizations

E.g. if a school says you tell the principle first before you call child line, you do not do this because the ethics code says do otherwise

Don’t assume that standard waives obligation to adhere to other standards in the ethics code

Question 20

how are you supposed to handle informal resolution of ethical violations

Answer 20

Discuss violation with offending psychologists to confirm whether misconduct has actually occurred and if appropriate, recommended corrective steps and ways to prevent future violations
-You are supposed to see it through

E.g. seeing someone post pictures online of groups, if they don’t take it down you have to escalate the situation

Question 21

when is it not feasible to informally resolve things on your own

Answer 21

-Previous attempts to discuss the violation with offending psychologist were ineffective
-Offending psychologist is inaccessible
o Informal resolution would violate an individual’s confidentiality rights-

Question 22

explain when to move forward and report ethical violations, not try to informally solve

Answer 22

As a rule of thumb, behaviors likely to cause substantial harm, and therefore require formal reporting, are of a kind similar to sexual misconduct, insurance fraud, plagiarism, and blatant intentional misrepresentation

Question 23

when does reporting ethical violations not apply

Answer 23

This standard does not apply when an intervention would violate confidentiality rights or when psychologists have been retained to review the work of another psychologists whose professional conduct is in question

E.g. client told you about sexual misconduct of another psychologist with whom the client had previously been in therapy, but they do not want you to say anything (confidentiality)

If you are called in to review something, so you would not report that thing

Question 24

explain cooperating with ethics committee

Answer 24

-Psychologists are required to cooperate with the ethics committee to ensure validity and viability of the ethics code

-Psychologist can request that an APA affiliated state psychological association ethics committee delay adjudication of a complaint pending the outcome of litigation related to the complaint

Question 25

explain improper complaints

Answer 25

not supposed to do this

Common improper complaints to the APA ethics committee involve
-Academic colleagues
-Business rivals
-Psychologists with opposing forensic roles

Violated if psychologists making a complaint had access to information refuting the accusation – whether or not they availed themselves of such information

Question 26

explain unfair discrimination against complainants and respondents

Answer 26

-Prohibits unfair discrimination against those who make ethics complaints
-Prohibits unfair discrimination against individuals who have been accused of, but not found to have committed an ethical violation

Question 27

what are the next steps after a complaint has been filed

Answer 27

-Complaints to the ethics committee may be brought by APA members or nonmembers or initiated by members of the ethics committee
-A complaint may be dismissed prior to review by the ethics committee
-If a case is opened, the psychologist against whom the complaint is made receives a charge letter and is given an opportunity to provide the committee with comment and materials regarding the allegations
-The ethics committee reviews the materials and resolves to either dismiss the case or recommend one of the following actions, these things are public information if you go to the PA state board of psychology

Question 28

what are the four recommended actions that the APA can do after an ethics complaint (sanctions)

Answer 28

Reprimand
-A severe criticism for a fault
-Occurs when violation does not cause substantial harm to another person or profession
-You have to report these things honestly

Censure
-Formal and official judgment condemning and/or blaming person for fault
-Occurs when violation was likely to cause harm but not substantial harm
-Goes on record, more serious than reprimand, formal judgment

Expulsion
-Removing the person from APA
-Occurs when violation is likely to cause substantial harm to another person or profession
-Must be reported to state board where further action may be taken

Stipulated resignation
-Committee finding that person committed a violation of the ethics code or failed to show good cause whey they should not be expelled-

Question 29

what other directives can the ethics committee issue (sanctions)

Answer 29

-Cease and desist from an activity
-Obtain supervision or additional training or education
-Be evaluated for and obtain treatment if appropriate
-Agree to probationary monitoring

Question 30

how does the APA notify about an ethics decision (notification)

Answer 30

-Informs the respondent and the compliant of the final disposition in a manner
-Provides to the APA membership on an annual basis the names of individuals who have been expelled and those who have resigned from membership while under investigation
-Informs the APA council of representatives in confidence who received a stipulated resignation and who resigned from membership while under investigation-

Question 31

what is the show cause procedure

Answer 31

The ethics committee can also take action against a member if a criminal court, licensing board, or state psychological association has already taken adverse action against the member

Question 32

what can happen from other bodies if you are sanctioned by ethics board (insurance companies)

Answer 32

-The ethics code is adopted in its entirety or in part in statue by more than half the state licensing boards

Insurance companies regularly require psychologists applying or reapplying for professional liability policies to reveal whether they have been the recipient of an ethics complaint
-Rates will go up

Many insurance companies retain the right to raise rates or cancel policies depending on the nature of an ethical violation

Question 33

explain APA ethics code and civil litigation

Answer 33

Ethics code violation does not by itself constitute grounds for legal action
-You can still be sued independent of whether or not you get in trouble with the board or not

Compliance with or violation of the ethics code may be admissible as evidence in some legal proceedings, depending on the circumstances

Question 34

explain penalty for practicing psychology without a license

Answer 34

-1st offense: guilty of misdemeanor and/or fine (<$1000) and / or prison time < 6 months

-Two or more offenses – fine > $2000 and/or prison > 6 months and < 1 year

Question 35

explain felony convictions and how it impacts licensure qualifications

Answer 35

-Section 6 act 52

-Controlled substance, drug, device and cosmetic act (producing these substances leads to losing license)

-At least 10 years have elapsed from date of conviction
-To be able to apply for licensure again, you can lose your license

-Check section 6 for outline of all penalties