Ethics Rounds

The Ethical Principles of Psychologists and Code of Conduct (2002), our Ethics Code, provides the foundation for the ethical practice of psychology. Students and trainees should have a thorough working knowledge of what is in the code and ample opportunity to explore how the code's language applies to their area of practice, research or teaching. A careful read shows how the code invites both trainees and more experienced psychologists to consider larger questions of what it means to be an ethical psychologist-questions that are fruitfully posed and explored during psychology training. Four examples involve:

  • Coming to know oneself as a clinician.

  • Examining the role of affects in identifying ethical dilemmas.

  • Educating ourselves about how language reflects the values of the dominant culture.

  • Asking what personal characteristics contribute to being an ethical psychologist.

Coming to know our strengths and weaknesses

Coming to know oneself as a clinician is not always associated with ethics. Yet the consequences of having a sense of one's strengths and weaknesses, of considering which clients one is well suited to work with and conversely which clients one best refers to a colleague, directly relates to Principle A in the Ethics Code, beneficence and nonmaleficence. The goodness of fit between a psychologist's unique talents and a client's unique clinical challenges can have a powerful effect on how well or poorly a treatment goes.

Psychologists who call APA's Ethics Office sometimes convey a sense of distress and even helplessness over a treatment that is going badly, yet which they feel an ethical obligation to continue out of a concern that not to do so might constitute abandonment. Along with recommending a clinical consultation during such a phone call, the office may also ask whether the psychologist is the best person to work with this particular client. It is interesting that this question can be met with a sense of relief, as if simply posing the question gives the psychologist permission to consider referring the client to another clinician who may be better suited to conduct the treatment.

Some psychologists are excellent in working with psychotic patients. Others are exceptional in working with clients who struggle with axis-II disorders. Coming to know which clients one works best with has important ethical implications because all of us are better suited to benefit certain clients than others. Training programs provide excellent opportunities to begin exploring this facet of our professional lives, especially so when the issue is framed as an ethical component of professional development.

Attending to affects

Using affects as cues to ethical dilemmas can likewise be a productive topic of discussion for psychologists in training. It is interesting and instructive to listen when trainees frame issues as ethical dilemmas. Sometimes their language is oriented largely toward cognitions, duties and rights, for example, "I thought I needed to break confidentiality when this patient threatened to hurt his roommate," or "I wasn't sure whether I needed to make a mandatory report after meeting with the family," or "It's the patient's right to do what she pleases, regardless of what I may think."

Very often, though, the cue to an ethical dilemma is a feeling rather than a thought. Phrases such as, "It didn't feel right for me to," "I wasn't comfortable with," "I became anxious when," "I started to worry that" can all be signals that the trainee is encountering an ethical dilemma that has not yet been fully formed in words. Put more colloquially, the pit of one's stomach can be as good an indicator of an ethical dilemma as can be one's frontal lobes.

A valuable part of ethics education can be training in how to recognize and put into words affects that are cuing ethical dilemmas. Practice will make one better at this skill and can foster a sense of the benefits of consultation, as described in the Preamble to the Ethics Code:

The development of a dynamic set of ethical standards for psychologists' work-related conduct requires a personal commitment and lifelong effort to act ethically; to encourage ethical behavior by students, supervisees, employees, and colleagues; and to consult with others concerning ethical problems.

Before resolving an ethical dilemma, a psychologist must first identify the dilemma. Learning that affects serve as cues that can be explored to identify and understand a dilemma more deeply can be a valuable part of development as an ethical psychologist.

Awareness of our values

The language we use may enforce values of the dominant culture in ways that are sometimes outside our awareness. Recently I had the privilege of speaking to graduate students in psychology at Gallaudet University, considered the world's premier university for deaf and hard-of-hearing students. During the course of my talk I made reference to the "hearing-impaired community," a comment that drew a visible reaction. After a moment of glances shot back and forth across the seminar room, one of the students told me in a respectful yet direct manner that "hearing impaired" was not an appropriate term because it implied deficit, and members of the community do not think of themselves in terms of deficit.

The comment humbled me and made me feel that I'd not done my homework, feelings I don't particularly enjoy. At the same time, I felt honored that the students had brought me into their world and shared a piece of their experience with me. The exchange highlighted how the life of a psychologist involves engaging with others about things that matter to people and that sometimes we are awkward and we stumble. Reflecting on the exchange also impressed upon me how easily our own worldviews become part of our work in a way that can make others feel diminished.

Personal and professional

Asking which personal characteristics contribute to being an ethical psychologist follows from appreciating how the person of the psychologist can be an essential part of our professional work. Distinguishing clearly between the private and the professional life of a psychologist is complex for several reasons. More of our private lives is available for public view than ever before, due in large part to technology that is seemingly ever-present. With technology having significantly diminished the realm of our privacy, personal events more readily make themselves felt in our professional lives. Also, as we interact with clients in deeply meaningful ways, the personal may evolve into the professional as more of our personal psychology becomes involved in the professional relationship.

An area ripe for ethical analysis is the relationship between the private and the professional. Examining this relationship will involve exploring an array of issues such as what kinds of personal information, when disclosed, serve to help or hinder a treatment; what personal characteristics of the psychologist facilitate or inhibit a healing relationship; and whether and in what manner the psychologist's personal morality-virtues and vices, in a manner of speaking-enhance or undermine the ethical practice of psychology. "What kind of person makes an excellent psychologist?", when accepted as a legitimate question for serious consideration, invites us to explore the role of our personal psychology, morality and behavior in our professional lives.

Becoming an ethical psychologist is a process that happens over the span of one's professional life. A thorough working knowledge of the Ethics Code is essential as we encounter and seek to resolve the ethical dilemmas that signal the nuance, complexity and value of what psychologists do. Also central to becoming an ethical psychologist will be contemplating questions that speak to our professional strengths and weaknesses, our awareness of how the values we hold manifest themselves in our work, and how we view the relationship between our professional and our personal lives.

Stephen Behnke is director of APA's Ethics Office.