Ethics Rounds

To ask what it means to be an ethical person is different from asking what it means to be an ethical psychologist. While "knowing right from wrong," "doing the right thing" and "acting morally" are ways we might answer the first question, none of these responses is adequate to answer the second. All miss an essential element: our role as psychologists.

Each profession has its own code of ethics. The reason stems from the role: Psychologists' relationship to the individuals and groups we serve is different from the relationship lawyers, accountants and even professionals closely related to us, such as physicians, have to their clients. Because role is central in determining the ethics of a profession, different professions have distinct codes of ethics, and being an ethical professional differs from being an ethical person.

The idea that being an ethical person is not the same as being an ethical psychologist strikes many trainees as counterintuitive, yet underscores the importance of education and training in the ethics of our profession. Individuals come to graduate school with considerable experience in relationships, yet must receive training before entering into a relationship with a client or research subject. Training in the ethics of our profession is essential even for the most ethical applicant to a psychology program.

Good training in ethics examines both the rules that govern our ethical behavior and the process by which we apply those rules in our professional lives. The link between our training and experience as psychologists and our decision-making process in ethics deserves special attention and re- emphasizes that a psychologist's ethical behavior stands apart from ethical behavior as a member of any other profession or as a private individual. Good ethics training in psychology teaches how to use our professional skills and knowledge to help us answer our ethics questions.

Think of the general principles in our Ethics Code as at a high level of abstraction, perhaps in the stars; the ethical standards at a lower level of abstraction, perhaps in the clouds; and we in our practices on the ground. Because the ethical standards are at a higher level of abstraction than where we practice on ground level, there is a gap--the gap between the clouds and the earth (with certain exceptions, such as the absolute prohibition against becoming sexually involved with clients). How do we close this gap? By applying the Ethics Code to the concrete situation. Where do we obtain the skills to apply the Ethics Code correctly? From our background, training and experience as psychologists. We draw upon what has made us psychologists to bring our Ethics Code down to earth.

Four standards from the Ethical Principles of Psychologists and Code of Conduct--our Ethics Code--illustrate the relationship between psychological training and psychological ethics as applied in our practices:

2.01 BOUNDARIES OF COMPETENCE

(b) Where scientific or professional knowledge in the discipline of psychology establishes that an understanding of factors associated with age, gender, gender identity, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, or socioeconomic status is essential for effective implementation of their services or research, psychologists have or obtain the training, experience, consultation, or supervision necessary to ensure the competence of their services, or they make appropriate referrals, except as provided in Standard 2.02, Providing Services in Emergencies.

By stating "Where scientific or professional knowledge in the discipline of psychology establishes that an understanding...is essential for effective implementation...," Standard 2.01(b) firmly grounds itself in the profession of psychology. To apply this standard, psychologists become familiar with scientific and professional knowledge about how these factors affect their work; an excellent place to start is APA's Guidelines for Psychological Practice with Older Adults (2003); Guidelines on Multicultural Education, Training, Research, Practice and Organizational Change for Psychologists (2002); and Guidelines for Psychotherapy with Lesbian, Gay and Bisexual Clients (2000). Note the Ethics Code does not direct psychologists how to act in a particular situation. Rather, the Ethics Code says that when providing professional services, psychologists inform themselves about scientific and professional knowledge to ensure the competence of their services.

3.07 THIRD-PARTY REQUESTS FOR SERVICES

When psychologists agree to provide services to a person or entity at the request of a third party, psychologists attempt to clarify at the outset of the service the nature of the relationship with all individuals or organizations involved. This clarification includes the role of the psychologist (e.g., therapist, consultant, diagnostician or expert witness), an identification of who is the client, the probable uses of the services provided or the information obtained, and the fact that there may be limits to confidentiality...

Standard 3.07 is particularly interesting in its relationship to psychological training. Many psychologists work at the request of third parties, for example in school, employment and legal settings. Good training impresses upon psychologists the value of identifying the client at the beginning of the relationship and of conveying who will have access to what information. While arrangements in third-party requests for services is complicated, unnecessary ambiguity on these points can severely compromise a psychologist's effectiveness. Standard 3.07 draws directly upon what we have learned as a profession about providing services to one person at the request of another. Psychologists apply their technical knowledge of how these relationships work so that, abiding by Standard 3.07, they minimize the likelihood of harm.

9.08 OBSOLETE TESTS AND OUTDATED TEST RESULTS

(a) Psychologists do not base their assessment or intervention decisions or recommendations on data or test results that are outdated for the current purpose.

(b) Psychologists do not base such decisions or recommendations on tests and measures that are obsolete and not useful for the current purpose.

Standard 9.08 provides an excellent illustration of how we use our background, training and experience in psychology to close the gap between an ethical standard and what happens in a psychologist's office or lab. Both clauses in Standard 9.08 use as a determining criterion usefulness for a particular purpose. While this standard is sometimes mistakenly interpreted to mean that anything other than a test's current edition is obsolete--a rigid interpretation that leaves no room for professional judgment--the standard actually directs psychologists to determine what is most appropriate for a given purpose. To make this determination, psychologists use their knowledge of a test's application--knowledge from their training and experience as psychologists--to bring Standard 9.08 to the ground level and decide which test or version of a particular test to use.

10.04 PROVIDING THERAPY TO THOSE SERVED BY OTHERS

In deciding whether to offer or provide services to those already receiving mental health services elsewhere, psychologists carefully consider the treatment issues and the potential client's/patient's welfare. Psychologists discuss these issues with the client/patient or another legally authorized person on behalf of the client/patient in order to minimize the risk of confusion and conflict, consult with the other service providers when appropriate, and proceed with caution and sensitivity to the therapeutic issues.

Standard 10.04, as much as any standard in the Ethics Code, calls upon a psychologist's clinical training and experience in its application. Knowledge of psychology brings this ethical standard from a higher level of abstraction to the ground; good clinical thinking is the means by which Standard 10.04 is applied to an actual circumstance.

Psychological ethics is different from any other kind of ethics. As we encounter ethical challenges and ethical dilemmas in our professional lives, we should remain mindful that we do so as psychologists, and that, as its Preamble indicates, our Ethics Code is designed for "the welfare and protection of the individuals and groups with whom psychologists work and the education of members, students and the public regarding ethical standards of the discipline" [emphases added]. These simple statements have profound implications for our ethics training and how we apply our Ethics Code. They should also be the source of considerable pride.

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