Ethics Rounds

APA's Annual Convention presents a wonderful opportunity to see the wide range of activities in which psychologists engage. The breadth of our profession--which spans all aspects of human and nonhuman animal experience--is staggering. Nowhere is this feature of psychology more evident than at convention, where 15,000 psychologists gathered this past August in San Francisco.

As Ethics Office director, I was impressed and delighted to see the vibrant interest in ethics at convention. Nearly 40 sessions listed "ethics" as a topic area. Programs put on by APA's Ethics Committee were attended by hundreds of members. A frequent topic of discussion during ethics presentations was next year's convention, in Boston; the planning had already begun for future ethics programs.

"Ethics and Interrogations, Confronting the Challenge"offered a set of programs addressing an issue that has challenged APA as an association, that of psychologists' involvement in military interrogations. "Ethics and Interrogations" was the culmination of a yearlong planning effort that started with an informal dinner conversation at the fall 2006 consolidated meetings. As a result of this discussion, the Board of Directors funded a planning group to meet in Washington and organize a convention program that would bring together experts from within and outside APA to explore the role of psychologists in interrogations from clinical, legal, ethical and human rights perspectives.

The board emphasized the importance of having all points of view well represented on the program. From the board's point of view, the program offered a unique opportunity to provide the membership with experts who could present and debate differing perspectives. The planning group responded by organizing nine, two-hour sessions with 44 participants. The success of "Ethics and Interrogations" was apparent at the very first session, when several hundred psychologists heard an informed and vigorous discussion on the question "What are psychologists doing at U.S. military detention centers?" Other session topics included "What does the research on interrogations tell us?," "What is the evolution of APA policy on ethics and interrogation?," "How do human rights and laws apply to detention centers?," "What are the impacts of ethnicity, language, and identity on interrogations?," "What are the effects of psychological torture and abuse?," "What ethical dilemmas do psychologists working in detention centers face?," and "What challenges and complexities does providing treatment to detainees entail?"

A town hall meeting provided a forum for members to voice their deeply held views on the appropriate position for APA to adopt. A fair characterization of the town hall meeting was that APA received stinging criticism from those who spoke, which APA's president, president-elect and one other member of the Board of Directors were present to hear. The town hall meeting was in keeping with the board's focus on ensuring that all perspectives were welcomed and clearly heard by APA's leadership.

"Ethics and Interrogations" provided a context for the Council of Representatives to elaborate on the appropriate role of psychologists in military interrogations through adoption of a resolution. The program was thus another step in APA's continuing examination of this issue. The initial step in this process was the 2005 Report of the Task Force on Psychological Ethics and National Security (PENS), which stated, "Psychologists do not engage in, direct, support, facilitate, or offer training in torture or other cruel, inhuman, or degrading treatment." The following year, the council adopted the "2006 Resolution Against Torture and Other Cruel, Inhuman, and Degrading Treatment or Punishment," which stated, among many other things:

BE IT RESOLVED that based upon the APA's longstanding commitment to basic human rights including its position against torture, psychologists shall work in accordance with international human rights instruments relevant to their roles.

In San Francisco, the council adopted the "Reaffirmation of the American Psychological Association; Position Against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment and Its Application to Individuals Defined in the United States Code as 'Enemy Combatants,'" which elaborated upon previous APA work on this issue by providing an extensive list of specific techniques, such as "waterboarding," that constitute torture, and by stating:

BE IT RESOLVED that the American Psychological Association affirms that there are no exceptional circumstances whatsoever, whether induced by a state of war or threat of war, internal political instability or any other public emergency, that may be invoked as a justification for torture or cruel, inhuman, or degrading treatment or punishment, including the invocation of laws, regulations, or orders.

In an article that appeared the Monday of convention, the Washington Post described the San Francisco resolution as "a rebuke of the Bush administration's antiterrorism policies." The PENS report, the 2006 and 2007 resolutions, and "Ethics and Interrogations, Confronting the Challenge" are all central to the evolution of APA's position.

In addition to convention programming on interrogations, the Ethics Committee was involved in several other programs. A recent focus of Ethics Committee work is how emergencies and disasters affect psychologists, who are expected to meet the needs of others in such times of crisis. The committee has been developing a relationship with the Advisory Committee on Colleague Assistance (ACCA), and each committee offered a convention program on this issue. The Ethics Committee's program was titled "Katrina's aftermath--Mississippi and Louisiana psychologists share personal and professional experiences"; ACCA's program was "Help for the helper--meeting the needs of psychologists impacted by disasters." A focus of these programs, as well as of the yearly Ethics Office invitational meeting, was identifying resources available to psychologists when disasters strike.

Each year the Ethics Committee collaborates with the Committee on Legal Issues to explore the legal and ethical aspects of some area of psychologists'' work. This year the joint program was titled "Ethical and legal considerations when responding to suicidal college students." The format called for members of each committee to comment on three vignettes from a college setting that involved a faculty member, a psychologist or an administrator dealing with concerns over a potentially suicidal student.

The final Ethics Committee yearly program involves committee commentary on a series of ethical vignettes. This year the committee addressed six issues, one of which involved a challenging marital treatment:

Approximately one year ago I began to see a woman in an individual psychotherapy who describes her marriage as very difficult. She and her husband have two latency-age children. While she denies any physical abuse, she does report a husband who is extremely narcissistic and who can be emotionally abusive. After having given the matter a good deal of thought, I decided that it would be helpful to have the husband in for a limited number of sessions, perhaps two or three, as an adjunct to our work. I also found myself curious as to how consistent my impression of him would be with my client's description. My client agreed, and I had the husband in for three sessions; two joint sessions with his wife and one individual session. Three weeks after these sessions the husband contacted me and wanted to see me for additional sessions and possibly a treatment of his own. I explained that I did not believe that additional sessions would be helpful, or that I was the best person for him to see on an individual basis. He now claims that he is my client and insists on seeing me. He says that for me not to see him would be abandonment. He is demanding to see my treatment records.

Other vignettes involved a colleague with a substance abuse problem, identifying information placed on a listserv request for consultation, an issue of authorship, confidentiality in the treatment of an adolescent and a supervisee with religious beliefs that were potentially interfering with her work.

Ethics took center stage at the convention. The program on interrogations underscored how ethics is a developmental process; our ethics grow and evolve. Convention is an excellent opportunity to explore where our ethics are and whence we've come, and to get a hint of where we are going.

Further Reading

Send questions, comments or suggestions regarding "Ethics Rounds"--or submit vignettes (without identifying information) for column discussion--to Ethics Rounds. "Ethics Rounds" welcomes your involvement and will confer with authors before publishing letters to discuss any confidentiality concerns. Previous "Ethics Rounds" columns can be found at APA's Ethics, in the "From the Director" section.