Ethics Rounds

Of the many privileges that come with directing the APA Ethics Office, the ones I enjoy most are having the opportunity to speak with psychologists across the country about the ethical challenges that arise in their work and discussing how they meet those challenges. Only since coming to APA have I appreciated the breadth of what psychologists do--our profession touches upon every aspect of human and animal behavior and experience--and every area of psychology has its unique ethical dilemmas. Each day in the Ethics Office is an education.

I felt especially fortunate when recently I had lunch with Dr. James Hansell, a psychologist who teaches at the University of Michigan and practices as a clinical psychologist and psychoanalyst in Ann Arbor. Dr. Hansell has written an undergraduate textbook with Dr. Lisa Damour, a practicing clinical psychologist in Cleveland who teaches abnormal psychology at John Carroll University. As I sat down to lunch with Dr. Hansell, I asked him to share with me how his textbook was faring. With some pride, he told me that the initial reception has been promising, but then I noticed a hesitation in his voice. At this point I should tell my readers that I've known Dr. Hansell for a number of years and so felt comfortable pressing him to share what was on his mind. The result was one of those conversations that is delightful precisely because it takes a thoroughly unanticipated turn.

Dr. Hansell remarked that when it came time to write his course syllabus, the thought of assigning his own textbook as required reading made him uncomfortable, given that he receives royalties for each book sold. I assured him that assigning one's own text had never been viewed as problematic under the APA Ethics Code and that often people use their own textbooks for perfectly legitimate reasons. It would be somewhat ironic, I noted, to spend years writing a textbook that surpasses others in the field or that makes a unique contribution to how an area of psychology is taught, only to be left unable to use the book with one's own students. While Dr. Hansell had considered this same reasoning when his book was published, a feeling of ethical unease nonetheless remained with him. Dr. Hansell came to use this feeling in a very interesting and creative way.

Reflecting on his lingering experience of unease indicated to him that work remained to be done in thinking the issue through, and he began by pushing himself to understand more deeply what he was feeling. Dr. Hansell saw a tension between his ethical responsibilities as a teacher, which required that he use materials he judged best for his students' educational experience, and his own self-interest, which had the potential to lead him astray in making that important assessment. Dr. Hansell reasoned that he could remove the self-interest aspect of the tension with relative ease; he would donate royalties when his was the required course textbook. But he also wondered whether over and above relieving the tension, he could actually use his ethical unease for his students' benefit.

Dr. Hansell decided to bring the issue directly into the classroom in the following way. At the beginning of each semester, he tells his students that he is requiring his book because he believes it will best facilitate the educational experience he hopes to provide. He emphasizes the importance of ethics to psychologists and acknowledges that the choice of his own text as required reading could be perceived as a conflict of interest:



Psychologists refrain from taking on a professional role when personal, scientific, professional, legal, financial, or other interests or relationships could reasonably be expected to (1) impair their objectivity, competence, or effectiveness in performing their functions as psychologists or (2) expose the person or organization with whom the professional relationship exists to harm or exploitation.

He explains that in order to remove the specter of such a conflict from the course, royalties from the book that are generated by the class will go to charity.

Dr. Hansell then tells the students that throughout the term they should identify charities that are related to the course subject matter (abnormal psychology). He keeps a list of charities suggested by the students, and at the end of the semester the class has a discussion concerning the various possibilities. Dr. Hansell also uses the discussion as an opportunity for the students to reflect on social and economic issues related to mental health and mental illness. Following its discussion, the class votes on the charities to which the royalties will be donated. The first class using Dr. Hansell's book voted for four charities in equal measure (several hundred dollars each): an Alzheimer's association, a local low-fee mental health clinic, a child and family services agency, and a tsunami relief agency for post-traumatic stress disorder work. (Dr. Damour agreed with her students that her royalties would be donated to tsunami relief.)

Dr. Hansell discovered an elegant and creative way to use his ethical unease in the service of his professional work. He recognized his ethical unease for what it was (a necessary first step), brought it to his students' attention in a manner that emphasized the centrality of ethics in the profession of psychology, and finally employed it as a stimulus to enhance his students' educational experience and make a contribution to mental health services. What makes Dr. Hansell's response elegant is that rather than recoiling from or trying to avoid his ethical unease, he embraced it in a generative way.

All of us have moments of ethical unease, which is a sign that we are struggling with an ethical challenge. Recognizing such moments for what they are can help us use our discomfort in constructive and creative ways. The study of ethics is both complicated and interesting because we will likely experience ethical unease at different moments than our colleagues. As an example, many highly ethical academics use their own textbooks as required reading in the classroom and retain the royalties; these psychologists almost certainly experience other, different moments of ethical unease. Often important is not so much the circumstances under which the experience of ethical discomfort arises, but rather how we use the experience.

Ethics is associated with enforcement and sanctions, and these are important aspects of our work. But ethics is much broader and involves the challenges that each of us encounters in our daily professional lives. Psychologists meet those challenges through a vast array of highly creative and interesting responses that span the breadth of our profession, which is why I feel privileged each morning I arrive at work and the phone rings.

The author thanks Drs. Hansell and Damour for allowing their names to be used in this "Ethics Rounds" column.

Further Reading

Send questions, comments or suggestions regarding "Ethics Rounds"--or submit vignettes (without identifying information) for column discussion-- via e-mail.