Welcome to the Nexus of Ethics, Psychology, Morality, Philosophy and Health Care

Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy

Tuesday, April 16, 2013

Why Should We Behave Ethically?

Stephen A. Ragusea, PsyD, ABPP

Guest Blog

Every psychologist must read and know the basic tenets of the American Psychological Association’s Code of Ethics in order to get through graduate school and obtain a license to practice psychology.  We’ve all read it.  We’ve all learned it.  We’ve all tried to apply it.  How many of us have asked the question, “Why bother?”  Obviously, the entire concept of ethical behavior is rooted in our system of morality and, although the word “should” often has a negative connotation in our psychotherapeutic lexicon, any ethics code is all about what we should and should not do.  Codes attempt to answer the question, “What’s the right thing to do in this situation?”

It’s interesting to me that nowhere in the current Ethics Code is this question directly addressed.  The issue is addressed only obliquely.  The Preamble states,

“Psychologists are committed to increasing scientific and professional knowledge of behavior and people’s understanding of themselves and others and to the use of such knowledge to improve the condition of individuals, organizations, and society.  Psychologists respect and protect civil and human rights and the central importance of freedom of inquiry and expression in research, teaching, and publication.  They strive to help the public in developing informed judgments and choices concerning human behavior.  In doing so, they perform many roles, such as researcher, educator, diagnostician, therapist, supervisor, consultant, administrator, social interventionist, and expert witness.  This Ethics Code provides a common set of principles and standards upon which psychologists build their professional and scientific work.”

It seems to me, what the preamble does is one thing.  It advises us that this code of shoulds and should nots is intended to guide our behavior to facilitate our work as psychologists.  Essentially, the Ethics Code advises us that we’ll do a better job of being psychologists if we follow the principles articulated there in.  It helps us do our work.

What is our work?  The jobs that psychologists do could fill a book, in fact, they fill many books.  But for most of the membership of this state psychological association, our work consists largely of psychological assessment and psychotherapy.  It’s important work. 

This Christmas, I was reminded of the importance of the work we do via a Christmas card I received from one of my former patients.   Here’s the story.   Almost three decades ago, I was asked to evaluate a family because one of the parents had been found guilty of abusing a child.  In response to a child’s episode of enuresis, the parent placed the child in a bathtub full of ice cubes and cold water for half an hour.  The community’s response was to place all three children in foster care.  When I was asked to evaluate the family, I administered a variety of psychological tests to the entire family.

Through the assessment process, I uncovered important information as I worked with this very poor, rural family. The parents had graduated from high school as Special Education students, with Wechsler IQs near the bottom of the borderline range.  But they also had near perfect handwriting and spelling on the Rotter and WRAT and that told me they were capable of learning.  The father worked as a laborer and the mother, while somewhat disabled, worked as a homemaker caring for her family.  While talking with the parents during interviews, I found them to be loving, devoted people.  I learned that they had treated the enuresis problem using the same disciplinary technique used on them when they were children.  In their minds, they weren’t being abusive; they were being good parents.  I established a good relationship with them during the evaluation and ultimately worked with them in family therapy, which largely consisted of psycho-education – I had them read Dr. Spock’s Baby and Child Care and then we discussed it, section by section.  We worked hard.  These two parents eventually got their kids back and raised them as well as they could given the limits of their intellect, education, and finances.  What would you expect to be the outcome?  Here’s what was in their annual Christmas card to me this year.  Obviously, the information has been disguised to protect identities.  However, the original punctuation is maintained.

“Our son, Tim, is in Columbus going through college at Ohio State, business engineering, our daughter Martha is going through college at Indiana University in Indiana, criminal justice she wants to be a detective and she also works at the grocery store.  Our youngest moved to Erie, PA, in July she works at a Walgreen pharmacy.  John and I are just fine.  Hope all is fine and well where you are.  Take care….”
  
We all have cases like this in our files, don't we?  We do very important work out there and sometimes we forget that reality.

There were a number of significant ethical issues in this case.  For example, all the potential dangers regarding multiple relationships needed to be navigated.  Clarifying the identity of my client or clients at various points was a challenge.  I didn’t always adhere to the letter of the then current Ethics Code,  but I certainly tried to adhere to the spirit of the document.  It helped me to do what I think was good work.  I think our system of ethics helps us all to do good work.  And, I think that’s why we have an Ethics Code and why we should behave ethically.   Maybe you’ve got a better reason, but that’s the best answer I can come up with.  It helps us do good work. And that’s why we’re here, isn’t it? 

References

American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American Psychologist,Vol. 57, 1060-1073. 

If you have specific suggestions for topics to be covered in The Ethics Corner, please e-mail me with your suggestions.  My e-mail address is ragusea@aol.com.