The American Psychological Association and torture: How could it happen?

Bryan Welch
International Journal of Applied Psychoanalytic Studies
Volume 14 (2)

Here is an excerpt:

This same grandiosity was ubiquitous in the governance's rhetoric at the heart of the association's discussions on torture. Banning psychologists' participation in reputed torture mills was clearly unnecessary, proponents of the APA policy argued. To do so would be an “insult” to military psychologists everywhere. No psychologist would ever engage in torture. Insisting on a change in APA policy reflected a mean-spirited attitude toward the military psychologists. The supporters of the APA policy managed to transform the military into the victims in the interrogation issue.

In the end, however, it was psychologists' self-assumed importance that carried the day on the torture issue. Psychologists' participation in these detention centers, it was asserted, was an antidote to torture, since psychologists' very presence could protect the potential torture victims (presumably from Rumsfeld and Cheney, no less!). The debates on the APA Council floor, year after year, concluded with the general consensus that, indeed, psychology was very, very important to our nation's security. In fact the APA Ethics Director repeatedly advised members of the APA governance that psychologists' presence was necessary to make sure the interrogations were “safe, legal, ethical, and effective.”

We psychologists were both too good and too important to join our professional colleagues in other professions who were taking an absolutist moral position against one of the most shameful eras in our country's history. While the matter was clearly orchestrated by others, it was this self-reinforcing grandiosity that led the traditionally liberal APA governance down the slippery slope to the Bush administration's torture program.

During this period I had numerous personal communications with members of the APA governance structure in an attempt to dissuade them from ignoring the rank-and-file psychologists who abhorred the APA's position. I have been involved in many policy disagreements over the course of my career, but the smugness and illogic that characterized the response to these efforts were astonishing and went far beyond normal, even heated, give and take. Most dramatically, the intelligence that I have always found to characterize the profession of psychology was sorely lacking.

The article is here.

The Bush Torture Scandal Isn’t Over

Daniel Engber
Slate.com
Originally published September 5, 2017

In June, a little-known academic journal called Teaching of Psychology published an article about the American Psychological Association’s role in the U.S. government’s war on terror and the interrogation of military detainees. Mitchell Handelsman’s seven-page paper, called “A Teachable Ethics Scandal,” suggested that the seemingly cozy relationship between APA officials and the Department of Defense might be used to illustrate numerous psychological concepts for students including obedience, groupthink, terror management theory, group influence, and motivation.

By mid-July, Teaching of Psychology had taken steps to retract the paper. The thinking that went into that decision reveals a disturbing under-covered coda to a scandal that, for a time, was front-page news. In July 2015, then–APA President Nadine Kaslow apologized for the organization’s involvement in Bush-era enhanced interrogations. “This bleak chapter in our history,” she said, speaking for a group with more than 100,000 members and a nine-figure budget, “occurred over a period of years and will not be resolved in a matter of months.” Two years later, the APA’s attempt to turn the page has devolved into a vicious internecine battle in which former association presidents have taken aim at one another. At issue is the question of who (if anyone) should be blamed for giving the Bush administration what’s been called a “green light” to torture detainees—and when the APA will ever truly get past this scandal.

The article is here.

Israeli education minister's ethics code would bar professors from expressing political opinions

Yarden Skop
Haaretz
Originally posted June 10, 2017

An ethics code devised at Education Minister Naftali Bennett's behest would bar professors from expressing political opinions, it emerged Friday.

The code, put together by Asa Kasher, an ethics and philosophy professor at Tel Aviv University, would also forbid staff from calling for an academic boycott of Israel.

Bennett had asked Kasher a few months ago to write a set of rules for appropriate political conduct at academic institutions. Kasher had written the Israel Defense Forces' ethics code.
The contents of the document, which were first reported by the Yedioth Ahronoth newspaper on Friday, will soon be submitted for the approval of the Council for Higher Education.

The article is here.

Judge Allows Lawsuit Against Psychologists in C.I.A. Torture Case

Sheri Fink
The New York Times
Originally published January 29, 2017

A federal judge on Friday allowed a case brought by former detainees to move forward against two American psychologists who helped devise the C.I.A.’s now-defunct program to interrogate terrorism suspects using techniques widely considered to be torture.

A United States District Court judge, Justin L. Quackenbush, denied a motion by the psychologists that sought to dismiss the case for lack of jurisdiction under provisions of a 2006 law that limits the ability of detainees to challenge their treatment.

“This ruling sends the strong signal that anyone who participates in shameful and unlawful government torture can’t count on escaping accountability in a court of law,” said Dror Ladin, a staff attorney for the American Civil Liberties Union, which, with the Gibbons law firm in Newark, represents the former detainees.

The article is here.

Senator Johnson wants to re-think Tennessee's counselor ethics

by Emily West
Nolensville Home Page
Originally posted December 6, 2016

Here is an excerpt:

“I don’t think it’s appropriate that we delegate that responsibility to a special interest group from Washington,” Johnson said. “There are other organizations that represent them. I think it’s worth having our own conversation … Tennesseans are best suited to determine what our state licensure requirements for our professional counselors should be rather than subrogating that right to a private organization.

“I believe our State Board of Professional Counselors is capable of this responsibility and that all Tennesseans seeking counseling will benefit as a result.”

Having the conversation could come come at a price, at least from the American Counseling Association’s perspective.

Right now, the ACA sees the potential for this type of legislation to become dangerous.

“I think what you do is run the risk of a couple of things,” ACA’s‎ Director of Government Affairs Art Terrazas said. “The insurance companies – who underwrite the liability – are going to take a second look if they want to insure the counselor outside of the code of ethics. There could be an impact if they stay or remained employed in the state of Tennessee.

“If they are meeting the industry standard, they may not want to practice there. Those who need to seek mental health clinicians could find there will be less of them. We are talking about folks suffering from depression, to those under 18, military families and also our veterans.”

The article is here.

Evidence-Based Practice and Psychological Treatments: The Imperatives of Informed Consent.

Charlotte R. Blease, Scott O. Lilienfeld and John M. Kelley
Front. Psychol., 10 August 2016

Here is an excerpt:

Professional competence—the ability to accurately assess problems, diagnose psychological disorders, recommend an appropriate course of treatment, and successfully carry out that treatment—varies depending on the degree to which the clinician keeps up to date with the latest research and effectively evaluates the evidence. The APA requires that clinicians be trained in EBP to be equipped to appraise the range of evidence regarding the efficacy of different forms of psychotherapy, to recognize the strengths and limitations of clinical intuition, and to understand the importance of patient preferences and values, as well as the relevance of the socio-cultural context in treating clients. In this way, the APA acknowledges that EBP requires knowledge of controlled clinical trials, but also underlines that trial data have inherent limitations. For example, such trials can be unrepresentative of individual patients given that they can be largely insensitive to such factors as age of patient, and comorbidity [American Psychological Association (APA), 2006; cf. Greenhalgh et al., 2014; Sheridan and Julian, 2016]. The APA also emphasizes the importance of keeping up to date with the latest process—and not merely outcome—data on how psychotherapies work [American Psychological Association (APA), 2006].

The duty to be professionally competent carries significant additional implications for the duty to respect patient autonomy. Historically, paternalism was the largely unquestioned bedrock of healthcare practice. Paternalism is defined as “the interference of a state or an individual by another person, against their will, and defended or motivated by the claim that the person interfered with will be better off or protected from harm” (Dworkin, 2010); it was defended on the grounds that doctors were the gatekeepers of medical knowledge, as well as the best judges of how to use that knowledge to serve the interests of patients. Today, healthcare ethics codes (in the West) eschew paternalism: professional clinicians are now obliged to be truthful and to provide adequate disclosure to patients about their diagnosis, the risks and benefits of various treatment options, and their duration and costs (Trachsel et al., 2015; Blease et al., 2016; Trachsel and Gaab, 2016). However, the quality of disclosures to patients depends on practitioner knowledge, illustrating once again why standards of evidence are enmeshed with ethics.

The article is here.

Professing the Values of Medicine The Modernized AMA Code of Medical Ethics

Brotherton S, Kao A, Crigger BJ.
JAMA. Published online July 14, 2016.
doi:10.1001/jama.2016.9752

The word profession is derived from the Latin word that means “to declare openly.” On June 13, 2016, the first comprehensive update of the AMA Code of Medical Ethics in more than 50 years was adopted at the annual meeting of the American Medical Association (AMA). By so doing, physician delegates attending the meeting, who represent every state and nearly every specialty, publicly professed to uphold the values that are the underpinning of the ethical practice of medicine in service to patients and the public.

The AMA Code was created in 1847 as a national code of ethics for physicians, the first of its kind for any profession anywhere in the world.1 Since its inception, the AMA Code has been a living document that has evolved and expanded as medicine and its social environment have changed. By the time the AMA Council on Ethical and Judicial Affairs embarked on a systematic review of the AMA Code in 2008, it had come to encompass 220 separate opinions or ethics guidance for physicians on topics ranging from abortion to xenotransplantation. The AMA Code, over the years, became more fragmented and unwieldy. Opinions on individual topics were difficult to find; lacked a common narrative structure, which meant the underlying value motivating the guidance was not readily apparent; and were not always consistent in the guidance they offered or language they used.

The article is here.

Do No Harm: The American Psychological Association wavers on its detainee policy

Susan Greene
The Colorado Independent
Originally published August 04, 2016

The American Psychological Association is wavering on a year-old policy designed to prevent psychologists from working with military or national security detainees.

Meeting in Denver for its annual convention, the nation’s largest professional association of psychologists this week considered and then postponed a decision on whether to allow members of the profession back to work at Guantanamo Bay, other military detention centers and CIA sites.
After a vote planned for Wednesday and then today, the group’s 173-member governing council tabled the discussion until February.

The debate stems from psychologists’ controversial role assisting the U.S. military and intelligence agencies in so-called “enhanced interrogation” efforts during George W. Bush’s administration. The post-9/11 program tried to squeeze information out of terror suspects detained at Abu Ghraib prison in Iraq, Guantánamo in Cuba and other sites by waterboarding, isolation and sleep deprivation – methods that international law deems to be torture. Bush’s justice officials were able to legally justify the interrogations on grounds that doctors’ mere presence assured that the tactics were safe.

The updated article is here.

Ethical Considerations Prompt New Telemedicine Rules

American Medical Association
Press Release
Originally released June 13, 2016

With the increasing use of telemedicine and telehealth technologies, delegates at the 2016 AMA Annual Meeting adopted new policy that outlines ethical ground rules for physicians using these technologies to treat patients.

The guidelines

The policy, based on a report from the AMA Council on Ethical and Judicial Affairs, notes that while physicians’ fundamental ethical responsibilities don’t change when providing telemedicine, new technology has given rise to the need for further guidance.

“Telehealth and telemedicine are another stage in the ongoing evolution of new models for the delivery of care and patient-physician interactions,” AMA Board Member Jack Resneck, MD, said in a news release. “The new AMA ethical guidance notes that while new technologies and new models of care will continue to emerge, physicians’ fundamental ethical responsibilities do not change.”

The pressor is here.

The job of ‘ethics committees’ should be ethically informed code consistency review

Søren Holm
J Med Ethics doi:10.1136/medethics-2015-103343

Moore and Donnelly argue in the paper ‘The job of “ethics committees”’ that research ethics committees should be renamed and that their job should be specified as “review of proposals for consistency with the duly established and applicable code” only.  They raise a large number of issues, but in this comment I briefly want to suggest that two of their arguments are fundamentally flawed.

The first flawed argument is the argument related to the separation of powers. Moore and Donnelly proceed from the premise that it is pro tanto better to have an institutional arrangement that separates code-making powers and decisional powers, and then proceed to argue that this separation is not feasible for what they call ‘ethics consistency review’ because “no matter who established any prespecified review standards, the review decision maker must be empowered at review to revise those standards when this would make for an ethical improvement.

The response article is here.

The job of ‘ethics committees’

Andrew Moore and Andrew Donnelly
J Med Ethics doi:10.1136/medethics-2015-102688

Abstract

What should authorities establish as the job of ethics committees and review boards? Two answers are: (1) review of proposals for consistency with the duly established and applicable code and (2) review of proposals for ethical acceptability. The present paper argues that these two jobs come apart in principle and in practice. On grounds of practicality, publicity and separation of powers, it argues that the relevant authorities do better to establish code-consistency review and not ethics-consistency review. It also rebuts bad code and independence arguments for the opposite view. It then argues that authorities at present variously specify both code-consistency and ethics-consistency jobs, but most are also unclear on this issue. The paper then argues that they should reform the job of review boards and ethics committees, by clearly establishing code-consistency review and disestablishing ethics-consistency review, and through related reform of the basic orientation, focus, name, and expertise profile of these bodies and their actions.

The article is here.

The Ethics of Doing Ethics

Sven Ove Hansson
Sci Eng Ethics
DOI 10.1007/s11948-016-9772-3

Abstract

Ethicists have investigated ethical problems in other disciplines, but there has not been much discussion of the ethics of their own activities. Research in ethics has many ethical problems in common with other areas of research, and it also has problems of its own. The researcher’s integrity is more precarious than in most other disciplines, and therefore even stronger procedural checks are needed to protect it. The promotion of some standpoints in ethical issues may be socially harmful, and even our decisions as to which issues we label as ‘‘ethical’’ may have unintended and potentially harmful social consequences. It can be argued that ethicists have an obligation to make positive contributions to society, but the practical implications of such an obligation are not easily identified. This article provides an overview of ethical issues that arise in research into ethics and in the application of such research. It ends with a list of ten practical proposals for how these issues should be dealt with.

The article is here.

Advancing Medical Professionalism in US Military Detainee Treatment

Leonard S. Rubenstein, Scott A. Allen, Phyllis A. Guze
PLOS One
Published: January 5, 2016
DOI: 10.1371/journal.pmed.1001930

Summary Points

• The United States Department of Defense and Central Intelligence Agency (CIA) promulgated policies and requirements that required health professionals to participate in the mistreatment of counter-terrorism detainees through participation in such practices as abusive interrogation and force-feeding of detainees, in violation of ethical standards established by associations representing the health professions.

• A report of the Defense Health Board to the Secretary of Defense on military medical ethics released in 2015 found that the Department of Defense “does not have an enterprise-wide, formal, integrated infrastructure to systematically build, support, sustain, and promote an evolving ethical culture within the military health care environment.”

• The Board also found that ethical codes promulgated by the health professions, including the duty to avoid harm, provide a sound basis for military medical practice, even taking into account the unique challenges often faced by military health professionals in reconciling the military mission with patient needs.

• The health professional community should urge the Secretary of Defense to adopt and implement the recommendations of the Defense Health Board, rescind directives authorizing participation of health professionals in interrogation and force-feeding because they are inconsistent with professional ethics, and provide ongoing advice and support for the reform process.

The article is here.

Why Ethics Codes Fail

By Laura Stark
Inside Higher Ed
Originally published July 21, 2015

Last week, an independent investigation of the American Psychological Association found that several of its leaders aided the U.S. Department of Defense’s controversial enhanced interrogation program by loosing constraints on military psychologists. It was another bombshell in the ongoing saga of the U.S. war on terror in which psychologists have long served as foot soldiers. Now, it appears, psychologists were among its instigators, too.

Leaders of the APA used the profession’s ethics policy to promote unethical activity, rather than to curb it. How? Between 2000 and 2008, APA leaders changed their ethics policy to match the unethical activities that some psychologists wanted to carry out -- and thus make potential torture appear ethical. “The evidence supports the conclusion that APA officials colluded with DoD officials to, at the least, adopt and maintain APA ethics policies that were not more restrictive than the guidelines that key DoD officials wanted,” the investigation found, “and that were as closely aligned as possible with DoD policies, guidelines, practices or preferences, as articulated to APA by these DoD officials.” Among the main culprits was the APA’s own ethics director.

The entire article is here.

Report to the Special Committee of the Board of Directors of the American Psychlogical Association

David H. Hoffman, Esq.
Danielle J. Carter, Esq.
Cara R. Viglucci Lopez, Esq.
Heather L. Benzmiller, Esq.
Ava X. Guo, Esq.
S. Yasir Latifi, Esq.
Daniel C. Craig, Esq.
SIDLEY AUSTIN LLP

July 2, 2015

EXECUTIVE SUMMARY

I. INTRODUCTION

In November 2014, the Board of Directors of the American Psychological Association engaged our Firm to conduct an independent review of allegations that had been made regarding APA’s issuance of ethical guidelines in 2002 and 2005, and related actions. These ethical guidelines determined whether and under what circumstances psychologists who were APA members could ethically participate in national security interrogations.

The gist of the allegations was that APA made these ethics policy decisions as a substantial result of influence from and close relationships with the U.S. Department of Defense (DoD), the Central Intelligence Agency (CIA), and other government entities, which purportedly wanted permissive ethical guidelines so that their psychologists could continue to participate in harsh and abusive interrogation techniques being used by these agencies after the September 11 attacks on the United States. Critics pointed to alleged procedural irregularities and suspicious outcomes regarding APA’s ethics policy decisions and said they resulted from this improper coordination, collaboration, or collusion. Some said APA’s decisions were intentionally made to assist the government in engaging in these “enhanced interrogation techniques.” Some said they were intentionally made to help the government commit torture.

The entire report is here.

Steps to Strengthen Ethics in Organizations: Research Findings, Ethics Placebos, and What Works

By Ken Pope
Journal of Trauma & Dissociation
Volume 16, Issue 2, 2015

Abstract

Research shows that many organizations overlook needs and opportunities to strengthen ethics. Barriers can make it hard to see the need for stronger ethics and even harder to take effective action. These barriers include the organization’s misleading use of language, misuse of an ethics code, culture of silence, strategies of justification, institutional betrayal, and ethical fallacies. Ethics placebos tend to take the place of steps to see, solve, and prevent problems. This article reviews relevant research and specific steps that create change.

The entire article is here.

APA names lawyer to examine claims it aided U.S. government in shielding psychologists who tortured prisoners

By John Bohannon
Science Magazine
Originally published November 17, 2014

The American Psychological Association (APA) last week named a former federal prosecutor to lead an investigation into its role in supporting the U.S. government’s interrogation of suspected terrorists.

A new book by reporter James Risen of The New York Times alleges that APA, the largest U.S. professional association of psychologists, bent its ethical guidelines to give psychologists permission to conduct such interrogations at the U.S. military base at Guantánamo Bay, Cuba, and elsewhere. The motivation, according to Risen, was to stay in the good graces of U.S. intelligence and defense officials. APA has denied the allegations and says that it worked closely with the CIA and the Pentagon "to ensure that national security policies were well-informed by empirical science."

The entire article is here.

Practicing School Psychology While Impaired: Ethical, Professional, and Legal Issues

Emery B. Mahoney, Richard J. Morris
Journal of Applied School Psychology 
Vol. 28, Iss. 4, 2012
DOI:10.1080/15377903.2012.722180

Abstract

Studies on impairment in psychologists and other mental health practitioners began appearing in the literature 30–35 years ago. Since then, research and related scholarly writings have continued to be published to more fully understand this concept and its components. In school psychology, however, little has been written regarding school psychologists’ delivery of psychological services while they are impaired. This is true even though the provision of such services violates numerous ethical principles and standards of professional conduct in the ethics code of the National Association of School Psychologists and the American Psychological Association. In this article, the authors review the prevalence and incidence data regarding impairment, as well as definitional issues regarding what constitutes impairment. Ethical and legal issues associated with practicing while impaired are also discussed, followed by a discussion of assessing risk for impairment in school psychologists and the presentation of a self-administered risk assessment scale on the basis of empirical and other literature in the area of ethics and professional standards in the practice of psychology. Future directions for developing an agreed-upon definition of impairment within the field of school psychology and future directions for research on assessing and predicting impairment in school psychologists are discussed.

(cut)

It is unfortunate that there is a paucity of research investigating impairment issues as applied specifically to school psychologists. As a result, on the basis of empirical research and risk assessment models developed with psychologists practicing in mental health clinics, private practice, and hospital settings, we have presented in Figure 1 the Instrument for Monitoring Psychologists’ Awareness of Impaired Responding (IMPAIR).

The entire article is here.

Are Human Rights Redundant in the Ethical Codes of Psychologists?

Alfred Allan
Ethics & Behavior
Volume 23, Issue 4, 2013
DOI:10.1080/10508422.2013.776480

The codes of ethics and conduct of a number of psychology bodies explicitly refer to human rights, and the American Psychological Association recently expanded the use of the construct when it amended standard 1.02 of the Ethical Principles of Psychologists and Code of Conduct. What is unclear is how these references to human rights should be interpreted. In this article I examine the historical development of human rights and associated constructs and the contemporary meaning of human rights. As human rights are generally associated with law, morality, or religion, I consider to which of forms of these references most likely refer. I conclude that these references in ethical codes are redundant and that it would be preferable not to refer to human rights in codes. Instead, the profession should acknowledge human rights as a separate and complimentary norm system that governs the behavior of psychologists and should ensure that they have adequate knowledge of human rights and encourage them to promote human rights.

The entire article is here.

Stanford panel debates: Does teaching ethics do any good?

In an event sponsored by the McCoy Family Center for Ethics in Society, faculty from Stanford’s business school, law school and Philosophy Department say such courses equip students with the tools to engage with ethical problems.

BY SALIL DUDANI
Stanford Report
Originally posted May 13, 2014

Stanford University requires every undergraduate to take a class that deals with ethics. But can something as personal as ethics be taught in a classroom? Can classes in ethics make students more virtuous individuals? Or is that the wrong question to focus on?

These are the issues that a panel of Stanford scholars addressed in an event titled Does Teaching Ethics do any Good? It was sponsored by the McCoy Family Center for Ethics in Society as part of a series of talks marking its 25th anniversary.

Approaching the topic from diverse academic backgrounds, the Stanford professors who participated in the discussion agreed that ethics classes cannot be expected to make students more ethical. However, they articulated several other benefits, such as teaching students to fruitfully and confidently engage in ethical dialogue.

The entire article is here.

Editor's note: In podcast Episode 8, we discuss the counterintuitive fact that teaching ethics or ethics codes does not necessarily make a person more ethical.