Five Steps to Get Students Thinking About Ethics

Karen Cotter, Laura Bond, & Lauren Fullmer

The Greater Good Science Center

Originally posted 22 FEB 23

Here is an excerpt and the 5 steps:

Five steps for ethical decision-making

Teaching ethical thinking aligns with the mission you may have as an educator to promote global citizenship. “Being a global citizen means understanding that global ideas and solutions must still fit the complexities of local contexts and cultures, and meet each community’s specific needs and capacities,” explains AFS-USA. While investigating real-world problems from many perspectives, students gain an appreciation for many sides of an issue and avoid the pitfall of simply reinforcing their preexisting attitudes.

Ethical thinking also enriches social-emotional learning. According to researchers Michael D. Burroughs and Nikolaus J. Barkauskas, “By focusing on social, emotional, and ethical literacy in schools educators can contribute to the development of persons with greater self-awareness, emotional understanding and, in turn, the capability to act ethically and successfully interact with others in a democratic society.” The five steps below serve as a seamless way to integrate ethical decision making into a science or STEM class.

These steps come from our Prosocial Design Process for Ethical Decision-Making, which itself is a synthesis of three frameworks: prosocial education (which focuses on promoting emotional, social, moral, and civic capacities that express character in students), the Engineering Design Process (an open-ended problem-solving practice that encourages growth from failure), and the IDEA Ethical Decision-Making Framework. This process offers a way for students to come up with creative solutions to a problem and bring ethical consideration to global issues.

1. Ask questions to identify the issue.

2. Consider the perspectives of people impacted to brainstorm solutions. 

3. Analyze research to design and test solutions. 

4. Evaluate and iterate for an ethically justifiable solution.

5. Communicate findings to all relevant stakeholders. 

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This ethical framework guides students to think beyond themselves to identify solutions that impact their community. The added SEL (social-emotional learning) benefits of self-reflection, social awareness, relationship skills, and appreciation of the world around them awaken students’ consciousness of core ethical values, equipping them to make decisions for the greater good. Using prosocial science topics like climate change empowers students to engage in relevant, real-world content to create a more equitable, sustainable, and just world where they experience how their humanity can impact the greater good.

The info is here.

APF Gold Medal Award for Life Achievement in the Practice of Psychology: Samuel Knapp

American Psychologist, 76(5), 812–814. 

https://doi.org/10.1037/amp0000894

This award recognizes a distinguished career and enduring contribution to the practice of psychology. Samuel Knapp’s long, distinguished career has resulted in demonstrable effects and significant contributions to best practices in professionalism, ethics education, positive ethics, and legislative advocacy as Director of Professional Affairs for the Pennsylvania Psychological Association and as an ethics educator extraordinaire. Dr. Knapp’s work has modified the way psychologists think about professional ethics through education, from avoiding disciplinary consequences to promoting overarching ethical principles to achieve the highest standards of ethical behavior. His focus on respectful collaboration among psychologists promotes honesty through nonjudgmental conversations. His Ethics Educators Workshop and other continuing education programs have brought together psychology practitioners and faculty to focus deeply on ethics and resulted in the development of the APA Ethics Educators Award.

From the Biography section

Ethics education became especially important in Pennsylvania when the Pennsylvania State Board of Psychology mandated ethics as part of its continuing education requirement. But even before that, members of the PPA Ethics Committee and Board of Directors, saw ethics education as a vehicle to help psychologists to improve the quality of their services to their patients. Also, to the extent that ethics education can help promote good decision-making, it could also reduce the emotional burden that professional psychologists often feel when faced with difficult ethical situations. Often the continuing education programs were interactive with the secondary goals of helping psychologists to build contacts with each other and an opportunity for the presenters to promote authentic and compassion-driven approaches to teaching ethics. Yes, Sam and the other PPA Ethics educators, such as the PPA attorney Rachael Baturin, also taught the laws, ethics codes, and the risk management strategies. facts.  But these were only one component of PPA’s ethics education program. More important was the development of a cadre of psychologists/ethicists who taught most of these continuing education programs.

The full award is here.

Engineers need a required course in ethics

Kush Saxena

qz.com
Originally posted November 8, 2019

Here is an except:

Typically, engineers are trained to be laser-focused on solving problems in the most effective and efficient way. And those solutions often have ripple effects in society, and create externalities that must be carefully considered.

Given the pace with which we can deploy technology at scale, the decisions of just a few people can have deep and far-reaching impact.

But in spite of the fact that they build potentially society-altering technologies—such as artificial intelligence—engineers often have no training or exposure to ethics. Many don’t even consider it part of their remit.

But it is. In a world where a few lines of code can impact whether a woman lands a job in tech, or how a criminal is sentenced in court, everyone who touches technology must be qualified to make ethical decisions, however insignificant they may seem at the time.

Engineers need to understand that their work may be used in ways that they never intended and consider the broader impact it can have on the world.

How can tech leaders not only create strong ethical frameworks, but also ensure their employees act with “decency” and abide by the ideals and values they’ve set out? And how can leaders in business, government, and education better equip the tech workforce to consider the broader ethical implications of what they build?

The info is here.

Gartner Fellow discusses ethics in artificial intelligence

Teena Maddox
techrepublic.com
Originally published October 28, 2019

Here is an excerpt:

There are tons of ways you can use AI ethically and also unethically. One way that is typically being cited is, for instance, using attributes of people that shouldn't be used. For instance, when granting somebody a mortgage or access to something or making other decisions. Racial profiling is typically mentioned as an example. So, you need to be mindful which attributes are being used for making decisions. How do the algorithms learn? Other ways of abuse of AI is, for instance, with autonomous killer drones. Would we allow algorithms to decide who gets bombed by a drone and who does not? And most people seem to agree that autonomous killer drones are not a very good idea.

The most important thing that a developer can do in order to create ethical AI is to not think of this as technology, but an exercise in self-reflection. Developers have certain biases. They have certain characteristics themselves. For instance, developers are keen to search for the optimal solution of a problem; it is built into their brains. But ethics is a very pluralistic thing. There's different people who have different ideas. There is not one optimal answer of what is good and bad. First and foremost, developers should be aware of their own ethical biases of what they think is good and bad and create an environment of diversity where they test those assumptions and where they test their results. The the developer brain isn't the only brain or type of brain that is out there, to say the least.

So, AI and ethics is really a story of hope. It's for the very first time that a discussion of ethics is taking place before the widespread implementation, unlike in previous rounds where the ethical considerations were taking place after the effects.

The info is here.

Moral Distress and Moral Strength Among Clinicians in Health Care Systems: A Call for Research

Connie M. Ulrich and Christine Grady
NAM Perspectives. 
https://doi.org/10.31478/201909c


Here is an excerpt:

Evidence shows that dissatisfaction and wanting to leave one’s job—and the profession altogether—often follow morally distressing encounters. Ethics education that builds cognitive and communication skills, teaches clinicians ethical concepts, and helps them gain communication skills and confidence may be essential in building moral strength. One study found, for example, that among practicing nurses and social workers, those with the least ethics education were also the least confident, the least likely to use ethics resources (if available), and the least likely to act on their ethical concerns. In this national study, as many as 23 percent of nurses reported having had no ethics education at all. But the question remains—is ethics education enough?

Many factors likely support or hinder a clinician’s capacity and willingness to act with moral strength. More research is needed to investigate how interdisciplinary ethics education and institutional resources can help nurses, physicians, and others voice their ethical concerns, help them agree on morally acceptable actions, and support their capacity and propensity to act with moral strength and confidence. Research on moral distress and ethical concerns in everyday clinical practice can begin to build a knowledge base that will inform clinical training—in both educational and health care institutions—and that will help create organizational structures and processes to prepare and support clinicians to encounter potentially distressing situations with moral strength. Research can help tease out what is important and predictive for taking (or not taking) ethical action in morally distressing circumstances. This knowledge would be useful for designing strategies to support clinician well-being. Indeed, studies should focus on the influences that affect clinicians’ ability and willingness to become involved or take ownership of ethically-laden patient care issues, and their level of confidence in doing so.

Students' Ethical Decision‐Making When Considering Boundary Crossings With Counselor Educators

Stephanie T. Burns
Counseling and Values
First published: 10 April 2019
https://doi.org/10.1002/cvj.12094

Abstract

Counselor education students (N = 224) rated 16 boundary‐crossing scenarios involving counselor educators. They viewed boundary crossings as unethical and were aware of power differentials between the 2 groups. Next, they rated the scenarios again, after reviewing 1 of 4 ethical informational resources: relevant standards in the ACA Code of Ethics (American Counseling Association, 2014), 2 different boundary‐crossing decision‐making models, and a placebo. Although participants rated all resources except the placebo as moderately helpful, these resources had little to no influence on their ethical decision‐making. Only 47% of students in the 2 ethical decision‐making model groups reported they would use the model they were exposed to in the future when contemplating boundary crossings.

Here is a portion from Implications for Practice and Training

Counselor education students took conservative stances toward the 16 boundary-crossing scenarios with counselor educators. These findings support results of previous researchers who stated that students struggle with even the smallest of boundary crossings (Kozlowski et al., 2014) because they understand that power differentials have implications for grades, evaluations, recommendation letters, and obtaining authentic skill development feedback (Gu et al., 2011). Counselor educators need to be aware that students find not providing appropriate feedback because of the counselor educator’s personal feelings toward the student, not providing students with required supervision time in practicum, and taking first authorship when the student performed all the work on the submission as being as abusive as having sex with a student.

The research is here.

The moral behavior of ethics professors: A replication-extension in German-speaking countries

Philipp Schönegger & Johannes Wagner
(2019) Philosophical Psychology, 32:4, 532-559
DOI: 10.1080/09515089.2019.1587912

Abstract

What is the relation between ethical reflection and moral behavior? Does professional reflection on ethical issues positively impact moral behaviors? To address these questions, Schwitzgebel and Rust empirically investigated if philosophy professors engaged with ethics on a professional basis behave any morally better or, at least, more consistently with their expressed values than do non-ethicist professors. Findings from their original US-based sample indicated that neither is the case, suggesting that there is no positive influence of ethical reflection on moral action. In the study at hand, we attempted to cross-validate this pattern of results in the German-speaking countries and surveyed 417 professors using a replication-extension research design. Our results indicate a successful replication of the original effect that ethicists do not behave any morally better compared to other academics across the vast majority of normative issues. Yet, unlike the original study, we found mixed results on normative attitudes generally. On some issues, ethicists and philosophers even expressed more lenient attitudes. However, one issue on which ethicists not only held stronger normative attitudes but also reported better corresponding moral behaviors was vegetarianism.

An Ethical Obligation for Bioethicists to Utilize Social Media

Herron, PD
Hastings Cent Rep. 2019 Jan;49(1):39-40.
doi: 10.1002/hast.978.

Here is an excerpt:

Unfortunately, it appears that bioethicists are no better informed than other health professionals, policy experts, or (even) elected officials, and they are sometimes resistant to becoming informed. But bioethicists have a duty to develop our knowledge and usefulness with respect to social media; many of our skills can and should be adapted to this area. There is growing evidence of the power of social media to foster dissemination of misinformation. The harms associated with misinformation or “fake news” are not new threats. Historically, there have always been individuals or organized efforts to propagate false information or to deceive others. Social media and other technologies have provided the ability to rapidly and expansively share both information and misinformation. Bioethics serves society by offering guidance about ethical issues associated with advances in medicine, science, and technology. Much of the public’s conversation about and exposure to these emerging issues occurs online. If we bioethicists are not part of the mix, we risk yielding to alternative and less authoritative sources of information. Social media’s transformative impact has led some to view it as not just a personal tool but the equivalent to a public utility, which, as such, should be publicly regulated. Bioethicists can also play a significant part in this dialogue. But to do so, we need to engage with social media. We need to ensure that our understanding of social media is based on experiential use, not just abstract theory.

Bioethics has expanded over the past few decades, extending beyond the academy to include, for example, clinical ethics consultants and leadership positions in public affairs and public health policy. These varied roles bring weighty responsibilities and impose a need for critical reflection on how bioethicists can best serve the public interest in a way that reflects and is accountable to the public’s needs.

Professional ethics takes a team approach

Richard Kyte
Lacrosse Tribune
Originally posted February 24, 2019

Here is an excerpt:

Why do some professions enjoy consistently high levels of trust while other professions rate low year after year?

Part of the answer may lie in the motivations of individuals within the professions. When I ask nursing students why they want to go into nursing, they invariably respond by saying they want to help others. Business students, by contrast, are more likely to be motivated by self-interest.

But motivation does not fully explain the reputational difference among professions. Most young people who go into ministry or politics also embark upon their careers with pro-social motivations. And my own experience of lawyers, bankers, real estate agents and car salespeople suggests that the individuals in those professions are just as trustworthy as anybody else.

If that is true, then what earns a profession a positive or negative reputation is not just the people in the profession but the way the profession is practiced. Especially important is the way different professions handle ethically problematic cases and circumstances.

The info is here.

A philosopher’s life

Margaret Nagle
UMaineToday
Fall/Winter 2018

Here is an excerpt:

Mention philosophy and for most people, images of the bearded philosophers of Ancient Greece pontificating in the marketplace come to mind. Today, philosophers are still in public arenas, Miller says, but now that engagement with society is in K–12 education, medicine, government, corporations, environmental issues and so much more. Public philosophers are students of community knowledge, learning as much as they teach.

The field of clinical ethics, which helps patients, families and clinicians address ethical issues that arise in health care, emerged in recent decades as medical decisions became more complex in an increasingly technological society. Those questions can range from when to stop aggressive medical intervention to whether expressed breast milk from a patient who uses medical marijuana should be given to her baby in the neonatal intensive care unit.

As a clinical ethicist, Miller provides training and consultation for physicians, nurses and other medical personnel. She also may be called on to consult with patients and their family members. Unlike urban areas where a city hospital may have a whole department devoted to clinical ethics, rural health care settings often struggle to find such philosophy-focused resources.

That’s why Miller does what she does in Maine.

Miller focuses on “building clinical ethics capacity” in the state’s rural health care settings, providing training, connecting hospital personnel to readings and resources, and facilitating opportunities to maintain ongoing exploration of critical issues.

The article is here.

Mozilla’s ambitious plan to teach coders not to be evil

Katherine Schwab
Fast Company
Originally published October 10, 2018

Here is an excerpt:

There’s already a burgeoning movement to integrate ethics into the computer science classroom. Harvard and MIT have launched a joint class on the ethics of AI. UT Austin has an ethics class for computer science majors that it plans to eventually make a requirement. Stanford similarly is developing an ethics class within its computer science department. But many of these are one-off initiatives, and a national challenge of this type will provide the resources and incentive for more universities to think about these questions–and theoretically help the best ideas scale across the country.

Still, Baker says she’s sometimes cynical about how much impact ethics classes will have without broader social change. “There’s a lot of power and institutional pressure and wealth” in making decisions that are good for business, but might be bad for humanity, Baker says. “The fact you had some classes in ethics isn’t going to overcome all that and make things perfect. People have many motivations.”

Even so, teaching young people how to think about tech’s implications with nuance could help to combat some of those other motivations–primarily, money. The conversation shouldn’t be as binary as code; it should acknowledge typical ways data is used and help young technologists talk and think about the difference between providing value and being invasive.

The info is here.

Code of Ethics Doesn’t Influence Decisions of Software Developers

Emerson Murphy-Hill, Justin Smith, & Matt Shipman
NC State Pressor
Originally released October 8, 2018

The world’s largest computing society, the Association for Computing Machinery (ACM), updated its code of ethics in July 2018 – but new research from North Carolina State University shows that the code of ethics does not appear to affect the decisions made by software developers.

“We applauded the decision to update the ACM code of ethics, but wanted to know whether it would actually make a difference,” says Emerson Murphy-Hill, co-author of a paper on the work and an adjunct associate professor of computer science at NC State.

“This issue is timely, given the tech-related ethics scandals in the news in recent years, such as when Volkwagen manipulated its technology that monitored vehicle emissions. And developers will continue to face work-related challenges that touch on ethical issues, such as the appropriate use of artificial intelligence.”

For the study, researchers developed 11 written scenarios involving ethical challenges, most of which were drawn from real-life ethical questions posted by users on the website Stack Overflow. The study included 105 U.S. software developers with five or more years of experience and 63 software engineering graduate students at a university. Half of the study participants were shown a copy of the ACM code of ethics, the other half were simply told that ethics are important as part of an introductory overview of the study. All study participants were then asked to read each scenario and state how they would respond to the scenario.

“There was no significant difference in the results – having people review the code of ethics beforehand did not appear to influence their responses,” Murphy-Hill says.

The press release is here.

The research is here.

Fostering Discussion When Teaching Abortion and Other Morally and Spiritually Charged Topics

Louise P. King and Alan Penzias
AMA Journal of Ethics. July 2018, Volume 20, Number 7: 637-642.

Abstract

Best practices for teaching morally and spiritually charged topics, such as abortion, to those early in their medical training are elusive at best, especially in our current political climate. Here we advocate that our duty as educators requires that we explore these topics in a supportive environment. In particular, we must model respectful discourse for our learners in these difficult areas.

How to Approach Difficult Conversations

When working with learners early in their medical training, educators can find that best practices for discussion of morally and spiritually charged topics are elusive. In this article, we address how to meaningfully discuss and explore students’ conscientious objection to participation in a particular procedure. In particular, we consider the following questions: When, if ever, is it justifiable to define a good outcome of such teaching as changing students’ minds about their health practice beliefs, and when, if ever, is it appropriate to illuminate the negative impacts their health practice beliefs can have on patients?

The information is here.

Getting Ethics Training Right for Leaders and Employees

Deloitte
The Wall Street Journal
Originally posted April 9, 2018

Here is an excerpt:

Ethics training has needed a serious redesign for some time, and we are seeing three changes to make training more effective. First, many organizations recognize that compliance training is not enough. Simply knowing the rules and how to call the ethics helpline does not necessarily mean employees will raise their voice when they see ethical issues in the workplace. Even if employees want to say something they often hesitate, worried that they may not be heard, or even worse, that voicing may lead to formal or informal retaliation. Overcoming this hesitation requires training to help employees learn how to voice their values with in-person, experiential practice in everyday workplace situations. More and more organizations are investing in this training, as a way to simultaneously support employees, reduce risk and proactively reshape their culture.

Another significant change in ethics training is a focus on helping senior leaders consider how their own ethical leadership shapes the culture. This requires leaders to examine the signals they send in their everyday behaviors, and how these signals make employees feel safe to voice ideas and concerns. In my training sessions with senior leaders, we use exercises that help them identify the leadership behaviors that create such trust, and those that may be counter-productive. We then redesign the everyday processes, such as the weekly meeting or decision-making models, that encourage voice and explicitly elevate ethical concerns.

Third, more organizations are seeing the connection between ethics and greater sense of purpose in the workplace. Employee engagement, performance and retention often increases when employees feel they are contributing something beyond profit creation. Ethics training can help employees see this connection and practice the so-called giver strategies that help others, their organizations, and their own careers at the same time.

The article is here.

Business ethics: am I boring you?

Katherine Bradshaw
The Guardian
Originally published November 8, 2012

Here is an excerpt:

We need to bridge the gap between ethics programmes and daily worklife – and stories can help us do that.

No matter how sophisticated we are as a society, stories continue to be our preferred way of communicating and sharing our experiences of life. From a book at bedtime to the latest cliffhanger of our favourite soap, stories help us connect and communicate our emotions and values with each other.

Business ethics training at its worst can include material which seems distant to staff and how they do their day-to-day job. A set of compliance dictats communicated with slides animated with clip art, or an eLearning programme with easy multiple choice questions conducted in isolation, is unlikely to engage anyone with what really matters.

Ethical values need to be embedded into company culture so that they are reflected in the way that business is actually done. This requires an ethics programme with objectives beyond just imparting knowledge and raising awareness of expected standards – the challenge is to communicate their relevance and importance at all levels and locations in a way that impacts on understanding, decisions and behaviours.

The article is here.

James Comey isn’t qualified for his new gig teaching ethics, experts explain

Olivia Goldhill
Quartz
Originally published January 27, 2018

Here is an excerpt:

“My entire professional life has been dedicated to ethics education. I’m disheartened by the fact that educational institutions hire people to teach ethics who really don’t have a background in ethics,” says Aine Donovan, director of the ethics institute at Dartmouth University.

Certainly, Comey’s own behavior as FBI director would make the basis of a strong case study, says Donovan. But Comey’s experience navigating a moral quandary is not sufficient qualification. “I’d rather have moral exemplars teaching an ethical leadership class than somebody who has even a whiff of controversy associated with them,” Donovan says. In addition, Donovan adds, it seems Comey did not make the right moral choice at every stage. For example, Comey leaked documents about his conversations with Trump. “I’m highly skeptical that that would ever pass ethical muster,” adds Donovan.

A “puzzling” choice

“There is much to be learned about [ethics from] studying Mr. Comey’s own conduct, but most of it is not positive,” Howard Prince II, who holds the Loyd Hackler Endowed Chair in Ethical Leadership at University of Texas-Austin, writes in an email. Overall, Comey is “a puzzling choice” to teach ethical leadership, he adds.

The article is here.

Antecedents and Consequences of Medical Students’ Moral Decision Making during Professionalism Dilemmas

Lynn Monrouxe, Malissa Shaw, and Charlotte Rees
AMA Journal of Ethics. June 2017, Volume 19, Number 6: 568-577.

Abstract

Medical students often experience professionalism dilemmas (which differ from ethical dilemmas) wherein students sometimes witness and/or participate in patient safety, dignity, and consent lapses. When faced with such dilemmas, students make moral decisions. If students’ action (or inaction) runs counter to their perceived moral values—often due to organizational constraints or power hierarchies—they can suffer moral distress, burnout, or a desire to leave the profession. If moral transgressions are rationalized as being for the greater good, moral distress can decrease as dilemmas are experienced more frequently (habituation); if no learner benefit is seen, distress can increase with greater exposure to dilemmas (disturbance). We suggest how medical educators can support students’ understandings of ethical dilemmas and facilitate their habits of enacting professionalism: by modeling appropriate resistance behaviors.

Here is an excerpt:

Rather than being a straightforward matter of doing the right thing, medical students’ understandings of morally correct behavior differ from one individual to another. This is partly because moral judgments frequently concern decisions about behaviors that might entail some form of harm to another, and different individuals hold different perspectives about moral trade-offs (i.e., how to decide between two courses of action when the consequences of both have morally undesirable effects). It is partly because the majority of human behavior arises within a person-situation interaction. Indeed, moral “flexibility” suggests that though we are motivated to do the right thing, any moral principle can bring forth a variety of context-dependent moral judgments and decisions. Moral rules and principles are abstract ideas—rather than facts—and these ideas need to be operationalized and applied to specific situations. Each situation will have different affordances highlighting one facet or another of any given moral value. Thus, when faced with morally dubious situations—such as being asked to participate in lapses of patient consent by senior clinicians during workplace learning events—medical students’ subsequent actions (compliance or resistance) differ.

The article is here.

Best Practices for School-Based Moral Education

Peter Meindl, Abigail Quirk, Jesse Graham
Policy Insights from the Behavioral and Brain Sciences 
First Published December 21, 2017

Abstract

How can schools help students build moral character? One way is to use prepackaged moral education programs, but as we report here, their effectiveness tends to be limited. What, then, can schools do? We took two steps to answer this question. First, we consulted more than 50 of the world’s leading social scientists. These scholars have spent decades studying morality, character, or behavior change but until now few had used their expertise to inform moral education practices. Second, we searched recent studies for promising behavior change techniques that apply to school-based moral education. These two lines of investigation congealed into two recommendations: Schools should place more emphasis on hidden or “stealthy” moral education practices and on a small set of “master” virtues. Throughout the article, we describe practices flowing from these recommendations that could improve both the effectiveness and efficiency of school-based moral education.

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.

Vignette 36: The Cancellation Conundrum

Dr. Wendy Malik operates an independent practice in a suburban area.  She receives a referral from a physician, with whom she has a positive working relationship.  Dr. Malik contacts the patient, completes a phone screening, and sets up an appointment with Mr. Larry David.

As is her practice, Dr. Malik sends a confirmation email, attaching her version of informed consent.  She instructs Mr. David that he does not have to print it out, only review it and they would discuss any questions at the initial appointment.

Several days later, Dr. Malik checks her email.  In it, Mr. David sent her an email with an attachment.  Mr. David asks Dr. Malik to review his edits on the informed consent document.

While Dr. Malik notes some suggested corrections on the document, Mr. David modified the cancellation policy.  Dr. Malik’s form (and standard policy) is appointments cancelled with less than 24-hour notice will be charged to the patient.  Mr. David added a sentence that if Dr. Malik cancels an appointment with less than 24 hours, Mr. David expects Dr. Malik to pay him an amount equal to her hourly rate.

Flustered by this edit, Dr. Malik contacts you for a consultation.

What are the ethical issues involved in this case?

What are the pertinent clinical issues in this case?

How would you help Dr. Malik work through these issues?

Would you recommend Dr. Malik call to address the issue ahead of the appointment or wait for the initial session?

At this point, must Dr. Malik keep Mr. David as a patient?

If not, does Dr. Malik need to contact her referral source about the issue?