The Ethical Ideologies of Psychologists and Physicians: A Preliminary Comparison

The ethical ideologies of psychologists (who provide health services) and physicians were compared using the Ethics Position Questionnaire. The findings reveal that psychologists tend to be less relativistic than physicians. Further, we explored the degree to which physicians and psychologists report being influenced by a variety of factors (e.g., family views) in their ethical decision making. Psychologists were more influenced by their code of ethics and less influenced by family views, religious background, and peer attitudes than were physicians. We argue that these differences reflect the varied professional cultures in which practitioners are trained and socialized.     

Influence of Culture on Ethical Decision Making in Psychology

This study focused on the influence of American and Chinese cultures on consequentialism orientation in decision-making within the broader context of psychologists’ academic roles and responsibilities. In addition, this study hypothesized that educational level would affect culturally influenced ethical decision making in both cultures. Based on the American Psychological Association Ethics Code, 20 ethical scenarios in 5 domains in psychology were created and used to examine the influence of culturally ethical beliefs on psychologists’ decision making among 181 participants. The results indicated that significant cultural differences in consequentialism orientation differentiated Chinese and American participants and influenced their resolution of ethical issues.     

An Exploratory Study: Perceptions of Ethical Behaviors Among Psychologists Practicing in the Caribbean

A sample of 44 psychologists who practice in the Caribbean completed a web-based survey containing 73 behavioral items related to ethical issues in professional practice. The aim of this exploratory study was to learn about perceptions regarding ethical behaviors that create ethical dilemmas and the level of agreement to their responses and to identify how demographic variables influenced their perceptions of ethical behaviors. Findings suggest that there was approximately an equal level of agreement on behaviors such as being an advocate for your client and being sexually involved with a current client rated as ethical and unethical, respectively. Several demographic variables and ethical behaviors such as level of degree and confidentiality issues were statistically significant. Finally, psychologists prefer the presence of a professional psychological association with an ethics committee.     

Complicating Narratives: Defining and Deconstructing Ethical Challenges in Community Psychology

In this concluding essay, we review the case studies presented in this Special Issue and examine whether community psychology has a distinctive approach to defining and resolving the core ethical canons of the Belmont Report (1979): Respect for Persons, Beneficence, and Justice. For two of these Principles—Respect for Persons and Beneficence—community psychologists elaborate upon and extend their definitions to consider their meaning in community‐based, social justice‐oriented research. The field's approach to Respect for Persons is multilevel in nature; in addition to respecting individuals and their diverse identities, we also have obligations to respect our community partnerships, the communities with whom we work, and the populations and cultures represented in our work. Similarly, for community psychologists, Beneficence is a multilevel construct that considers risks and benefits at the group, community, and cultural levels of analysis. With respect to Justice, community psychologists’ views of our ethical responsibilities are qualitatively different in meaning from the original Belmont Report and from disciplinary‐specific interpretations of this principle in ethical guidance documents from psychology, sociology, and evaluation. Our valuing of social change demands that we contribute to individual and group empowerment and liberation, and in so doing, that we avoid collusion with oppressive systems. Thus, we define our ethical responsibilities for promoting Justice as more action‐oriented than do other disciplines. The essay closes with an exploration of future directions for developing a comprehensive ethical framework for community psychology.     

Professional ethics of psychologists and physicians: morality, confidentiality, and sexuality in Israel

Clinical psychologists' and nonpsychiatric physicians' attitudes and behaviors in sexual and confidentiality boundary violations were examined. The 171 participants' responses were analyzed by profession, sex, and status (student, resident, professional) on semantic differential, boundary violation vignettes, and a version of Pope, Tabachnick, and Keith-Spiegel's (1987) ethical scale. Psychologists rated sexual boundary violation as more unethical than did physicians (p less than .001). Rationale (p less than .01) and timing (p less than .0001) influenced ratings. Psychologists reported fewer sexualized behaviors than physicians (p less than .05). Professional experience (p less than .01) and sex (p less than .05) were associated with confidence-violating behavior. Overall, 78% of the sample reported attitudes or behaviors associated with boundary violations. The behavior violations were correlated (r = .49). Actual violators rated vignette violators more leniently than did nonviolators (p less than .01).     

Ships in the Rising Sea? Changes Over Time in Psychologists’ Ethical Beliefs and Behaviors

Beliefs about the importance of ethical behavior to competent practice have prompted major shifts in psychology ethics over time. Yet few studies examine ethical beliefs and behavior after training, and most comprehensive research is now 30 years old. As such, it is unclear whether shifts in the field have resulted in general improvements in ethical practice: Are we psychologists “ships in the rising sea,” lifted by changes in ethical codes and training over time? Participants (N = 325) completed a survey of ethical beliefs and behaviors (Pope, Tabachnick, &; Keith-Spiegel, 1987). Analyses examined group differences, consistency of frequency and ethicality ratings, and comparisons with past data. More than half of behaviors were rated as less ethical and occurring less frequently than in 1987, with early career psychologists generally reporting less ethically questionable behavior. Recommendations for enhancing ethics education are discussed.     

Ethics in Psychology and Law: An International Perspective

Some psychologists working in the psychology and law (psycholegal) field feel that the profession does not provide them with adequate ethical guidance even though the field is arguably one of the oldest and best established applied fields of psychology. The uncertainty psychologists experience most likely stems from working with colleagues whose professional ethics differs from their own while providing services to demanding people and the many moral questions associated with the administration of law. I believe psychology’s ethics does, however, provide adequate moral guidance. It has a sound historical basis, has face validity and emphasizes those social moral principles that allow psychologists to best serve individuals and society. Psychologists may nevertheless be confronted with conflicting demands because there are other norm systems that also regulate their behavior as researchers and practitioners, and they, like all people, are influenced by their conscience. Ultimately, psychologists working in the psycholegal field will be best served if they have good knowledge of, and have internalized, the ethical principles of psychology.     

The perception of ethical dilemmas in clinical practice

The empirical diagnosis presented in this paper is based on interviews with nurse practitioners and physicians designed to elicit their perceptions on the nature and role of ethical dilemmas in clinical practice. Having selected five of these perceptions or views which were common and significant, the philosophical therapy offered consists in, first, a general discussion of ethical dilemmas and, second, a critical analysis of each of the five views with the aim of pointing out confusions and errors, the recognition of which can be of applied and practical help in the clinical setting.     

人类胚胎干细胞研究伦理问题的调查和讨论

此次对各级医生进行关于人类胚胎干细胞研究伦理认知的调查研究,其目的是为制订相关的伦理准则提供认知依据,调查是在我国东西部二个城市的8家三级医院进行,采用随机抽样、自愿无记名填写信息表方法调查.调查结果表明,50%以上医生认为早期胚胎不是道德意义的人,70%以上医生对胚胎干细胞的研究表示支持.海峡两岸的医生由于有相同的文化根源,在对待胚胎干细胞研究的伦理观点及态度上极其接近.     

Attitudes of Oregon psychologists toward physician-assisted suicide and the Oregon Death With Dignity Act

Since the passage of the Oregon Death With Dignity Act (ODDA), psychologists have been grappling with how to fulfill their legally specified role in the process of physician-assisted suicide. We surveyed Oregon psychologists to elicit their views on assisted suicide and the process of assessing patients who request such assistance. There was a high degree of support for assisted suicide and the ODDA, but also a minority who were highly opposed. Most survey respondents raised ethical or practical concerns with their role as assessors. Many important questions about how evaluations in the complex area should be conducted remain unanswered.     

Ethical Issues in Psychologists' Professional Practice: Agreement Over Problematic Professional Behaviors Among Spanish Psychologists

A sample of 703 Spanish psychologists completed an online survey containing 114 behaviors related to professional practice in different areas. The aim of the study was to learn which professional behaviors create ethical dilemmas most often for psychologists and how they respond to these issues. Findings suggest that psychologists who have actually faced a particular dilemma are less strict on judging the inappropriateness of a possible ethical transgression than those psychologists who have not experienced it. Also, four clusters can be identified according to the attitude of respondents toward the dilemmas, namely “rejection,” “aprioristic,” “utilitarian,” and “no conflict.”     

Should the "slow code" be resuscitated?

Most bioethicists and professional medical societies condemn the practice of "slow codes." The American College of Physicians ethics manual states, "Because it is deceptive, physicians or nurses should not perform half-hearted resuscitation efforts ('slow codes')." A leading textbook calls slow codes "dishonest, crass dissimulation, and unethical." A medical sociologist describes them as "deplorable, dishonest and inconsistent with established ethical principles." Nevertheless, we believe that slow codes may be appropriate and ethically defensible in situations in which cardiopulmonary resuscitation (CPR) is likely to be ineffective, the family decision makers understand and accept that death is inevitable, and those family members cannot bring themselves to consent or even assent to a do-not-resuscitate (DNR) order. In such cases, we argue, physicians may best serve both the patient and the family by having a carefully ambiguous discussion about end-of-life options and then providing resuscitation efforts that are less vigorous or prolonged than usual.     

Advertised Australian counselling psychologists: A descriptive survey of their practice details and self perceived competence in six counselling psychology practice areas

This survey research in a field setting aimed to describe psychologists who advertised themselves in the Australian Yellow Pages as counsellors, thus providing a snapshot of advertised counselling psychologists in Australia. Data was collected using a multiple mailing survey method and resulted in a 62.2% return rate. The psychologists’ (a) demographic characteristics, (b) training and development, (c) provision of services, (d) professional involvement, and (e) their self perceived competence in working with (i) depression, (ii) anxiety, (iii) substance use, (iv) clients from non English speaking backgrounds and Indigenous and Torres Strait Islander individuals, (v) clients who are same sex attracted (gay, lesbian, and bisexual individuals), and (vi) clients using electronic mail and instant messaging were assessed. Advertised Australian counselling psychologists tend to be female, mature and Caucasian. The majority of the psychologists surveyed live in urban areas. Master and Bachelor level degrees were most often reported, a minority held doctoral degrees. The average psychologist charged $96.32 per hour, less than the Australian Psychological Society (APS) recommended fee for an hour of service. Eclectic and cognitive behaviour therapy were indicated most often as the theoretical orientations guiding psychological work. Psychologists belonged almost exclusively to the Australian Psychological Society as a professional association. Surprisingly, 2.9% of psychologists indicate not following an ethical code in their work and 3.9% failed to ensure that their work was covered by professional indemnity insurance. Advertised psychologists are thus described and suggestions are given for the further development of the profession. Regarding their self perceived competence, Australian advertised psychologists present as having self perceived strengths and areas of weakness regarding their counselling competence. This indicates that they are aware of their varying ability to work with various issues and populations. The self perceived competence of Australian psychologists in six specific counselling practice areas and suggestions for future training and development are provided.     

The “Good” Psychologist, “Good” Torture,and “Good” Reputation—Response to O’Donohue,Snipes, Dalto,Soto, Maragakis,and Im (2014) “The Ethics of Enhanced Interrogations and Torture”

O’Donohue et al. (2014) sought to derive, from classical ethical theories, the ethical obligation of psychologists to assist “enhanced interrogations and torture” (EIT) in national defense scenarios under strict EIT criteria. They asked the American Psychological Association to adopt an ethics code obligating psychologists to assist such EIT and to uphold the reputation of EIT psychologists. We contest the authors’ ethical analyses as supports for psychologists’ forays into torture interrogation when (if ever) the EIT criteria obtain. We also contend that the authors’ application of these ethical analyses violates the Geneva Conventions, contravenes military doctrine and operations, and undermines psychology as a profession. We conclude that “good” public reputation is not owed to, or expected by, “good” intelligence professionals, and collaborating operational psychologists must share their providence.     

Recognition of names of eminent psychologists

Faculty members, graduate students, undergraduate majors, and introductory psychology students checked those names they recognized in the list of 228 deceased psychologists, rated for eminence, provided by Annin, Boring, and Watson. Mean percentage recognition was less than 50% for the 128 American psychologists, and less than 25% for the 100 foreign psychologists, by the faculty subjects. The other three groups of subjects gave even lower recognition scores. Recognition was probably also influenced by recency; median year of death of the American psychologists was 1955, of the foreign psychologists, 1943. High recognition (defined as recognition by 80% or more of the faculty group) was achieved by only 34 psychologists, almost all of them American. These highly recognized psychologists also had high eminence ratings, but there was an equal number of psychologists with high eminence ratings that were poorly recognized.     

Psychotropic Medication Consultation in Schools

Abstract

Assessing, consulting, and intervening with students being treated with psychotropic medications is an increasingly common activity for school psychologists. This article reviews some of the literature providing evidence for the greater need for training in school psychopharmacology. A legal and ethical case study is presented that highlights the complexity of medication issues for school psychologists. Training programs are encouraged to examine current curricular requirements to insure that graduates are exposed to evidenced-based treatments including pharmacological approaches. It is vital that school psychologists examine their own competencies as they work to ethically and legally consult with families and physicians to improve adaptive functioning in school-aged populations.     

Ethical evaluation of "retainer fee" medical practice

This article examines the reasons that some physicians have recently opted to reduce the size of their practice rosters to allow more time for each patient in exchange for a retainer fee from patients. These physicians also offer supplementary, nonmedical amenities to patients as part of their service. Because physicians have reduced the size of their practice rosters and have increased the price tag for their services, some patients have lost access to their care. We have tried to assess the ethical propriety of such a change in the design of medical practices by weighing plausible, ethically relevant arguments favoring and opposing RFMP. Physicians are ethically obligated first and foremost to promote and protect the health of their patients. RFMP fulfills this duty directly by ensuring prompt and ample professional time for the care of patients. It does so indirectly by allowing time for physicians' continuing education, which in turn should upgrade the quality of care. It also advances the ethical goals of autonomy as it allows patients to choose their own physicians and to spend their money as they please. On the other hand, these ethical positives are offset by the cost of retainer fees that may exclude access of patients to their physicians' care. Even if ethical tradition obligates physicians primarily to patients under their specific care, as professionals and as private citizens, they also have a responsibility to support the health of the entire community. RFMP does little to advance this cause, except that by optimizing the conditions under which their own private patients receive healthcare, they call attention to shortcomings in prevailing public healthcare policies, which by comparison fall short of that standard. An assumption that health is not properly a market commodity, and that all people should receive healthcare on equal terms, would expose RFMP to moral reproof. From an ethical perspective, we find sufficient cause for concern and caution in this innovative style of practice. Nevertheless, the weight of arguments presented here does not seem to justify unequivocal moral condemnation of RFMP. As neither pro nor con views seem to have settled the ethical question, definitive moral judgment on RFMP will probably depend on the outcome of future experience and ongoing evaluation. The implications of RFMP for any future healthcare system are not clear, at least to us.     

Integrating Contextual Issues in Ethical Decision Making

Many issues in ethics arise in relation to the contexts in which psychologists work. However, most ethical decision-making models reproduce the way in which psychologists tend to approach ethics by focusing on ethical dilemmas and proposing a step-by-step response to deal with them. Although these models might be useful, their emphasis on reactive approaches and their lack of contextualization constitute significant limitations on their applicability. In this article, an approach to ethical decision making that highlights the importance of the context in developing proactive strategies to solve ethical issues is proposed. This approach is further explained through its application to medical and rural settings. The implications of these suggestions to the training in ethics are finally discussed.     

The Development of Family Loyalty and Relational Ethics in Children

Despite little research investigating how family loyalty and relational ethics develop in children, theorists suggest that children's early family loyalty experiences play a significant role in their future relationships. Twenty-four children, ages 5–10 years, were interviewed to examine developmental trends in children's conceptualizations of family and family loyalty and their reasoning through parent-child ethical dilemmas. Results indicate (a) younger children possess a simpler, more concrete schema for family and family loyalty than do older children and (b) younger children are less able than older children to adopt their parents' perspectives in reasoning through ethical dilemmas.A psychotherapist with T. W. Ponessa & Associates     

Professional Boundary Ethics Attitudes and Awareness Among Nurses and Physicians in a University Hospital in the Kingdom of Saudi Arabia

This study sought to gauge ethical attitudes about professional boundary issues of physicians and nurses in the Kingdom of Saudi Arabia. Respondents scored 10 relevant boundary vignettes as to their ethical acceptability. The group as a whole proved “aware/ ethically conservative,” but with the physicians' score falling on the “less ethically conservative” part of the spectrum compared to nurses. The degree of ethicality was more related to profession than to gender, with nurses being more “ethical” than physicians.