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.     

Prevention and public health. Psychology's response to the nation's health care crisis

Psychology as a scientific and applied discipline has a unique responsibility to participate in the pursuit of strategies that reduce the nation's health care needs. As a social and behavioral science, psychology can contribute to unraveling the processes underlying conditions of health and disorder. As an applied discipline, psychology can work to design effective interventions to promote human health and to avoid disease and dysfunction. Insofar as these endeavors are unsuccessful, psychology can help reduce significant contributors to the nation's morbidity and mortality. Achieving such success, however, challenges psychologists to collaborate effectively, to combine science with practice and policy, and to address complex philosophical and ethical issues concerned with individual freedom and public responsibility.     

Special perspective: An immodest proposal: should treating mental health professionals be barred from testifying about their patients?

Notwithstanding ethical rules that address therapeutic and forensic role conflicts for psychologists and psychiatrists, overzealous patient advocacy by therapists, tightened reimbursement for therapy, and a growth market for forensic psychology and psychiatry, have led many therapists to appear willingly as forensic experts on behalf of their patients. Existing ethical rules, as well as other proposed approaches to address this problem, assume that it can be resolved by modest changes in existing practice that permit therapists to testify as long as their testimony avoids psycholegal opinions. This essay questions whether these modest changes can adequately address this problem and advances consideration of a more radical proposal to address this problem, prohibiting therapists from testifying about their patients. © 1998 John Wiley & Sons, Ltd.     

Transforming psychological practice and society. Policies that reflect the new paradigm

As people with disabilities challenge psychology to acknowledge the sociopolitical foundations of their marginalization, they urge psychologists to help improve disability policy within and beyond the borders of the discipline. Understanding disability through a social paradigm offers opportunities to reframe the way psychologists define problems related to disability, to develop more collaborative relationships between psychologists and people with disabilities, and to adopt new professional responsibilities with respect to the disability community. The authors address the impact of the social paradigm on policies within psychology that guide consulting, advocacy, and training. The impact of national policy decisions, such as those associated with reimbursement, on practice and training is also discussed. Highlighted throughout are points of controversy prompted by new disability frameworks that remain open to illumination from the field.     

Twenty-first century ethical challenges for psychology

Foreseeable social and technological changes will force us to reevaluate our thinking about ethically appropriate ways to fulfill our mission of using psychology to advance human health and welfare in the twenty-first century. Three categories of challenge related to societal and technological changes have become particularly evident. First, increasing patterns of delivering services over substantial distances by electronic means (i.e., telepsychology) demand consideration. Second, we must parse our ethical obligations to individuals, to groups, and to society at large as our influence working behind the scenes as "invisible" psychologists grows. Finally, as we witness the accelerating demise of psychiatry, we must take care not to follow a similar path. As we face new ethical challenges, we must continually ask ourselves where our responsibilities lie as individuals and as a profession. We must learn not to repeat the mistakes of the past and focus instead on optimizing the future for a science and practice of psychology focused on human health and welfare.     

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.     

Sociopolitical diversity in psychology. The case for pluralism

Psychology celebrates diversity, recognizes the value and legitimacy of diverse beliefs, and strives to be inclusive. Yet, the profession lacks sociopolitical diversity. Most psychologists are politically liberal, and conservatives are vastly underrepresented in the profession. Moreover, when sociopolitical views guide the research, advocacy, or professional practice of psychologists, those views most often are liberal. The lack of political diversity in psychology has unintended negative consequences for research, policy advocacy, clinical practice, the design and implementation of social interventions, and professional education. It excludes or marginalizes conservatives and conservative views, having detrimental effects on the profession in each of these areas. This article examines the importance of political diversity and the negative consequences of its absence and provides strategies for increasing sociopolitical pluralism in psychology.     

Feeding the Hungry Other: Levinas,Breastfeeding, and the Politics of Hunger

Breastfeeding has become a subject of moral concern as its benefits have become well known. Encouraging mothers to breastfeed has been the goal of extensive public health promotion efforts. Emmanuel Levinas makes absolute responsibility to the Other central to his ethics, with giving food to the Other the paradigmatic ethical act. However, Levinas also provides an important critique of the autonomous individual who is taken for granted by breastfeeding promotion efforts. I argue that the ethical obligation to feed the hungry child must be recognized as coextensive with meeting the needs of women, especially given the current absence of important social and economic supports for breastfeeding. Under a Levinasian framework, each of us is ethically responsible for feeding children; this responsibility is not limited to mothers. This ethical responsibility needs to be expressed through improving social and economic supports necessary for those individuals who wish to breastfeed, instead of attempting to convince women to breastfeed. This ethical responsibility must also be understood in a broader context of a politics of hunger, which provides access to quality food for all, and goes beyond mere nutrition to include the importance of culture, touch, and intimacy in the enjoyment of food—what Levinas calls “good soup.”     

Ethical social justice: Do the ends justify the means?

This article offers an ethical decision‐making model, informed by community psychology values, as a means for guiding psychologists when engaging in social justice‐oriented work. The applicability of this model is demonstrated through a case analysis elucidating how America's psychologists individually and collectively arrived at the decision to endorse torture—ostensibly as a means for preventing terrorism. Critics have wondered how the American Psychological Association succumbed to these involvements, and how to prevent such ethical lapses in the future. Unfortunately, the American Psychological Association's ethical codes fail to provide explicit guidance for psychologists' involvement in social justice work that impacts communities and systems. To address this gap, we present a values‐driven, ethical decision‐making framework that may be used to guide psychologists' future practices. This framework infuses fundamental community psychology values (i.e., caring and compassion; health; self‐determination and participation, human diversity, social justice; and critical reflexivity) into a 9‐step model.     

On becoming a child advocate in school psychology

Child advocacy is becoming an important concept as well as practice in education and other serivices for children. There are definite societal reasons for the evolution of formal advocacy mechanisms, not the least of which is the functioning of professionals. School psychology provides an ideal opportunity for many child advocacy concepts to be implemented. However, the individual psychologists must have a personal commitment to “follow through” to see that children's needs are met. Child advocacy can be built into the school psychology training program in both philosophy and practice.     

The movement from ethics to social relationships for Levinas,and why decency obscures obligation

According to Emmanuel Levinas, the individual bears an infinite obligation to the other person. In the Talmudic reading “Judaism and revolution,” Levinas suggests that we move from the ethical encounter (and infinite obligation) to social relationships (with limited obligations) using contracts—both particular contracts and the social contract. So social relationships are created by limiting obligation, and as a result these relationships can only be practically acceptable, not ethical. Jewish religious practice for Levinas should also be understood as a set of negotiated limits to our infinite obligation.     

Ethical practice from the perspective of the forensic psychologist: Commentary on the uses and value of the Australian Psychological Society (2007) Code of Ethics

Forensic practice in Australia and around the world attracts a high level of public and judicial scrutiny. The way in which the forensic psychologist conducts him or herself in ethically challenging situations is important not only to the reputation of the individual practitioner, but to the profession more widely. This paper outlines some of the ethical issues that commonly arise in forensic psychology practice and discusses these in relation to the recently published Australian Psychological Society (2007) Code of Ethics. Four ethically challenging scenarios are described and discussed in terms of how the Code might be used to offer guidance to psychologists about how they might best respond.     

Balancing Confidentiality and Collaboration Within Multidisciplinary Health Care Teams

As multidisciplinary perspectives are increasingly integrated into the treatment of health problems, opportunities for clinical psychologists in medical settings are expanding. Although cross-discipline collaboration is at the core of multidisciplinary treatment models, psychologists must be particularly cautious about information sharing due to their profession??s ethical standards regarding patient confidentiality. Psychologists?? ethical obligations require them to achieve a delicate balance between contributing to the treatment team and protecting patient confidentiality. In the current review, relevant ethical standards and federal guidelines are applied to everyday practices of clinical psychologists in medical settings. Additionally, recommendations for individual psychologists, health care organizations, and graduate training programs are presented.     

Canaries in the Ethical Coal Mine? Case Vignettes and Empirical Findings for How Psychology Leaders Have Adopted Twitter

Twitter, an online application, allows users to post microblog statements in real time. Have psychologists in leadership positions adopted Twitter? What ethical standards are navigated in doing so? Little research has examined the adoption rate of Twitter within a sample of psychologists. This article outlines a series of case vignettes depicting ethical dilemmas encountered by psychologists who adopt Twitter. Data reviewing Twitter adoption by professional psychologists who served as president within psychology advocacy organizations reveal higher adoption rates from student group leaders than professional organization advocacy presidents. Implications for ethical standards and professional development are discussed.     

AIDS: ethics, justice and social policy

ABSTRACT Principles of justice and equality demand that HIV seropositive individuals and those with AIDS should not be discriminated against in any area of social provision. If social policy on AIDS is constructed in terms of reciprocal obligations, that is if obligations to the HIV seropositive individual and obligations of the HIV seropositive individual are given equal weight, the civil rights of HIV seropositive individuals may be secured and this may create a climate in which HIV seropositive individuals will more readily notify partners, and others at risk of infection, of their HIV status. It is conceivable that such a climate could facilitate greater control of the spread of HIV/AIDS.     

Psychology and the politics of same-sex desire in the United States: an analysis of three cases

Psychological science has assumed an increasingly explicit role in public policies related to same-sex desire in the United States. In this article, we present a historical analysis of the relationship between policy discourse and scientific discourse on homosexuality produced within U.S. psychology over the 20th and early 21st centuries through the lens of three cases: Bowers v. Hardwick (1986), Lawrence v. Texas (2003), and Perry v. Schwarzenegger (2010). Our analysis suggests that, for the majority of its disciplinary history, psychology produced knowledge that supported a status quo of legal and cultural subordination for same-sex-attracted individuals. The discipline's shift in understanding of homosexuality, reflected in a 1975 policy statement of the American Psychological Association, reversed this relationship and opened up space for advocacy for social and political change regarding homosexuality. Our analysis of policy decisions rendered by the courts reveals the increasingly important role psychological science has assumed in challenging the legal subordination of same-sex-attracted individuals, though the basis upon which psychological science has sought to inform policy remains limited. We conclude with a critical discussion of the type of knowledge claims psychologists have traditionally used to advocate for gay and lesbian rights, suggesting the vitality of a narrative approach which can reveal the meaning individuals make of legal subordination and political exclusion.     

Ethical Concerns of Nonclinical Forensic Witnesses and Consultants

Current research suggests that nonclinical forensic psychologists[sup1] are appearing increasingly more often in the legal arena. We argue that many of the ethical dilemmas that face these psychologists differ from those encountered by clinical forensic psychologists. To test the accuracy of this assertion, 37 nonclinical forensic psychologists were surveyed to identify some of the ethical issues and dilemmas they have encountered while engaging in expert testimony or pretrial consulting. Respondents were asked also about how they have resolved these ethical issues and whether they were aware of the "Specialty Guidelines for Forensic Psychologists" (Committee on Ethical Guidelines for Forensic Psychologists, 1991). Results of the survey are discussed in terms of the need for additional regulatory guidelines or professional standards that speak directly to the ethical issues confronting nonclinical, forensic expert witnesses and consultants.     

Rehabilitation. Psychology's greatest opportunity?

Rehabilitation is one of the fastest growing areas in the health industry. Supported by several key pieces of legislation, psychologists have established themselves as integral health care providers in rehabilitation. Although psychologists have benefited from legislated membership in rehabilitation, most individual psychologists and the psychological associations have failed to recognize the importance of public policy for the practice of psychology. Escalating health care costs have resulted in major revisions in the manner in which health insurers reimburse treatment. Medicare, the major federal health insurance provider, increasingly has been viewed as a model for the provision of all health care. The historic exclusion of psychologists from Medicare has limited the scope of psychologists' practice and the growth of professional psychology. The recent inclusion of psychologists in Medicare improves but does not solve practice and policy issues confronting psychology. Knowledge of national health policy formulation and greater participation by psychologists in health policy is necessary to secure the scope of professional practice most psychologists expect.     

Extended cognition,personal responsibility,and relational autonomy

The Hypothesis of Extended Cognition (HEC)—that many cognitive processes are carried out by a hybrid coalition of neural, bodily and environmental factors—entails that the intentional states that are reasons for action might best be ascribed to wider entities of which individual persons are only parts. I look at different kinds of extended cognition and agency, exploring their consequences for concerns about the moral agency and personal responsibility of such extended entities. Can extended entities be moral agents and bear responsibility for actions, in addition to or in place of the individuals typically held responsible? What does it mean to be “autonomous” when one’s cognition is influenced and supported by a milieu of environmental factors? To answer these questions, I explore strong parallels between HEC’s critique of individualism in cognition, and feminist critiques of individualist accounts of self, agency, and autonomy. This relational and social conception of autonomous agency, as scaffolded and supported (or undermined and impaired) by a milieu of social, relational, and normative factors, has important lessons for HEC. Drawing together these two visions of distributed and decentralized aspects of personhood highlights how cognition, action, and responsibility are inextricably linked. It also encourages a reconceptualization of all cognition and all concerns about responsibility for actions, not simply as sometimes “extended” around individuals, but as fundamentally communal, social, and normative, with individual cognition and individual moral responsibility being derivative special cases, not the paradigm examples. Individuals are merely one of many possible loci of cognition, action, and responsibility.