Ethical and legal issues in group counseling

Legal and ethical issues involved in group work are reviewed and discussed. Variations in different professional ethics codes are discussed. Recommendations for consideration by group leaders are made.     

Ethical and legal issues in e-mail therapy

Psychologists and psychiatrists recently started using electronic mail (e-mail) to conduct therapy. This article explores relevant ethical and legal issues including, among others, the nature of the professional relationship, boundaries of competence, informed consent, treating minors, confidentiality, and the duty to warn and protect. To illustrate these complex issues, two services currently operating are discussed. To address potential hazards to clients and the profession, a new ethical standard for e-mail therapists is offered.     

Health and legal issues in undercover narcotics investigations: Misrepresented evidence

This paper outlines some types of psychological disturbances found to occur in narcotics agents who use undercover investigative methods. Research results and other clinical findings dismiss popular notions of multiple personalities as a mental injury caused by prolonged role played pseudoidentities. Coping strategies for dealing with certain paranoid reactions are seen as potential sources of contamination in the gathering of evidence of criminal activity. Issues related to questions of health versus operative talents in selecting for personal suitability for undercover work are presented.     

Munchausen syndrome by proxy: Clinical review and legal issues

Well-established policies and procedures govern the identification, management, and treatment of most variations of child abuse. For many therapists, such cases have become “routine”. Munchausen syndrome by proxy is an under-recognized form of child abuse in which a parent feigns or creates illness in a child specifically to have the child subjected to unnecessary diagnostic tests and treatments by medical practitioners. Variations range from false reports of fevers or allergies, to life-threatening abuse, such as surreptitious poisonings or injections with toxic substances. This article reports a case example of Munchausen syndrome by proxy, provides a review of historical, diagnostic and management issues, and discusses legal issues relevant to detection of the perpetrator and protection of the child victim.     

Children with AIDS in the public schools: The ethical issues

The question of whether to allow children with AIDS to attend public school generates explosive emotions and has wide-reaching consequences. This paper focuses on the perspective of parents of well children who may be asked to attend school with children who have AIDS. These parents are poised at the heart of the dilemma: they are the ethical “bottom line,” and an argument that fails to satisfy them ought not to satisfy anyone. The conflicting commitments these parents face are first to the parentchild covenant which requires them to act in their child's best interests, and second, to the principles of beneficence and justice, which require them not to further burden a sick child with ostracism and isolation. Almost exact parallels exist between this issue and that of proxy consent by parents for children's participation in low-risk, non-therapeutic research. The lengthy and important debate between Paul Ramsey and Richard McCormick on this question is analyzed, concluding that McCormick's position in favor of thoughtful proxy consent is the more compelling. Returning to the question of allowing children with AIDS to attend school, the essay shows why the parallels are persuasive. On the ethical level, the apparent conflict of obligations is almost exactly the same; on the pragmatic level, the essay shows why sharing a classroom with a child who has AIDS is comparable to the “low-risk” category that the National Commission for the Protection of Human Subjects found acceptable in its 1978 guidelines. The essay concludes that parents of healthy childrenmay and ought to accept the presence of children with AIDS in the public school.     

Generating items during testing: Psychometric issues and models

On-line item generation is becoming increasingly feasible for many cognitive tests. Item generation seemingly conflicts with the well established principle of measuring persons from items with known psychometric properties. This paper examines psychometric principles and models required for measurement from on-line item generation. Three psychometric issues are elaborated for item generation. First, design principles to generate items are considered. A cognitive design system approach is elaborated and then illustrated with an application to a test of abstract reasoning. Second, psychometric models for calibrating generating principles, rather than specific items, are required. Existing item response theory (IRT) models are reviewed and a new IRT model that includes the impact on item discrimination, as well as difficulty, is developed. Third, the impact of item parameter uncertainty on person estimates is considered. Results from both fixed content and adaptive testing are presented.This article is based on the Presidential Address Susan E. Embretson gave on June 26, 1999 at the 1999 Annual Meeting of the Psychometric Society held at the University of Kansas in Lawrence, Kansas. —Editor     

Ethical and legal issues in conducting research involving elderly subjects

Older people are increasingly the focus of biomedical and behavioral research not only because the elderly constitute the fastest growing segment of our population but because there is a societal concern to improve the elderly's quality of life. The profound need to advance that research carries with it an equally profound obligation to protect the rights and welfare of elderly research subjects, and thus raises difficult ethical and legal issues. Against a background of foundational principles for the protection of human subjects, we discuss whether older subjects should be treated as a special class, the ethical and legal issues over informed consent, capacities for consent, and special problems related to cognitive impairment. We discuss surrogate/proxy consent procedures in research, recruitment of elderly subjects, conflicts of interest, special problems regarding institutional research, and risk/benefit analyses. We offer recommendations and practical guidelines for conducting current and future research involving elderly participants.     

Major legal and ethical issues in behavioral treatment: Focus on institutionalized mental patients

Proponents of behavior therapies advocate expanded use of this approach based on its pragmatics and clinical successes. Critics, however, point not only to abuses in implementation, but charge that the behavioral approach is inherently unethical, especially when used with institutionalized mental patients. This article will review these arguments as well as provide an updated exploration of relevant court decisions impacting behavioral treatment in mental institutions. Suggested courses of action are then provided.     

Neuroimaging techniques for memory detection: scientific, ethical, and legal issues

There is considerable interest in the use of neuroimaging techniques for forensic purposes. Memory detection techniques, including the well-publicized Brain Fingerprinting technique (Brain Fingerprinting Laboratories, Inc., Seattle WA), exploit the fact that the brain responds differently to sensory stimuli to which it has been exposed before. When a stimulus is specifically associated with a crime, the resulting brain activity should differentiate between someone who was present at the crime and someone who was not. This article reviews the scientific literature on three such techniques: priming, old/new, and P300 effects. The forensic potential of these techniques is evaluated based on four criteria: specificity, automaticity, encoding flexibility, and longevity. This article concludes that none of the techniques are devoid of forensic potential, although much research is yet to be done. Ethical issues, including rights to privacy and against self-incrimination, are discussed. A discussion of legal issues concludes that current memory detection techniques do not yet meet United States standards of legal admissibility.     

Some ethical and legal issues in Germany involving informed consent and patenting

This paper elaborates on discussions in Germany regarding some of the ethical and legal issues in the area of the use and patenting of inventions involving human tissue. The issues discussed pertain to the benefits and problems regarding informed consent and the issue of property rights as they relate to the donation of cells and tissue. An earlier version of this paper was presented at an international conference, “The Ethics of Intellectual Property Rights and Patents,” held in Warsaw, Poland on 23–24 April, 2004.     

The order-restricted association model: Two estimation algorithms and issues in testing

This paper presents a row-column (RC) association model in which the estimated row and column scores are forced to be in agreement with an a priori specified ordering. Two efficient algorithms for finding the order-restricted maximum likelihood (ML) estimates are proposed and their reliability under different degrees of association is investigated by a simulation study. We propose testing order-restricted RC models using a parametric bootstrap procedure, which turns out to yield reliablep values, except for situations in which the association between the two variables is very weak. The use of order-restricted RC models is illustrated by means of an empirical example. Francisca Galindo performed this research as a part of her PhD. dissertation project at Tilburg University.     

Amnesia and competency to stand trial: A review of legal and clinical issues

Recent case law is discussed regarding the role of amnesia in determining competency to stand trial. Clinical issues are examined for a range of amnestic conditions on a spectrum of organic and functional disorders. Clinical methods are explored for establishing the extent of amnesia and its relevance to competency.     

Conceptual issues in the definition of death: A guide for public policy

Theoretical Medicine and Bioethics - Current medical and legal literature generally favors a definition of death based on total cessation of brain functioning. It does not, however, supply the...     

The $1000 genome: ethical and legal issues in whole genome sequencing of individuals

Progress in gene sequencing could make rapid whole genome sequencing of individuals affordable to millions of persons and useful for many purposes in a future era of genomic medicine. Using the idea of $1000 genome as a focus, this article reviews the main technical, ethical, and legal issues that must be resolved to make mass genotyping of individuals cost-effective and ethically effective. It presents the case for individual ownership of a person's genome and its formation, and shows the implications of that position for rights to informed consent and privacy over sequencing, testing, and disclosing genomic information about identifiable individuals. Legal recognition of a person's right to control his or her genome and the information that it contains is essential for further progress in applying genomic discoveries to human lives.     

Parricides: Characteristics of offenders and victims,legal factors,and treatment issues

Parricides account for about 2% of all homicides. Perpetrators are typically White middle-class males without a history of prior criminal convictions. Most parricides involve single-victim, single-offender situations, with firearms more likely to be used against fathers than mothers. The popular literature as well as much of the professional literature have presented youths who killed a parent as prosocial individuals who feared for their lives. Adults who killed a parent have typically been presented as suffering from a severe mental disorder. These two scenarios describe many parricides. However, major mental disorders among youthful parricidal offenders, conduct disorder and antisocial personality disorder as well as other psychiatric comorbidities also occur in a significant proportion of parricides. Youthful and adult offenders experience different legal outcomes and receive mental health services in differing contexts. We review offender and victim characteristics, as well as legal and treatment issues, and outline needs for future research.