Interrogating the ethics of operational psychology

Commissioned amidst allegations of collusion between American Psychological Association officials and Central Intelligence Agency and Department of Defense officials involved in the enhanced interrogation programme, the July 2015 Hoffman Report documented a decade of collusion between American Psychological Association and Department of Defense officials in unethical national security interrogations. However, interrogation support is but one of numerous areas where psychologists are directly aiding military and intelligence operations, an area known as operational psychology. The ethical issues posed by the larger field of operational psychology have received little public discussion apart from apologia by operational psychologists themselves. To stimulate public review of operational psychology, leaders of the movement to remove psychologists from national security interrogations convened, in September 2015, a group of experts to work towards a consensus set of principles to guide future discussion. Participants included psychologists, physicians, and social scientists; military and intelligence professionals; and attorneys, ethicists, and human rights advocates. The discussion also drew upon years of dialogue between participants and military health and intelligence professionals. The workshop produced “The Brookline Principles on the Ethical Practice of Operational Psychology,” with implications for the profession of psychology and for civil society.     

A utilitarian argument against torture interrogation of terrorists

Following the September 2001 terrorist attacks on the United States, much support for torture interrogation of terrorists has emerged in the public forum, largely based on the “ticking bomb” scenario. Although deontological and virtue ethics provide incisive arguments against torture, they do not speak directly to scientists and government officials responsible for national security in a utilitarian framework. Drawing from criminology, organizational theory, social psychology, the historical record, and my interviews with military professionals, I assess the potential of an official U.S. program of torture interrogation from a practical perspective. The central element of program design is a sound causal model relating input to output. I explore three principal models of how torture interrogation leads to truth: the animal instinct model, the cognitive failure model, and the data processing model. These models show why torture interrogation fails overall as a counterterrorist tactic. They also expose the processes that lead from a precision torture interrogation program to breakdowns in key institutions—health care, biomedical research, police, judiciary, and military. The breakdowns evolve from institutional dynamics that are independent of the original moral rationale. The counterargument, of course, is that in a society destroyed by terrorism there will be nothing to repair. That is why the actual causal mechanism of torture interrogation in curtailing terrorism must be elucidated by utilitarians rather than presumed.     

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.     

How Organizational Hunger May Have Contributed to the American Psychological Association’s Scandal Over the Ethics of Torture

The recent scandal over the American Psychological Association’s (APA) change in ethical policy on torture has been reported by journalists and by a team led by an independent reviewer, a former federal prosecutor. Additional observations have been provided by current and former APA leaders and members at large posting on the APA website. There seems to be a consensus that the APA, through a corruptive subgroup, colluded with the United States Government to change the APA ethical standards to provide cover for the Department of Defense’s “enhanced interrogation” of suspected terrorists. Examining the flawed decision-making process through a group dynamics lens, the author examines the extent to which corruptive motives and manipulative (if not deceptive) practices led to collusion and a policy inconsistent with APA values and mission. He also offers recommendations to other professional organizations as to how to avoid corruptogenic group processes.     

Professional Autonomy in Belgium

The Belgian health care system has a few features that may havecontributed to the rising costs of health care: patients' freechoice of physicians, large clinical freedom of physicians, essentiallya fee-for-service remuneration for medical specialists in which the feesare agreed between insurance funds and physicians. The increased medicalconsumption and costs have prompted the state and insurance companies totake measures that limit the professional autonomy of the physicians.Access to medical education, free until 1997, is now restricted. Themedical profession is organized in the Order of Physicians that hasestablished a code of professional ethics that has moral but not legalforce. So far, there is no special legislation for thepatient–physician relationship, though laws on specific issueslike organ transplantation contain duties for physicians. In recentyears a debate is taking place on patients' rights, of which informedconsent is central and gaining importance in medico-legal publications.An analysis of (ethical and legal) regulations concerning thewithholding or withdrawal of treatment by physicians demonstrate thatthe profession still enjoys a large clinical autonomy, though duediscussion with the patient has become more explicitly required. Therespect for professional autonomy is not primarily due to any formalpower that the Order of Physicians would have, but is rather grounded inthe generally high quality of the patient–physician relationshipthat in ethical terms is considered essentially as a confidencerelationship rather than a contractual relationship.     

生物医学人体受试者研究未来面临的挑战

人体受试者研究的伦理问题在今后将会愈益引起关注,如何看待知情同意的代理权？如何处理不同文化背景下的知情同意原则？在商业利益诱惑下背离本人健康利益和知情同意是否有效？受试者的利益回报,以及体试验研究要求的双盲,随机、对照等原则可能面临的新问是,都是人体受试者研究未来面临的挑战。     

Ethical considerations in the management of military related concussion

Since the year 2000 over 300,000 military service members have been diagnosed with mild traumatic brain injury/concussion. Consequently, this injury has become the subject of increased awareness and study within the military healthcare environment. Although single and/or isolated concussions typically heal in a relatively rapid fashion with limited to no long-term sequelae, there is debate in the field about the impact of repeat concussion. To this end, various ethical challenges arise when managing patients with such injuries. Several papers outlining these issues with regard to athletes have been published in the sports medicine literature. However, because providers caring for military service members must make return-to-duty-decisions, practice within the military setting results in a number of unique ethical considerations. More specifically, management of service members with a history of repeat concussion and increasingly complicated recoveries, as well as the potential for premature return-to-duty are topics of concern for military health care providers. Using the American Psychological Association ethical principles and standards, the current article outlines various ethical challenges to concussion management in the military setting. The ethical principles of Beneficence and Nonmaleficence and Respect for People’s Rights and Dignity, as well as the 3 related ethical standards of Competence, Avoiding Harm, and Conflict of Interest are discussed. Policy changes are highlighted as a proximal solution to these ethical challenges.     

The futures of physicians: Agency and autonomy reconsidered

The corporatization of U.S. health care has directed cost containment efforts toward scrutinizing the clinical decisions of physicians. This stimulated a variety of new utilization management interventions, particularly in hospital and managed care settings. Recent changes in fee-for-service medicine and physicians' traditional agency relationships with patients, purchasers, and insurers are examined here. New information systems monitoring of physician ordering behavior has already begun to impact on physician autonomy and the relationship of physicians to provider organizations in both for-profit and ‘not-for-profit’ sectors. As managed care practice settings proliferate, serious ethical questions will be raised about agency relationships with patients. This article examines health system dynamics altering the historical agency relationship between the physician and patient and eroding the traditional autonomy of the medical profession in the United States. The corporatization of medicine and the accompanying information systems monitoring of physician productivity is seen to account of such change, now posing serious ethical dilemmas.     

Ethical Issues in Engineering Models: An Operations Researcher’s Reflections

This article starts with an overview of the author’s personal involvement—as an Operations Research consultant—in several engineering case-studies that may raise ethical questions; e.g., case-studies on nuclear waste, water management, sustainable ecology, military tactics, and animal welfare. All these case studies employ computer simulation models. In general, models are meant to solve practical problems, which may have ethical implications for the various stakeholders; namely, the modelers, the clients, and the public at large. The article further presents an overview of codes of ethics in a variety of disciples. It discusses the role of mathematical models, focusing on the validation of these models’ assumptions. Documentation of these model assumptions needs special attention. Some ethical norms and values may be quantified through the model’s multiple performance measures, which might be optimized. The uncertainty about the validity of the model leads to risk or uncertainty analysis and to a search for robust models. Ethical questions may be pressing in military models, including war games. However, computer games and the related experimental economics may also provide a special tool to study ethical issues. Finally, the article briefly discusses whistleblowing. Its many references to publications and websites enable further study of ethical issues in modeling.     

Ethical Issues in Family-Centered Primary Care

In 1969 a new primary care medical specialty, family practice, was formally created. One element in the development of this specialty from the roots of general practice was an understanding of the importance of family process in health and health care. Family physicians are now trained to work with families in the provision of primary medical care, and many provide some formal family counseling and therapy. The family physician who works with families faces many of the same ethical conflicts with which family therapists are confronted. The primary relationship of the family physician to his or her patients, however, as the provider of continuing health care, modifies these conflicts and creates new and vexing problems.     

Security,Profiling and Equality

How, exactly, must we strike the balance between security and equality? Must we insist, out of respect for the equality of persons, that the police refrain from using ethnic profiling and opt for some other strategy in their pursuit of terrorists, or must we allow the police to continue with this policy, which seems to sacrifice equality for the sake of security? This paper assesses the ethical status of ethnic profiling from the perspective of the ideal of equality. The paper shows how the ethical status of ethnic profiling changes depending on how exactly we specify the egalitarian ideal. Furthermore, it argues that on a plausible interpretation of the ideal of equality, ethnic profiling is not in principle objectionable.     

Don't Be Chicken: Bioethics and Avian Flu

This article reviews the history of smallpox and ethical issues that arise with its threat as a biological weapon. Smallpox killed more people than any infectious disease in history-and perhaps three times more people in the 20th Century than were killed by all the wars of that period. Following a WHO-sponsored global vaccination campaign, smallpox was officially declared eradicated in 1980. It has since been revealed that the Soviet Union, until its fall in the early 1990s, manufactured tens of tons of smallpox for military purposes. A worry is that some of this may have fallen into the hands of "rogue" nations or terrorists. Current U.S. debate questions whether smallpox vaccine should therefore be made available to the American public, which-like the rest of the world-now lacks immunity. Because the vaccine is considerably dangerous, public dialogue cannot resolve this matter if evidence material to the likelihood of attack is classified (i.e. secret). I conclude by recommending numerous future areas for ethics research related to the weaponization of smallpox.     

Suicide and the military justice system.

The United States military is sensitive to suicide. There are military policies that direct the formation of active suicide prevention programs. The U.S. military emphasizes a humanitarian approach. Modern military law, however, may view suicidal behavior as deviant. The prosecution of this behavior, although theoretically possible, has never occurred until recently. The U.S. military has now convicted soldiers for attempted suicide and assisted suicide. This article reviews these recent court decisions and suggests revisions in the military law.     

Confidentiality in the military

This article presents and analyzes options military physicians face regarding whether or not to respect gay servicepersons' confidentiality. This situation is considered to be generic to others that involve similar conflicts. Dilemmas arising before and after the emergence of HIV-related diseases are discussed. Recommendations regarding psychiatrists' ethical obligations when conducting forensic exams are compared with military physicians' obligations to respect servicepersons' confidentiality. It is suggested that military psychiatrists should violate servicepersons' confidentiality under some circumstances, but generally should warn them in advance that they will do so. Possible exceptions exist when warning servicepersons would increase the likelihood that justice would be violated or substantial harm would occur.     

Smallpox revisited?

This article reviews the history of smallpox and ethical issues that arise with its threat as a biological weapon. Smallpox killed more people than any infectious disease in history--and perhaps three times more people in the 20th Century than were killed by all the wars of that period. Following a WHO-sponsored global vaccination campaign, smallpox was officially declared eradicated in 1980. It has since been revealed that the Soviet Union, until its fall in the early 1990s, manufactured tens of tons of smallpox for military purposes. A worry is that some of this may have fallen into the hands of "rogue" nations or terrorists. Current U.S. debate questions whether smallpox vaccine should therefore be made available to the American public, which--like the rest of the world--now lacks immunity. Because the vaccine is considerably dangerous, public dialogue cannot resolve this matter if evidence material to the likelihood of attack is classified (i.e. secret). I conclude by recommending numerous future areas for ethics research related to the weaponization of smallpox.     

An Ethical Framework for Evaluating Experimental Technology

How are we to appraise new technological developments that may bring revolutionary social changes? Currently this is often done by trying to predict or anticipate social consequences and to use these as a basis for moral and regulatory appraisal. Such an approach can, however, not deal with the uncertainties and unknowns that are inherent in social changes induced by technological development. An alternative approach is proposed that conceives of the introduction of new technologies into society as a social experiment. An ethical framework for the acceptability of such experiments is developed based on the bioethical principles for experiments with human subjects: non-maleficence, beneficence, respect for autonomy, and justice. This provides a handle for the moral and regulatory assessment of new technologies and their impact on society.     

Danger! Psychotherapists at work

The rapid growth of psychotherapeutic movements in recent years has led to a free market. Vast numbers of psychotherapists of different theoretical persuasions are now on offer. While such a choice has its obvious advantages, it creates bewildering confusions in the minds of potential clients. How can the clients tell which psychotherapist or psychotherapeutic entepise to opt for? How can they know whether they have made an appropriate choice? How do they know which therapy works best under which conditions? Are there a set of criteria laid down which might guide the client in making a judicious choice? Can they be assured that after a senes of agreed sessions, they will get better? These are extremely serious issues. The paper discusses the practical and ethical implications underlying these issues and offers specific suggestions and guidelines as to how the clients might safeguard their own interests when it comes to choosing an appropriate psychotherapist.     

Human Enhancement and Communication: On Meaning and Shared Understanding

Our technologies have enabled us to change both the world and our perceptions of the world, as well as to change ourselves and to find new ways to fulfil the human desire for improvement and for having new capacities. The debate around using technology for human enhancement has already raised many ethical concerns, however little research has been done in how human enhancement can affect human communication. The purpose of this paper is to explore whether some human enhancements could change our shared lifeworld so radically that human communication as we know it would not be possible any longer. After exploring the kinds of communication problems we are concerned with as well as mentioning some possible enhancement interventions that could bring about such problems, we will address some of the ethical implications that follow from these potential communication problems. We argue that because of the role that communication plays in human society, this issue deserves attention.     

Report of the AMA Council on Ethical and Judicial Affairs: professionalism in the use of social media

Although many physicians have been using the internet for both clinical and social purposes for years, recently concerns have been raised regarding blurred boundaries of the profession as a whole. In both the news media and medical literature, physicians have noted there are unanswered questions in these areas, and that professional self-regulation is needed. This report discusses the ethical implications of physicians' nonclinical use of the internet, including the use of social networking sites, blogs, and other means to post content online. It does not address the clinical use of the internet, such as telemedicine, e-prescribing, online clinical consultations, health-related websites, use of electronic media for clinical collaboration, and e-mailing patients (some of which are already covered in the AMA's Code of Medical Ethics).     

TERRORISM, SELF-DEFENSE, AND WHISTLEBLOWING

In a recent paper given at a Symposium on terrorism, Thomas Hill, Jr., discussed "Making Exceptions Without Abandoning the Principle: Or How a Kantian Might Think about Terrorism." His argument, however, after acknowledging that "terrorists of course often claim to have morally worthy ends and also means that are morally justified in the context," and further stating that "some such claims deserve a serious hearing,"¹ goes on to deal with the related question of
…what one may justifiably do in response to morally indefensible terrorism.²