|
|
|
|
|
|
By Tony Cellucci, Ph.D., ABPP
Idaho State University
Five years and seven drafts in the making, the new APA ethics code takes effect June 1, 2003. Although there are a number of notable differences from the 1992 code (a line by line comparison is available on the APA website under ethics), there is clearly much continuity with the previous edition and general consistency with ethics texts. Several changes appear more related to the need within such documents for general housekeeping and improved organization rather than any major shift in thinking. For example, forensic practice is addressed throughout rather than having a separate section, and, consistent with prior commentary, the code applies equally to telehealth activities.
Bill Doverspike makes the point that the new code attempts to limit liability by stating in the Introduction that the ethics code is not intended to be a basis for civil liability, dropping reference to specialty guidelines, and using the term "reasonable" to reference the standard of prevailing professional judgment. The important distinction between General Principles (5), which are aspirational, and explicit Ethical Standards (89) is maintained. The principles were revised substantially and are more akin to Kitchner's normative principles (e.g., beneficence and non-malfeasance), although justice was added and social responsibility deleted. Justice is concerned with promoting both access and equal quality of services provided by psychologists. The statement psychologists strive to contribute a portion of their professional time without compensation is retained under fidelity and responsibility. Unfortunately, what appears to be lost with social responsibility is advocacy (i.e., encourage the development of law and social policy that serves the interests of
|
|
|
|
|
|
|
|
|
|
|
patients and the public).
A number of specific changes in the standards are noteworthy. Informed consent provisions (3.10) were generally strengthened and include providing an appropriate explanation and obtaining assent with minors, beyond the consent of their legal representative. It is further clarified that competence (2.01) can be attained by relevant education, training, supervised experience, consultation, or study. A new standard (2.20) also recognizes that psychologists provide services in emergencies. Multicultural issues are addressed under competence, as well as in the standard on the appropriate use of assessments (9.02) in which instruments used are either validated for the population or their limitations noted.
Celia Fisher, who chaired the APA Ethics Code Task Force, has highlighted the new standard on the release of test data (9.04) as most likely to affect practice. Driven to some degree by HIPAA, this standard defines test data (vs. stimuli) as the test scores and written protocols on which we record patient responses and instructs that these should now be released to the client or their representative. A psychologist may refrain from releasing such data if substantial harm or misrepresentation would result but this is likely to be regulated by law. (I suspect I need to write more legibly).
Another addition is a new standard (7.04) under Education and Training that limits the degree to which programs can require students or supervisees to provide personal information or participate in therapy activities. This suggests a need for clinical training committees to discuss what type of self-disclosures they do expect of their students and to clarify in program materials rights and responsibilities, as well as
|
|
|
|
|
|
|
|
|
|
|
procedures for students with personal problems. Information about stipends and benefits has also been added to what is included in an accurate description of a program (7.02).
The language used in discussing multiple relationships (3.05) is now more neutral, acknowledging that multiple roles that would not be reasonably expected to cause loss of objectivity or professional effectiveness, conflicts of interest, or exploitation of the patient are not unethical. On the other hand, a new standard (10.6) prohibits psychologists from having sexual relationships with relatives or significant others of their patients (i.e., the Princes of Tides standard). There is also a new standard on Group Therapy (10.03) that requires therapists to clarify roles and confidentiality, although this might be considered expected practice.
Finally, there already existed language in the prior ethics code to plan for patient care if services were to be disrupted by illness or death; this standard (3.12) now includes retirement planning. Some may find it comforting to know that we also can protect ourselves. Psychologists may ethically terminate therapy when threatened or otherwise endangered (10.10) by patients or related individuals. I hope these examples have piqued your interest. The new code is clearly must reading for psychologists and surely there will be more commentary forthcoming.
Doverspike, W. F. (2003). The 2002 Ethics Code: An Overview. Retrieved April 14, 2003, from http://www.division42.org/ MembersArea/Nws_Views/articles/Ethics/ethics_code.html
Fisher, Celia (2003, January/February). Test data standard most notable change in new APA ethics code. The National Psychologist, p.12.
|
|
|
|
|
|
