The diagnosis, assessment and treatment in psychology offer plenty of opportunity to make crucial decisions. However psychologists find it difficult to know the legal requirement when confronted with a particular situation. This is because the rules and laws either do not address all situations or need to be interpreted to address a particular situation. The APA guidelines help psychologists to make ethical decisions at all situations. The understanding of the implications of legal requirements, the need to remain competent by continues learning, respecting the obligations to the client are all part of the psychologists work profile.
The practice of psychology throws up several situations for pondering; to think and decide, to separate the right from wrong. Psychology is involved with dilemmas and ethics. To ensure that psychologists stand up to the responsibilities and expectations associated with them, the American Psychologists Association (APA) has formulated its own ethics; the APA Ethical Principles of Psychologists and Code of Conduct. This APA Ethics Code provides guidelines to both, general ethical conduct and specific situational conduct. The code helps psychologists to face ethical problems and dilemmas. However, in the course of the practice of psychology, psychologists often come across complex ethical situations, for which reliance to APA ethics code alone, do not show the right way. Sometimes an ethical dilemma can have several solutions compatible with all ethics; however the most appropriate solution is selected by critical thinking. Sometimes by following one particular standard, psychologists may breach another standard. When making decisions associated with their profession, psychologists must consider all applicable laws and regulations of the psychology board, in addition to the Ethics Code. Psychologists can also look to guidelines that have been endorsed by other scientific or psychological communities, apart from their own conscience. When the ethical conduct is in confrontation with the law or regulations, then the psychologists must show their commitment to the laws, while taking steps to resolve the conflict, responsibly.
A major difficulty with the statutes and rules of the licensing board is that it often doesn’t have sufficient information appropriate to a situation encountered with a client. Thus the need to be acquainted with professional ethics is very important for the psychologist to confront such situations. Psychologists with minimum or insufficient training in ethical decision making or those with old ethical ideas do not have serious compulsions for updating their knowledge with current understanding. It is widely believed that the regulatory bodies do not function objectively and are biased in their decisions and activities (Woody, 2007). It is therefore speculated whether psychologists should be restricted to guidelines and ethics, leaving legal aspects to attorneys and judges.
Informed consent and refusal rights of clients are an integral part of psychology. The philosophy behind obtaining informed consent is that the client has the right to decide the treatment his body should receive. The patient cannot be forced to take a treatment which he or she doesn’t want. Except when testing is justified mandatory or obvious, psychologists should always obtain informed consent of the client. Even the common and extensively used therapy procedures are liable to prosecution, if the client contests that he or she has not permitted the use of such treatments. It is generally unlawful to touch a person without the individual’s consent. Informed consent is also required for the use of psychotropic medications. Several legal issues are associated with the use of psychotropic medications as they have a powerful effect on the thought and behavior of the client. Here the client needs to be informed about the potential side effects, drug interactions, other risks and precautions that need to be taken. The informed consent should be sought after explaining the nature and need of the assessment, the third parties involved in the assessment and the conditions of confidentiality. When the services of an interpreter are required by the psychologist, then the informed consent of the client to use an interpreter, needs to be sought. Sometimes when flooding or implosion techniques are used to deliberately raise anxiety levels, the client needs to clearly understand the procedures beforehand. Even if the client agrees to the procedure without properly understanding them, the client can sue for assault which does not require physical body injuries (Meyer, 1995). The patients also reserve the right to refuse treatment. A competent adult has the right to refuse treatment when he or she sees the associated risks and other factors as unbearable. Such decision of the client needs to be respected even if such decisions can harm the client.
The diagnosis, assessment and treatment of mental diseases are different from physical illnesses. The role of ethics is more stressed in mental health and psychology, than in most other fields. The direct influence of the mental health professional or the psychologist in producing a desired treatment outcome independently, is considerably limited as much depends on the patient’s ability to cooperate with the treatment. Psychologists seek to develop desirable outcomes in their clients through critical thinking using appropriate skills and strategies. The desirable outcomes in clinical practice include accurate diagnosis, effective treatments and exact predictions on future behavior and acts. When the clinical inferences are right, they improve the lives of people and when these are incorrect, they prolong the psychological distress. Psychologists must analyze critically the decisions they make at all stages of interaction with their clients, including information collection, interpretation of information, treatment selection and treatment evaluation. Psychologists need to form their assessments and decisions using the most and best available evidences. Psychologists thus base the foundations of their diagnosis and treatment on their observation and provided information.
When the assessment results are interpreted, either manually or by automation, psychologists need to take into consideration, the associated test factors, test-taking abilities and other attributes of the assessed client. The psychologists also need to highlight the factors which might influence their judgment or lower the accuracy of their interpretations; like situational, cultural or personal factors (APA, 2003).
Clinical psychologists depend on the observations of an individual’s behavior, personal experience and history to make diagnosis and treatment decisions. This intrusion into the life of a client, gives the psychologist immense data on the individual, which is intended to be used to improve the life of the client. Thus the methods used to seek data, the interpretation of the data, the susceptibility of the client as a result of revealing, the validity of the interpretation and conclusions reached, are all of immense importance to the client. The misuse or abuse of the client data can have serious consequences. Therefore, the treatment by psychologists is associated with safeguarding the information of the client, while using it beneficially for the client. Psychologists are always responsible for the test records of their clients. Since psychologists consult or refer with other professionals and institutions, on the needs of the people they work with, they need to be concerned about confidentiality compliance from these associates. Though psychologists have several obligations with their employer, which might not be binding on them once they leave the employment; they are bound to the confidentiality of the test materials and the results of the patients, irrespective of their employment status. However; the public trust in psychology to deliver is eroded when psychologists violate confidentiality. When the conduct of a psychologist can be interpreted as a breach of ethics, the matter can be brought to the person’s attention through an informal resolution. When an informal resolution seems inappropriate, the ethical violation may be reported to committees on professional ethics.
Psychologists need to be competent in their service to clients they work with, and ensure safeguarding of their rights and welfare. As the judgments and actions of the psychologists have the potential to even affect the lives of others, the psychologists must ensure that their influence is not misused. Psychologists sometimes use tests which may not have been developed by themselves, however they are still responsible for using them with accountability. The testing guidelines emphasize ethical responsibility with regard to personal ability and competency. Psychologists have to restrain themselves from advising or treating client’s beyond their competency level. Before the psychologist assumes complete responsibility for a particular test, it should be confirmed that the psychologist has appropriate skills and training for executing the same. Psychologists must also be conscious of their own state of physical and mental health, and its influence with their work. When they realize they are not able to reign in certain personal influences or prevent them from interfering with their work, they need to seek treatment for themselves, and consulting a close and trusted colleague would be a proper initial step. While accepting responsibility for their behavior, psychologists need to identify and manage conflicts of interest, which could potentially lead to harm or exploitation. When deception is employed to maximize benefits and is ethically justified, the psychologists have a major obligation to evaluate the need, the consequences and the responsibility of addressing the harmful effects of these techniques.
Although the profession of psychology undoubtedly throws up ethical dilemmas, they are more guided through ethical codes, than legal interpretations. As self decisions and situational decisions are part of the ethics code, ethical codes are more relevant for any situation than legal stipulations which are either inappropriate for most situations or needs to be interpreted for a particular situation. Whatever the guidelines followed, psychology has certain core values which psychologists internalize with time, which contributes to its effective teaching and practice
Meyer R.G (1995) Preparation for licensing and board certification examinations in psychology: The professional, legal and ethical components. Psychology Press
American Psychological Association (2003) A Ethical Principles of Psychologists and Code of Conduct [Electronic Version]. Downloaded Electronically on 21st September 2008 from http://www.apa.org/ethics/code2002.html#1_04
Woody R.H (2007) Today’s reality for the practice of psychology. University of Nebraska at Omaha. Conduct [Electronic Version]. Downloaded Electronically on 22nd September 2008 from