How the ethics codes are built: APA and CPA

Transcript

RyanPicture an ethics committee meeting. A complaint comes in about a psychologist. The charge? She did no free or reduced-fee work all year. Not one pro bono hour.

SoheeAnd the person complaining points to the Ethics Code, which really does say psychologists strive to give some of their professional time for little or no compensation.

RyanSo, can she be sanctioned? Hold that thought. Welcome to EPPP Prep, the podcast. I'm Ryan.

SoheeAnd I'm Sohee. Today we're looking at the architecture of the ethics codes themselves: the American Psychological Association's code, and the Canadian Psychological Association's code. Once you see how they're built, a whole category of exam questions gets easier.

RyanLet's start with the APA Ethics Code. Its full name is the Ethical Principles of Psychologists and Code of Conduct. It was adopted in 2002 and amended in 2010 and 2016.

SoheeAnd it has four parts. An Introduction, a Preamble, five General Principles labeled A through E, and then the specific Ethical Standards.

RyanHere's the single most important structural fact. The Preamble and the General Principles are aspirational goals. The Ethical Standards are enforceable rules for conduct.

SoheeThe Code is blunt about it. General Principles do not represent obligations, and they should not form the basis for imposing sanctions.

RyanSo, back to our committee. Striving to give a portion of professional time for little or no compensation. Where does that line live?

SoheeIn Principle B, Fidelity and Responsibility. It's a General Principle. So it's an ideal to aim for, not a rule anyone can be disciplined under. The complaint fails on exactly that point.

RyanAnd the Code goes further. It says that relying on the General Principles as a basis for sanctions distorts both their meaning and their purpose.

SoheeLet's walk through all five principles, because the exam likes to match a scenario to a principle.

RyanPrinciple A is Beneficence and Nonmaleficence. Psychologists strive to benefit the people they work with and take care to do no harm. It also asks them to be aware of how their own physical and mental health might affect their ability to help.

SoheePrinciple B, Fidelity and Responsibility, is about trust. Psychologists clarify their roles, accept responsibility for their behavior, and seek to manage conflicts of interest that could lead to exploitation or harm. They're also concerned about their colleagues' ethical compliance. And that's where the pro bono line lives.

RyanPrinciple C is Integrity. Accuracy, honesty and truthfulness in science, teaching and practice. No stealing, cheating, fraud, subterfuge, or intentional misrepresentation of fact.

SoheePrinciple C has a nuance about deception, too. Where deception may be ethically justifiable, psychologists have a serious obligation to consider the need for it, its possible consequences, and their responsibility to correct any mistrust or harm that results.

RyanPrinciple D is Justice. Fairness and justice entitle all persons to access to, and benefit from, psychology's contributions, and to equal quality in its services. Psychologists take precautions so their biases and the limits of their competence don't lead to unjust practices.

SoheeAnd Principle E is Respect for People's Rights and Dignity. Privacy, confidentiality, and self-determination. It says special safeguards may be needed for people whose vulnerabilities impair autonomous decision making. And it names cultural, individual and role differences, such as age, gender identity, race, culture, disability, language and socioeconomic status.

RyanA quick way to hold these. A is help and don't harm. B is trust and responsibility. C is honesty. D is fairness. E is rights and dignity.

SoheeNow, who and what does the Code actually cover? This is another favorite.

RyanIt applies only to psychologists' activities that are part of their scientific, educational or professional roles. And it applies across contexts: in person, postal, telephone, Internet, and other electronic transmissions.

SoheeBut purely private conduct is not within the purview of the Ethics Code.

RyanPause and think. A psychologist argues with a neighbor about a fence one Saturday. It has nothing to do with her work. Is that an Ethics Code matter?

SoheeOn those facts, no. That's purely private conduct. Now imagine she starts offering the neighbor a professional opinion as a psychologist. The question becomes whether she's acting in her role as a psychologist, and that's exactly the line the Code draws.

RyanTwo more Introduction facts that turn up as answer choices. First, lack of awareness or misunderstanding of an Ethical Standard is not itself a defense to a charge of unethical conduct.

SoheeSo, I didn't know that rule, doesn't work. Second, APA isn't the only body that can act. Violations may lead to sanctions by other bodies, whether or not the psychologist is an APA member. State psychological associations, psychology boards, other state or federal agencies, and payors for health services.

RyanAnd here's the flip side. The Code is not intended to be a basis of civil liability. Whether someone violated it does not, by itself, decide whether they're legally liable in a court action.

SoheeThen there's a word you see all over the Standards. Reasonable.

RyanThe Code defines it. Reasonable means the prevailing professional judgment of psychologists engaged in similar activities in similar circumstances, given the knowledge the psychologist had, or should have had, at the time.

SoheeOr should have had. That's the phrase to notice. You're measured against your peers, and you can't hide behind not knowing what you should have known.

RyanAnd one more. When the Code sets a higher standard of conduct than the law requires, psychologists must meet the higher ethical standard.

SoheeOkay, let's cross the border. The Canadian Code of Ethics for Psychologists. Fourth edition, approved by the Canadian Psychological Association's Board of Directors in January 2017.

RyanIt's built differently. Four ethical principles, each opening with a values statement, followed by ethical standards that show how the principle applies.

SoheeThe four are: Principle One, Respect for the Dignity of Persons and Peoples. Two, Responsible Caring. Three, Integrity in Relationships. And Four, Responsibility to Society.

RyanAnd here's what makes the Canadian Code so testable. The principles are ordered by the weight each should generally get when they conflict.

SoheeRespect for dignity generally gets the highest weight, except when there's a clear and imminent danger of bodily harm to someone.

RyanResponsible caring is second. It requires competence, maximizing benefit and minimizing harm, and it's carried out only in ways that respect dignity.

SoheeIntegrity in relationships is third. In some circumstances, values like openness and straightforwardness might need to be subordinated to the first two principles.

RyanAnd responsibility to society is fourth. The Code says the dignity, well-being and best interests of persons and peoples, and integrity in relationships, should not be sacrificed to a vision of the greater good of society.

SoheePause and think, number two. Under the Canadian Code, a psychologist feels pulled between a client's dignity and a broad benefit to society. Which generally carries more weight? And what's the big exception to dignity coming first?

RyanDignity generally wins, because Principle One carries the most weight and responsibility to society the least. The exception is a clear and imminent danger of bodily harm to someone.

SoheeAnd notice the Canadian Code's own caution. The complexity of many conflicts precludes a firm ordering of the principles. The order is a general guide, not a formula.

RyanOne more Canadian theme is vulnerability. The Code says psychologists' greatest responsibility is to persons and peoples in the most vulnerable position, and that safeguards should increase in proportion to vulnerability.

SoheeWhich echoes the APA's Principle E and its special safeguards. And like the APA Code, the Canadian principles apply whatever the communication modality: spoken, written, in person, or remotely by phone, text, video or online.

RyanSo how does the exam test all of this?

SoheeThree patterns. One, the aspirational versus enforceable trap. An answer says a psychologist violated a General Principle and will be sanctioned for it. Be suspicious. Principles guide; Standards are enforced.

RyanTwo, matching. A scenario about honest reporting points to Integrity. Equal access and bias point to Justice. Self-determination and privacy point to Respect for People's Rights and Dignity.

SoheeThree, scope. She didn't know the standard, isn't a defense. She isn't an APA member, so nothing can happen, is wrong too, because boards and other bodies can act. And purely private conduct sits outside the Code.

RyanLet's recap. The APA Code has an Introduction, a Preamble, five General Principles, and the Ethical Standards. Principles are aspirational; Standards are enforceable.

SoheeA, beneficence and nonmaleficence. B, fidelity and responsibility. C, integrity. D, justice. E, respect for people's rights and dignity.

RyanThe Code covers professional roles in any medium, but not purely private life. Not knowing a standard is no defense. And reasonable means the judgment of similar psychologists, given what you knew or should have known.

SoheeThe Canadian Code has four principles in a general order of weight: dignity, caring, integrity, society. Dignity comes first, except when there's a clear and imminent danger of bodily harm.

RyanIf ethics has felt like a sea of numbered rules, today you got the map those rules sit on. That map will make every other ethics episode easier.

SoheeTake it one standard at a time. You're building something solid here. Thanks for listening to EPPP Prep.

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