Ethical Issues of Psychological Patient Case - Research Paper Example

? Ethics In the recent times ethical issues concerning psychological practices are gaining much recognition among healthcare practitioners and social workers. This is primarily because of cultural diversity and immense social influence over the psychologists and patients both. Hence it is highly significant to reanalyze this subject while studying the guidelines provided by APA. American Psychological Association has well defined codes of ethics regarding the practice of psychologists. These are widely concerned about maintaining confidentiality of patients while ensuring that they receive mental treatment with complete consent and socio-economic implications. Although protecting the individual privacy is difficult in community practice setting but it can be done through integrating the multiple relationships and gaining informed consent from clients. This paper critically discusses the case of Carolyn, a girl who could not afford the psychological treatment and therefore the practitioner suggested her to live with a family who could give her accommodation whereas in return Carolyn was supposed to do their household work. Her psychologist while planning the treatment plan neglected APA ethical codes of conduct and thus he could not evaluate the outcomes of any moral mishap. Soon after the treatment was started people in Carolyn’s surrounding began to learn about her illness due to the family members she was living with. Consequently, she ran from that place after suffering from intense emotional damage. This entire situation and specifically the role of psychologist are evaluated and critically studied in this paper. Moreover, the socio-cultural implications if in case Carolyn was treated in clinic are also discussed. Ethics Introduction Treating a psychological patient is extensively complex in nature because of patient’s sensitive information and emotional consequences of the treatment. These patients are required to share personal information which isn’t a part of their public image therefore psychologists have to maintain significantly high confidentiality. This becomes even more important in private practice setting where some of the community members are directly or indirectly involved in the treatment (Shapiro, 2011). Similar case happened with Carolyn where she was first evaluated by the psychologist who identified the traces of mild mental disorder in her IQ test. She was then asked to go for a mental treatment but since Carolyn was unemployed therefore she could not afford it neither she could qualify for the government disability benefits. Hence the psychologist was asked to give her free treatment whereas she was recommended to live with a family while working for them. This sound very good to Carolyn and she agreed. However, once her treatment started people in the church came to know about her hidden illness and started treating her differently. This discouraged Carolyn to continue the treatment and as a result she ran away from that place leaving everything behind. The case of Carolyn presents significant example about the importance of ethics in psychological treatments. This paper aims to discuss it with respect to the American Psychological Association’s Code of Ethics, APA General Principles, Standards of multiple relationships and informed consent. Moreover, the case would be studied under the implications of legal, social and cultural aspects. APA Code of Ethics The American Psychological Association’s Code of Ethics represents a balanced approach towards confidentiality and the critical details of different psychological treatments. In broader terms, the balance of confidentiality means that a psychologist is legally responsible to consider morals and ethics in all the treatments. Mental patients are somewhat different from regular patients of any physical disease and hence they required to be treated with greater sensitivity. This is because of the cultural norms and the myths affiliated with mental disorders which actually make a patient feel extremely uncomfortable to talk about his illness. Moreover, these patients often try to quit the treatment if people around them know their impairment as it happened with Carolyn. Thus maintaining confidentiality is specifically important for psychologists and people who are associated with such patients in anyway (APA, 2002). In order to help practitioners around the world to draw a clear distinction between their obligations and ethical requirements American Psychological Association has given clear guiding principles and standards of practice (Pipes, 2005). APA’s code of ethical conduct was initially devised in order to identify the hierarchy of obligations for psychologists. This was done to ensure that psychologists across America give the highest priority to their patients without compromising the ethics. Furthermore, APA has given weightage to the flexible decisions in psychological treatments, for instance, it permits the psychologists to use patients’ personal information for particular purposes. It gives clear understanding about the therapeutic goals, medical laws, professional responsibilities of psychologists and the distinguished needs of stakeholders which are different from patient to patients. The APA’s codes of ethics play a vital role in the overall development of ethically sound and socially responsible psychologists who not only ensure patient’s confidentiality rather they also look after their emotional and mental needs (APA, 2002). In Carolyn’s case the psychologist could only maintain confidentiality with the participation of family who was providing her accommodation. But since he was unable to do so therefore he not only violated the APA code of ethics rather he also made Carolyn’s case worst than before. General Principles of APA Ethics Code American Psychological Association has five fundamental codes of ethics. These are primarily devised to limit unethical activities in psychological treatments while considering all the socio-cultural concerns. Moreover, the General Principles are significantly inspiring and proved to be a guiding source for new professionals in the field. Although they are not imposed on psychologists but on the whole they present strong purpose and meaning for the professional practices while giving due regard to the discretion of patients (Fisher, 2012). Principle 1: Beneficence and Nonmaleficence These two terms represent the fundamental requirement for performing the job of psychologists i.e. they must strive to benefit the entire humanity without damaging anyone around them. In their routine practices psychologists seek to provide welfare to the mentally disadvantaged groups of the society. They are needed to fulfill the rights of patients who come up to them for medical assistance. However, if during the course of action they encounter any conflict then they are expected to resolve them in an ethical manner without harming others. Psychological analysis and scientific procedures might be influential for some people therefore psychologists must critically evaluate all the financial, personal, social and organizational matters prior to conducting any treatment (Fisher, 2012). For instance, in case of Carolyn, her psychologist actually failed to identify the negative outcomes which she might face as a result of living with an anonymous family. This subsequently violated her confidentiality and the society came to know about her illness. Principle 2: Fidelity and Responsibility The relationship between psychologists and their patients is highly momentous in nature because of trust and sharing of personal information. In the modern world this relationship has become even more crucial since now the psychologists are required to involve community for certain treatments. Hence as per the general principles of APA psychologists must accept the responsibility of their actions while managing all the variances which might arise (Fisher, 2012). For instance, when Carolyn initially started facing strange behavior from fellow church members then her doctor should have interfered by arranging another accommodation for her. However, the psychologist acted highly irresponsible towards the social consequences of her treatment and ultimately she ran away. Principle 3: Integrity Integrity literally means honesty which is in fact the building principle for any occupation. It is even more important in psychological treatments because in this case both the doctor and the patients have to be honest in all the matters. Moreover, psychologists are responsible to promote integrity in society while encouraging truthfulness in teaching and scientific procedures. They must not involve in fraudulent activities or cheating the clients. As per the requirement of honest behavior they must also correct their wrong attitudes (Fisher, 2012). This is also associated with mindfulness as some of the researchers have attributed it to be the most important quality of psychologists (Brown, 2003). The poor level of integrity is clearly reflected from Carolyn’s psychologist who did not evaluated her medical treatment from all possible aspects. Principle 4: Justice Justice and ethics are equally important in medical, legal or social services because something that is unethical is also considered illegal in the modern world. APA recognizes that individual patients and practitioners must be treated justly. They should be able to benefit from one another under the law. Psychological procedures must not involve anything which is against the prevailing justice. If in case any individual faces violation of his/her confidentiality then they are entitled to register an appeal in court (Fisher, 2012). Carolyn should have done something similar to this but since she was mentally ill therefore her fellow members should have requested legal authorities to proceed against her psychologist and the family for their highly unethical and illegal behavior. Principle 5: Respect for Dignity and Rights There is nothing more valuable than human rights and dignity. Since psychologists deal closely with human nature therefore they must give due attention to the protection of their patient’s rights. This primarily involves one’s secrecy, self respect and dignity. Psychologists are well aware about the ideas of respect and those which lead to possible personality damages (Fisher, 2012). Hence Carolyn’s psychologists must have informed the family about ethical measures involved in her treatment so that they might not engage in humiliation of her fundamental rights. Standards of multiple relationships and informed consent In addition to the General Ethical Principles APA have different standards for ensuring fair treatment of mental patients. These standards are formulated to avoid cases such as the one of Carolyn’s. Multiple Relationships Multiple relationships in a psychological treatment usually indicate situations where the psychologist is associated with a patient in his professional role. Simultaneously he is also involved in another relationship with the same person or someone associated with him/her. The third situation occurs when the psychologist promises to build another relationship with his patient or someone related to him/her in future. Although psychologists are suggested not to involve in multiple relationships but these might occur due to the special requirements of different cases (Fisher, 2012). For instance, in Carolyn’s treatment her psychologist was professionally associated with her while on the other hand he was also in close contact with the family who provided her accommodation. Carolyn’s psychologist was unable to manage multiple roles which he was playing at the same time. Eventually he failed to recognize lapses in treatment procedure while he also missed out the social outcomes. Informed Consent When complex psychological treatments are conducted then the practitioner is required to get the consent of patients. This is not only a legal requirement but also an ethical necessity (Fisher, 2012). As in Carolyn’s case psychologist had already gained her consent over the treatment but since she was not mentally fit therefore he should have asked the church authorities for their approval prior to sending her to the family. This was significantly important in order to avoid further problems. Legal socio-cultural implications of the psychologist and the client In the contemporary world social and cultural diversity have become a major source of influencing psychological practices. People especially belonging to the disadvantaged groups of the society face immense problems in terms of social recognition when it come to psychological treatments (Crisp, 2011). In Carolyn’s case there were significant legal and socio-cultural implications for both psychologist and the client. For instance, the psychologist should have analyzed the environment Carolyn was going to live in. On the other hand he was supposed to tell the family regarding the ethical concerns of her treatment. This should have been subsequently linked with the evaluation of social responses Carolyn might receive. Moreover, following is the brief description of socio-cultural implications provided by APA which Carolyn’s psychologist should have considered (Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations, 2013). Identifying the peculiar factors pertaining to the family culture and the social environment of church. Understanding the crucial role of ethics and cultural norms in psychological treatments while considering the legal implications. Evaluating the elements which might affect the mental health of Carolyn such as social gossips or the myths regarding psychological illness prevailing in the society. Helping Carolyn so as to face the socio-cultural challenges during the course of treatment. This could have been done through regular counseling. Conclusion If Carolyn’s psychologist was working on her in a community mental health clinic instead of a private practice setting then the situation must have been totally different. For instance, he would have been able to abide by the all five general principles of APA code of ethics including beneficence, responsibility, integrity, justice and respect for rights. It is easier to help mental patients in a completely controlled environment of clinics rather than keeping track of all their activities in a large community where there is high cultural influence (Dana, 1994). Moreover, the psychologist must have been able to maintain his direct relationship with Carolyn without the interference of family members. He should have dealt with her by integrating the spiritual principles with the normative practices (Plante, 2007). In that case Carolyn could have been easily and effectively evaluated for different treatments while her progress could also be judged. Moreover, there is highly probability of successfully controlling the impacts of socio-cultural implications in a closed clinical setting. Hence in such circumstances Carolyn must have continued the treatment without any humiliation or violation of her basic rights. References APA. (2002). Ethical principles of psychologists and code of conduct. American Psychologist, 1060–1073. Brown, K. &. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology , 822-848. Crisp, R. (2011). The Psychology of Social and Cultural Diversity. UK: John Wiley & Sons. Dana, R. (1994). Testing and Assessment Ethics for All Persons: Beginning and Agenda. Professional Psychology: Research and Practice , 349-354. Fisher, C. B. (2012). Decoding the Ethics Code, A Practical Guide for Psychologists. Los Angeles: Sage. Guidelines for Providers of Psychological Services to Ethnic, Linguistic, and Culturally Diverse Populations. (2013). Retrieved Dec 4, 2013, from American Psychological Association. Pipes, R. H. (2005). Examining the Personal–Professional Distinction: Ethics Codes and the Difficulty of Drawing a Boundary. American Psychologist , 325–334. Plante, T. (2007). Integrating Spirituality and Psychotherapy: Ethical Issues and Principles to Consider. JOURNAL OF CLINICAL PSYCHOLOGY , 891–902. Shapiro, D. &. (2011). Malpractice in Psychology: A Practical Resource for Clinicians. Washington: American Psychological Association. Read More