Thesis on "Law and Ethics"

Thesis 5 pages (1811 words) Sources: 4

[EXCERPT] . . . .

Ethics

Psychology has a professional code of ethics

Most therapist acknowledge code

Nuance to making decisions produced by unique ethical dilemmas

Current Dilemma

APA Ethical Standards 1.18 and 1.25

Defines 'Barter'

Trading therapy service for non-monetary compensation

Notes potential ethical dilemma produced by barter

Exploitation

Multiple relationships

General damage to treatment process iii. Provides exception for some instance of barter

Where otherwise would be to deny treatment

To patient

To community

Implications To Case Study

Trading service for professional partnership

Would endanger counselor objectivity

Would divert from mental health focus iii. Could result in exploitation of patient's 'writer's block' condition for personal gain of therapist

Would constitute a violation of the APA ethical standards

Appropriate measures to be taken

a. Decision must be made as loss of objectivity has already occurred

b. Several steps must be taken to ensure patient is done least harm

i. Cease counseling

ii. Refer patient to a new counselor iii. Begin new partnership after suitable period apart

1. 1 year

Abstract: The psychology profession is governed by standards of professionalism and ethical integrity. While the APA offers a code, the variance of potential circumstances resulting from the counselor/patient relationship can lead to many dilemmas in this regard. This account considers one such dilemma from a first-person perspective, relaying a case in which a therapist wishes to enter into a professional partnership with a patient who is a screenwriter for a living. Considering the ethical implications of this desire, the account here considers the APA's stance on such issues as barter for therapy services and the danger of multiple relationships to the counselor/patient dynamic. The account offers a resolution for ending therapy and pursuing a different professional partnership.

Psychology Ethics, Multiple Relationships and Barter

The relationship between patient and therapist is an inherently sensitive one. In many instances, the degree of personal disclosure, the development of some level of personal dependency and the likelihood of emotional attachment will have the effect of making this a relationship due for careful treatment. This is a responsibility which falls upon the psychologist, in whom is invested a significant amount of trust concerning ethical consistency, professional integrity and interpersonal sensitivity. Therefore, any aspect of the relationship which has the potential to divert from the doctor/patient structure can be destructive to the treatment or healing process. It must fall upon the responsible psychologist therefore to ensure that this relationship never exits the boundaries of appropriate interaction lest the patient succumb to a fundamentally unhealthy relationship with one responsible for improving emotional health and stability. The implications can be extremely problematic, with the psychologist in a unique position to exploit the weaknesses and undermine the insecurities of the patient based on insights and knowledge gained during the therapy process.

In accordance with APA Ethical Standard 1.18 and APA Ethical Standard 1.25, it should be considered a direct violation of professional code and ethical responsibility when a psychologist allows the doctor/patient relationship to be tainted either by inappropriate interaction or inappropriate exchange. To the latter point in particular, it is considered a direct conflict of interests for the therapist to accept anything other than monetary compensation for therapeutic treatment, with any bartering producing an unnatural and potentially biased scenario for the practitioner which may be exploitative. Before proceeding to our personal case study, it is noted that there are principled exceptions to this rule and that these too are essentially ethically-founded cues. According to the text by Fisher (2008), "providing services in return for bartered goods is ethically permissible in situations when to not do so would deprive clients/patients of needed services or run counter to community economic or cultural practices." (Fisher, 185)

This means that occasions in which bartering of any sort is acceptable must be those in which, prompted by the demands of a patient or patient population, the therapist might otherwise be withholding treatment. In such instances, the imperative for treatment could be considered sufficient to justify accepting something other than monetary compensation for treatment. However, as stated, these are exceptions and cannot be viewed as a state of normalcy based on the inherent risks of allowing compensation to take on a form more abstract and potentially emotionally loaded than monetary compensation. As the Fischer text indicates, "psychologists need to be cautious about accepting bartered goods or services from clients/patients in lieu of monetary payments because such arrangements have an inherent potential for client/patient harm, exploitation, and unethical multiple relationships.' (Fisher, 185)

Quite certainly, this is a primary concern in my own relationship with a patient, whose profession has actually intrigued great personal interest in me. As a practitioner guiding a patient through what he has described a case of 'writer's block,' I am compelled by his work as a screenwriter. This is a profession which has always interested me on a personal level and I believe that I have an ability to be successful in this realm as well as in my current practice. Therefore, I am inclined to view that there are certain inherent benefits to my coming into contact with a man who is both steeped within this profession and who is in clear need of my assistance.

That said, it is strikingly clear that any such overture would be in direct violation of the responsibilities and ethical parameters defining my role in his treatment process. The danger of 'multiple relationships' is here especially apparent, with any sort of partnership revolving on the process of screenwriting causing a deviation in my role and breeding any number of potential conflicts in my ability to remain objective toward the patient. That said, the situation has promoted a personal dilemma for me as a practitioner with a desire for and intent to make the eventual leap into the screenwriting profession. Based on the fact that this disposition might well distract from my duties as a professional or diminish my objectivity toward the specific problems being suffered by the patient, it is not an impulse which at this juncture I can simply dismiss. It would be ethically remiss to overlook the impact which the patient's profession and my interests possess in their intercession.

Therefore, it is clear that I am already faced with a dilemma and that it is not reasonable or appropriate at this juncture to avoid taking some form of action to alter the scenario. Therefore, I have begun to weigh the various implications of this dilemma in order to arrive at a conclusion that conforms with prevailing ethical and professional standards. Doing so, of course, requires what research indicates is an intensive process of scenario examination. Indeed, "according to Rest (1982), 'executing and implementing a plan of action involves figuring out the sequence of concrete actions, working around impediments and unexpected difficulties, overcoming fatigue and frustration, resisting distractions and other allurements and keeping sight of the eventual goal.'" (Koocher & Keith-Spiegel, 15)

In this case, the eventual goal is to accomplish that which is best for the patient while also using the conditions of the APA Code of Ethics and accepted consensus on professional integrity render a decision that conforms with my expectations of myself as a qualified practitioner. This points of course to the complexity of achieving the appropriate ethical orientation in a situation where there is likely to be some negative cost to my decision. Namely, a failure to act could significantly compromise the therapy treatment process, however acting will most assuredly be disruptive to the process in some manner. Indeed, research points inevitably to the fact "that ethical questions are seldom resolved with a yes or no answer. Adequate resolution of ethical dilemmas involves a process of thinking that seeks to protect the basic values of autonomy, nonmaleficence, beneficence, and justice." (Holcomb, 1554)

The complexity of the dilemma is founded on my apparent self-interest and the manner in which this has already potentially diverted from my abilities to be objective in listening and in providing responsive counseling. With respect to my interest in screenwriting, it is apparent that I have come to desire a professional relationship of some manner with my client and that this is impossible under the conditions of our current relationship.

Moreover, the danger of finding ourselves in a barter situation where I offer counsel in exchange for access to screenwriting opportunities is sufficient to counter-indicate the ethicality of any such relationship in accordance with our discussion held here above. Therefore, action on the issue is required with decisiveness and expedience. The process of making this decision is guided by a philosophical interest in truly determining that which is most 'right' given the conditions of the situation. Accordingly, I am forced to weigh principles and what Jordan & Meara (1990) refer to as 'virtue ethics.' According to their article, "typically, principles are used to facilitate the selection of socially and historically acceptable answers to the question 'What shall I do?' when confronted by ethical dilemmas. Virtue ethics, however, generally focus on the question 'Who shall I be?'" (Jordan & Meara,… READ MORE

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