There aren’t many doubts that ethical principles are vital in Medicine. There isn’t a soul in this world who can’t imagine terrible ends for a surgeon going rogue. So, why do there seem to be so many doubts about Psychology?
Ethical principles and codes are as vital to psychology as to any other science, perhaps even more. Why? Because it is not always obvious to determine what’s right and the psychologist’s role when something goes wrong.
Several credible institutions, such as APA, have very detailed guidelines in this field. You, as a psychologist or therapist, should know and look for when you need guidance or are confronted with a dilemma.
Ethical Dilemmas
There are situations when you have good reasons to act in two different and contradictory ways. They are both valid but incompatible – this is a dilemma, and you can find it more often than you’d think in practice.
It is impossible to predict all the situations you can face. With the constant evolution, new possibilities are constantly emerging. Here is when you look at the fundamental ethical principles.
There are areas of significant ambiguity, and you can’t afford to harm your patient. In our daily practice, we are confronted with tough decisions due to our knowledge of how our actions and words greatly impact others. Look carefully at the following principles, and they’ll help you decide.
Going for the basics
In 1984, Kitcher proposed five fundamental principles you must know and follow as guidelines in ambiguous situations. Keeping them in mind will help you make good decisions, considering what’s best for your patient.
Autonomy
Patients are free to make their own choices (even if you think what they choose isn’t the best for them), and you must respect that.
They have the right to be duly informed, so they can make an informed choice or give informed consent. You can’t hold information or make decisions for them just because you know better.
When confronted with a dilemma, you must ensure you’re not doing anything behind your patient’s back. If you are hiding something from your patient, you’re wrong. If you’re deciding for them, you’re wrong. None of that is ethical.
Nonmaleficence
Nonmaleficence means do not cause intentional harm by actions or inaction.
This means you must inform your client of potential risks or discomfort that may come from therapy. You must also consider how much discomfort after a session is licit or if your actions are causing more suffering than needed. Not all patients are the same; you need to be aware of this.
Another situation is when your client is a minor or an elder – and sure, you must respect privacy, it is the basis of therapy – but your patient is clearly in danger. This is a dilemma. In this case, easy to solve – their lives are more important than their trust in you. You can’t abandon or ignore someone who can’t stand for themselves. You’d be harming them knowingly.
Beneficence
Your primary role as a therapist or psychologist is contributing to your patient’s health and well-being. That can lead you to situations where you want so badly to help that you’re trying to make decisions for your patients. You think you know better.
Regardless of your good intentions, this is paternalism, and you limit their autonomy.
Remember what your professional training was, and remind yourself what your abilities are and what you were trained for. As much as you want to do more, you should restrict yourself to the limits of your competencies.
Justice
It is your job to ensure the equality of your services. Minorities should have the same access to psychological evaluation and treatment as any other person, and the quality of your work must be the same for everyone.
As a therapist, you contribute to the well-being of a person or a community, so you must provide that, no matter who’s in front of you. Yet, we all have our biases and prejudices. If you don’t feel able to offer a good service, no matter the reason, you must refer the patient to a colleague who can do it.
Fidelity
You and your patient have a compromise; you must be loyal and respect it. Trust is vital to the therapeutic relationship, so you must carefully inform and debate that relationship with the patient as early as the first session.
This also protects you, so think it through and be very specific with the patient. Read a lot about ethics to imagine different scenarios and what you would do. Your patient must be as informed as possible.
The bigger picture of ethics
These principles are not a specific answer to an ethical dilemma but work as a safe board to guide yourself with caution. The safety of your patient and their therapeutic work is vital for its success.
In case of any doubt, you should always take a step back and thoughtfully analyze these principles to ensure you’re not going against them.
Therapeutic work is about trust and confidence, but it is also our job to be fair and provide safety for our patients and others around them. Ethical principles guide us to the best course of action.
Ethics knowledge is a vital
Ethical principles are critical in Psychology, Medicine, and other sciences. Throughout your career, you’ll face dilemmas and have doubts about the best course of action. The five fundamental principles of Kitcher, not offering specific answers to every ethical dilemma, are an excellent basis to look for before making a decision.
In times of uncertainty, psychologists must reflect on these ethical tenets to ensure their actions align with their responsibilities to their patients and society. Ethical principles guide psychologists toward the best effort to pursue trust, fairness, and safety for their patients and the community.
Psychology in our World 