2. • Evolving mental health practice, the increasing acceptance and
utilization of behavioral science data in legal proceedings.
• Laws governing psychologists court decisions, federal and
state orders and the enforceable standards of Ethics Code (APA,
2002).
• For the most part, the laws regulating the practice of psychology
are consistent with generally recognized ethical values.
Introduction
3. When Laws and Ethics Collide:
What Should Psychologists Do?
(Knapp et al., 2007)
Law and Ethics
4. APA Code 1.02
If psychologists’ ethical responsibilities conflict with law, regulations,
or other governing legal authority, psychologists clarify the nature of
the conflict, make known their commitment to the Ethics Code, and
take reasonable steps to resolve the conflict consistent with the
General Principles and Ethical Standards of the Ethics Code.
5. A Decision-Making Process
Consider the following clinical situation:
Example 1
• A psychologist in solo practice terminated a patient for nonadherence
with treatment (HIPAA,1996). The patient made harassing and
threatening phone calls to the psychologist. The psychologist refused to
respond as it would harm the patient. Later, the patient demanded a
face-to-face meeting with the privacy officer (who was the psychologist
himself)
Respect for the patient’s autonomy vs. Nonmaleficence
6. Considerations to address
1. Requirement of the law
2. Ethical obligations
3. Personal values
4. Reconcile the demands of the law and your ethical concern
5. Balance the law or your ethical values
6. Anticipate Conflicts and take preventive measures
(Knapp et al., 2007)
7. What does the law require?
Example 2
• A patient states that he feels strong urges to harm a
third party with whom he had a fight the week before
over an ex wife.
• The treating psychologist, who works in a state that
has a duty-to-protect law, believes that notifying the
threatened third party would precipitate the very
violence that the psychologist wants to prevent.
• State law
• Legal consultation.
• Standards
regarding the duty
to warn or protect.
• Clinical
interventions
8. Discerning Ethical and Clinical Obligations
Situations in which psychologists act unethically:
• Extraneous factors.
requires “moral perceptions” (Fowers, 2005)
• Law requires them to violate an ethical value.
Seek legal consultation
• Overidentification with the patient’s suffering.
• A failure to appreciate the total ethical impact of their decisions,
or unwise compassion.
9. A psychologist was treating a man who was accused of
assaulting his wife. In one session that the wife attended as a
collateral contact, the husband acknowledged that he had
struck her. Months later the psychologist received a court order
stating that she was to appear in court to testify that the
husband admitted to striking his wife. The husband did not
want the psychologist to testify.
Taking Steps to Avoid Conflicts
Conflict between Confidentiality and Court's order to testify
Example 3
• Standard
1.02
• Explain the
dilemma
10. Unavoidable Conflict Between Law and Ethics
• Example 4
Suspected Abuse by parent…..report mandated by the
law…danger of self harm.
• Consulting other sources of moral and ethical guidance.
• Clinical solutions
• Virtue Ethics
• Ethically outstanding colleagues
11. If the decision is made not to obey the law.
• Ensure understanding of law requirement and ethical obligations
• Consider alternatives
• Contemplate violating a law only if no viable alternative is
available.
If a decision is made to obey the law.
• Minimize the negative impact
• Inform the client of the legal obligation
12. Anticipate Conflict
• Minimize the conflict by being explicit with the patient at the start
of psychotherapy (Example 4)
• Explaining the common exceptions to confidentiality, giving the
client an opportunity to ask questions.
• Revisiting the issues throughout the course of treatment as
needed.
• Consequences of a disclosure known to a client, better decision
about what information to reveal.
13. Conflicts between the law and ethics can be avoided if psychologists
anticipate problems ahead of time or engage in integrative problem
solving. At times, however, psychologists may need to choose
between following the law and protecting the welfare of their clients
or an ethical value. Careful practical wisdom or deliberation is
necessary when such decisions are made.
Conclusion
14. References
American Psychological Association. (2002). Ethical principles of psychologists and code of
conduct. American Psychologist, 57, 1060–1073.
Fowers, B. J. (2005). Virtue and psychology: Pursuing excellence in ordinary practices.
American Psychological Association.
Knapp, S., Gottlieb, M., Berman, J., & Handelsman, M. M. (2007). When laws and ethics
collide: What should psychologists do?. Professional Psychology: Research and
Practice, 38(1), 54.
