In Episode 5, John continues to outline relevant factors related to ethical decision-making. The psychologist's fiduciary responsibility is emphasized. Additionally, John outlines one ethical decision-making model as well as cognitive biases and emotional factors involved with ethical decision-making. John will make suggestions on how to improve ethical decision-making.
2. Describe one decision-making model
Identify one cognitive bias and one emotional
factor that can adversely affect ethical
decision-making
Outline three strategies to aid with ethical
decision-making
3. We reviewed that ethical decision-making can
be complex
4. Rational Psychologist: Know the Code!!
Psychologist Patient
Learn the rules
Apply the rules
Outcomes will follow
6. Distinguish ethical decision-making from
clinical decisions, risk management, and legal
questions (even though there is overlap)
7. We reviewed the Acculturation Model both as
ways to acculturate to psychology as well as
how ethical decisions are made
8. Acculturation Model of
ethical development
Integration Separation
Assimilation Marginalization
Higher on
Professional Ethics
Higher on Personal
Ethics
Lower on Personal
Ethics
Lower on
Professional Ethics
9. We reviewed the five foundational principles
on which the APA ethics code is founded
We touched on the idea that the APA ethics
code does not have an ethical decision-
making strategy
Ethical dilemmas are usually a function of two
competing foundational principles
11. Psychologist is the expert and has greater
power in the relationship
Patient is vulnerable
Psychologist is ultimately responsible for
what happens in treatment
12. Often ethical dilemmas involve apparent
conflicts between respect for patient
autonomy versus beneficence
13. Identify the competing ethical principles
Help to determine which principle has
precedence and why
The importance of emotion in ethical
decision-making and moral judgments
Cognitive biases are also important to
consider
14.
15. The APA Ethical Principles and Code of
Conduct do not include a model of
ethical decision-making
Other resources may aid with decision-
making, but do not highlight how to work
through dilemmas
17. 1. Goal is to define the problem by identifying
the conflicting ethical principles
2. Generate a wide range of possible solutions
and identify pros and cons
3. Merge or knit the possible solutions
together in a way that maximizes the
benefits and limits the disadvantages
4. Implement
5. Look back or evaluate
18. “integrative framework”
steps two and three generate solutions that
maximize your personal values within the
context of your professional role
19. Avoid dichotomous thinking– either I have to
do x or y.
Duty to Warn example: either I have to warn
the potential victim of a threat or I have to
protect confidentiality.
20. 1. We have to train ourselves to think about
larger ethical principles first
2. We need to have the ability to slow
ourselves down prior to making good,
ethical decisions
Why?
21. Malcolm Gladwell’s book “Blink”
Jonathan Haidt’s book on Moral Intuition
David Pizarro’s work on motivated moral
reasoning
22. Top down approach
Start with ethical principles
Work from those principles to make good
decisions about our work
25. Negative emotions related to
ethical and moral decision-making
Positive emotions related to our
good decision-making skills and
ethical knowledge
Fear
Anxiety
Disgust
Disrespect
Passion
Calmness/Centered
Empathy
Respect/Sympathy
Elevation
26. The Fundamental Attribution Error
Actor Observer Bias
Availability Heuristic
Trait Negativity Bias
Confirmation Bias
Competence Bias
27. This cognitive style places an undue
emphasis on the patient’s behavior in the
therapeutic relationship
Overemphasis on the patient
Psychologist may lack insight into what s/he
is doing to promote those responses
28. This cognitive style places an undue
emphasis on external factors for the
psychologist’s behavior
In an attempt to avoid responsibility, the
psychologist can overemphasize the patient’s
role in the ethical dilemma.
29. This cognitive error leads one to use
information that readily comes to mind or
easiest to access
Easiest to go with that which is most
representative of the patient or scenario
30. When the psychologist more readily recalls
unpleasant characteristics of the patient as
compared with positive characteristics of the
patient
It is common for psychologists to work with
individuals they do not like or enjoy
31. The cognitive style in which psychologists
look for evidence to confirm their beliefs
about the patient or the situation.
Motivated moral reasoning
32. Dunning-Kruger Effect: a cognitive bias in
which unskilled individuals suffer from
illusory superiority, mistakenly rating their
ability as much higher than average.
Poor performers fail to learn from their
mistakes.
And, they fail to internalize direct feedback
from others.
33. Length of time in treatment
Patient complexity
Emotional intensity/therapeutic relationship
Current focus (or lack thereof) in treatment
35. Knowledge base: APA code, foundational
principles, state law, regulation, case law
Become aware of emotional factors
Remain aware of cognitive biases/situational
factors
Patient/relationship factors
Outcomes are uncertain – Ambiguity remains
37. Why study ethics and ethical decision-
making as a part of clinical practice?
38. Fiduciary Responsibility
Providing the highest quality of care possible
Reinforcing doing the best possible for your
patient
Better treatment outcomes
40. Good general basis to contemplate and
discuss ethical issues in psychological
practice
Look at vignettes as training tools
Remain aware of ethical issues in your
practice and work on skill building
41. Future podcasts will look at ethical-decision
making, clinical issues, and risk management
with vignettes on the Ethics and Psychology
website
I will have guests to help review clinical
vignette using the Acculturation Model, the
foundational principles, personal biases
(personal ethics and morality) and give
possible options to resolve the dilemma