A mixed methods investigation of the effects of ranking ethical principles on decision making: Implications for the Canadian Code of Ethics for Psychologists.

Abstract

The principles in the Canadian Code of Ethics for Psychologists (CCEP; Canadian Psychological Association, 2000) are ranked in order of importance. Although there is some support for the ranking, it is unclear whether its utilization leads to more ethical making. We investigated whether medical residents and undergraduate students who were given information about the ranking would provide more ethical (i.e., in accordance with the CCEP) and consistent responses to dilemmas and would be more confident in their decisions than participants not provided with ranking information. Forty-seven medical residents and 45 students were taught about the CCEP principles. Half of the participants were provided with information about the ranked order. Participants responded to 6 vignettes describing ethical dilemmas with courses of action, by rating whether the course of action was ethical and providing a by rationale. Participants, who knew about the ranking, provided ratings that were more consistent with the CCEP although the pattern varied across vignettes. Moreover, participants in the ranked condition made decisions faster than participants in the unranked condition. We found no evidence that participants were more likely to agree with each other when familiar with the CCEP hierarchy. Finally, students in the ranked condition were less confident than students in the unranked condition whereas ranking did not affect the residents' confidence. Thematic analysis of participants' rationales revealed that, among those who responded inconsistently with the CCEP, some had misunderstood the ethical principles, misinterpreted the relative vulnerability of the parties depicted in the vignettes, and/or provided rationales that were consistent with the code whereas their ratings were not. Specific contextual factors that affected are discussed as are the implications of these findings for the CCEP. Keywords: code of ethics, ethical principles, making, training The Canadian Code of Ethics for Psychologists (CCEP, Canadian Psychological Association [CPA], 2000) was developed to reflect the collective wisdom of Canadian psychologists (Sinclair, Poizner, Gilmour-Barrett, & Randall, 1987) and is considered to be one of the most influential and well-respected psychological codes of ethics around the world (Hadjistavropoulos, 2008). One of the objectives in the development of the CCEP was to provide rules (i.e., ethical principles) (Sinclair et al., 1987, p. 5) to aid psychologists in the process of ethical making. As such, the code is comprised of four ethical principles. These principles are I: Respect for the Dignity of Persons, II: Responsible Caring, III: Integrity in Relationships, IV: Responsibility to Society. These principles are not necessarily discrete; a degree of overlap may occur among them and it is recommended that all four principles be included and balanced in ethical making (Sinclair & Pettifor, 2001, p. 19). Moreover, to further guide psychologists, the CCEP also provided a ranked order of importance of its ethical principles wherein Principle I is weighted more heavily than Principle II (and III and IV), which is weighted more than Principle ?? and so on (Sinclair et al., 1987). The ranking was developed based on the code development committee's impression of the manner in which a sample of psychologists tended to resolve ethical dilemmas and was confirmed through consultations with psychologists' organisations (Sinclair et al., 1987). In conjunction with the principles' hierarchical organisation, the code also outlines 10 specific steps intended to facilitate ethical making. Step 1, for example, involves identification of the individuals and groups potentially affected by the decision (CPA, 2000, p. 3). Step 2 involves Identification of ethically relevant issues and practices, including the interests, rights and any relevant characteristics of the individuals and groups involved and of the system or circumstances in which the ethical problem arose (CPA, 2000, p. …