Ethical Complaints Research Articles

Reducing Ethical Complaints Through Professional Counselor Competency in Court Testimony

Professional counselors experience increasing levels of ethical complaints when they provide opinions in child custody cases; the complaints question their competency levels. The purpose of the study was to examine competencies and ethical considerations for 277 counselors and 66 psychologists. The study used a new, validated professional competence standards instrument through a closed-ended survey. Data analysis included a t test and found that psychologists had higher levels of competency than did counselors, a Mann–Whitney U test found that psychologists had higher levels of complaints than did counselors, and factorial analyses of variance showed a main effect between experience and ethical complaints. Recommendations for future research include studying factors influencing levels of competency among counselors when providing testimony. These findings may assist the counseling profession with a greater understanding of competency in custody matters, resulting in counselors better serving children and families embroiled in conflicted divorce and custody disagreements, and minimizing the negative impact on the mental health of all involved.

What’s New in the 2016 Ethics Code?

What’s New in the 2016 Ethics Code?

Reválida para la profesión de Trabajo Social en Puerto Rico: aspectos a reflexionar.

Por los últimos años, la profesión del Trabajo Social en Puerto Rico ha estado en un fuerte debate de si se debería crear una reválida para la misma. Lo interesante es que, en general, nuestro gremio profesional no simpatiza con la filosofía detrás de las reválidas. Aun así, presiones externas a la profesión han convencido a una parte del gremio sobre la necesidad de implementar una reválida, aunque vaya en contra de sus ideales. Entre dichas presiones se encuentran, por mencionar algunas: 1) Que seamos de las pocas profesiones que no revalidan; 2) Que existe la posibilidad que el Estado imponga una reválida sin nuestra consulta; 3) Que se considera que la profesión amerita tener una reválida para ganar prestigio; 4) Que urge la necesidad de establecer un filtro de los y las egresadas de las universidades para reducir las querellas éticas en el futuro y de vez regular la formación profesional. Dicho esto, el artículo reflexionará mis preocupaciones de implementarse una reválida en nuestra profesión. Entre ellas, se encuentra que podríamos terminar mercantilizando la profesión. También expongo mis inquietudes de que se establezca una reválida estilo “talla única”, que tenga la intención de fracasar a los estudiantes, que homogenice los currículos, elimine el pensamiento crítico, que no sea cónsona con las inteligencias múltiples, que propicie la competencia y que sea incapaz de medir otras capacidades humanas más afines con los valores y principios de la profesión.

Board Takes Action on Wide Range of Issues

Board Takes Action on Wide Range of Issues

Resource Document May Provide Guide to Ethical Issues in Everyday Practice

Resource Document May Provide Guide to Ethical Issues in Everyday Practice

Ethics and Complaints Procedures for Psychoanalytic Organisations: Some Thoughts About Principles

This paper offers a contribution to the development of a model for ethical and disciplinary codes applicable to psychoanalytic work, arguing that because this work involves unconscious processes, associated ethical codes and complaints procedures must take them into account. Seeking the best way to enable best practice within any particular organisation appears to be replaced by a fear of litigation that results in rules that disable management from the control of bad practice by overemphasising staff employment rights. While these employment codes make it almost impossible to identify and dismiss malign attacks by patients on individual professionals, they also interfere with a proper enquiry into the factors that precipitated the complaint. The paper describes an approach, based upon the psychoanalytic model of the function of the mind as it can be reproduced within organisations, which both protects patients from inappropriate and abusive behaviour, by their therapists, and protects therapists from patients, whose pathology leads them to make devastating attacks on therapists' careers. 'Informed consent', if treated as if a static state, can become an unhelpful concept that gets in the way of thinking about an ethical code. Consent by the patient to the process of psychoanalytic therapy is itself the object of analytic work, and therefore is a process, not a static or fixed position.

“No Cause for Action”: Revisiting the Ethics Case of Dr. John Leso

Recent revelations – from government documents and investigative reports – have brought renewed attention to the disturbing involvement of U.S. psychologists in the abuse and torture of “war on terror” detainees. In light of these revelations, this commentary examines the American Psychological Association's inexplicable decision to close – without any sanction – an ethics complaint filed against psychologist John Leso for his role in the abusive treatment of prisoners at the Guantanamo Bay detention facility. The essay reviews key components of the case: the relevant background and context, Dr. Leso’s documented actions at Guantanamo, the APA's ethical standards, the ethics complaint rules and procedures, the justifications invoked by the APA leadership to defend the no-sanction decision, and recommendations for what should be done now.

Disciplinary supervision following ethics complaints: goals, tasks, and ethical dimensions.

Clinical supervision is considered an integral component of the training of psychologists, and most of the professional literature is focused on this type of supervision. But psychologists also may supervise fully credentialed colleagues in other circumstances. One such context occurs when licensing boards mandate supervision as part of a disciplinary order. When supervision is provided in disciplinary cases, there are significant implications for the ethical dimensions of the supervisory relationship and concomitant ethical challenges for supervisors. Not only are the goals, objectives, and supervisory tasks of disciplinary supervision distinct from other types of supervision, but the supervisor's ethical responsibilities also encompass unique dimensions. Competence, informed consent, boundaries, confidentiality, and documentation are examined. Recommendations for reports to licensing boards include a statement of the clinical or ethical problems instigating discipline, description of how these problems have been addressed, and an assessment of the supervisee's current practices and ability to perform competently.

Analysis of the Reported Ethical Complaints and Violations to the Commission on Rehabilitation Counselor Certification, 2006–2013

This study reviewed ethical complaints and violations received from Fiscal Year 2006–2013 by the Commission on Rehabilitation Counselor Certification. There were 71 complaints, of which 37 cases (52.1%) progressed to full adjudication. Of the cases involving a violation, more than half (56.4%) involved ethical misconduct pertaining to role and relationship boundaries, client rights and welfare, and honest and responsible conduct. Strategies to ameliorate common violations as well as define and promote the ethical behavior of all Certified Rehabilitation Counselors are provided.

"Comparable Placebo Treatment" and the Ethics of Deception

Recent research, especially with functional brain imaging, demonstrated cases where the administration of a placebo produces objective effects in tissues that are indistinguishable from those of the real therapeutic agents. This phenomenon has been shown in treatments of pain, depression, Parkinsonism, and more. The main ethical complaint against placebo treatment is that it is a kind of deception, where supposedly we substitute what works just psychologically for a real drug that actually works on the tissue level. We claim that the scientific findings bring to a new level the seeming deconstruction of the distinction between "placebo" and "real" drugs, and that instances of placebo treatment which fulfill this criterion should be recognized as a unique category-we call it "comparable placebo treatment" (CPT). The paper uses an analysis of the notion of deception to argue that CPT does not amount to deception; that it can preserve patient autonomy; and that it is therefore morally legitimate.

Ethics Commentary: The Psychotherapeutic Relationship

Immanuel Kant once observed, “We are not gentleman volunteers; we are conscripts in the army ofmoral law” (Murdoch 1992, p. 35).We recognize that many individuals act primarily, perhaps exclusively, in self-interest. But Kant’s observation that there is a moral imperative—what he called a “categorical imperative”—is indeed compelling. We cannot ignore the fact that moral demands are placed upon us by virtue of our living in a social order with other human beings. Physicians and health professionals in particular live in a moral order, with obligations incumbent on them by virtue of the needs of those who seek their help. Acknowledging that there are scoundrels among professionals, those motivated solely by self-interest and not in the service of others, we recognize that there are certain demands that health professionals cannot escape. Specific moral obligations are imposed on them by virtue of their relationship with patients or clients. This relationship is shaped by the clinician’s promise and expertise to heal and by the imbalance that naturally exists between a person in need and a person who seeks to provide treatment, answers, and comfort in relation to that need. Whether one understands those obligations as allegiance to conscience, allegiance to God, allegiance to society, or a more direct allegiance to the patient or client, the obligations are present. PROFESSIONALISM IN THE PSYCHOTHERAPEUTIC RELATIONSHIP

Seeking Justice in Missouri: The Case of The Honorable Barbara T. Peebles

A travesty is underway in St Louis, Missouri involving Associate Circuit Judge Barbara Peebles. Judge Peebles is a good judge - thoughtful, balanced, and fair. But on September 28, 2012, the State’s Judicial Commission on Retirement, Removal and Discipline recommended removal of Judge Barbara Peebles from the bench. A black woman, Judge Peebles, has sat on the bench for twelve years. Until last year, not a single ethical complaint had been lodged against her in her entire legal career; as an assistant city counselor, prosecutor, the first commissioner of the St. Louis Drug Court, or as a judge. Thus, one would expect the violations and findings that led to the recommendation of removal to be extraordinary. To many of us attorneys reading the case, all the findings put together, barely constituted grounds for a public reprimand, with a temporary suspension as a long shot, representing a bad year in the overall context of a good legal career. But removal of a sitting judge with no prior complaints on her record?? Are these people serious? Even more disturbing, however, is the fact that the poorly written Commission report, as well as the testimony, only provided a hint of the real story behind this extraordinary action. That is, the “who, what, where, why and how of this case, especially the who, the “how,” and the why, are largely absent. What is going here?This essay examines the context, setting and players in this drama, as well as, the Commission's findings. It then turns to the back story or what the essay argues is the real story of this case. It is a story involving petty politics, power, race and gender.The Supreme Court of Missouri is scheduled to hear arguments regarding the recommendation of removal on this January 3, 2013.

9 Upsetting Dilemmas

9 Upsetting Dilemmas

Protecting Psychiatrists’ Reputations on the Internet

Back to table of contents Previous article Next article Communications and UpdatesFull AccessProtecting Psychiatrists’ Reputations on the InternetAlan A. Stone, M.D., and Paul S. Appelbaum, M.D.Alan A. StoneSearch for more papers by this author, M.D., and Paul S. AppelbaumSearch for more papers by this author, M.D.Published Online:1 Sep 2012https://doi.org/10.1176/appi.ajp.2012.12050623AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: The reputation of physicians is now at risk on the Internet. Dr. Gabbard’s clinical case conference in the May issue (1) provides a striking example. A resident providing good clinical care seems helpless to protect his professional reputation in the face of critical web postings by the patient’s mother, becoming a victim of “the Internet era.” Dr. Gabbard suggests that guidelines on “how to respond to [such] attacks should be developed.” We would like to offer some ideas about how to begin that process.Although there are services (e.g., emerit.biz [2]) that offer to help doctors establish and protect their reputation by being proactive, these entities apparently have no effective remedy against negative postings. Indeed, one web site has a “wall of shame” that lists physicians who have tried to prevent postings of negative comments (3). Sites are protected by federal law against suits for defamation, and anecdotal evidence indicates that physicians who initiate legal action against the posting individual are likely to make matters worse.It seems to us that this is a problem that requires some institutional remedy; self-help is apparently unavailing. What can the aggrieved psychiatrist ethically do given the constraints of confidentiality? Confidentiality is waived when ethics complaints or malpractice suits are initiated by patients; psychiatrists have the right to defend themselves. Perhaps an attack on the Internet might be considered to constitute a “limited waiver.” As in this case, it was ethically appropriate, even without consent or a waiver, to have a clinical case conference and to publish what we take to be a disguised (unidentifiable) account. We suggest the creation of an Internet ombudsman—a mental health professional not involved in the care of the patient or the family. An aggrieved psychiatrist acting under the partial waiver and the accepted practice of consulting a colleague would identify the derogatory posting. The ombudsman would review the patient’s care and the posting and when appropriate would go to the web site and post a limited response (e.g., “I have reviewed this posting in my capacity as ombudsman [for the clinic, for the hospital, for the medical school, for the District Branch of APA] and am of the opinion that this posting misrepresents the quality of the clinical care provided by the doctor.” In the Internet age, it may well become necessary for every organized mental health setting to have a page on their website to which the ombudsman could refer those accessing the derogatory posting for further information about the psychiatrist and the provision of treatment.In this case report, the postings included “antipsychiatry” material. In responding to these allegations, an institutional site might do a service not only for aggrieved psychiatrists but for the entire profession. These are tentative suggestions, but one thing is clear: one cannot deal with the challenges of the Internet without becoming part of it.Cambridge, Mass.New York, N.Y.Dr. Appelbaum has equity in the Classification of Violence Risk program (COVR, Inc.). Dr. Stone reports no financial relationships with commercial interests.References1 Gabbard GO: Clinical challenges in the Internet era. Am J Psychiatry 2012; 169:460–463Link, Google Scholar2 Medical Justice. http://emerit.bizGoogle Scholar3 RateMDs Inc. www.rateMDs.comGoogle Scholar FiguresReferencesCited byDetailsCited ByNone Volume 169Issue 9 September 2012Pages 991-991 Metrics PDF download History Accepted 1 June 2012 Published online 1 September 2012 Published in print 1 September 2012

A 5-Year Review of Ethics Complaints to the American Society of Plastic Surgeons

The Code of Ethics of the American Society of Plastic Surgeons (ASPS) exists to encourage and enforce ethical behavior among its members. Complaints against individual members may be filed by patients or their representatives, members of the Society, or other members of the public. Data from a total of 677 complaints from 2004 to 2008 were reviewed by the author. These complaints were categorized with regard to geographic area, type of complaint, and the outcome of the investigation of the complaint, including disciplinary actions. The system of managing these complaints within the Society is discussed. States with the most complaints filed included California, Florida, Texas, Illinois, and New York, with all others having a minimal number. The most common complaint was filed regarding unethical advertising, followed by unprofessional conduct and participation in a contest. Differences in frequency of complaints were statistically significant (Fisher's exact test, p < 0.001). Fifty-four cases were heard by the Judicial Council, with 31 receiving discipline, primarily the less severe types of censure. The total number of complaints per year seems to be trending downward. Ethical complaints (filed mostly by ASPS members) vary in frequency according to geographic area and the type of complaint. A downward trend was noted in the total number of complaints over the years 2004 to 2008, although this was not statistically significant. Given the basic purposes of the development of a code of ethics and its subsequent enforcement, the ethical construct within the ASPS seems to serve the specialty well.

Board Will Help Members Navigate Practice Changes

Board Will Help Members Navigate Practice Changes

Ethics Commentary: Ethical Considerations in Caring for People Living With Addictions

Ethics Commentary: Ethical Considerations in Caring for People Living With Addictions

Reflections in Response to the Nevada Judicial Evaluation Pilot Project

Our colleagues at the University of Nevada Reno, the authors of the Nevada Judicial Evaluation Pilot Project: Final Report (NJEPP Report) and the Nevada Judicial Evaluation Project: Supplement to the Final Report (NJEP Supplement), have done an admirable job of setting up a framework for a workable program. They succeed in identifying key components for a successful judicial performance evaluation (JPE) program for Nevada. In the spirit of collaboration, and because of our good faith interest in making sure that Nevada’s JPE system is as fair as it can possibly be, we wish to supplement the NJEPP Report’s findings with some additional reflections on creating a system that meets the Commission’s goals.Our key observations are as follows: 1) there is a potential for bias in any judicial evaluation program. Steps must be taken to mitigate this possibility, 2) the survey respondent groups must be carefully identified, and instruments must be sensitive to the strengths and weaknesses of the assessments from each group, 3) because response bias is likely to lead to unreliable results, steps must be taken to boost the response rates of the various respondent groups, 4) care must be taken when aggregating the survey data, as implicit value judgments are made whenever averages are computed, 5) the process of creating, implementing, interpreting and utilizing judicial evaluation data will require many different groups of actors. The roles of these groups must be clearly delineated, 6) the use of state-sponsored JPEs in contested judicial elections is unprecedented. The use of such a program in this context raises critical issues of fairness and threatens the integrity of the electoral process, 7) female and minority judges are the most likely to be evaluated harshly, even when the JPE system is well designed, because of unconscious biases. In the interest of fairness, questions that are the most likely to bring into the evaluation process unconscious biases should be either eliminated or weighed less, and 8) The Commission should consider creating a system whereby each piece of information is weighted systematically and a priori. Putting more weight on objective measures (e.g., ethical complaints filed against a judge, record of whether a judge has been overturned by a superior court, and number of cases handled) may help to alleviate some of the potential for bias and unfairness.

Ethical and professional considerations in divorce and child custody cases.

The provision of psychological (e.g., psychotherapy, coparenting, mediation, collaborative divorce, child custody evaluation) services for families of divorce are growing specialties for many clinical and forensic psychologists. However, practice in domestic relations psychology, such as divorce and custody assessment and testimony, is a high-risk venture for incurring ethics complaints and law suits. The lead article and the three commentaries that follow enumerate the various roles practitioners might play, clarify how each role requires specific skill sets that may be outside one’s particular competence and necessitate additional training, describe how countertransferential issues arise, urge meticulous record keeping, discuss some of the subtleties of confidentiality and the releasing of information, describe how transparency in clarifying expectations leads to a lowering of contentiousness, and provide tips for divorce and forensic practice. The special challenges associated with psychologists being tempted to move beyond

Code of Ethics for the American Association of Physicists in Medicine: Report of Task Group 109

A comprehensive Code of Ethics for the members of the American Association of Physicists in Medicine (AAPM) is presented as the report of Task Group 109 which consolidates previous AAPM ethics policies into a unified document. The membership of the AAPM is increasingly diverse. Prior existing AAPM ethics polices were applicable specifically to medical physicists, and did not encompass other types of members such as health physicists, regulators, corporate affiliates, physicians, scientists, engineers, those in training, or other health care professionals. Prior AAPM ethics policies did not specifically address research, education, or business ethics. The Ethics Guidelines of this new Code of Ethics have four major sections: professional conduct, research ethics, education ethics, and business ethics. Some elements of each major section may be duplicated in other sections, so that readers interested in a particular aspect of the code do not need to read the entire document for all relevant information. The prior Complaint Procedure has also been incorporated into this Code of Ethics. This Code of Ethics (PP 24-A) replaces the following AAPM policies: Ethical Guidelines for Vacating a Position (PP 4-B); Ethical Guidelines for Reviewing the Work of Another Physicist (PP 5-C); Guidelines for Ethical Practice for Medical Physicists (PP 8-D); and Ethics Complaint Procedure (PP 21-A). The AAPM Board of Directors approved this Code or Ethics on July 31, 2008.