Ethical principles in psychotherapy within a broad psychological and medical deontological framework: An international comparison / Principios éticos en psicoterapia dentro de un amplio marco deontológico psicológico y médico: una comparación internacional

Awareness of ethics codes and professional guidelines is crucial to a professional role in psychotherapy practice. Psychotherapy practice is increasingly heterogeneous, and there is much discussion about their effectiveness for clients. In some countries, psychotherapy is an autonomous profession. In others, is part of the professional features of psychologists and psychiatrists, and it is possible to find other health professionals working as psychotherapists in some countries. Considering that ethical principles are central to the performance of a profession, we intend to find connections between the ethical principles for psychotherapists and psychologists or psychiatrists. A critical review was done to promote an integrative vision of ethics codes in psychotherapy. Content analysis of the ethics codes in psychotherapy was per-formed. Confidentiality, competence, and integrity were the principles more frequently found. Psychotherapists seem to have a major concern with interpersonal relationshipsand are less linked to social responsibility. (AU)

El conocimiento de los códigos éticos y las directrices profesionales es crucial para desempeñar un papel profesional en la práctica de la psicoterapia. La práctica de la psicoterapia es cada vez más heterogénea y se discute mucho sobre su eficacia para los clientes. En algunos países, la psicoterapia es una profesión autónoma. En otros forma parte de las características profesionales de psicólogos y psiquiatras, y es posible encontrar a otros profesionales de la salud trabajando como psicoterapeutas en algunos países. Considerando que los principios éticos son centrales para el desempeño de una profesión, pretendemos encontrar conexiones entre los principios éticos para psicoterapeutas y psicólogos o psiquiatras. Se realizó una revisión crítica para promover una visión integradora de los códigos de ética en psicoterapia. Se realizó un análisis de contenido de los códigos de ética en psicoterapia. La confidencialidad, la competencia y la integridad fueron los principios más frecuentemente encontrados. Los psicoterapeutas parecen tener una mayor preocupación por las relaciones interpersonales y están me-nos vinculados a la responsabilidad social. (AU)

Deontología y confidencialidad en psiquiatría y psicología clínica en España / Deontology and confidentiality in psychiatry and clinical psychology in Spain

Introducción: En el ámbito de la salud mental la cualidad deontológica o ética profesional de todo el personal sanitario está regulada por los correspondientes códigos internacionales y nacionales de los preceptivos colegios profesionales. Material y método: Estudio crítico de los códigos deontológicos españoles y otros internacionales de referencia, para las especialidades oficiales de psiquiatría y psicología clínica. Resultados y discusión: Esos códigos normalizan la confidencialidad como asunto imperativo y son de obligado cumplimiento para sus colegiados. Los facultativos tienen igualmente la máxima exigencia bioética de ostentar siempre la formación y actualización óptimas en su campo, lo que es aplicable tanto si actúan pública como privadamente, o son de una u otra especialidad. Las actuaciones facultativo-paciente más paternalistas solo podrán ser válidas en la actualidad cuando los usuarios sean incapaces de elegir voluntariamente o de realizar acciones autónomas. Sin embargo, resultan especialmente sensibles las situaciones que conlleven riesgo de heteroagresión, suicidio, consumo de sustancias o se den en menores de edad. Por tanto, puede haber conflicto bioético entre la confidencialidad facultativa y el deber de proteger e informar a otra persona involucrada. Conclusiones: En nuestro país, la salvaguarda de los principios de interés público de no-maleficencia y justicia tendrá que prevalecer sobre los más individuales de autonomía y beneficencia (AU)

Introduction: In the field of mental health, the deontological quality or professional ethics of every sanitary professional, including those who are not physicians, is constantly regulated by the corresponding national and international codes of the professional colleges or associations. Method and material: Critical study of the Spanish deontological codes and other international ones which are a reference point for the official specialities in psychiatry and clinical psychology. Results and discussion: Those codes normalise confidentiality as an imperative matter and are obligatory for the college members. Physicians also have the highest bioethical exigence to always have the optimal training and updating in their field, which is applicable for both public and private practice and for both psychiatrists and clinical psychologists. At present, the most paternalistic physician-patient actions can only be acceptable when the users are unfit to choose voluntarily or make autonomous actions. However, the situations involving risk of hetero-attack, suicide, substance use or related to minors are especially sensitive. Therefore, there may be a bioethical conflict between physicians confidentiality and the duty to protect and inform an implied third person. Conclusions: In our country, the safeguard of the public interest principles of non-maleficence and justice will have to prevail over the more individual ones of autonomy and beneficence (AU)

Introducció: En l'àmbit de la salut mental la qualitat deontològica o ètica professional de tot el personal sanitari està regulada pels corresponents codis internacionals i nacionals dels preceptius col·legis professionals. Material i mètode: Estudi crític dels codis deontològics espanyols i uns altres internacionals de referència, per a les especialitats oficials de psiquiatria i psicologia clínica. Resultats i discussió: Aquests codis normalitzen la confidencialitat com a assumpte imperatiu i són d'obligat compliment per als seus col·legiats. Els facultatius tenen igualment la màxima exigència bioètica d'ostentar sempre la formació i actualització òptimes en el seu camp, la qual cosa és aplicable tant si actuen pública com privadament, o són de l'una o l'altra especialitat. Les actuacions facultatiu-pacient més paternalistes només podran ser vàlides en l'actualitat quan els usuaris siguin incapaços de triar voluntàriament o de realitzar accions autònomes. No obstant això, resulten especialment sensibles les situacions que comportin risc de heteroagressió, suïcidi, consum de substàncies o es donin en menors d'edat. Per tant, pot haver-hi conflicte bioètic entre la confidencialitat facultativa i el deure de protegir i informar una altra persona involucrada. Conclusions: Al nostre país, la salvaguarda dels principis d'interès públic de no-maleficència i justícia haurà de prevaler sobre els més individuals d'autonomia i beneficència (AU)

Reflexões sobre a disciplina de história da psicologia no estado do Mato Grosso do Sul / Reflections on History of Psychology's course in Mato Grosso do Sul / Reflexiones acerca de la asignatura de Historia de la Psicología en Mato Grosso do Sul

Este artigo objetivou analisar a organização do ensino da disciplina de História da Psicologia, baseando-nos em cursos de graduação em Psicologia, no estado do Mato Grosso do Sul. Inicialmente, inventariaram-se as instituições que possuem cursos de Psicologia, acessando os seus sites e aplicando questionários aos seus coordenadores. Em seguida, organizaram-se algumas características gerais dos cursos e das instituições anuentes. Posteriormente, discutiu-se como o ensino da História da Psicologia auxilia na formação de estudantes, introduzindo-os ao estudo da Psicologia e às suas contendas científicas e profissionais. Ele contribui, com críticas, ao que se empreende no presente, embora apresente dificuldades de proporcionar algo introdutório mesclado a reflexões avançadas em uma disciplina. Por fim, observou-se que ele pode ser alocado e articulado com outras disciplinas, fazendo interface com os domínios da Ontologia, Epistemologia, Lógica e Ética.

This article aimed to analyze the History of Psychology subject teaching organization, based on the Psychology undergraduate courses in Mato Grosso do Sul. Initially, institutions with Psychology courses were inventoried; their websites were accessed and surveys were applied to their coordinators. Ten, some general characteristics of these courses and institutions were organized. Afterwards, it was discussed how the teaching of History of Psychology helps the students training, introducing them to Psychology and its scientific and professional strife. It also contributes with criticism on what have been done in the present, although it has some boundaries providing introductory issues mixed to advanced reflections on Psychology. Finally, it was observed that this teaching could be placed and articulated with other subjects, interfacing with Ontology, Epistemology, Logics and Ethics domains.

Este artículo tuvo como objetivo analizar la organización de la enseñanza de la asignatura de Historia de la Psicología, basándose en cursos de grado en Psicología, en el estado de Mato Grosso do Sul. Al principio, se inventariaron las instituciones que poseen cursos de Psicología, accediendo a sus sitios web y aplicando cuestionarios a sus coordinadores. A continuación, se organizaron algunas características generales de los cursos y de las instituciones anuentes. Después, se discutió cómo la enseñanza de la Historia de la Psicología auxilia en la formación de estudiantes, introduciéndolos al estudio de la Psicología y a sus contiendas profesionales y científicas; contribuye, con críticas, a lo que se emprende en el presente; presenta dificultades de proporcionar algo introductorio y múltiple, mezclado con reflexiones avanzadas en una disciplina; puede ser asignado y articulado con otras disciplinas; puede hacer interfaz con los dominios de la Ontología, Epistemología, Lógica y Ética.

Códigos éticos en la publicación de artículos científicos en las disciplinas de la psiquiatría y psicología / Ethical considerations in the publication of scientific articles in the disciplines of psychiatry and psychology

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Psicoterapia: quanto custa a sessão? / Psychotherapy: how much should a session cost? / Psicoterapia: ¿cuanto cuesta la sesión? / Psychotherapy: how much should a session cost?

Esta pesquisa teve como objetivo conhecer as principais dificuldades enfrentadas pelos psicólogos no processo de estabelecimento dos seus honorários referente aos serviços de psicologia clínica na cidade de Caruaru/PE. Foi executada através de métodos qualitativos, sendo utilizada a entrevista semidirigida para coleta dos dados e na sistematização dos dados utilizamos a análise de conteúdo de Bardin. Participaram da pesquisa três psicólogas que residem e trabalham na cidade referida. Ficou evidente que as orientações sobre o estabelecimento dos honorários na prática clínica ou inexistiram ou foram inconsistentes; quando o assunto são as dificuldades enfrentadas ao estabelecer o valor da sessão percebemos certa ansiedade quando necessitam negociar o valor com o paciente devido à falta de instrução. Ao final, percebemos que as vivências práticas que facilitaram o manejo do dinheiro na relação, foram as trocas de experiência entre os colegas, a flexibilização do valor a partir da necessidade real do cliente e principalmente da forma de pagamento. Concluímos que se faz necessário sensibilizar as instituições de ensino de psicologia e seus professores para sistematizar discussões sobre o tema, apesar de compreendermos que não existe consenso sobre o assunto e que precisamos fomentar mais pesquisas nesta área para proporcionar um maior suporte teórico.

This research aimed to study the main difficulties faced by psychologists in the process of establishing their fees for clinical psychology services in the city of Caruaru / PE. It was performed using qualitative methods, using semi--directed interview for data collection and tabulation using Bardin content analysis. Three psychologists living and working in this city participated in the study. It became obvious that the guidelines on the establishment of fees in clinical practice either did not exist or were inconsistent when the subject faced difficulties in establishing the cost of the session. We perceived anxiety when negotiation with the patient was required and this was attributed to a lack of education. In the end, we realized that the practical experiences that facilitated the management of money in the relationship were the exchange of experience among colleagues, the flexibility needed due to client's financial issues and also payment format. We conclude that it is necessary to educate psychology teaching institutions and their teachers to systematize discussions about the subject although we understand that there is no consensus on the subject and we need to encourage more research in this area to provide greater theoretical support.

Esta investigación tuvo como objetivo conocer las principales dificultades enfrentadas por los psicólogos en el proceso de establecer sus honorarios rela-cionados con los servicios de psicología clínica en la ciudad de Caruaru / PE. Fue realizada a través de métodos cualitativos, siendo utilizada la entrevista semidirigida para la recolección de datos y en la sistematización de los datos se utilizó el análisis de contenido de Bardin. Participaron de la investigación tres psicólogas que residen y trabajan en la ciudad citada. Fue evidente que las orientaciones sobre el establecimiento de los honorarios en la practica clínica o no existieron o fueron inconsistente; cuando el asunto son las dificultades enfrentadas al establecer el valor de la sesión se notó cierta ansiedad cuando necesitan negociar el valor con el paciente debido a falta de instrucción. Al final, fue percibido que las vivencias practicas que facilitaron el manejo del dinero en la relación, fueron los intercambios de experiencia entre los colegas, la flexibilización del valor a partir de la necesidad real del cliente y principal-mente la forma de pagamento. Se concluyo que es necesario sensibilizar las instituciones de enseñanza de psicología y sus profesores para sistematizar discusiones sobre el tema, a pesar de comprender que no existe consenso sobre el asunto y que es necesario fomentar más investigaciones en esta área para proporcionar un soporte teórico mayor.

Ethical considerations for psychologists in the time of COVID-19.

Psychologists are in a position to respond to the COVID-19 pandemic through research, practice, education, and advocacy. However, concerns exist about the ethical implications associated with transitioning from face-to-face to online or virtual formats as necessitated by stay-at-home orders designed to enforce the social distancing required to flatten the curve of new COVID-19 cases. The purpose of this article is to review potential ethical issues and to provide guidance to psychologists for ethical conduct in the midst of the current crisis and its aftermath. In addition to contextualizing relevant ethical considerations according to the principles and standards of the current American Psychological Association's ethics code, vignettes are presented to exemplify the ethical dilemmas psychologists in various roles may face when responding to COVID-19 and to offer suggestions and resources for resolving potential conflicts. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Herramientas de autocuidado para el profesional psicosocial como factor protector de su salud mental y bienestar / Self-care tolos for the psychosocial profesional as a protective factor of his mental health and wellbeing

El texto esboza de una manera reflexiva el lugar de los factores protectores que son vitales para el trabajo de los profesionales en el contexto psicosocial; surgen, entonces, algunas de las herramientas encausadas al apoyo sistemático que desde el bienestar individual será vital pensarlo y actuarlo en pro de una mejor calidad de vida en lo profesional y personal. Dentro de los hallazgos se viabiliza la importancia del autocuidado, cuidado de sí y lo paradojal del estar bien para que otros estén bien, y el encuentro terapéutico como alternativa para privilegiar la palabra, el discurso, el apoyo a otros que apoyan y la formación institucional y gremial que se traduce en apuestas políticas y gremiales hacia el cuidar a quien se dispone profesionalmente a cuidar a otros. ¡Vaya tarea la que se propone!

The text outlines a reflection concerning the place of protective factors that are vital for the work of professionals in the psychosocial context; Then some of the tools for systematic support emerge that, from the individual well-being, will be vital to think about and act on it in favor of a better professional and personal quality of life. Among the findings are the importance of self-care, self-care and the paradox of being well so that others are well, the therapeutic encounter as an alternative to privilege the word and the speech, the support to others who support and the institutional and union training; which translates into political and union bets towards caring for those who are professionally willing to take care of others. What a challenging task!

Autocuidado en el psicólogo / The psychologist's self-care

The therapeutic practice focuses mainly on the literacy instruction of the patientconsultant-client in the management of their interpersonal relationships, as well as in the different problems that are the reason for consultation. This partially relegates the therapist who, also, places his own being at risk in the context of the consultation, in the link between the consultant and the therapist. With this in mind, the objective of this article has to do with the development of self-care skills in the psychologist: a protective factor of mental health in professional practice. Method: the documentary review was carried out from a qualitative orientation which is based on a rigorous description of the facts or situations, at the same time, a hermeneutical methodology was used; Through the state of the art, an attempt was made to understand the existing literature on the current research proposal. Conclusions: self-care as a protective factor of mental health in professional practice is aimed at promoting prevention actions based on self-reflexivity and resilience skills in the face of self-care in search of well-being and mental health.

Your Robot Therapist Will See You Now: Ethical Implications of Embodied Artificial Intelligence in Psychiatry, Psychology, and Psychotherapy.

BACKGROUND: Research in embodied artificial intelligence (AI) has increasing clinical relevance for therapeutic applications in mental health services. With innovations ranging from 'virtual psychotherapists' to social robots in dementia care and autism disorder, to robots for sexual disorders, artificially intelligent virtual and robotic agents are increasingly taking on high-level therapeutic interventions that used to be offered exclusively by highly trained, skilled health professionals. In order to enable responsible clinical implementation, ethical and social implications of the increasing use of embodied AI in mental health need to be identified and addressed. OBJECTIVE: This paper assesses the ethical and social implications of translating embodied AI applications into mental health care across the fields of Psychiatry, Psychology and Psychotherapy. Building on this analysis, it develops a set of preliminary recommendations on how to address ethical and social challenges in current and future applications of embodied AI. METHODS: Based on a thematic literature search and established principles of medical ethics, an analysis of the ethical and social aspects of currently embodied AI applications was conducted across the fields of Psychiatry, Psychology, and Psychotherapy. To enable a comprehensive evaluation, the analysis was structured around the following three steps: assessment of potential benefits; analysis of overarching ethical issues and concerns; discussion of specific ethical and social issues of the interventions. RESULTS: From an ethical perspective, important benefits of embodied AI applications in mental health include new modes of treatment, opportunities to engage hard-to-reach populations, better patient response, and freeing up time for physicians. Overarching ethical issues and concerns include: harm prevention and various questions of data ethics; a lack of guidance on development of AI applications, their clinical integration and training of health professionals; 'gaps' in ethical and regulatory frameworks; the potential for misuse including using the technologies to replace established services, thereby potentially exacerbating existing health inequalities. Specific challenges identified and discussed in the application of embodied AI include: matters of risk-assessment, referrals, and supervision; the need to respect and protect patient autonomy; the role of non-human therapy; transparency in the use of algorithms; and specific concerns regarding long-term effects of these applications on understandings of illness and the human condition. CONCLUSIONS: We argue that embodied AI is a promising approach across the field of mental health; however, further research is needed to address the broader ethical and societal concerns of these technologies to negotiate best research and medical practices in innovative mental health care. We conclude by indicating areas of future research and developing recommendations for high-priority areas in need of concrete ethical guidance.

Ethical considerations on the complicity of psychologists and scientists in torture.

INTRODUCTION: The long-standing debate on medical complicity in torture has overlooked the complicity of cognitive scientists-psychologists, psychiatrists and neuroscientists-in the practice of torture as a distinct phenomenon. In this paper, we identify the risk of the re-emergence of torture as a practice in the USA, and the complicity of cognitive scientists in these practices. METHODS: We review arguments for physician complicity in torture. We argue that these defences fail to defend the complicity of cognitive scientists. We address objections to our account, and then provide recommendations for professional associations in resisting complicity in torture. RESULTS: Arguments for cognitive scientist complicity in torture fail when those actions stem from the same reasons as physician complicity. Cognitive scientist involvement in the torture programme has, from the outset, been focused on the outcomes of interrogation rather than supportive care. Any possibility of a therapeutic relationship between cognitive therapists and detainees is fatally undermined by therapists' complicity with torture. CONCLUSION: Professional associations ought to strengthen their commitment to refraining from engaging in any aspect of torture. They should also move to protect whistle-blowers against torture programmes who are members of their association. If the political institutions that are supposed to prevent the practice of torture are not strengthened, cognitive scientists should take collective action to compel intelligence agencies to refrain from torture.

The Ethical Principles of the Portuguese Psychologists: An Empirical Approach.

One thousand four-hundred thirty Portuguese psychologists answered a questionnaire that had been designed in order to ascertain the level of acceptability of a set of proposed ethical principles, which subsequently served as a basis for the Portuguese Psychologists' Ethics Code. On the one hand, the results show that, as expected, the ethical principles rated high on the evaluation scale. On the other hand, the results also highlighted the need for a formal regulation of the practice of psychology in Portugal, especially in view of participants' noticeable failure to recognize the importance of the principle of professional integrity. The responsibility of psychologists in modern societies is huge. As such, the large number of different training programs in Portugal, and the implied lack of a strong professional identity, is a cause of concern. The creation of a professional association allows an external identification of the profession in terms of aims and methods. The main goal of such an association is to promote public trust and enhance public demand. The results also indicate that training and experience lead to a higher valorization of ethical principles, and this is an insight that will be of great importance to the professional practice of psychology.

Racismo e envelhecimento da população negra / Black population racism and aging / Racismo y envejecimiento de la población negra

Os entraves dispostos pelo racismo atravessam negativamente a população negra em diversos âmbitos e sentidos. São heranças históricas que se apresentam de forma clara ou velada até os dias atuais e, quando relacionados à velhice, os tópicos que compõem o racismo se amplificam e tomam novas facetas. Conceitos psicossociais são influenciados diretamente pela perpetuação do modelo hierárquico de raças, influindo diretamente nos elementos socioeconômicos, iniquidades em saúde, demandas familiares, violência, entre outras formas desfavoráveis de experiências da população negra, desde o nascimento até a velhice. Dessa forma, a prática psicológica pautada num fazer ético-político se faz necessária, enquanto oposição a tais práticas racistas ainda contemporâneas ­ marcando-se como propósito deste estudo ratificar essa recomendação; assim, tal prática psicológica mostra sua relevância enquanto práxis científico-metodológica na ruptura com um passado que ainda se faz presente.

The obstacles posed by racism cross the black population negatively in different spheres and senses. They are legacies of history that present themselves clearly or cover up to the present day, and when related to old age, the topics that make up racism are amplified and take on new facets. Psychosocial concepts are directly influenced by the perpetuation of the hierarchical model of races, directly influencing socioeconomic elements, health inequalities, family demands, violence, among other unfavorable experiences of the black population from birth to old age. In this way, the psychological practice based on an ethical and political action becomes necessary as opposed to such racist practices still contemporary ­ marking itself as the purpose of this study to ratify this recommendation; Thus, this psychological practice shows its relevance as a scientific and methodological praxis in the rupture with a past that is still present.

Los obstáculos dispuestos por el racismo atravesan de forma negativa a la población negra en diversos ámbitos y sentidos. Son herencias de la historia que se presentan de forma clara o cubierta hasta los días actuales, y cuando relacionado a la vejez, los tópicos que componen el racismo se amplifican y toman nuevas facetas. Los conceptos psicosociales son influenciados directamente por la perpetuación del modelo jerárquico de razas, influyendo directamente en los elementos socioeconómicos, desigualdades en salud, demandas familiares, violencia, entre otras formas desfavorables de experiencias de la población negra, desde el nacimiento hasta la vejez. De esta forma, la práctica psicológica pautada en un hacer ético y político se hace necesaria como oposición a tales prácticas racistas aún contemporáneas que se marcan como el propósito de este estudio de ratificar esta recomendación; Así, esta práctica psicológica muestra su relevancia como praxis científica y metodológica en la ruptura con un pasado que aún se hace presente.

Outcomes of Notifications against Psychologists in the New Zealand Health Regulation Context 2004-2015.

Research focusing on disciplined health practitioners is growing though exploring lower level decisions is also important. This study examines the outcomes and characteristics of psychologists subject to formal notifications between 2004 and 2015. Data were extracted from archived notification files (N = 396) held by the New Zealand Psychologists Board alongside publically available decisions of the Health Practitioners Disciplinary Tribunal (N = 13). Annually, <2% of practising psychologists were subject of a notification. Outcomes varied by type of notification but the vast majority resulted in no further action either at initial triage or after further investigation. Notifications involving psychologist scope practitioners and those with overseas qualifications prior to New Zealand registration were significantly more likely to result in further investigation. All 13 prosecutions resulted in a finding of guilt. Further research is needed to explore risk factors and why female practitioners may be over-represented in cases of sexual boundary transgressions.

Ethical aspects of data sharing and research participant protections.

Open access is fast becoming the norm across science. Sharing research data broadly has the potential to accelerate scientific progress, optimize the value of data, and promote scientific integrity. However, data sharing also poses new practical and ethical challenges to the conduct of research with human participants. This article provides an overview of how open access to research data has impacted the core principles of research ethics-respect for persons, beneficence, and justice-and, in turn, how a reinterpretation of these principles translates to procedures for the protection of the rights and wellbeing of human research participants. (PsycINFO Database Record

Responsible practices for data sharing.

Research transparency, reproducibility, and data sharing uphold core principles of science at a time when the integrity of scientific research is being questioned. This article discusses how research data in psychology can be made accessible for reproducibility and reanalysis by describing practical ways to overcome barriers to data sharing. We examine key issues surrounding the sharing of data such as who owns research data, how to protect the confidentiality of the research participant, how to give appropriate credit to the data creator, how to deal with metadata and codebooks, how to address provenance, and other specifics such as versioning and file formats. The protection of research subjects is a fundamental obligation, and we explain frameworks and procedures designed to protect against the harms that may result from disclosure of confidential information. We also advocate greater recognition for data creators and the authors of program code used in the management and analysis of data. We argue that research data and program code are important scientific contributions that should be cited in the same way as publications. (PsycINFO Database Record

Ethics and Confidentiality for Psychologists in Academic Health Centers.

Psychologists in academic health centers (AHC) face important ethical issues including confidentiality when working with a multidisciplinary team, sharing of information through the electronic health record, obtaining informed consent in a fast-paced healthcare environment, cultural competency in the medical setting, and issues related to supervision and training. The goal of this paper is to describe ethical issues for psychologists in AHCs in the context of case examples, and to consider ethical decision-making tools to enhance clinical care. Considerations for best practices in integrated care settings will be discussed, and the APA Ethical Standards will be referenced throughout.

Refining moral agency: Insights from moral psychology and moral philosophy.

Research in moral psychology has recently raised questions about the impact of context and the environment on the way the human mind works. In a 2012 call to action, Paley wrote: "If some of the conclusions arrived at by moral psychologists are true, they are directly relevant to the way nurses think about moral problems, and present serious challenges to favoured concepts in nursing ethics, such as the ethics of care, virtue, and the unity of the person" (p. 80). He urges nurse ethicists and scholars to evaluate the impact these findings may have for moral theory. In this paper, I review some of Paley's (Nursing Philosophy, 13, 2012, 80) critique, focusing on the argument that theories of nursing ethics have failed to account for the role of context; both in terms of its impact on the way nurses make moral judgements and in terms of the environment's influence on the way the mind works. I then examine nursing literature on moral agency, and focus on the role of the environment and context play within existing theory. I argue that theories of moral agency have often accounted for the role of context on the way nurses make decisions; however, less attention has been paid to its impact on the mind. With this background, I use insights from the fields of moral philosophy and moral psychology to refine the conceptualization of nurse moral agency in a way that is reflective of current cognitive, philosophical and nursing practice-based science.

Ethical behaviour of physicians and psychologists: similarities and differences.

OBJECTIVE: To compare the coping patterns of physicians and clinical psychologists when confronted with clinical ethical dilemmas and to explore consistency across different dilemmas. POPULATION: 88 clinical psychologists and 149 family physicians in Israel. METHOD: Six dilemmas representing different ethical domains were selected from the literature. Vignettes were composed for each dilemma, and seven possible behavioural responses for each were proposed, scaled from most to least ethical. The vignettes were presented to both family physicians and clinical psychologists. RESULTS: Psychologists' aggregated mean ethical intention score, as compared with the physicians, was found to be significantly higher (F(6, 232)=22.44, p<0.001, η2=0.37). Psychologists showed higher ethical intent for two dilemmas: issues of payment (they would continue treating a non-paying patient while physicians would not) and dual relationships (they would avoid treating the son of a colleague). In the other four vignettes, psychologists and physicians responded in much the same way. The highest ethical intent scores for both psychologists and physicians were for confidentiality and a colleague's inappropriate practice due to personal problems. CONCLUSIONS: Responses to the dilemmas by physicians and psychologists can be categorised into two groups: (1) similar behaviours on the part of both professions when confronting dilemmas concerning confidentiality, inappropriate practice due to personal problems, improper professional conduct and academic issues and (2) different behaviours when confronting either payment issues or dual relationships.

How Do Our Values Inform Ethical Research? A Narrative of Recognizing Colonizing Practices.

How do you reconcile tensions between ethical research practice, personal values, and disciplinary values? This article focuses on an ethical challenge involving the engagement of rural Indigenous community members that emerged during my PhD fieldwork. The narrative illustrates the necessity to engage in critical reflexive research practice, a process which saw me respond to my own feelings of "wrong" and "right," contemplate a distinction between procedural ethics and virtue ethics in community-based research, explore colonizing research practices, and endeavor to reconcile an instance where the values of community psychology appeared in contest. The "voice" in this narrative is that of the first author; the dual authorship reflects the ongoing collaboration between both authors. When this ethical issue came about, our relationship was one of "student" and "supervisor"; we are now colleagues and friends.

Community Data Collection with Children of Mothers Living with HIV: Boundaries of the Researcher Role.

The TRACK-II program is a multi-site, community-based randomized controlled trial evaluating an intervention to assist mothers living with HIV (MLH) in disclosing their HIV status to their young children. Many participants-both mothers and children-reported significant depression and/or suicidal ideation, a phenomenon that presented ethical challenges. This article focuses on participants at one site (Atlanta). Through the vignette of "Jordan," we describe ethical challenges that may arise when faced with the responsibility of maximizing participants' safety while maintaining the boundaries of the researcher role. Guided by community psychology values, our team has taken measures within our role as researchers to empower and protect children and mothers endorsing suicidal ideation. For example, we have relied on relationships with community-based organizations and AIDS service organizations to connect HIV-affected families to mental health services. Furthermore, we have expanded our system of documentation to follow-up adequately with families at risk, and we track family resources to promote a strengths-based framework. We have solicited families' feedback about their supports and needs to understand how we may best serve them by connecting them to the resources they report needing most and empowering them to care for themselves.