Ethical Issues In Assessment And Testing

Ethical Issues In Assessment And Testing

It is imperative for the psychologist to be initially aware of the fact that none of the existing ethical theories will singularly provide a tailor made solution for his client in the most ethically approved way. In as much as they represent different viewpoints of ethical justification, ethical theories potentially conflict with each other when applied to a particular case at the same time. This leaves the psychologist to rely more on his intuition and creativity than the ethics theory models. However it should be remembered that his recommendations and subsequent actions should be within the confines of the American Psychological Association’s Ethics Code. Though not an exact formula for unraveling ethical challenges, the APA Ethics Code offers an interpretation of broad rules of conduct whose application should be driven by a desire to do the right thing simply because it is right.

In this case study the psychologist is confronted by a conflict whose cause can be attributed to his inability to determine what is right between making a full disclosure about his patient to her husband thereby weakening her case for child custody, or putting the mental heath of his patient first by holding on to information that would reflect negatively in her case. Different ethical theories would interpret this dilemma in very different ways but of great importance to psychologists is finding a solution that reflects a moral disposition; one which does not contravene the principles of APA’s Ethics code. Doing the right thing, and making the right choice as well, are factors associated with moral principles, obligations and ideals (Beauchamp & Childress, 2001). As an ethically responsible professional, the psychologist must therefore base his decisions on ethical models that are best designed, morally and professionally, to address the dilemma about his client’s case. A single model of ethical reasoning alone is not sufficient enough for professional practice so careful attention to the details involved in the conflict and adherence to his ethical code are necessary ingredient in resolving the conflict.

Employing Kant’s formalist ethical theory would act negatively on the welfare of the client in this case. Kant’s formalist model “proposes that there is a rational solution for every ethical question and that the acceptability of any ethical maxim can be established beyond any doubt purely by rational deduction” (Ford, 2000, p. 71). This approach denies the existence of conflict when perfect and imperfect duties collide because the perfect would prevail. When applied to the our case the psychologist should not be facing any dilemma because doing what is socially accepted as the right thing would make him present a full report including his patient’s records of potential instability and alleged paranoia which would jeopardize her chances of gaining custody of her sons. The woman has already been diagnosed with clinical depression which renders her susceptible to persistent feelings of sadness, memory problems, and a loss of hope and self esteem among other symptoms. She is in an endless plunge down an abyss without anything to hold on to except, as she puts it, “my children.” According to Kant, the psychologist is already in the wrong for having withheld information about his client’s suspicion of her husband’s adultery. For Kant there are no circumstances that would call for further reasoning about the application of a rule on a particular context beyond the concept of right or wrong. This kind of analysis as much as it revolves around the applicability of moral principles in arriving at ethical solutions, it does not correspond to the way people practically apply rules in solving moral problems (Fisher, 2008).

The most appropriate model of ethical reasoning that can be applied to resolve the apparent ethical conflict in this case would be Wallace’s (1988) ethical contextualism. This approach relies on using situational conditions to find solutions in ethical dilemmas. Ethical contextualism acknowledges that conflicts happen and that there are no universal ethical principles that can be applied in every dilemma involving a conflict between competing ethical principles. The ever changing contexts of human life can not be judged solely on the basis of ethical rules like Kant’s formalist theory. “How could a set of principles anticipate the continual and extensive changes in the human condition?” (Wallace, 1988, p. 17). By borrowing extensively on ethical contextualism, the psychologist can resolve the conflict in our case using the following nine step approach. The first approach would be to identify the ethical considerations involved in the woman’s case. Top on this list is the psychologist’s regard for the mental health of his client. She is clinically depressive and on the verge of developing an anxious personality disorder. How would his decision impact on her treatment? In evaluating potential ethical considerations, the psychologist should dwell on one principle and disregard others as being of less importance. A contextual approach takes into consideration all the principles relevant to the case in order to evaluate the ethical impact of a decision on the situation as a whole. The client is the principal figure in this case but there is her husband and family who stand to be affected by the situation. Her marriage is on the verge of a break up. What consequences would the psychologist’s decisions have on this marriage and the family involved? This initial appraisal aims at establishing whether an ethical conflict exists or not and if it does then what is the most ethical decision that can apparently be made. In our case a conflict exists and the psychologist has to make a decision that puts into consideration the welfare of his patient as well as her children regardless of his previous omission of pertinent information about the woman.

The second step involves gathering as much pertinent information about the case as possible. The facts of a situation are as important as the decision itself. For example the psychologist in this case should not disregard the fact that his client’s has a husband whose insistence on her instability has played a significant role in her depression. His further insistence on being consulted about all aspects of her therapy and having a formal access to her assessment records shows that there is some information he does not want to be revealed without his knowledge. This might validate the wife’s claim about the extramarital affair the husband is having. The psychologist should make an extra effort to review every available data related to the husband’s activities in order to verify his credibility. His insistence on divorce on the grounds of the wife’s ‘breakdown’ poses an increased danger to her mental health as well as her recovery chances.

The woman is willing to present her accusations to the husband so the issue of confidentiality does not arise and the psychologist should go ahead and make amends to his earlier assessment report and include all the information he had previously omitted. All this should be done in consultation with the client, advising her along on the consequences the revelations will have on her custody case. Fact gathering should also include legal guidelines, her intellectual as well as personality assessment, and consultation with her inpatient therapist.

The third step involves a second appraisal of the conditions involved. The psychologist aims at determining whether the conflict has been exhaustively resolved or not. In the fourth step, the psychologist conducts metaethical deliberations to determine whether the ethical principles he has been applying are relevant to the conflict at hand or not. The meatethical significance of every consideration is discussed in detail to determine each deliberation’s relevance to the matter at hand. He can make a decision at this point if the deliberations are found to be relevant to the conflict and can resolve the dilemma. It is obvious that the husband intends to use his wife’s medical records to make his support his divorce and custody case. The woman’s depressive condition has been significantly augmented by lack of concern and emotional care by the husband and a loss of her children, who are the only meaningful reasons for her clinging to sanity, would devastate her mental health. Should the psychologist adopt a Kantian ethical approach and make required revelations about her state of mental health, she could definitely lose the custody of her children. The conflict still exists because the ethical principles he has adopted do not solve the dilemma, so he has to carry on to the fifth step that requires metaethical deliberations on finding an ethical solution to the conflict.

This step involves a second deliberation with emphasis on prioritization of the ethical considerations by their relevance to the case. The main question here is how each consideration works towards the improvement of the quality of human life. On a metaethical level he might have to question himself on what matters most between his client’s mental heath and the custody of the children. He might have to confront the issue of his withholding information about his client’s accusations and the real motive behind it. If he did it to protect her from a cheating husband or to strengthen her case for child custody for the sake of her sanity, he would still have to confront the question whether his client’s custody of the children in her unstable mind would be of any good to anyone involved in the case. At this point the psychologist has to formulate a solution that best serves his professional ethical duty.

The sixth step is known as the tertiary appraisal where the psychologist has to generate options from his professional ethical considerations. He resorts to the pragmatic application of ethical code to the concrete context of the case. From the options he has generated, he selects the one that is most consistent with the fundamental ethical relevance to the situation and does least or no harm at all to the case. This is a creativity activity where the psychologist seeks to primarily safeguard his client’s mental health without jeopardizing the other ethical considerations like the welfare of her children which might impact negatively on the primary objective. Wallace (1988) states that practical wisdom, which is the core of ethical contextualism, involves giving consideration to every ethical aspect that is relevant to the deliberations at hand. The looming divorce presents the biggest threat to the woman’s recovery. The psychologist at this point should start exploring the possibilities of marital therapy sessions.

In the seventh step, the psychologist takes all the available options and estimates the consequences each of them carries. For example if he goes ahead and provides the information he had omitted about his client’s accusations of her husband’s adultery, his client would not object it since she did not offer any objections about it. There is no issue of breaking client confidentiality here. She even seems welcome to having the information included in the assessment report as long as she gets the custody of her children. If he does not divulge the information in the hope of protecting her vulnerability, the client herself might even lodge a malpractice complaint if she goes ahead with the divorce on the grounds mental and emotional torture through infidelity only to find the information missing in her medical report. The best option should be the one accompanied by the least future damage to her well being. The eighth step is all about making the final decision. The psychologist will decide on a course of action she will follow based on the deliberations he has made. In this case the main ethical consideration was the future welfare of his client. Her treatment relies on how the she will take the divorce and the subsequent child custody case. She suffers from depression and not in a position to be exposed to courtroom wrangles at this point. The best decision will involve her husband dropping the divorce case which will negate the need for the fight over custody of children. The couple should be encouraged to seek for marital therapy instead.

The importance of documenting the entire decision making process should not be downplayed either. To demonstrate his awareness of the matter, the psychologist should document not only the information he used in arriving at the decision, but also the names and dates of all the people he contacted in all the whole deliberation process.

References

Beauchamp, T. L., & Childress J. F. (2001). Principles of biomedical ethics (5th ed.). Oxford:OxfordUniversity Press.

Fisher, C. B. (Ed.). (2008). Decoding the ethics code: A practical guide for psychologists.London: Sage Publishers.

Ford, G. G. (2000). Ethical reasoning in mental health professions. New York: CRC.

Wallace, J. D. (1988). Moral relevance and moral conflict. Ithaca: Cornell University Press.