ETHICS : VIGNETTES

1. Dr Hope Charity, the clinical psychologist, had just completed six structured sessions of systematic desensitisation for Mr Gold, a solicitor, for management of work-related anxiety. Mr Gold, a handsome man whom she quite liked, was otherwise well-adjusted. Two weeks after the termination of their successful therapeutic venture, Mr Gold sent Dr Charity a bunch of red roses, and a note conveying his thanks and an invitation to dinner and the opera. She found that she really wanted to accept the invitation. If she did, would she be transgressing the Code of Conduct of APS or the Registration Board? If so, why?

2. A responsible TV program was interested in photographing ongoing treatment being conducted by a psychologist as part of joint research in a correctional institution. They guaranteed to distort the facial images of the group participants. The psychologist's university was encouraging her to gain publicity for her research. Would this be a breach of confidentiality requirements? Would it breach broader client/research participant welfare commitments? Who needed to be consulted before it was possible to go ahead with this enterprise? The participants? Senior Corrective Service staff? More junior Service staff? Researcher colleagues? The University Ethics Committee?

3. You are in independent practice. A young male client attends for behavioural modification. He tells you he has met a nice girl and wants to settle down. He has recently resigned from a bikie gang. He gives you details of his involvement in various anti-social acts including a vicious bashing which you recall was covered by the media about 12 months ago when a reward was offered for information leading to the conviction of the perpetrator.

4. An organisational psychologist, Mr, Mr Christopher Findit, carrying out a research contract for the Sydney branch of an international company, had negotiated the contract with the local manager, Ms Glowinthedark, herself an honours graduate from Oxford University. The lady, a very attractive and competent woman one year his senior, asked him to dinner and, though strongly attracted to her, he was concerned about the ethics of beginning a possible sexual relationship with her. Would such a relationship constitute a sexual relationship with a client? Would he risk censure and possible deregistration?

5. A first year psychology student participated in a required laboratory exercise designed to demonstrate the effects of negative feedback on mood levels. The debriefing which was to be held by the tutor after data collection was not held until the following week, because of lack of class time. The student reported that severe damage to his self-esteem had resulted from this experience, and withdrew from the subject. Is than an acceptable laboratory exercise for such students? Was it conducted ethically? What is the next ethical step for staff to take with this student?

6. Mr Kenneth Crimesave, a clinical psychologist employed by the Department of Corrective Services, was begged by a prisoner in Goulburn Gaol to carry out hypnosis to help the prisoner, John Angst, learn whether or not he had committed the murder with which he had been charged on circumstantial evidence. Mr Crimesave was a fully qualified psychologist and held a Diploma in Clinical Psychology from the Australian Society of Hypnosis. John Angst was clinically depressed and claimed amnesia for some hours of the night of the murder; John himself had been the victim of protracted sexual abuse in his early teens. He had not entered a plea of 'guilty' or 'not guilty' and was under some pressure within the gaol system, as the victim of the murder had been a six year old child. John Angst argued that even to recall committing the murder would be better for him than the agony of not remembering. He had read the police statement of facts relating to the murder. He wept and repeatedly begged Kenneth Crimesave to 'put me out of my misery and help me remember; if you don't I will almost certainly kill myself' Should Crimesave hypnotise Angst? If not, why not? If he does decide on proceeding with hypnosis, what are the problems he and/or Angst would face?

7. A mother seeks your help with her 10 year old child who seems to have behavioural problems. During a therapy session with the child, re reveals his intense hatred of his mother's new boyfriend for various subjective reasons. He insists that you keep this information a secret between you and him. The child's mother wishes to know what her son said in the session because she says 'he is my son, and as I am paying for the treatment, I have every right to know."

8. A clinical psychologist, Dr Hope Charity, was treating a young woman aged 22 years for Post-Traumatic Stress Disorder following an armed holdup in the workplace. The patient's mother phoned Dr Charity and asked if she could be told of the patient's problems and advised how she could help. The patient still lived at home with her mother. The mother was, in Dr Charity's judgement, expressing sincere concern for her daughter. What should Dr Charity do?

9. You have discovered that your friend and colleague, a clinical psychologist in partnership with a medical practitioner, is collaborating with the doctor (ie using medical receipts and provider numbers) to gain Medicare benefits for his psychology clients.

10. You are counselling a gay man who has tested as HIV positive. He has not told his lover, with whom he is not practising safe sex. His lover is known to have tested negative for the virus. Your client is afraid to tell his lover because he fears that he may be rejected by him. You feel that this decision puts the lover at considerable risk, and you feel responsible for this.

11. Mr and Mrs B attend your clinic. They have three children, girls aged 4,6 and 8. Mrs B tells you that she has just discovered that Mr B has been sexually molesting their eldest daughter for the past 3 years. Mr B admits his actions and is very contrite. Mrs B is struggling to understand. She does not wish to go to the police, but wants to forgive him and keep the family together if he gets help. Both seek counselling for themselves and for their daughter. They both agree that the child does not appear to be unduly emotionally traumatized by the admitted abuse.

12. The non-custodial parent of an eight year old boy asks a psychologist to assess his functioning. The parent involved has not discussed this with the child's mother. It is to be done without knowledge or permission of the custodial parent. Should he be encouraged to discuss this with her? If he does not, should you do so? And if this assessment reveals the need for an intervention, should this be discussed with the custodial parent? If so, by whom?

13. You have undertaken marriage counselling for a couple beset by problems of domestic violence. After three consultations the husband drops out of therapy. The wife continues to consult you alone for some time. Six moths later a solicitor for the wife writes to you requesting a psychological report in support of the wife's application for an Apprehended Violence Order against the husband.

14. You are in independent practice and have been contacted by a solicitor for an insurance company who has asked you to undertake a neuropsychological assessment of a child client who is claiming compensation. You are told that you would then be required to appear in Court as an expert witness. Although you have had no prior experience or training in neuropsychological assessments, you have recently purchased an expensive and comprehensive battery of tests which would be more than sufficient for the undertaking.

15. You and your professional partner have undertaken a complicated research project for which you have received generous funding from the State Government. For various reasons you are late starting the project and then you have a falling-out with your partner which results in the dissolution of the partnership. You feel unable to complete the research alone and your ex-partner is no longer interested. However, you have put in what you consider to be a great deal of time in preparation for the project, ie search of literature, preliminary reading and the like as well as some work on the instruments and method.

16. You are in independent practice. A client is referred to you for stress management by a local general practitioner. After a careful assessment you are of the opinion that the client has all the symptoms of a duodenal ulcer. No medical investigation has been done by the referring doctor, who had indicated that he believed he client was suffering work-related stress. You have a sister who is an excellent medical practitioner who specializes in intestinal disorders.

17. A senior psychologist in private practice, Dr James Sure, was asked by a firm of solicitors to provide written comment on the report of a psychiatrist, Dr Henry Fame, on a compensation patient. The senior psychologist found that the assessment and the interpretation of test results was quite inconsistent with his own earlier assessment. If Dr Sure provides a circumspect and carefully worded critique of Dr Fame's report, is he committing a breach of the APS Code of Conduct? On what grounds? Is he committing a breach of the Registration Board's Code of Conduct? On what grounds? Can Dr Sure be sued for defamation as a result of his report?

18. You are in private practice. A new client informs you that the previous psychologist she consulted made sexual advances towards her and she is now very nervous about seeing a psychologist. Three other clients have made similar comments about the same psychologist, but none are willing to make a formal complaint for fear of 'repercussions'.

19. You are a senior psychologist in independent practice. You learn that one of your colleagues has been using body work with some of his clients, while alone with these clients. You colleague does not appear to have made clear the differences involved in using this type of intervention, compared with other psychological interventions. Nor does he seem to have been careful to secure properly informed consent in writing from these clients. What are your responsibilities in relation to those earlier clients. What are your responsibilities in relation to any other clients of this colleague now and in the past?