Ethics-related issues are gaining complexity and becoming very vital for current-day mental health professionals. Yet, these issues are inadequately addressed in the traditional teaching curriculum of mental health professionals and in day-to-day practice. I was glad to see a comprehensive book devoted to this field. This text is of immense value, not only for mental health professionals working in the forensic sector, but also for mental health professionals at large.
Editors of the book have distinguished academic backgrounds. The contributors include professionals from the mental health and legal fields. The book includes 20 chapters neatly organized into four sections: general principles of ethics, confidentiality and privilege, ethics standards in clinical practice, and ethics in teaching, which also incorporates chapters on ethics in research and publication.
Being a sound mental health professional entails that the individual be competent, practice her profession with integrity, be aware of her limitations, respect the dignity of the client, and understand the do’s and don’ts of practice from an ethics perspective. These issues are elaborated in the chapters in the section on general principles of ethics.
The chapter on informed consent outlines the components of informed consent and traces the historical antecedents to the current consent procedures. The practitioner has the onus, not only of providing relevant information about treatments and procedures, but also of disclosing his own limitations, with regard to his training and expertise, and his value systems. The chapter on privacy and confidentiality discusses situations in which communication must be disclosed and instances in which information may be disclosed to third parties. I liked the several legal case examples cited by the authors. The chapter on Tarasoff and duty to protect provides an excellent description of the Tarasoff cases (Tarasoff I and Tarasoff II) and a discussion of their implications for mental health professionals.
Boundary violations have been a major ethics concern in the mental health profession. The ethics and legal implications of boundary violations (sexual contact with patients, misuse of professional influence) are discussed in the section on general ethics standards in practice. This section also discusses professionals’ responsibilities in maintaining patients’ records.
The chapter on ethics in research, an important inclusion in the book, is very informative. The author cites some examples of early research, which by current ethics standards would be viewed with horror. (Example: a study of volunteer soldiers who were injected with blood infected with the virus that transmits yellow fever.) Matters of ethics that arise in the different stages of the study, ranging from the decision to conduct the study, to the design of the study, data collection, and analysis are discussed. The more obvious as well as the more subtle ways in which research studies can lend themselves to manipulation are discussed. The next chapter focuses more specifically on the ethics of publication.
The book includes as appendices two professional codes: The American Psychological Association’s (APA) Ethical Principles of Psychologists and Code of Conduct (2002) and the Code of Ethics of the National Association of Social Workers (1999). These are important references for students and practitioners. The APA code is frequently referenced in the book and used as a yardstick for discussions.
The contributors have done a marvelous job of presenting updated information. I noticed some overlap of content across chapters. Also, as a psychiatrist, I would have liked to see a separate chapter pertaining to problems in ethics that arise from the psychiatric profession’s relationship with the pharmaceutical industry.
Overall, this is an essential book for students in training as well as for mental health practitioners in academic and clinical settings. The editors should be commended for their efforts to sensitize mental health professionals on ethics and legal issues, which, despite their importance, are often sidelined.
- American Academy of Psychiatry and the Law
