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Review Essays of Academic, Professional & Technical Books in the Humanities & Sciences


Taking Biology Seriously: What Biology Can and Cannot Tell Us About Moral and Public Policy by Inmaculada de Melo-Martin (Rowman & Littlefield Publishers) (Paperback) Discussions of human biology and its consequences for ethics and public policy are often misguided. Both proponents and critics of behavioral genetics, reproductive cloning, and genetic testing have mistaken beliefs about the role of genes in human life. Taking Biology Seriously calls attention to the social context in which both the science and our ethical precepts and public policies play a role. More

Liberation Biology: The Scientific And Moral Case For The Biotech Revolution by Ronald Bailey (Prometheus Books) In this book the author argues that the coming biotechnology revolution will liberate human beings to achieve their full potentials by enabling more of us to live flourishing lives free of disease, disability, and the threat of early death. More

Decoding the Ethics Code: A Practical Guide for Psychologists by Celia B. Fisher (Sage) introduces psychologists, professionals with whom they work, and the public to the 2002 American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct. The book helps psychologists apply the Ethics Code to the constantly changing scientific, professional, and legal realities of the discipline. Author Celia B. Fisher addresses the revised format, choice of wording, aspirational rationale, and enforceability of the code and puts these changes into practical perspective for psychologists.

Decoding the Ethics Code provides in-depth discussions of the foundation and application of each ethical standard to the broad spectrum of scientific, teaching, and professional roles of psychologists. This unique guide helps psychologists effectively use ethical principles and standards to morally conduct their work activities, avoid ethical violations, and, most importantly, preserve and protect the fundamental rights and welfare of those whom they serve.

Decoding the Ethics Code features easy reference to a wide range of information, including

    • Clear examples of behaviors that would comply with or violate enforceable standards
    • A brief overview of the history behind the Ethics Code, enforcement of the code, professional liability issues, and the relationship between ethics and law
    • Flagging of standards that represent significant new directions in ethics regulation and enforcement as compared with the previous code
    • Integration throughout the text of the implications of the Health Insurance Portability and Accountability Act (HIPAA) for compliance with numerous standards
    • Easy identification of standards relevant to forensic practice, school psychology, industrial-organizational psychology, use of the Internet, prescription privileges, military and police psychology, and managed care

Decoding the Ethics Code ill help new and established psychologists, psychology professors, students in graduate psychology programs, other mental health professionals, and the public understand and apply the new Ethics Code to their unique circumstances.

Ethics in Psychotherapy and Counseling: A Practical Guide by Kenneth S. Pope, Melba J. T. Vasquez (Jossey-Bass) Written for mental health professionals, Ethics in Psychotherapy and Counseling provides comprehensive guidance in areas in which ethical dilemmas occur. It offers insights into confronting and honoring the ethical responsibilities inherent in the day-to-day work of mental health practitioners. Guide to the complexities of modern-day ethics. For psychologists in practice and those teaching courses and workshops in ethics. Ethics in Psychotherapy and Counseling gives guidance in areas in which ethical dilemmas occur and offers insights into confronting and honoring the ethical responsibilities inherent in the work of mental health practitioners. Explores issues of informed consent, sexual and nonsexual relationships with clients, cultural difference, and confidentiality. Includes appendices of codes of conduct and ethical principles for psychologists, and guidelines for ethical counseling in a managed care environment.

"An excellent blend of case law, research evidence, down-to-earth principles, and practical examples from two authors with outstanding expertise. Promotes valuable understanding through case illustrations, self-directed exercises, and thoughtful discussion of such issues as cultural diversity."—Dick Suinn, president-elect 1998, American Psychological Association

"The second edition of this unique volume provides invaluable ethical guidance for psychologists engaged in professional practice. The scenarios and accompanying questions will prove especially helpful to those who offer courses and workshops concerned with ethics in psychology." —Charles D. Spielberger, former president, American Psychological Association; distinguished research professor of psychology, University of South Florida

"Pope and Vasquez have taken an excellent text to the next level. This book is outstanding in its comprehensiveness and its currency. Its accessible style makes it useful for students as well as experienced professionals and a must for ethics courses." —Beverly Greene, professor of psychology, St. John's University

"A wonderful, helpful guide to the complexities of modern-day ethics. As hard as it is to imagine, this revision of their landmark text is even more timely, insightful, and important." —Patrick DeLeon, past-recording secretary, American Psychological Association

"A wise and useful book that should be in every practitioner's library and be required in all clinical and counseling training programs."—David Mills, former director, APA Ethics Office

"A splendid book. . . . This is essential reading for all those in psychotherapy and related fields." —Clifford Stromberg, partner, healthcare law, Hogan & Hartson , Washington , DC  

Ethics for Psychologists: A Commentary on the Apa Ethics Code by Mathilda B. Canter, Bruce E. Bennett, Stanley E. Jones, Thomas F. Nagy (American Psychological Association (APA)

Ethics in Psychology: Professional Standards and Cases by Patricia C. Keith-Spiegel, Gerald P. Koocher (McGraw-Hill)  is a graduate level textbook on the subject of ethical dilemmas in counseling. The authors definitely meet their goal in exploring the APA's Ethical guidelines and applying them pratically to the practicing therapist and academic. Their use of humorous "psuedo-psychologists" illustrate well the problem of many counselors who get themselves into ethical dilemmas each year innocently. I believe every therapist and academic should read this book at least once a year in order to minimize the ethical issues that are a part of everyday practice. Non-APA practitioners may find the book slanted toward doctoral-level therapists being the minimum for competence but there is great wisdom in this book.

Now in a new edition, Ethics in Psychology, considers many of the ethical questions and dilemmas that psychologists encounter in their everyday practice, research, and teaching. The book has been completely updated in response to evolving trends in psychological research and practice, as well as extensive changes in the American Psychological Association's ethics code. Taking a practical, commonsense approach to ethics in modern-day psychological practice, this useful book offers constructive means for both preventing problems and resolving ethical predicaments. This new edition retains the key features that have contributed to its popularity, including extensive case studies that provide illustrative guidance on a wide variety of topics, such as fee setting, advertising for clients, research ethics, sexual attraction, classroom ethics, managed care issues, confidentiality, and much more.

Whether one's interests lie in psychological practice, counseling, research, or the classroom, psychologists today must deal with a broad range of ethical issues--from charging fees to maintaining a client's confidentiality, and from conducting research to respecting clients, colleagues, and students.

Now in a new edition, Ethics in Psychology, the most widely read and cited ethics textbook in psychology, considers many of the ethical questions and dilemmas that psychologists encounter in their everyday practice, research, and teaching. The book has been completely updated in response to evolving trends in psychological research and practice, as well as extensive changes in the American Psychological Association's ethics code. Taking a practical, common sense approach to ethics in modern-day psychological practice, this useful book offers constructive means for both preventing problems and resolving ethical predicaments. This new edition retains the key features which have contributed to its popularity, including extensive case studies that provide illustrative guidance on a wide variety of topics, such as fee setting, advertising for clients, research ethics, sexual attraction, classroom ethics, managed care issues, confidentiality, and much more. Highly readable, the book unites an accessible style with humorous anecdotes that highlight the human side of ethics and make the book a pleasure to read. Ethics in Psychology has proven to be an indispensable guide to ethical decision-making for practicing psychologists and students in psychology.

Confidentiality: Ethical Perspectives and Clinical Dilemmas edited by Charles Levin, Allannah Furlong, Mary Kay O'Neil (The Analytic Press) What is sometimes described with alarm as the "crisis of confi­dentiality" has been brewing for some years; but there has also been a concomitant trend that is equally alarming: the flaccid response of the mental-health professions themselves. The sense that psycho­analysts in particular, who tend to be so knowing about the importance of confidentiality, were missing the boat on this issue was an impor­tant spur to the decision by the IPA and the Canadian Psychoanalytic Society to cosponsor a conference sharing the podiums and the work­shops with professionals and academics from other fields, on an equal footing. Participants from other fields included a justice of the Supreme Court of Canada, the president of the Law Commission of Canada, the presidents of the Human Rights Commission and of the Information Access Commission of Quebec, members of Parliament, the Rector and Vice-Chancellor of Concordia University, the McGill University ombudsperson, the privacy advocate of the U.S. Department of Health and Human Services, the chief ethicist of the Cana­dian Medical Association, representatives from major law firms, administrators and legal representatives of public and parapublic social-service organizations, prominent legal scholars from all across North America, and philosophers and ethicists from North America, Europe, and Israel.

Thinking in public about the conditions of its own practice is relatively new for psychoanalysis. Critics of psychoanalysis have tended to characterize it as a secretive "movement," pointing to the "apos­tolic" nature of its early organizational structure and to its still rela­tively exclusive system of training (Gellner, 1985). These criticisms have been echoed in recent years by psychoanalysts themselves (Kernberg, 1986; Eisold, 1994). Among outside critics, moreover, there is a widespread, related perception of confidentiality as a disingenu­ous ethical rationale for evading scientific and public scrutiny. To overcome these not entirely unjustified impressions, psychoanalysis has had to recognize and to acknowledge its somewhat eccentric and therefore vulnerable status within the world of science and society.
The challenge will be to give a credible accounting of this ec­centricity without retreating once again into passive isolation and defensive hermeticism. The task is hard because the material with which psychoanalysts work tends to fall outside the conventional domain of scientific and commonsense objects, gravitating to areas of subjective experience traditionally associated with notions of ro­mantic inspiration, "madness," and the soul. In premodern societies, these domains were the preserve of bards, seers, mystics, and priests, liminal figures who normally acted under cover of poetic license or divine authority. In sharp contrast, psychoanalysis provides no such exculpating disclaimer, preferring to stand or fall on its own merits as an integral part of the contemporary-knowledge project in the ordi­nary enlightenment sense. It is a difficult area in which to do research and practice-a field in which the intimacy of the clinical encounter generates very particular and odd ethical requirements. Yet the pro­fession does not present itself as an unfathomable mystery about which noninitiates have nothing worthwhile to say.

Robert Wallerstein (1976) once remarked on the "inextricable intertwining of scientific endeavour with ethical and moral presup­positions and implications" (p. 369). Such intermingling may be gen­erally true of all fields of inquiry, but there are reasons to think that it is a special problem for psychoanalysis. Normally, the intertwining of which Wallerstein spoke is not so "inextricable" that technical or scientific arguments and reasons cannot be distinguished fairly clearly from ethical arguments and reasons. This is not so easy to do in psychoanalysis. The relationship between clinical and ethical consid­erations in psychoanalysis seems to be so symbiotic that an analyst is likely to find himself offering clinical rather than ethical reasons for making an ethical decision. This reliance on clinical justifications for ethical precepts is typical of the in-house debates over confidentiality. Because ethical guidelines in psychoanalysis tend be derived from the clinical specifics of psychoanalytic practice rather than from philo­sophical first principles, consistency in the terms of debate is difficult to achieve. For example, sharply contrasting positions on the ethics of reporting analyses in psychoanalytic training may be grounded in similar considerations of clinical effectiveness and responsibility. Therapeutic and scientific arguments have been advanced both in opposition to and in favor of obtaining informed consent for the publication of case material (Stoller, 1988).

If the deciding factor in the ethics of psychoanalysis is often the clinical implications of the decision rather than its formal ethical signifi­cance, is the opposite ever true? Are clinical or scientific decisions made for primarily ethical reasons in psychoanalysis, as they often are in medical practice or physical research? The answer, here, is also less clear than it may be in other fields. To be sure, decisions about research in psychoanalysis have been profoundly affected by ethical consid­erations, but these in turn may have been generated by therapeutic factors, such as concerns about the effect of certain information­gathering methods, for example, the intrusiveness of tape recording, on the treatment process itself.

Another important example of ambiguity has to do with the "limits" of confidentiality itself: should confidentiality be broken in cases of danger to the patient or possible harm to another, such as suicide, homicide, or child abuse? The common strategy is to view this dilemma as a conflict between the interests of the individual (the patient) and the interests of society. This is not always helpful, though, because the patient's health should also count as a paramount inter­est of society, as does the security of the psychotherapeutic treat­ment (Jaffee v. Redmond, 1996). Moreover, restricting ourselves to the patient's interests is problematic since the patient may not know what his best interests are. A good example of just how ethically uncertain such apparently straightforward situations may be in psy­chotherapy is the famous Tarasoff case, which lies at the root of the existing reporting laws and informs legal notions of a psychotherapist's "duty to warn" and "duty to protect" in North America. It is not widely known that the Tarasoff decision never resulted in a trial; the parties settled out of court once the tribunal held that a therapist could in principle be held liable if he failed to warn a potential victim of a client's dangerous intentions. Even less well-known about this case is that the treating psychologist did in fact break confidentiality and report his patient's murder threats to the police, though not the victim to be (Slovenko, 1990). The patient left treatment as a result of this betrayal and committed the murder two months later. Would "society" have been better served if the patient's confidentiality had been re­spected and he had remained in treatment? Was the breach of confi­dentiality in this case actually in violation of all the significant values at stake: the aims of treatment (to heal), the interest of society (public safety), and the interest of the patient's victim (to remain alive) ?

It is difficult to disentangle ethical and clinical reasoning in psy­choanalysis for two main reasons, which distinguish psychoanalysis from virtually every other profession, even within the mental health field. First, the patient and the analyst are necessarily involved in an intense intersubjective relationship in which the roles of transference and countertransference cannot be set aside for treatment purposes because they are precisely the "stuff' of the treatment process. Second, the psychoanalyst is bound, clinically and ethically, to nurture the expression of unconscious mental life and to protect it. Both of these unique conditions tend to encourage a confusing, but in principle,

defensible blending of the clinical and the ethical strands of reason­ing in many vital areas of psychoanalytic work where confidentiality is concerned. The consequence, however, is that fundamental precepts and policies in psychoanalytic ethics remain provisional and highly controversial.

In the ethics of confidentiality, psychoanalysis is still at the "data­gathering stage." Indeed, as all the chapters in this volume make clear, psychoanalysis is still in the process of defining the terms and boundaries of the ethical debate. Numerous basic orientation ques­tions remain unanswered. Is there an ethics intrinsic to psychoanalysis, and, if so, to what extent can it legitimately supersede more widely accepted bioethical principles and procedures of ethics? Can psycho­analysis be, in some limited but meaningful sense, outside the law? How can the inevitable tensions between professional ethics and public law best be adjudicated from a psychoanalytic point of view? Moreover, what do psychoanalysts really mean when they say that treatment is confidential? Are they referring to a contract between two parties, and, if so, does the patient have the right to abrogate this contract? Does the contract imply ownership rights? Is confidentiality more like a sacred duty, as seems to be implied in the Hippocratic oath, a kind of mystical commitment to the patient about which only psychoanalysts can speak? Or is this esoteric connotation actually an allusion to much broader but hitherto poorly explicated notions about the conditions of professional life, a sort of "culture" of confidentiality whose parameters extend beyond the psychoanalytic dyad? Finally, whether confidentiality operates within or beyond the law, whether it is a form of contract, a moral obligation, or a professional ethos, why is it so important for psychoanalytic treatment? Is the need for the patient's trust a sufficient or credible explanation? What is the evidence for this claim, and how compelling is it to a disinterested observer? Does the practice of confidentiality have deeper roots in psychological development and even the biology of the brain? Does it in some way reflect the essential conditions of thought (Aulagnier, 1986)?

The editors of this volume and its contributors are not aware of any ideal method of ordering the many questions and topics that comprise the contemporary debate about confidentiality. To make things easier for the reader, we have supplied each chapter with a brief editorial note, an approach that seems less cumbersome than a lengthy summary of the entire book and all its varied contents. The chapters are grouped under four separate sections (Thinking about Confidentiality; Dilemmas in Treatment, Research, and Training; Clini­cal Practice; and Professional Ethics and the Law) that we hope are self-explanatory and thematically consistent. It was felt, however, that Section 3, Clinical Practice, deserved further contextualization. This section has been provided with a separate introduction of its own, in recognition of the vital role of research in ethics, and of the sensitive position in which clinical reporters place themselves when addressing the public.

The reader should not enter this volume expecting a consensus. Our history as a profession does not provide the prerequisites for such a simple state of affairs. In 1965, Anne Hayman of the British Psychoanalytical Society was ordered to testify about someone who was alleged to be her analysand. She refused even to state whether or not the individual in question was in treatment with her (Hayman, 1965). Sadly, her legendary example did not alter the disposition of the law, or even of the psychoanalytic profession, toward the ques­tion of confidentiality. The latter was not placed high on the psycho­analytic agenda of problems to be addressed until quite recently. The wake-up call came 30 years after Hayman's stand, mainly from two sources: the publication of a ground-breaking study by Christopher Bollas and David Sundelson, The New Informants (1995), and the American Psychoanalytic Association's amicus curiae brief to the United States Supreme Court in Jaffee v. Redmond (1996). Since then, much r work has been accomplished; but if there is a consensus among the contributors to this book, it is that there is much work still to be done, not only in the form of research but also in terms of the inter­nal organization of psychoanalysis, as well as in the appropriate public forums.

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