Decoding The Ethics Code: Chapter 3 Notes

Principle A: Beneficence and Nonmaleficence

• Psychologists strive to benefit those with whom they work and take care to do no harm.

• Dual obligation: safeguard welfare and rights of those interacted with, and welfare of animal subjects in research.

• When conflicts arise among obligations, resolve responsibly to avoid or minimize harm.

• Must guard against misuse of influence from personal, financial, social, organizational, or political factors.

• Should be aware of how their own physical and mental health can affect their ability to help others.

• Principle A reflects the joint influence of beneficence (to do good) and nonmaleficence (to do no harm); harms can occur without being wronged in rightly practiced psychology.

• Examples of standards reflecting this principle:

  • $2.02$, Providing Services in Emergencies

  • $3.09$, Cooperation With Other Professionals

  • $8.09$, Humane Care and Use of Animals in Research

  • $8.14$, Sharing Research Data for Verification

• Three illustrative examples of balancing good and harm:

  • Preserve academic standards and ensure grading fairness (teaching context) by possibly giving a poor or failing grade.

  • Conduct randomized clinical trials (RCTs) balancing long-term benefits for the field against short-term harms to participants receiving an experimental treatment of unknown effectiveness.

  • In some contexts, disclosing confidential information to protect a client/patient, student, or research participant from self-harm or from harming others may have moral priority over privacy (see $4.05$, Disclosures).

• Throughout the Ethics Code, avoid harm by:

  • maintaining competence (Standards $2.01$, Competence; $2.03$, Maintaining Competence),

  • avoiding exploitation,

  • minimizing privacy intrusions in reports/consultations,

  • basing opinions/reports only on sufficient information, and

  • terminating therapy when continued services are likely to harm the client/patient (Standards $3.04$, Avoiding Harm; $3.05$, Multiple Relationships; $3.08$, Exploitative Relationships; $9.01$, Bases for Assessments; $10.10$, Terminating Therapy).

• Psychologists are also required to minimize harm by taking steps to ameliorate harms caused by misuse of their work (Standard $1.01$, Misuse of Psychologists’ Work).

• To maximize good and minimize harm, Principle A calls for awareness of personal problems that could lead to exploitation or harm (Standard $2.06$, Personal Problems and Conflicts).

• COVID-19 Pandemic context (Need to Know): The Belmont Report (NIH, 1979) underpins Beneficence/Nonmaleficence in protecting participants. The pandemic raised new questions about evaluating benefits vs burdens across diverse populations, expedited ethics reviews, and data/privacy concerns with mobile health apps and big data (Klar & Lanzerath, 2020; Paxton, 2020). Stressors on staff and participants highlighted the need for self-care and organizational support during crises (Chappell & Singer, 2020; Coleman, 2020; Bompart, 2020).

• Additional COVID-19 related considerations include balancing rapid public health decisions with participant protections and recognizing stressors on researchers and clinicians.

Principle B: Fidelity and Responsibility

• Psychologists establish relationships of trust with those they work with; aware of responsibilities to society and communities.

• Uphold professional standards, clarify roles and obligations, accept appropriate responsibility for behavior, and manage conflicts of interest to prevent exploitation or harm.

• Consult with, refer to, or cooperate with other professionals and institutions as needed to serve the best interests of those served.

• Strive to contribute a portion of professional time for little or no compensation or personal advantage.

• Fidelity involves faithfulness to others: promise-keeping, fiduciary responsibilities, and maintaining appropriate professional relationships.

• Develop a professional identity as a psychologist to guide conduct in research and practice, and to resolve tensions in line with professional values and integrity.

• Forensic psychologists, organizational psychologists, and others have context-specific obligations arising from their relationships (e.g., with attorneys, insurers, the court; ACA-integrated primary care settings).

• Related standards reflect fidelity and responsibility: $1.01$ Misuse of Psychologists’ Work; $1.04$ Informal Resolution of Ethical Violations; $1.05$ Reporting Ethical Violations; $3.05$ Multiple Relationships; $3.06$ Conflict of Interest; $3.09$ Cooperation With Other Professionals.

• Other standards intersect with fidelity (e.g., $8.01$ Institutional Approval for IRBs; Chapter 12 on IRBs; Chapter 13 on assessments; Chapter 14 on religion/spirituality).

• NEED TO KNOW Fidelity and Responsibility During COVID-19 and Future Emergencies:

  • Build trust during crises; consider pro bono or reduced-fee services; adapt online teaching/supervision for students/trainees with limited internet access; develop eHealth competencies; discuss competency limitations with clients/patients (Standards $3.09$, $6.04$, $7.03$, $7.06$, etc.; $2.02$, $10.01$).

  • Interprofessional work in emergencies may require self-assessment of competency and honest discussion with colleagues about limitations (Standards $1.03$, $2.02$, $3.04$, $10.01$).

• Ethical responses to emergencies include self-care and maintaining professional responsibilities despite personal challenges.

Principle C: Integrity

• Psychologists seek accuracy, honesty, and truthfulness in science, teaching, and practice.

• Do not steal, cheat, or engage in fraud or misrepresentation; keep promises and avoid unwise commitments.

• When deception could maximize benefits and minimize harm, carefully weigh need, consequences, and the obligation to correct mistrust or harm.

• Maintaining integrity requires honest communication, truth-telling, promise-keeping, and accuracy; avoid making commitments that cannot be met and correct misrepresentations.

• Ethical examples include:

  • Standards $5.01$, Avoidance of False or Deceptive Statements;

  • $6.04$, Fees and Financial Arrangements;

  • $8.10$, Reporting Research Results.

• Psychologists advertising services must present information clearly; clients may be vulnerable to exploitation if not well-informed (Standards $3.08$, Exploitative Relationships; $5.01$, False Statements).

• In legal contexts, when serving as expert witnesses, psychologists should present findings objectively, disclose relevant material, and offer unbiased interpretations (Forensic psychology standards, APA, 2013a).

• Deception in Research is permitable only under stated criteria (Standard $8.07$, Deception in Research) with evaluation of necessity vs. harm and corrective actions.

• NEED TO KNOW Deception in Psychotherapy:

  • While deception is discussed for research, there is little explicit guidance for deception in psychotherapy.

  • Similar to general population, therapists and clients may engage in deception by omission or to protect privacy or avoid harm; such dynamics can damage the therapeutic alliance if present in psychotherapy (Curtis & Hart, 2015; Curtis & Kelly, 2019; Dickens & Curtis, 2019).

• Continued discussion on deception in psychotherapy highlights the ethical tension when deception might occur and its potential impact on treatment.

Principle D: Justice

• Psychologists recognize fairness and justice, ensuring all persons have access to psychology's benefits and to equal quality in processes, procedures, and services.

• Exercise reasonable judgment; ensure biases and limitations do not lead to unjust practices.

• Justice involves three domains:

  • Distributive Justice: fair access to benefits and contributions of psychology (Standards $1.08$, $3.01$, $3.02$, $3.03$); related Hot Topics in human rights, multicultural competence (Chapter 6).

  • Procedural Justice: fairness of rules and practices; use population-sensitive and valid instruments; avoid biased designs.

  • Interactional Justice: fairness in interpersonal exchanges; ensure respect and appropriate treatment in all interactions (Standards $3.05$, $3.08$, $6.05$, $8.04$; $10.02$, $10.03$).

• Related standards promoting fairness in testing, assessment, and organizational contexts: $2.04$ Bases for Scientific and Professional Judgments; $7.06$ Assessing Student and Supervisee Performance; $9.01$ Bases for Assessments; $9.02$ Use of Assessments; $10.02$ Therapy Involving Couples or Families; $10.03$ Group Therapy.

• Interactional justice emphasizes clear communication about who is the client and what responsibilities each party holds at the outset of treatment (Standards in 3.05, 3.08, 6.05, 8.04, 10.02, 10.03).

• NEED TO KNOW Social Justice and Relational Power Dynamics:

  • Social justice aims to reduce health, educational, economic, and political inequities by addressing sociopolitical injustices via empowerment.

  • Psychologists must be aware of power conferred by professional identities and avoid reproducing historic injustices when working with marginalized groups (Hailes et al., 2020).

  • Relational power dynamics may arise among psychologists who share group identities with clients; cultural humility is essential.

  • Community-engaged approaches should be truly collaborative and equitable, not superficial.

  • A primary care ethic emphasizes openness, appreciation, collaboration, and interprofessional communication (Nash et al., 2013).

Principle E: Respect for People’s Rights and Dignity

• Psychologists respect the dignity and worth of all people and their rights to privacy, confidentiality, and self-determination.

• Special safeguards may be needed for individuals or communities with impaired autonomous decision-making.

• Respect cultural, individual, and role differences (age, gender, race, ethnicity, culture, national origin, religion, sexual orientation, disability, language, socioeconomic status) and adapt practices accordingly.

• Strive to eliminate biases in one’s own work and in the field; avoid condoning discriminatory actions by others.

• Informed consent standards reflect autonomous decision-making: $8.02$ Informed Consent to Research; $9.03$ Informed Consent to Assessment; $10.01$ Informed Consent to Therapy; and standard $3.10$, Informed Consent (recognize limitations when decisional capacity is reduced).

• See Chapter 8 (privacy/confidentiality) for related guidelines; $7.04$, Student Disclosure of Personal Information; $10.03$, Group Therapy; and references to genetic testing considerations in Chapter 12.

• Giving Voice to the Lived Experience of Individuals with Mental Disorders:

  • People with mental health disorders are vulnerable to stigma and dismissal; clinicians should actively listen, use open-ended questions, leverage patient knowledge to set goals, and address injustices in care (Kurs & Grinshpoon, 2018; Parcesepe & Cabassa, 2013).

• Assessment considerations under Principle E:

  • Ensure clarity about test purposes before administration so results reflect the intended construct (Standard $9.03$, Informed Consent to Assessment).

  • Explain results (Standard $9.10$, Explaining Assessment Results) and provide test results access (Standards $9.04$, Release of Test Data; $9.11$, Maintaining Test Security).

• Ethical Principles and Client-Generated Prejudicial Comments:

  • When clients make biased comments toward marginalized groups, consider:

  • Competence to handle bias (Standard $2.05$, Bases for Scientific and Professional Judgments).

  • Weighing whether to address the prejudice during or after incidents; consider impact on others (supervisors, office staff).

  • Self-reflection on motives and the balance between social justice advocacy and client welfare.

  • First steps may include expressing empathy and using open discussion to explore underlying motives; in some contexts, create dissonance to confront harms.

Ethical Commitment and Virtues in Psychology

• Ethical commitment: a strong desire to do what is right because it is right; reflects a moral disposition and emotional responsiveness to apply the APA Ethics Code.

• Virtues: dispositional habits guiding ethical action, acquired through social nurturance and professional education; provide motivation and skills to act ethically (Beauchamp & Childress, 2019; Fowers, 2012).

• Focal virtues for psychology emphasize avoiding overreliance on rules and grounding decisions in character and wisdom.

• Conscientiousness: motivation to do what is right, diligence, lifelong learning; discerning: context-sensitive insight and good judgment; prudent: practical wisdom to apply ethical solutions in real contexts.

• The most salient virtues vary by role; the client-therapist power dynamic highlights benevolence, care, empathy, emotional self-regulation, compassion; prudence, discretion, and trustworthiness are important in scientific decision-making; honesty in reporting is tied to science and teaching.

• Forensic and organizational settings require timely, reasonable, and ethical workload management, keeping commitments, and maintaining professional boundaries.

• Openness to the Other: core virtue for multicultural practice; commitment to multicultural understanding rather than merely complying with multicultural “shoulds”; related to cultural humility and positive client outcomes.

• Virtue ethics supports a primary care/interprofessional approach that values collaboration, respect for other disciplines, and clear interprofessional communication (Nash et al., 2013).

• Table 3.1 (Principles, Virtues, and Ethical Awareness) maps each General Principle to corresponding virtues and ethical awareness.

Table 3.1: Principles, Virtues, and Ethical Awareness (summary)

• Principle A: Beneficence and Nonmaleficence → Virtues: Compassionate, humane, nonmalevolent, prudent; Ethical Awareness: identify best interests, competencies, and actions to maximize good/minimize harm.

• Principle B: Fidelity and Responsibility → Virtues: Faithful, dependable, conscientious, committed to professional growth; Ethical Awareness: obligations to individuals/communities, professional responsibilities, and legal duties.

• Principle C: Integrity → Virtues: Honest, reliable, self-aware, genuine; Ethical Awareness: know what is possible before commitments, correct misconceptions or mistrust.

• Principle D: Justice → Virtues: Judicious, fair, open to complexity; Ethical Awareness: identify vulnerabilities, avoid unjust practices, and recognize fairness in procedures and outcomes.

• Principle E: Respect for People’s Rights and Dignity → Virtues: Respectful, considerate; Ethical Awareness: safeguarding autonomy, privacy, dignity, and acknowledging diverse differences.

Professionalism as a Value System for Health Service Psychology

• Health service psychology (HSP) is an organizing framework for preventive, consultative assessment and treatment across diverse settings.

• Professionalism is a core HSP competency, defined as values guiding actions and social contract with clients, colleagues, and society.

• Key values aligned with General Principles and virtues for responsible conduct include:

  • Responsibility and lifelong professional development

  • Integrity and courage in upholding ethical standards

  • Openness to others, cultural humility, and continuous self-evaluation

  • Humanism: caring, compassion, dignity and patient choices

  • Productive collaboration and mutual understanding across differences

  • Commitment to psychology’s social contract and societal responsibility

• Can virtues be taught? While education cannot automatically close the gap between knowing and doing, senior members can model ethical commitment and help students develop moral character through ongoing practice and reflection. Lifelong learning and deliberate habit formation are essential for moral excellence.

Can Virtues Be Taught?

• Pellegrino (1989) argues that teaching virtue alone cannot bridge the gap between knowledge and action; ethics education should focus on understanding the code and fostering moral development.

• Professional moral character develops through mentorship, modeling, and habitual practice; lifelong learning supports ongoing moral growth.

• Emphasis on developing self-awareness about how prioritizing different virtues influences ethical decisions and their consequences.

Virtues, Moral Principles, and Ethical Awareness: Case-Driven Ethics

• Chapter cases introduce ethical dilemmas that require applying General Principles and virtues, balancing professional obligations with personal values.

CHAPTER CASES AND ETHICS DISCUSSION QUESTIONS (Selected Overview)

• Case 3.1: Dr. Shue overhears heterosexist comments in a private space; questions about whether she should intervene and whether to discuss with faculty.

• Case 3.2: Military psychologist evaluated a civilian seeking a PTSD diagnosis to avoid shelling; questions about conflicting humanitarian vs. military duties and consequences of agreeing/denying.

• Case 3.3: Pediatric oncology case involving egg freezing for an 11-year-old with parental religious objections; discuss tensions between personal/parental values and patient autonomy; self-care strategies.

• Case 3.4: Principle C and deception in psychotherapy; evaluate justifications for or against deception in specific rescheduling and disclosure scenarios.

• Case 3.5: Anti-Semitic rhetoric by a client; discusses whether to continue treatment and steps to protect client welfare.

• Case 3.6: Postdoctoral intern on a forensic ward conducting informed consent for fMRI research; patient misconceptions about benefits; discuss moral distress and resolution strategies.

• These cases require integrating principles A–E, virtues, and the tension between professional and personal values; they illustrate real-world ethical decision-making and the role of self-care and supervision in difficult cases.

NEED TO KNOW: Giving Voice to Lived Experience of Mental Disorders

• Individuals with mental health disorders face stigma and misperceptions; clinicians should actively address these injustices by listening, using open-ended questions, leveraging patient knowledge for goal setting, and validating experiences.

• Emphasizes patient-centered care and inclusion of patient perspectives in treatment planning and evaluation.

NEED TO KNOW: Assessment and Confidentiality

• Assessments: provide information about purpose prior to testing to ensure results reflect intended constructs; explain results; provide access to results (Standards $9.03$, $9.10$, $9.04$, $9.11$).

• Privacy and confidentiality: protect test results from unauthorized use; maintain, disseminate, and dispose of confidential records appropriately (Standards $6.02$, $7.04$, $10.03$).

• Informed consent: to research, assessment, and therapy (Standards $8.02$, $9.03$, $10.01$); consider decisional capacity and provide additional safeguards when capacity is limited.

NEED TO KNOW: Ethical Principles and Client-Generated Prejudicial Comments

• When clients express prejudiced views, psychologists must balance:

  • Competence to address prejudices (Standard $2.05$)

  • Whether to address the prejudice during or after the incident; consider the impact on others involved (e.g., supervisors, trainees, staff)

  • Self-reflection on motives and alignment with social justice and client welfare

  • The potential benefits of discussing prejudices versus the risk of harm or retraumatization

• Empathy and understanding may be appropriate first steps; in some contexts, normative dissonance may be used to help clients confront how prejudicial beliefs harm them or others.

NEED TO KNOW: Ethical Commitment and Virtues in Practice

• Virtue-based approaches emphasize developing and applying virtues such as conscientiousness, discernment, prudence, openness to others, cultural humility, self-care, and professionalism.

• The chapter underscores that ethics education should cultivate moral sensitivity, practical wisdom, and the ability to apply principles to diverse contexts.

NEED TO KNOW: Self-Care and Professional Well-Being

• Stressors in psychology include exposure to suicidality, abuse, violence, and high-stakes decisions; burnout, moral distress, and boundary challenges can result without proper self-care.

• Recommended self-care strategies:

  • Minimize social isolation through peer consultation or supervision; participate in professional conferences and informal gatherings

  • Schedule non-work activities; set boundaries for work-related communications

  • Maintain healthy lifestyle habits (sleep, nutrition, exercise)

  • Diversify caseload; manage workload to avoid overload

  • Consider personal psychotherapy to increase self-awareness and emotional competence

• Mindfulness-Based Stress Reduction (MBSR) has shown positive effects on counseling skills and therapeutic relationships; used in graduate training and supervisory mentoring

• Radical healing for BIPOC psychologists emphasizes culturally responsive strategies, advocacy, and community engagement; resources include the Psychology of Radical Healing Collective and culturally anchored supports (Ibeh, 2019; French et al., 2019; Syllabus on Radical Healing, 2020).

NEED TO KNOW: Stress, Morality, and Virtue Misuse

• Moral identity can protect against moral disengagement but can also justify harmful actions when used to diffuse responsibility or compare unfavorably with others.

• Without adequate training, moral identity may encourage inappropriate boundary behavior or over-identification with compassion.

Virtue-Based Treatments in Psychotherapy

• Virtue-based treatments focus on cultivating client virtues (e.g., forgiveness, hope, self-control, compassion) to promote relational maturity and meaning.

• First described by Jankowski et al. (2020) with examples like forgiveness-focused interventions; such approaches emphasize patient-centered, culturally contextualized pathways to well-being.

• Critiques note potential overemphasis on individual agency and Western concepts; contemporary approaches stress contextual and community-level interventions, recognizing sociocultural contexts.

• Evidence suggests therapist virtues (empathy, hope, cultural humility) can be indirectly linked to client well-being, working alliance, and symptom improvement; virtues are seen as complementary to other treatment modalities.

Virtues, Professional Awareness, and Ethical Decision-Making

• To recognize when ethical issues require attention, psychologists should be familiar with General Principles and corresponding virtues and stay attuned to ethical awareness in practice.

• Table 3.1 connects Principles A–E with virtues and ethical awareness to guide decision-making in diverse contexts.

Need-to-Know: Professional Competence and Diversity

• Familiarity with cultural differences and acquiring relevant competencies is essential for effective practice; psychologists must guard against biases arising from their own or others’ prejudices.

• The profession emphasizes ongoing self-reflection, humility, and an openness to learning from diverse client experiences.

Summary of Key Concepts

• The APA Ethics Code values five General Principles (A–E) that guide ethical thinking but do not prescribe specific actions; actual standards are enforceable and context-dependent.

• Principle A emphasizes beneficence/nonmaleficence; Principle B fidelity/responsibility; Principle C integrity; Principle D justice; Principle E respect for rights and dignity.

• Ethics in crisis contexts (e.g., COVID-19) require adaptive professionalism, self-care, and ethical flexibility while maintaining core standards.

• Fidelity and Responsibility stress trust, professional identity, and accountability to colleagues and society; emergencies increase the need for pro bono work and interprofessional collaboration.

• Integrity requires honesty in all professional activities, with careful consideration of deception in research and clinical practice; deception in psychotherapy requires careful ethical appraisal.

• Justice involves distributive, procedural, and interactional justice, with attention to testing fairness, access to services, and cultural considerations; social justice aims to reduce systemic inequities and power imbalances.

• Respect for Rights and Dignity highlights informed consent, privacy, confidentiality, and recognition of diverse identities; practitioners must empower patients and ensure autonomous decision-making.

• Virtue ethics offers a character-based framework, highlighting conscientiousness, discernment, prudence, openness to others, and self-care as essential for sound ethical practice.

• Self-care, mindfulness, and burnout prevention are necessary components of professional competence, especially in demanding contexts like pediatrics, forensics, and integrated care.

• Virtue-based treatments are emerging as supplements to traditional therapies, fostering client virtues to promote healing, while acknowledging cultural and contextual considerations.