Psychologists confront ethical dilemmas on a daily basis.  These may range from issues around maintaining patient confidentiality to complex issues about how to approach multiple and overlapping patient's situations.  This book presents a positive and approachable resource for the profession.  At one level the book is a commentary on the American Psychological Association's Code of Ethics, however it is more than just a commentary.  Many psychologists will be able to relate to the vignettes and practical examples that are built into the discussion and which assist to underline the relevance and applicability of the ethical guidelines under discussion.

The book is divided into themes which broadly follow the flow of the APA Code of Ethics and which also take into consideration other relevant codes and legislation.  The book also takes a 'whole of career' approach, discussing issues from early training and residency through to various career stages or changes that psychologists may experience.  Hence, discussion incorporates issues related to private practice, multi-practitioner situations, business issues, research, provision of supervision, forensic psychology, special issues and eventually retirement.  At each of these stages there are ethical issues — both general to the profession and specific to that stage — which need to be considered. 

For some, this book will be a useful tool or handbook to augment training — especially when progressing into unfamiliar areas of practice.  For others this book may be a first systematic introduction to ethical issues in psychology.  Seasoned practitioners will find that the path of many of the ethical issues is well trodden but that the book nevertheless provides a solid reminder and a way of bringing a range of issues into focus within a single discussion.

The book's purpose is to clarify the guiding ethical values of the profession and seek to explain where they originate from, how they hang together and why they are important.  It seeks to offer a positive antidote to the disciplinary reaction so often promoted when things go wrong, by urging that psychologists are in a position to prepare for most situations — and to protect themselves and their patients appropriately.  Ethics is not about punishment, but it is about making positive well reasoned value judgments and incorporating these into daily practice.  It provides a way of fulfilling the potential of the individual within the context of the profession at the highest standards of integrity. 

Having established the positive potential of good ethics, the authors explore the foundations for / of ethical behavior (Ch 2).  Here they review several common or dominant theories of ethics — virtue ethics, utilitarianism, deontological ethics, and principle-based ethics.  While this review is very welcome, they dismiss the first three far too quickly and opt for principle-based ethics as their preferred approach.  It would have been useful to see at least some more sustained argument on this issue and some more solid reasoning about why they arrived at their choice.  Principle-based ethics is one approach, but it has flaws that are not touched on at all.  For instance, principle-based ethics rarely leads to unambiguous guidance, it tends to suffer from counter examples that can significantly cloud particular situations or instances. 

Ethics emphasizes that it is not only what is implemented but how it is implemented that matters.  This acknowledgement runs sensitively through the book.  At each stage the authors examine a range of appropriate professional responses to an issue or situation and use examples of good practice to tie this in with practice.  This is the focus of the book — the application of good ethics.

The authors utilize a 5 step model for decision making as a practical tool to guide psychologists in making ethical judgments.  Again, there are other decision making tools around in the field and the authors simply adopt one without justification or reference to the fact that there are others.  However, the lack of discussion of alternate models is probably not a great issue given the central focus of the book.  They have chosen a model which is simple, easily memorized (through the mnemonic IDEAL) and which thus lends itself well to the kinds of applications they envisage.

The vignettes threaded through the book are on the whole well placed and illustrative.  However, more of them could have been used to draw out the dilemma or difficulty being discussed rather than simply illustrating good practice.  The ideal of what good practice is will be reasonably evident to psychologists in most situations, but how one resolves the range of potential ethical dilemmas and how one avoids some of the inadvertent slips (e.g., confidential conversations unintentionally overheard in a waiting area) is of intense interest to psychologists.  Many of the serious ethical issues are not as easily resolved as the vignettes would seem to suggest. 

How one achieves good practice ethics utilizing the principle-based ethics recommended by the book and the IDEAL model could have been far more thoroughly discussed and illustrated.  It felt almost as though the authors believed that once they had identified their approach to ethics and their preferred model, that the application would, in the main, be self-evident.  All in all, this book is an excellent and competently written resource, but for those seeking more interaction with than introduction to some of the ethical issues in psychology, other resources will need to be used to supplement this book.

© 2007 Erich von Dietze

Erich von Dietze, Ph.D., Manager, Research Ethics, Murdoch University, Western Australia 

Categories: Psychology, Ethics