Medical Psychology: Ethics of Professional Practice

Introduction

Ethical issues mainly refer to what is right and good in a society. It deals with learning virtues and vices in a society. The society acts as a determiner or rather the judge determining the good and right doings of an individual. Once an individual learns the ethnics of a society, then he or she is bound to adhere or rather follow, failure to which he or she is considered immoral. Ethical issues are applied not only in the society but also in workplace and all other places where people interrelate in the society. However the ethical issues vary with the society and the place at which they are bound to be applied. Based on moral principles, there is always a right thing to do. This not only depends with the moral principles but also the situation and the society in which an individual is in. (Lakin, 2001).

In medicine, psychologist can function under a multidisciplinary team which includes occupational therapist who can give therapy in group and training sessions, social worker to counsel clients regarding their condition among other.

Conflict can arise between medical model and psychological branch creating pressure on the psychologist to adhere to the medical rules, however the psychology principle need to be adhere to as listed by American Psychological Association (APA). However, some principles are challenged and especially the confidentiality principle since in the medical set up, the results must be reported and usually in writing thus exposing the patients’ information. (Yocorzynsky, 2002)

Abstract

Medical psychologists have ethical issues. Until recently medical psychologists have not been authorized to prescribe medication, but is there consequences or issues that hinders them from this? This paper looks at the states that have been authorized, and the requirements in order to be authorized.

It also looks at the set American Psychological Associations principles and ethical codes of conducts which the medical psychologists need to adhere to for effectiveness in their working. Its according to APA principles and ethical code of conduct that the paper has analyzed the importance of following them as showing their importance in developing competence and working within its boundary as well as detecting the role of medical psychologists roles in their field as well as in the society.(Stein, 2004).

It’s only after an extra training when a medical psychologist is authorized to prescribe medication. Higher training ensure that the medical psychologists to be familiar not only in clinical aspects of the patient but also the patient’s care and management.

Introduction

Medical psychology is a psychology branch that deals with psychological problems in medicine of practice like the disability, bereavement, terminal illnesses, psychological aspect of pain and medical advice reactions among others. psychology, profession deals with promoting effective human functioning, while a professional psychologist should be able to use quality services to people in organized controlled and ethical manner, on the bases of attitude, skills psychological knowledge to facilitate effective human functioning.(Mylobodsky,2004).

Ethical awareness is needed when proving psychological treatment within medical set up.

Medical psychologists are bound to adhere to the American Psychological Associations’ (APA) principles, ethical standards as well as codes of conduct. (Scott, 2000)

These principles are aspiration in nature whose purpose is to guide the psychologist to attain good ethical ideals, and be able to operate effectively in their profession.

These principles are classified as: Principle A, Principle B, Principle C, PrincipleD & PrincipleE.

Both medical psychologists and psychologists should have a competence boundary, for effective operation.

Some states like New Mexico, Louisiana, have authorized medical psychologists to prescribe medication.

Medical psychology is a clinical psychological practice branch with psychologists having undergone an extra specialized training such that they can prescribe medicine in the care management of patients. It involves managing of patient mind and body since the two are indivisible. Medical psychology uses social, psychological and biological branches to assess, treat and prevent both physical and mental illnesses, using pharmaceutical specific behavioral and psychotherapeutic methods to enhance persons response to illness and prevents further illnesses by matching person’s personality style, character and ability.(Lichtenberger,2004.

Medical psychology came into place as a result of clinicians training in biological aspect of mental illnesses relating to physical. It adopted a biopsychosocial approach from medicine which relates the mind and body, and differentiates illness from disease, this relationship shows that incases of illnesses of either the body or mind both should be treated as in both are affected.

Medical psychology was introduced to enhance application of knowledge from many branches and especially biological medicine, social and biological medicine to treat and prevent diseases.

In the past, medical psychologist were not allowed to prescribe medication, but currently some states have been authorized after further training of clinical psychologists and an additional training and education in postdoctoral level in neuroscience, biochemistry, clinical medicine pharmacology, among others.

Currently Louisiana, New Mexico, and other American armed services authorizes psychologists to prescribe medication. Medical psychologists who are licensed and authorized to prescribe medication, keenly considering Drug, Enforcement Administration (DEA) which is a United States terminology. All prescriptions given in United States should bear the DEA number and prescribing the doctors number. The DEA’s Controlled Substances Act (CSA) allows doctors to prescribe drugs for medical purposes only. This act was formed as a result drug traffic getting suppressed in US as a result of World War II. This made many addicts to start using antidiarrheal with powdered opium and paregoric. There was also increased thefts in pharmacies and hospitals among other legitimate sources of drugs, issues that made barbiturate to be recognized as a drug abuse problem.(Mysiobodsky,2004)

The DEA which is a United States Department of Justice Law enforcement agent fights drugs war. The department leads domestic enforcement agencies against illegal drug trade, and at the same time, it coordinates and pursues United States drug investigation abroad.

The American Psychological Association (APA) principles and code of conduct gives standards of professional conduct and guidance for psychologists which are applicable by the APA and by other bodies willing to adopt them. These Ethic code should not be a base of civil liability. Medical psychologists enhance that helping people they work with and creating no harm to them. They act in ways that they try to take care of the rights of the people they deal with both at their profession and affected people, bearing in mind that their judgments and actions affect other people’s life. Medical psychologists enhances their good mental and physical health as they help patients medical psychologists are usually aware of their professional responsibility to the society, thus they uphold good conduct clarity in their profession, and are responsible for their behavior. They comply with ethics, and are always ready to help without personal advantage and compensation. (Sweet, 2003).

Medical psychologists ensure trustfulness, in psychological practice, accuracy and honesty, thus they do not engage in fraud or intentional misinterpretation of facts, because they consider their obligation need, and likely result of their mistrust and inaccuracy.

The medical psychologists give reasonable judgment taking care not to entertain unjust practices. The dignity and value of all people is also a factor that medical psychologists consider. They are restricted to promoting privacy, self determination and confidentiality of individuals. They respect culture, gender, ethnicity and age since the ethics or since these factors singly of all of them contributes in determination of what is good or bad in a given society. With these, I consider medical psychologists adhering to the principle B, principle C, principle D and Principle E of the APA principles of psychologists’ code of conduct. (Fisher, 2003, P 247)

Medical psychology is involved in various areas. Psychologists work in collaboration with physicians in addressing medical issues and they can work wholly as consultant. Medical psychologists should ensure competence in their work to protect their patients. The competence can be either intellectual where one get empirical knowledge and good judgment in practice a particular patient, while emotional competence is the where medical psychologists can use emotions clinical material used in treatment. These are among the ethical conflicts that a medical psychologist should tackle to enhance effective working. These can be sorted out by recognizing competence boundary as stated by the APA principles maintaining current knowledge due to changing world that has rapid emerging diseases and illnesses. (Heermance, 2001).

Various people’s background can be an ethical conflict to a medical psychologist, but having a chance to work with various people who come from various backgrounds can help in sorting out the issue.

The world in which we are is rapidly developed with automation taking the lead over manual work, thus medical psychologists should ensure that their psychological assessment is updated and if possible computerized to enhance better psychological testing since poor psychological assessment can lead to ineffectiveness and poor quality results improper and harmful dual relationships can act as a barrier to quality psychological interpretation of results thus a medical psychologist should avoid this and involve himself in proper and harmless relationships with both the patient, relatives and the society at large.

Ethical principles should inform therapeutic practice, despite the challenging ethical problems for the practitioner, when working with medical problems. This is because these problems are related to medical problems’ nature, for example in cases where the patients mental functioning is affected, therapist need not to be contented with the patients decision, but rather assess the decision, and in cases where a medical psychologist deals with infectious and deadly diseases, he is restricted to maintaining secrecy and deal with the issue of possibility of causing harm to other people.(Marcus,2003).

Multidisciplinary teams and especially where there is varying philosophies of approaches to patient care, poses a challenge to medical psychologists as in every discipline has a different approach on patients case confidentiality. This leaves a medical psychologist in such set up to address wider ethical concerns, requiring complexity in their work and at the same time adding interest in the challenging therapy.

Though working in medical set up, ethics should not be violated. If a medical institution in which the medical psychologist is work conflict, with the ethics code, the nature of the conflict should be clarified by the medical psychologist, and ensure that their commitment in the ethics code, and to a feasible extent, the conflict should be resolving allowing adherence to the ethics codes. However if the conflict is irresolvable using this means psychologists needs to adhere to the law requirements, regulation or governing legal authority, incases of conflict between regulations and other governing legal authorities.

However the Ethical can be violated by other psychologists, and once one of the psychologist knows this attempts should be made to resolve the violation by informing the individual, and incase where of informal resolution is appropriate and its intervention do not violate any confidentiality rights that may be involved.

Incases where ethical violation harms or tends to harm an individual or organization, and or is not resolvable informally, medical psychologists should take further action which could include referring to National or states committees regarding the professional ethics, appropriate institutional authorities, and or licensing boards. However this does not apply where intervention could violate confidentiality rights or incases where psychologists are to review other psychologists’ work whose professional conduct is being queried.

According to American Psychological Association ethical principles and code of conduct, medical psychologists are competent. This is clearly seen because the five principles (A-E) of the APA, gives a clear picture that only competent medical psychologists can be allowed to give services to the patients. Conduct research but only in the area of their competence. With this, it’s clear that no medical psychologist is allowed to work beyond his or her competency either in educating supervising experiences, consultation training, and professional experience among others.

Competence boundaries enhances that professional knowledge in psychology establishes understanding of factors involved with Age, sexual orientation, language, disability ethnicity or social economic status thus enabling better services implementation and supervision ensuring competency in their services.

Medical psychologists take steps in ensuring their working competence and in protecting patients, and other clients from harm. In case where medical psychologists are require to provide services to clients whose mental health service is not available, and having not received the necessary competence, medical psychologists with closely related previous training or rather experience can offer the service to avoid denial or delay of the service if the incompetence medical psychologists tries to obtain competence either through research, study or consultation.

If medical psychologists plan to give services or to research on areas or technologies they had not done or practiced before, they should take education explanation, research or study prior to the exercise to enhance competence (medical psychologists should always keep taking efforts to develop and maintain their competences

According to the American Psychological Association ethical principles and code of conduct, medical psychologists should be in an ability to relate well with others, not discriminating at the onset of the services the relationship with all individuals involving in a third party requesting for services. The clarification involves addressing the medical psychologists’ role, identifying the client, limits to confidentially and the probable use of the services and obtained information. The medical psychologists should never aim at exploiting the people they work with and for example employees, research participants among other, but instead they should cooperate with other professionals, to enhance competency and effective outcome of their work.

Psychologists keep off from having on a professional role when involving scientific, legal, financial or professional interest that could outer their efficiency, competence objective, when taking their roles as psychologists or from exposing their clients to harm, exploitation or giving out their clients confidential information.(Ahia,2003).

This is because as either medical psychologists or psychologists there are supposed to adhere to the code of conduct and principles of APA, in case when a medical psychologist gets to understand his or her person status inhibiting his or her therapy, always assistance or should be sort or try to get professional consultation, in order to be able to determine whether to suspend, limit or terminate their work-related duties. The termination can also be as a result of understanding that the client no longer requires the services, or that the client is being harmed by the continued therapy. Threats or becoming endangered by the client or patient or a client/patient’s relative can lead to a medical psychologist terminating his or her therapy to the patient.

This means that the psychologists should not only keep the patient or rather the client away from harm but also give him or herself protection against being hurt.

According to ethical principles of psychologists and codes of conduct, medical psychologists have many roles to play. Despite the promoting both professional and scientific knowledge to themselves and others, they use the knowledge in improving individuals’ organizations’ and the society’s condition. (Kitchner, 2000).

Medical psychologist protects and respect civil and human rights, promoting the freedom to inquire and of expression in teaching, publication and research. They help in public development of informed judgments and choices in human conduct and behavior. By doing so, they play roles in educating, diagnosing, therapy, social intervention, expert witnesses, supervising in consultancy especially in health set ups and in administration.(Evans,2004).

It with the codes of conducts and ethical standard, that the psychologists enhance their scientific and professional skill. (Zeigler, 2004.).

The medical psychologists fosters the understanding of ethics and in treating of ethic related illness as well promoting behavior changes from worse to better especially in peer influenced youths. By following and abiding to the principles, they promote social development as a result of their responsible and intelligent action.

They also unite and work together with public where by they relate with them in sorting out sex harassment, and other harassment.

The America Psychological Association (APA) has set ethical principles of psychologists’ codes of conduct. These are bound to the followed by both medical psychologists as well as psychologists. The principles are sub-titled as A, which states that they should always work to benefit their clients/patients and not to harm them, principle B, which states that they should ensure they provide and be trusted by their clients/patient, principle C, accord to which they should work in ensuring honesty, truthfulness as well as accuracy, principle D, where they are required to be honesty and fair to all their client/patients and principle E, which requires the both medical psychologists and psychologists to respect other people’s Dignity and rights.

However in medicine some of the principles are compromised by medical psychologists unintentionally and especially when the medical report has to be reported and the information preserved either in computer or in files as the information can be retrieved and can be viewed by many personnel in the health institution thus reducing privacy and confidentiality. The APA ethical principles of psychologists gives competence boundaries to psychologists thus by observing these principles both medical psychologists and psychologists can work effectively thus enhancing their professional provision to the society. (Ellos, 1990.).

Although conflicts have been arising, either ethical conflicts, or conflicts of interest, they can be sorted out by involving other psychologists on the same line of operation, and by adhering to the APA principles and codes of conduct, and when conflict of interest is unavoidable, and then the therapy research or training can be terminated.(Hurty,2003).

Recommendation

I recommend the use of APA ethical principles and codes of conduct by the medical psychologists as in the incorporation of these ethical principles, and the ability to use the codes of conduct in their profession practice enhances effective, true, honest, accurate results in treating the patients mind.

It’s also good that the medical psychologists are authorized to prescribe medication though in very few states and I recommend their authorization to enhance better treatment to patients since with the extended training in their profession I do not see any harm if they prescribe medication.

I would advice the introduction of the Drug Enforcement Administration (DEA) in other states and countries to ensure legal trade on drugs and also to coordinate and pursue in countries and states after they are imported, or manufactured.

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