1
Test Your Ethical Knowledge: How Well Do You Know the Ethics Code
October 26, 2017
Eden Resort, Lancaster, PA
Presenter: Rachael Baturin, MPH, JD
Director of Legal and Regulatory Affairs
Modified Bloom’s Educational Taxonomy
Level / Definition / ExampleKnowledge / Being able to recite a definition or give a fact / Psychologists must obtain the informed consent of patients before giving therapy (some exceptions).
Comprehension / Understanding the definition, concept, or fact. / The purpose of informed consent is to secure the permission of the patient to start treatment after the patient has been given information that is likely to influence their decision to participate in therapy.
Application / Being able to apply a concept in actual practice. / Knowing what informed consent processes mean and being able to walk a patient through the informed consent process.
Analysis/Synthesis / Understanding the component parts of a concept and where it fits together with other parts of the concept. / Informed consent, at least according to the APA Ethics Code requires informing patients of the nature and anticipated course of therapy, fees, involvement of third parties, and limits of confidentiality and to provide patients with the opportunities to ask questions. Informed consent is one of many processes in the therapeutic relationship that is designed to build trust and to set up parameters likely to ensure the success of treatment
Evaluation / What is your opinion of the fact or concept? How does it fit into your value system? / Informed consent processes further the overarching goal of showing respect for patient autonomy.
Creativity / How can you build upon the concept or apply it in unique ways or unique circumstances / Are there other ways to promote respect for patient autonomy?
Anderson et al. (2000). Taxonomy for learning, teaching, and assessing. Boston: Allyn & Bacon.
To be at the “top of your game” ethically you need to know: (1) content of laws/regulations/standards governing the practice of psychology, (2) an ethical decision making model; (3) self-care/self-regulation and self-reflection; (4) protective “habits of practice” and good judgment.
Common Questions (e.g., continuing education, subpoenas, length of time to keep records)
1. Which is TRUE about mandatory continuing education?[1]
a. Psychologists must receive 30 contact hours of CE every renewal period
b. Psychologists can count CE programs from organizations approved as APA or AMA providers of CE
c. Under some circumstances psychologists can use writing or teaching as CE to fulfill CE requirements
d. All of the above
2. Psychologists must turn over records in response to a subpoena[2]
TRUE FALSE
3. Dr. Elizabeth Bennett received a document demanding the release of her records. It was signed by a judge. That document was most likely
a. A subpoena b. a court order
4. Dr. Dora Copperfield wants to get rid of old files. According to the State Board of Psychology, she may destroy all files if it has been ___ years since the last patient contact.
5. Which of the following are NOT true? Psychologists must
a. keep records for at least 5 years after the last patient contact
b. retain the basis upon which test results were obtained for at least 5 years since the last patient contact
c. make plans for the disposition of the records in the case of their death or disability
d. give copies of test materials to anyone who requests, assuming a subpoena or a valid release from a patient
6. The facts that trigger action under the Emerich decision include:[3]
a. patient has an identifiable victim
b. patient poses a threat of “imminent harm”
c. mental health professional concludes, on the basis of their professional judgment, that a third person is in danger
d. all of the above occur
7. Pennsylvania law requires psychologists to give patients a copy of their records.
TRUE FALSE SOMETIMES
8. The term test materials refers to
a. Patient responses to test stimuli b. Copyrighted tests
c. The APA Code of Conduct d. All of the above
9. Psychologists may turn over test materials to anyone assuming a valid release of information has been received
TRUE FALSE
10. Under the Mental Health Procedures Act, any individual who has a serious mental illness may be hospitalized involuntarily if they have
a. Attempted to substantially harm themselves within the last 30 days
b. Attempted to substantially harmed others within the last 30 days
c. Mutilated themselves in the last 30 days
d. Any of the above
11. Dr. Artful Dodger has a patient who is not improving and is unlikely to improve, but who wants to continue treatment. The legal standard is that Dr. Dodger may:[4]
a. Not terminate the patient without his or her consent
b. Terminate the patient without his or her consent if clinically indicated to do so
c. Terminate the patient without his or her consent, if the “three month” rule is followed
d. Not terminate unless the consultation of a psychiatrist is sought
12. The APA ethics codes state that multiple relationships are always unethical.
TRUE FALSE
13. The State Board of Psychology, through regulation, requires all psychologists to adhere to the standards of the American Psychological Association.
TRUE FALSE
14. Psychologists may release confidential information if
a. they receive a court order
b. the patient has signed a release (or authorization)
c. they are mandated by law (such as a child abuse reporting law) to do so
d. all of the above
15. Supervision is the same as consultation TRUE FALSE
16. The State Board of Psychology can deny a license to an applicant who has poor moral character
TRUE FALSE
17. The Standards of the APA Ethics Code apply to all psychological services including telehealth services
TRUE FALSE
18. The records of school psychologists working in the schools and the records of college counseling centers are governed by FERPA and state laws
TRUE FALSE
19. Under HIPAA, state laws that are more protective of patient privacy, from the standpoint of the patient, trump federal law.
TRUE FALSE
20. Even without a release from a patient, psychologists may discuss a case if it is done with consultants for professional purposes, and without an undue invasion of privacy.
TRUE FALSE
More Difficult Questions
21. In Pennsylvania, psychologists must immediately warn an actual or intended sexual partner if their HIV positive patient intends to have sexual relationships with them (if the HIV infected patient has not informed their sexual partner of their serostatus).
TRUE FALSE
22. In Pennsylvania, the executor of an estate can demand and receive the psychological records of a deceased patient.
TRUE FALSE
23. Psychologists in Pennsylvania are mandated reporters of
a. suspected child abuse b. medical errors (if working in a hospital)
b. impaired drivers d. all of the above
24. Children who are 14 years old or older and who seek treatment voluntarily have the same control over confidentiality as adults (except for child abuse reporting laws).
TRUE FALSE
25. Estelle Havisham, a troubled 16 year old with narcissistic personality disorder, is receiving treatment upon the consent of her parents. Even without her consent information about her treatment may be sent to:
a. primary care provider (with parents consent)
b. another current mental health professional (with parents consent)
c. to her parents, at least to the extent necessary for them to make an informed decision about treatment
d. all of the above
26. In Pennsylvania children of any age may seek treatment on their own without parental consent if
a. There is an emergency b. They are emancipated
c. They are married d. All of the above
27. In Pennsylvania a child of any age can seek treatment from a licensed drug and alcohol facility without parental consent.
TRUE FALSE
28. In the Grossman decision, a psychologist was disciplined for
a. Treating a child without the consent of both parents when there was a court order of joint legal custody
b. Evaluating a child for the purposes of developing a treatment plan without the consent of both parents when there was a court order of joint legal custody
c. Conducting a child custody evaluation without the consent of both parents when there was a court order of joint legal custody
d. None of the above
29. When receiving a referral from Children and Youth it is prudent to
a. assume that the representative of Children and Youth always has the legal authority to consent to treatment
b. assume that the representative of Children and Youth has the legal authority to consent to an evaluation, but not necessarily to treatment
c. verify the legal authority of Children and Youth by learning of the contents of the court order specific for this child
d. None of the above
30. A child represents her age as 15 and seeks treatment from a psychologist. For clinical reasons it appeared inappropriate to involve the parents in treatment. The psychologist documented the reported age of the child and her capacity to give informed consent. Later, the psychologist learns that she was only 13 when she initiated treatment. According to the minors consent to treatment law, the psychologist is
a. Legally liable for treating a minor without parental consent
b. Legally liable only if the parents had joint legal custody as specified in a court order
c. Not liable for misrepresentations on the part of the child
d. None of the above
31. When faced with a difficult ethical question, it is best to call the State Board of Psychology and ask them what to do because they are obligated to help psychologists work through difficult ethical questions.
TRUE FALSE
32. Dr. Pickwick wants to stop treatment with a patient. Which one of these situations would constitute abandonment?
a. He packed his schedule so full that he could not schedule a patient for two weeks despite the fact that the patient claimed it was a life-endangering emergency
b. his patient quit treatment; did not respond to a follow up letter offering more appointments
c. he terminated the patient who no longer needed treatment
d. all of the above constitute abandonment
33. According to the APA Ethics Code, test materials are the same as test data.
TRUE FALSE
34. Psychologists always have to use the most recent version of a psychological test.
TRUE FALSE
35. Dr. Copperfield wanted to send the confidential information on his patient (Mr. Barkus) to his primary care physician. Dr. Copperfield asked Mr. Barkus,if he would be willing to consent to the release and Mr. Barkus stated, “Barkus is willing.” Based on this verbal assent, may Dr. Copperfield send the confidential information to the primary care physician?
YES NO
36. The ethics code of psychologists allow them to share information on patients without their consent if
a. classroom materials adequately disguise the identity of the persons involved
b. the psychologist follows the "best interest" rule
c. a family member wants the information
d. a patient threatens serious property damage
37. Under the Mental Health Procedures Act, any person who has an involuntary hospitalization under section 303 of the Act has the right to
a. An informal hearing before a judge (or master) b. An attorney to represent them
c. the right to hear the evidence against them and ask questions d. All of the above
38. Psychologists are required to report impaired psychologists to the licensing board unless
a. the impaired psychologist is getting treatment
b. the information were obtained as part of a treatment relationship
c. the psychologists is treating the psychologists who is apparently impaired
d. all of the above
39. the reporting of elder abuse is mandated for psychologists who work in
a. solo practices b. privately owned group practices
b. long term care facilities for older adults d. all of the above
40. The record keeping regulations of the State Board of Psychology require psychologists to include
a. custody arrangements for minor children b. the nature and substance of all treatment contacts
b. copies of all patient authorizations d. all of the above
More Difficult, Applications, and Use of Professional Judgment[5]
41. Which of the following is true about safety contracts for suicidal patients?
a. Safety agreements are a good risk management procedure because courts tend to give high deference to the presence of a safety agreement, regardless of how it fits into the overall treatment of the patient.
b. Evidence shows that they help prevent suicides
c. Suicide experts believe that their use is the standard of care for suicidal patients
d. None of the above
42. Dr. Copperfield was named in a court order that he was supposed to provide family education for a particular family. Before accepting this court assignment, Dr. Copperfield needs to
a. do whatever the court says, because he cannot disobey a court order
b. clarify with the court what it means by “family education”
c. at least attempt mediation with the family before engaging in family education
d. all of the above
43. You are reviewing the psychological testing of another psychologist. If done correctly, that psychologist should
a. Identify the bases of all of the substantive conclusions
b. Use the latest version of the psychological test or explain why the latest version was not used
c. Clearly identify if he or she used the results of any previous psychological tests
d. All of the above
44. After going through the informed consent process with a new patient, he blurts out that he intends to kill the man who is having an affair with his wife. Upon hearing this you should
a. try to learn more about the seriousness of the threat
b. discern if he has the means or opportunity to implement this threat
c. develop a relationship with the patient
d. All of the above (a, b, and c)
e. Immediately warn the intended victim
45. When treating suicidal patients it is best to keep as few notes as possible because any clever attorney can take your notes and use them against you.
TRUE FALSE
46. The most common source of licensing board complaints against psychologists, nationwide, is for