The Canadian Code of Ethics for Psychologists is a document that frames the values that psychologists must adhere to in our work. A formal code has existed in North America since 1953, when the American Psychological Association took responsibility for articulating standards for American psychologists. With only minor wording changes, this code and its several revisions (until 1977) have been adopted by the Canadian Psychological Association (CPA) under the title Ethical Standards for Psychologists.
There are several purposes for having a Code for psychologists:
· having a code establishes psychologists as a legitimate health care profession
· a code is there to provide support and guidance to practicing psychologists
· having a code holds practicing psychologists to certain responsibilities and duties
· a code provides a means for practicing psychologists to resolve individual dilemmas
Our Canadian code contains for basic principles, which are described as follows:
Principle I: Respect for the Dignity of Persons and Peoples. This principle, with its emphasis on inherent worth, non-discrimination, moral rights, distributive, social and natural justice, generally should be given the highest weight, except in circumstances in which there is a clear and imminent danger of bodily harm to someone.
Principle II: Responsible Caring. This principle generally should be given the second highest weight. Responsible caring requires competence, maximization of benefit, and minimization of harm, and should be carried out only in ways that respect the dignity of persons and peoples.
Principle III: Integrity in Relationships. This principle generally should be given the third highest weight. Psychologists are expected to demonstrate the highest integrity in all of their relationships. However, in some circumstances, Principle III values (e.g., openness, straightforwardness) might need to be subordinated to the values contained in the Principles of Respect for the Dignity of Persons and Peoples, and Responsible Caring.
Principle IV: Responsibility to Society. This principle generally should be given the fourth highest weight of the four principles when it conflicts with one or more of them. Although it is necessary and important to consider responsibility to society in every ethical decision, adherence to this principle needs to be subject to and guided by Respect for the Dignity of Persons and Peoples, Responsible Caring, and Integrity in Relationships. When the welfare of an individual or group appears to conflict with benefits to society, it is often possible to find ways of working for the benefit of society that do not violate respect for dignity, responsible caring or integrity. However, if this is not possible, the dignity, well-being and best interests of persons and peoples, and integrity in relationships should not be sacrificed to a vision of the greater good of society.
As we can see, the Code is ordered in descending order with the most important principle (i.e., Respect for the Dignity of Persons and Peoples) listed first. In practice, this principle means honoring confidentiality, giving clear information before offering treatment (so a person can make an informed decision), and providing non-discriminatory treatment to the best of our abilities and referring to others when any of these conditions cannot be met.
Principle II: Responsible Caring, can be divided into three main values: competence (i.e., proving oneself to be skillful, knowledgeable and able to practice); beneficence (doing good, when possible) and non-maleficence (avoiding harm, when possible). In practice, the code is weighted so that avoiding harm is the most important of the values, followed by competence and finally, doing good or beneficence. The Canadian Code of Ethics was written with a strong regard for the rights of individuals to dignity, fairness, and autonomy/freedom. However, psychology--perhaps more so than many other service professions--emphasizes a caring relationship. The psychologist Carol Gilligan, was among the first to point out that our professional concerns with individual rights tends to overlook our more social values, such as caring, compassion and connectedness. Gilligan's work revealed the limitations of creating a social contract (i.e., code of ethics) solely upon a hierarchy of individual rights without also attending to our social networks of responsibility.
It is time, therefore, that psychologists consider how to emphasize the "care" in Responsible Caring. After all, what can we say about care in a document that does not include any terms such as affection, attention, interest? The word concern is mentioned six times in the Responsible Caring section. But when we care for something--truly, deeply care--we usually have more than 'concern' for that thing or person. The strongest forms of care are towards the things or people that we have love for. But the word love is not mentioned anywhere in the document. In fact, the most likely place one is to encounter the term when looking at literature in psychological ethics will be to discuss the prohibitive taboo that forbids therapists from sleeping with their patients! Is this a problem? I believe it is. While the word love seems rather squishy, sentimental or overtly sexual in contemporary discussions it has a rich history and meanings which can deeply inform the way psychologists—and other health care providers—ethically practice their craft.
In a landmark but rather nondescript book, the Canadian psychologist John Alan Lee considers the concept of love to be multivaried and best described as encompassing a spectrum of subtypes and forms, sort of like colors in a rainbow. In fact, his Colour Wheel of Love contains what he considered to be the primary types (i.e., pragma, mania, agape) and the secondary types of love. Most categorizations of love can be found in Greek literature including:
Agape – Universal love for humanity; love for the divine
Eros – sexual love; appreciation of beauty
Philia – affection, friendship between comrades
Storge – love for one’s family, team, country, community
Philautia – self-love, which can be positive (i.e., self-esteem) or negative (i.e., narcissism)
Xenia – hospitality; friendship for a guest or foreigner
Of course, other cultures have a rich history of words and concepts that even more dimensions of love and with detail and nuance that we may not have in the English vocabulary. My favorite example is the word Ubuntu from South Africa. Ubuntu—which can be translated as “I am because you are”—can be taken to be a spectral combination of agape (i.e., love for humanity) and philautia (love for oneself). The essence of Ubuntu—in contrast to much of Western philosophy—suggests that one gains a full measure of themselves only by consideration of their belonging in the world of others. Self-development, in other words, cannot be achieved simply through working on bettering one’s personal fortunes but requires a deep commitment to upholding the well-being of the worlds one belongs to (e.g., neighborhood, workplace, church, city, country, global village etc.).
When it comes to Responsible Caring, I think we have profoundly neglected the rich and varied history and philosophy on love and caring. Good treatment may require all forms of love. A good therapist is one that believes in humanity (agape), appreciates the beauty in a person’s life (eros), feels deep affection for their patients (philia), has a deep sense of commitment and responsibility to others (storge), health self-esteem (philautia) and a sense of hospitality or welcoming to those seeking help (xenia). There is no substitute for good care—not even the absence of bad care!
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