Ethics in Psychology: A History Review PDF

Canadian Psychology / Psychologie canadienne © 2017 Canadian Psychological Association 2017, Vol. 58, No. 1, 20 –29 0708-5591/17/$12.00 http://...

Canadian Psychology / Psychologie canadienne © 2017 Canadian Psychological Association 2017, Vol. 58, No. 1, 20 –29 0708-5591/17/$12.00 http://dx.doi.org/10.1037/cap0000086 CPA Gold Medal Award for Distinguished Lifetime Contributions to Canadian Psychology / Prix de la médaille d’or de la SCP pour contributions remarquables à la psychologie canadienne au cours de l’ensemble de la carrière Ethics in Psychology: Recalling the Past, Acknowledging the Present, and Looking to the Future CAROLE SINCLAIR 1996). The emphasis in these publications was on demonstrating Toronto, Ontario, Canada the influence of societal evolution and its various structures, val- ues, and expectations on the journey: in particular, on the various ways in which ethical principles and values were articulated and promoted along the way. However, the emphasis also has been on Abstract demonstrating the deep roots of the ethical principles and values Over the past several decades, modern psy- we espouse as psychologists in today’s world and how they reflect chology has come a long way in its ethics our common humanity (Sinclair, 2012, p. 17). journey. In this article, by looking at various For this current article, I have chosen to provide an overview time periods between the mid-19th century and the present, I and some personal reflections on a history that is closer to home: provide an overview and personal reflections on some of the namely, the ethics journey travelled by modern psychology from major events and changes in thinking that have occurred during the mid-19th century to the present. Similar to other travelogues, this journey, as well as outline some of the ethical challenges I there are many events, challenges, and changes in thinking that are think we can expect in the immediate future. The role of local not included due to limitations of time and space. It is a journey and world events are explored, along with the role of scandals, whose first 9 or 10 decades I inherited when first entering psy- community concerns, legal developments regarding regulation, chology, have lived for the past five decades, and am still living. globalization, and changes in thinking about ethical decision As such, I must declare a probable bias and lack of objectivity in making and about rules versus aspirational ethics. Particular em- what I have chosen to cover and in what depth. The article is phasis is given to the national as well as the international offered not as a final word but only as part of the record. scenes, including the contributions of the Canadian Psychologi- Although modern psychology has faced and will continue to cal Association, the Canadian Code of Ethics for Psychologists, face many ethical challenges, I believe it has come a long way in and the Universal Declaration of Ethical Principles for its ethics journey since the mid-19th century. One indication of this Psychologists. “long way” is the sheer attention paid to ethics in the literature. Keywords: codes of ethics, ethical decision making, ethical guidelines, Table 1 contains the results of an April 2016 search of PsycNET history of psychology, globalization, scandals, social justice for literature that contained the terms “professional ethics” or “experimental ethics.” The increase in attention to ethics in the Ethics is at the core of every discipline. (Universal Declaration of literature over time is striking, especially the exponential increases Ethical Principles for Psychologists, 2008) occurring first just after the Second World War, then in the 1960s, In previous publications, I have traced the ethics journey of followed even more strikingly in the most recent two and a half various disciplines and professions since ancient times and across decades. many cultures (Sinclair, 1993, 2012; Sinclair, Simon, & Pettifor, In the travelogue that follows, the content is divided into the same time periods as those used in Table 1. For each time period, Table 1 Number of Articles About Experimental or Professional Ethics The author thanks the many Canadian and international psychologists who have been part of my personal journey in psychology ethics. In Appearing in PsycNET, Per Time Period particular, she would like to thank Jean Pettifor, who had a profound Time period Number of articles influence on Canadian psychology’s ethics journey as well as the ethics journey of many other countries. This article is dedicated to her memory. 1801–1900 18 The author also wishes to thank Janel Gauthier for his very helpful 1901–1920 16 feedback on a draft of the CPA Conference presentation on which this 1921–1940 26 article is based. 1941–1960 228 Correspondence concerning this article should be addressed to Carole 1961–1980 1,743 Sinclair, 608-60 Inverlochy Boulevard, Thornhill, ON, Canada L3T 4T7. 1981–2000 9,415 2001–Present 20,179 E-mail: [email protected] 20  ETHICS IN PSYCHOLOGY 21 reflections will be offered on some of the major events, challenges, 1901–1920 and changes in thinking that have impacted our journey, including Over the next 20 years, psychology continued to differentiate its pace and direction. Insofar as it is possible, this will include itself as a separate discipline, with both scientific and applied attention to the areas of research, practice, education, and training, interests. The first university psychology departments (vs. psy- the development of codes and guidelines, and social responsibility chology labs) were established, as were journals devoted to psy- and social justice. chology. There was further development of research methods, including some statistical analyses (e.g., correlation), and the 1801–1900 Binet-Simon intelligence test was developed in France in 1904 to identify children needing help in schools. This test was translated During the majority of the 1800s, psychology was not viewed or and began to be used in North America. The literature of the time practiced as a distinct discipline. It began to differentiate itself also reflected an increasing interest in developing other applied from such disciplines as medicine and physiology only in the last tests (e.g., mental capacity in adults, “virtue”). quarter of the 19th century. For instance, two of the individuals With respect to professional and experimental ethics, the num- considered founders of modern psychology, Wilhelm Wundt ber of articles was again quite small, only 16 over a 20-year period. (1832–1920) and William James (1842–1910), were trained as Some of the articles continued to discuss ethics in general as a physicians, although they both also worked in the areas of phys- focus of study (the “science of ethics”), with no reflection on its iology and philosophy. It was not until the 1870s and 1880s that role or meaning for members of a discipline, and with ethics courses devoted to “psychology” were taught, experimental psy- continuing to be seen as a personal matter. Other articles, however, chology labs were established, and the label “psychologist” was began to deal with ethical questions and concerns specific to the discipline, including applications of psychology (e.g., Binet-Simon used. The American Psychological Association (APA) was test) by persons not properly trained, raising the issue of creden- founded in 1892. For the most part, early psychologists were tialing for the first time; exploration of the appropriate use of interested in the study of “consciousness” (perception, attention, psychology in courtrooms (e.g., determining mental competency, thinking, emotions), but using the research methods of the natural “insanity”); concerns about conflicts of interest; importance of sciences (e.g., physiology, medicine). sympathy and trust in client relationships; and justifications for the The date of the first article on professional or experimental use of animals in research (e.g., “animals do not feel pain the way ethics in PsycNET is 1856. From that year to the beginning of the humans do”). 20th century, a total of 18 articles appeared. Of the 18, only 6 As with the 19th-century articles, none of the articles addressed appeared in books or journals with “psychology” in the title. the possible need for ethics education or training, or the need for Others appeared in such publications as American Journal of codes or guidelines. With respect to the areas of responsibility to Sociology, Education, Medicine and the Mind, and System of society and social justice, only one article addressed these issues, Moral Science. The majority of the articles were about ethics in arguing that when working with children, it is important that general as it applied to the general public, with no specific mention psychologists are aware of the “social problems” the children are of how ethics applied to the discipline itself or to the members of having to live with. the discipline. Three articles provided reactions (two defensive and one supportive) to the demands of antivivisectionists regarding the 1921–1940 use of animals in research. One article raised a question about the During this 20-year time period, there was continued growth of possible use of hypnotism in the courts as a test of whether the discipline, including different schools of thought (e.g., behav- someone is guilty. None of the articles mentioned the need for iourism, social learning theory, Gestalt psychology). There also ethics education for the members of the discipline, or the need for was an increased development and use of psychometric tests, and ethics codes or guidelines. Rather, ethics seemed to be viewed as increased applications of psychology with schools, organisations, a personal matter. and individual clients. The Canadian Psychological Association With respect to social responsibility and social justice, a strong (CPA) was founded in 1939. theme in some of the more theoretical articles was whether science With respect to professional and experimental ethics, the num- can take the place of philosophy and theology in finding solutions ber of articles increased somewhat, but still only 26 articles ap- to society’s problems (defined in the articles primarily as “crimi- peared. The focus of the articles, however, shows a distinct nality” and “aggression”). In my view, however, some of these change, with an increasing awareness of the importance of ethics articles reflected what we would now see as a misuse of science to a discipline and the importance of psychologists conducting and little awareness of the harm that can be done by prejudicial themselves ethically. In addition to articles about confidentiality beliefs and a lack of acknowledgment of social justice issues. One and the importance of avoiding conflicts of interest, the first articles appeared suggesting that codes of ethics (à la medicine, particularly troubling statement in one article demonstrates this: dentistry, architecture, law) are needed and desirable for psychol- Science teaches our legislators to sort out and separate children who ogy. In fact, a report, “The Obligations of the Professional Psy- are born with bad instincts and evil heredity... to employ every chologist,” was produced in 1939 by the American Association for means capable of restraining their impulses... and if this fails, to Applied Psychology’s Committee on Professional Ethics (Coxe, endeavour to send these untamed animals to swell the colonial army, 1940). It was not an ethics code, but did propose the following two where their craving to do harm will be usefully appeased. (de Fleury obligations: (i) “The professional psychologist’s first consideration & Collins, 1900, pp. 91–92) in the welfare of human beings as individuals” and (ii) “The 22 SINCLAIR scientific psychologist’s first consideration is the advancement of formed consent, (ii) the responsibility to balance risks and benefits, psychological knowledge.” and (iii) the unacceptability of doing harm to an individual for the One of the first set of guidelines used by psychologists also purpose of benefitting society. The events in the concentration appeared during this time, when APA adopted the American camps and the development of the Nuremberg Code seemed to Medical Association’s “Rules Regarding Animals” on the recom- serve as a wake-up call to many disciplines other than just medi- mendation of APA’s Committee on Precautions in Animal Exper- cine, and raised consciousness about the importance of having imentation (Young, 1928). This event is significant insofar as it codes of ethics that clearly state the discipline’s ethical principles demonstrates a growing recognition that guidelines may play a role and that address the scientific as well as the professional compo- in helping members of a discipline to understand their responsi- nents of the discipline. Within many disciplines, including psy- bilities and conduct themselves ethically. chology, ethics was no longer being seen as just a personal matter, As with the earlier articles, none of the articles during this time and those that had never had a code of ethics began to develop period addressed the possible need for ethics education or training, them. in spite of the evidence of a growing belief that ethics is not just The American Psychological Association (APA) led the way for a personal matter. With respect to the areas of responsibility to psychologists. In 1947, it established the Committee on Ethical society and social justice, there seemed to be an increasing recog- Standards for Psychologists, which by 1953 produced a set of nition that the discipline has responsibilities to society with regard provisional ethical standards that was adopted by the APA Coun- to its members behaving ethically in their psychology activities. cil. In 1959, a final set of ethical standards was adopted (APA, However, only one article addressed a specific related matter, 1959). The development of this code had a direct impact on namely the need for advocacy by the discipline to prevent courts psychology organisations in other countries either adopting the from releasing confidential information to the press. APA code (e.g., Canada) or developing their own code using the APA code as a model (e.g., France, Norway). It also had a direct impact on other disciplines, some of which also used the APA code 1941–1960 as a model (e.g., sociologists, group workers). The indirect impact During this time period, there was a large increase in the number of the development of the APA code is that it was the beginning of of psychology departments and psychology researchers, as well as a trend that would gain much momentum over the following in the number of psychology practitioners. This was a significant decades. time for psychology in many ways. It included the development of But in addition to the above events, what was the content of the the APA ethics code and movement to the formal professionaliza- 228 experimental or professional ethics articles published during tion of psychology (e.g., training standards, credentialing, licens- this time? A review of the abstracts for these articles indicates that ing). psychologists were exploring many of the same ethical issues we As indicated in Table 1, there was a large increase in the worry about presently (e.g., confidentiality, conflicts of interest, literature on professional and experimental ethics, with 228 articles objectivity, consent, uses and misuses of the scientific paradigm, listed in PsycNET. One might well ask the reason for the sudden and the use of deception in research). In addition, however, there increase. Certainly, the expansion of psychology, especially into also were articles about the pros and cons of such matters as (i) the areas of application, may explain some of the increase. However, Nuremberg Code principles (too restrictive for psychology?), (ii) it is generally thought to be the result of the development of the procedures for processing complaints of unethical behaviour (too Nuremberg Code of Ethics in Medical Research (Nuremberg punitive?), and (iii) credentialing, licensing, and regulation (up- Code, 1947), which provided a set of ethical principles for re- sides and downsides). With respect to training in ethics, de Palma search, developed at the end of the Second World War in response and Drake (1956) published the first formal paper on this topic. to the highly harmful experiments conducted by physicians on The results of a survey sent to psychology programs across the US concentration camp inmates. These experiments were often very and Canada indicated that only 9% had a formal course in ethics, painful and frequently led to permanent harm or to the death of the although a further 6% were planning to offer such a course. Sixty research participants, who had no choice about whether they percent reported that they had little or no training in ethics. Some participated. The experiments were carried out in spite of physi- stated that they thought it was not warranted or questioned whether cians having sworn to the Hippocratic Oath (which endorses the ethics can be taught at all—that selection of ethical graduate ethical principle of “do no harm”) and having other ethics codes students was the better course to follow. and guidelines to guide them. In defending themselves during the With respect to the areas of responsibility to society and social Nuremberg trials, the physicians’ justification for these acts was justice, in my opinion the literature seemed to reflect a general that the concentration camp victims were not patients, therefore commitment to working in the best interests of humanity and such codes as the Hippocratic Oath did not apply, and that the society, but little attention to social justice issues. experiments were a “contribution to knowledge” and could benefit society. They also defended their actions by pointing out that 1961–1980 similar experiments had been carried out in other parts of the world. (Note: The other experiments cited in the defense invariably This time period is a very important one in CPA’s own ethics had been carried out with vulnerable persons—prisoners, unknow- journey, as it was the period leading up to concerted efforts to ing hospital patients, persons who had been enslaved, or persons develop the first Canadian Code of Ethics for Psychologists with developmental disabilities.) (Canadian Psychological Association, 1986/2000). It was a time of The Nuremberg Code addressed the scientific component of a rapid growth of both the scientific and applied dimensions of discipline, and included such principles as (i) the need for in- psychology, but also included many developments related to pro-  ETHICS IN PSYCHOLOGY 23 fessionalization of the discipline. The need for ethics education without the awareness or informed consent of the research partic- and training of members of the discipline became generally ac- ipants enlisted. cepted and, partly due to media exposés, it was a time of growing Within psychology during this time, there were two particular public awareness and concern regarding the effects of war, various research studies that, although not leading to the type of media forms of discrimination, and social justice issues. As will be seen exposés noted above, led to considerable ethical angst and dia- below, this public concern had an impact on developments within logue both within and outside the discipline of psychology. In my psychology and other disciplines. opinion, these studies had a strong influence on the direction of our As indicated in Table 1, there was a large increase in ethical ethics journey. The first was Milgram’s obedience study (Milgram, dialogue within the profession, producing 1,743 articles regarding 1963). The second was the Stanford prisoner study (Haney, Banks, experimental and professional ethics, in comparison to the 228 that & Zimbardo, 1973). had appeared in the previous 20-year period. This dialogue in- Milgram’s study was designed to find out how easily ordinary cluded an evident growing awareness by members of the discipline people could be influenced into committing the type of atrocities regarding human rights and social justice issues. that occurred in the Second World War. In particular, he was With respect to the practice dimension of psychology, major interested in exploring the role of obedience to authority. His steps were taken toward professionalization. Licensing became experiment involved use of a confederate who was to be shocked much more formalized, and the Association of State and Provincial in increasing doses to a level labelled dangerous whenever he Psychology Boards (ASPPB) was founded in 1961 to serve “reg- made a mistake on a learning task. If a research participant ulatory boards” in both the United States and Canada, where such hesitated in giving an increased level of shock, he was instructed Boards were being set up by government statute. The Boards to do so by a researcher present in the room. A few refused to generally had three legally mandated functions related to protect- continue, but some continued to shock to the level of dangerous- ing the public: (i) ensuring applicants were qualified and compe- ness. Milgram used the results to structure a theory about obedi- tent, (ii) the development of “codes of conduct,” and (iii) investi- ence to authority. However, ethical concerns were raised about gating complaints and taking disciplinary action where warranted. several aspects of the study, including (i) the high use of deception By 1980, more than half of the jurisdictions in North America had (e.g., the purpose of the study was disguised; the “learner” was a such legally mandated Boards. confederate and was actually not being shocked), (ii) the harm to With respect to ethics education and training, a new survey the participants (several showed much distress as the experiment (Tymchuk, Drapkin, Ackerman, Major, Coffman, & Baum, 1979) proceeded), and (iii) not making it clear that the research partici- found that 63% of APA clinical programs had a formal course in pants had the right to withdraw. ethics, with an additional 29% having an informal format for the The Stanford prisoner study was designed to explore the psy- teaching of ethics. It also found that 95 % of respondents believed chological effects of becoming a prisoner or becoming a prison ethics can and should be taught—a distinct change from the results guard, and to find out whether the level of brutality reported of the survey that had been done 24 years before (de Palma & among prison guards in American prisons was primarily disposi- Drake, 1956). Although there was no overall agreement about tional or environmental. College students were enlisted and ran- what or how to teach, the literature at the time reflected a growing domly assigned to being either a prisoner or prison guard. The belief that full protection of the public cannot take place without 2-week experiment was stopped after only six days as the “prison students being taught how to think through an ethical issue or guards” became increasingly abusive and the “prisoners” were dilemma, and work out solutions (i.e., a preventative rather than showing increasing distress. The ethical concerns raised about this reactive approach to ensuring ethical behaviour and protecting the study included (i) lack of fully informed consent, (ii) lack of public). Significantly, in 1979, APA’s Criteria for Accreditation of identification of potential risks and harms before the experiment Doctoral Training Programs mandated ethics education for all began, and (iii) lack of protections from harm for both the “pris- students in clinical doctoral programs (APA, 1979). oners” and the “guards.” With respect to research, several events strongly influenced the These four experiments led to several significant events related content and form of developments in research ethics, both in to research ethics. In addition to changes in the APA code, a strong psychology and in other scientific disciplines. In spite of the influence on what was eventually included in the Canadian Code, Nuremberg Code and other broadly accepted international docu- and a large increase in attention to research ethics in the psychol- ments that specified ethical expectations for research, media ex- ogy literature, other significant happenings occurred primarily posés of seriously unethical research started to appear, leading to outside the discipline. One of these was the influential Belmont strong public reaction. One of these was the Tuskegee syphilis Report, a product of the National Commission for the Protection of experiment, which had been conducted from 1932 to 1972. This Human Subjects of Biomedical and Behavioural Research (1979), experiment had included not telling rural African American men which was set up by the United States government in 1974. The receiving free health care that they had syphilis, and not treating Belmont Report was organized around three well-defined ethical them with penicillin when it became available in the early 1940s, principles: (i) Respect for Persons, (ii) Beneficence, and (iii) in order that the “natural progression of the disease” could be Justice, and paid a great deal of attention to how to protect studied. Another exposé was of the Central Intelligence Agency vulnerable persons from unethical research. (CIA) sponsorship of research between 1953 and 1963, aimed at Another significant event was the establishment of Institutional understanding brainwashing and effective interrogation tech- Review Boards in the United Sates and Research Ethics Boards in niques. One of the research studies sponsored took place at the Canada, based on the belief that there needed to be more oversight Allan Memorial Institute in Montreal, which involved LSD, “eras- of research in order to prevent harm and to prevent violations of ing minds and memories,” and “re-building personality,” often the rights of participants. A third significant event was the devel- 24 SINCLAIR opment of laws to protect whistleblowers, as there was evidence The belief that ethical codes and guidelines are needed and can that persons aware of unethical studies had attempted to have them be helpful became even stronger during this time period. The changed or stopped, but were unsuccessful and punished for trying following list of major documents that appeared demonstrates this, to bring the problems to light. and also gives an idea of the ethical issues and challenges of the The 1961 to 1980 time period also saw a proliferation of day. relevant-to-psychology ethics documents, guidelines, and codes, reflecting the rising awareness of the importance of ethics in a 1. Short Checklist for Nonsexist Research (CPA, 1983). discipline and the types of ethical concerns expressed by both the discipline and the public during this time. Some of the major 2. Guidelines for the Elimination of Sexual Harassment (CPA, documents are listed below. 1985). 1. Declaration of Helsinki: Recommendations Guiding Medi- 3. Guidelines on Research Involving Human Subjects (Medi- cal Doctors in Biomedical Research Involving Human Sub- cal Research Council of Canada, 1988). jects. (World Medical Association, 1964/1975). 4. ASPPB Code of Conduct (ASPPB, 1991). 2. Casebook on Ethical Standards of Psychologists (American Psychological Association Committee on Ethical Standards 5. Guidelines for Providers of Services to Ethnic, Linguistic, for Psychology Committee on Scientific & Professional and Culturally Diverse Populations (American Psycholog- Ethics & Conduct, 1967). ical Association Office of Ethnic Minority Affairs, 1993). 3. Ethical Principles in the Conduct of Research With Human 6. Record Keeping Guidelines (APA Committee on Profes- Participants (APA, 1973). sional Practice & Standards, 1993). 4. Standards for Educational and Psychological Tests (APA, 7. Declaration of Geneva: International Ethical Guidelines 1974). for Bio-medical Research involving Human Subjects (World Medical Association, 1993). 5. Standards for Providers of Psychological Services (Amer- ican Psychological Association Task Force on Standards for 8. Guidelines for Child Custody Evaluations in Divorce Pro- Service Facilities, 1977). ceedings (APA Practice Directorate, 1994). 6. Ethics: Report of the Consultative Group on Ethics (Canada 9. Strategies for Private Practitioners Coping with Subpoenas Council, 1977). or Compelled Testimony for Client Records or Test Data (APA, 1996). 7. Ethical Principles for the Conduct of Research in the North (Canadian Man-and-the-Biosphere Programme, 1977). 10. Guidelines for Non-discriminatory Practice (CPA, 1996). 8. Illustration and Interpretation of the CPA Guidelines for 11. Guidelines for Psychological Evaluations in Child Protec- Assessment of Sex Bias and Sex Fairness in Career Interest tion Matters (APA, 1998). Inventories (CPA, 1978). 12. Tri-council Policy Statement: Ethical Conduct for Research 9. Ethical Guide for Research with Human Subjects (Social Involving Humans (Medical Research Council of Canada, Sciences and Humanities Research Council of Canada, Natural Sciences and Engineering Research Council of 1979). Canada, & Social Sciences and Humanities Research Coun- cil of Canada, 1998). 10. Guidelines for Therapy and Counselling with Women (CPA, 1980). 13. Guidelines for Psychotherapy With Lesbian, Gay, and Bi- sexual Clients (APA, 2000). 11. Guidelines for the use of Animals in Research and Instruc- tion in Psychology (CPA, 1982). 14. Guidelines for Research in Ethnic Minority Communities (Council of National Associations for the Advancement of 1981–2000 Ethnic Minority Interests, 2000). During this time period, the professionalization of psychology 15. Canadian Code of Ethics for Psychologists (1986, 1991, became well established. By 2000, all North American states and 2000; CPA, 1986/2000). provinces had regulatory Boards. Ethics became a standard part of the curriculum, at least for applied psychology graduate students As can be seen from the last item on the above list, not only was and, again, a large increase in ethical dialogue is evident in the the first Canadian Code of Ethics for Psychologists developed 9,415 articles about professional or experimental ethics that ap- during 1981–2000, but two revisions as well. Until the first edition peared during this time (vs. 1,743 for the previous 20 years). This appeared in 1986, CPA had been one of the countries using the dialogue included increased attention to responsibility to society, APA code. CPA had adopted the 1959 APA code for a 3-year trial, human rights, and social justice issues. followed by adoptions of APA’s 1963 and interim 1977 code  ETHICS IN PSYCHOLOGY 25 revisions (APA, 1963, 1977). However, serious discussions of the 6. Inclusion of both minimal and aspirational standards possibility of CPA developing its own code had begun in the last (i.e., not a “code of conduct”). two years of the 1970s, when Canadian psychologists began to express discomfort about some of the changes that had been made 7. Presentation of the Code as an umbrella document, to the 1977 revision and some of the changes being proposed for providing a framework for other documents and for the 1979 revision. It was thought that some of the changes re- proactive as well as reactive ethics. flected the specific cultural and legal configuration of the United Permeating the objectives, unique features, and steps involved States, and that a made-in-Canada code would better reflect Can- in developing the Code were several core beliefs that strongly ada’s culture (Dunbar, 1998; Sinclair, 1993; Sinclair, Poizner, influenced the process and outcome. First was the belief that no Gilmour-Barrett, & Randall, 1987). Having our own code also ethics code could keep up with developments in the field and, as appealed to our sense of national identity and the observation that such, needed to be more than lists of rules; rather, they needed to other countries (Britain, France, Australia, and Germany, to name help psychologists to think through dilemmas and new areas of only a few) had developed their own codes. practice. Second was the belief that ethical challenges and dilem- The group asked to work on this task, of which I was a member, mas were not best resolved by trying to decide which of the spent the first year exploring the purposes of ethics code as competing values or interests are good and which are bad; rather, reflected in the international and interdisciplinary literature, as it is a matter of deciding, based on higher-order values (e.g., well as their perceived strengths and weaknesses. (For details ethical principles), which value or interest should take precedence regarding this exploration and the next sections on the develop- in a particular situation (e.g., respecting the law vs. not harming ment of the Canadian Code of Ethics for Psychologists, see someone). A third core belief was that, in order for our discipline Sinclair, 1993, 1998, 2011; Sinclair et al., 1987). Based on the to truly protect the public, we need to aspire to ethical excellence results of this review, the group proposed four objectives for a as a discipline, not just worry about the bottom line. Related to this Canadian code: was the belief that disciplines need to act as moral communities; 1. To develop a code that would be more conceptually that is, they have a responsibility to ensure that the discipline as a whole and all members are self-reflective and, when serious con- cohesive and thereby a better educational tool for training flicts in values occur, do not put their own self-interests or those of in ethical practice. their discipline above their higher duty of care to those involved in 2. To develop a code that would be more inclusive of their activities. (Although the term “moral community” was not recently developed areas of practice. incorporated into the Code until the 2000 edition, I believe that a reading of the first two editions reflects this core belief.) 3. To give more explicit guidelines for action when ethical Locally, the impact of the Code included its adoption by psy- principles are in conflict. chology organisations across Canada. It also included a change in the 1992 revision of the APA code insofar as the revision acknowl- 4. To explicitly reflect the most useful decision rules (i.e., edged that members might need to go beyond the APA code to ethical principles) for ethical decision making. resolve some ethical dilemmas, and incorporated a possible role for personal conscience. The Code also led to changes in the ethics By 1986, after much consultation with Canadian psychologists questions for the Examination for Professional Practice in Psy- and many drafts, the first edition of the Canadian Code was chology (EPPP), which is the examination taken by psychologists adopted by CPA. The resulting document contained several fea- in most jurisdictions across North America who wish to become tures that were unique at the time for ethics codes, some of which registered in their jurisdiction. Until the 1990s, the ethics questions remain unique today: on this exam were based on the APA code, and often required familiarity with specific wording in the APA code, requiring 1. The underlying ethic was expressed as a social contract. Canadian graduate students to know the APA code in detail. As the Canadian Code became the adopted code across Canada, serving 2. The ethical standards (after a Preamble) were orga- as the basis for ethics training of our graduate students, a concerted nized around the four ethical principles espoused in the effort was put forth by ASPPB to change all the ethics questions on Code (Respect for the Dignity of Persons, Responsible the exam to those that could be answered correctly whether you Caring, Integrity in Relationships, and Responsibility were trained on the Canadian Code or the APA code. By the late to Society). 1990s, this was accomplished by making the majority of questions 3. The four ethical principles were ordered according the vignette based. relative weight each generally should be given when Local impact was not unexpected. The Code had been written they come in conflict, although some exceptions were for Canadian psychologists, and there was no expectation that its noted and it was stated that all four needed to be impact would go beyond what was relevant to Canadian psychol- considered. ogists. What was unexpected was the international impact of the Code. By 2000, it was evident that the fact that we had developed 4. Inclusion in the Preamble of a model for ethical deci- our own code, the approach we had taken in developing it, and its sion making. underlying core beliefs had captured the imaginations of many international psychology organisations. For example, the European 5. Inclusion of a role for personal conscience. Federation of Psychologists’ Associations (EFPA), which has 32 26 SINCLAIR member countries, developed the Meta-code of Ethics in 1995 included members whose cultural heritage was Eastern, as well as (European Federation of Psychologists’ Associations, 1995/2005). members who were of indigenous heritage. The resulting members Rather than being a complete code, it contained four ethical were from Canada, China, Colombia, Finland, Germany, Iran, principles and a set of values for each principle, which member New Zealand, Singapore, South Africa, the United States, and countries were to use in developing their own codes of ethics (but Zimbabwe. In addition to the diversity found in working group with specific ethics standards specific to the country). The Meta- members, the process also included broad international consulta- code was organized around its four ethical principles. Other ex- tion at congresses around the world, and regular reports to the amples of the influence of the Canadian Code can be seen in the IUPsyS General Assembly (with delegates from 85 countries) and ethics codes of such countries as Ireland, New Zealand, and the IAAP Board of Directors (with members from 60 countries). Mexico. To identify the most agreed upon and universal ethical princi- ples and values to be included, four avenues of research were 2001–2016 pursued: The next 20-year time period is not yet complete. We are still 1. Comparison of codes of ethics in psychology to identify living it. It has been a time of rapid development of the discipline commonalities in the ethical principles used to develop around the world, and a time of new ethical challenges related to them. (i) advances in technology, (ii) collaborative interdisciplinary prac- tice and research, (iii) increased legal and regulatory expectations, 2. Review of ethics codes of other disciplines to identify the and (iv) rapid globalization. ethical principles used. All of these areas are important to understanding developments in ethics in psychology since 2001. However, due to time and 3. Review of internationally recognised documents such as space limitations, I have chosen to concentrate on the area of the Universal Declaration of Human Rights and the Uni- globalization because I see it as having had the greatest impact on versal Declaration of Global Ethics to delineate the us in this time period and giving rise to the most interesting moral principles that underlie them. developments. Related to the increase in globalization are such factors as 4. Review of historical documents to identify the roots of advances in technology, increased ease of travel, economic devel- “modern” ethical principles. opments, and political events, which have given rise to the devel- opment of international structures and collaborations, as well as The first three avenues of research led to five principles that large-scale migrations of persons and peoples to other parts of the were eventually reduced to four (by combining Competence and world. Although positive views of globalization often cite the Caring): (i) Respect for the Dignity of Persons and Peoples, (ii) possibility of greater understanding, peace, cooperation, and har- Competent Caring for the Well-Being of Persons and Peoples, (iii) mony, negative views express concern of greater suffering due to Integrity, and (iv) Professional and Scientific Responsibility to increased opportunities for exploitation and domination (Pettifor, Society. The fourth avenue of research involved the study of 12 Sinclair, & Falender, 2014). different documents for physicians between the years 1750 BCE to In psychology ethics, the most important development related to 1948 CE, and included documents from Babylon, India, Greece, positive globalization in my view has been the development of the Persia, Egypt, Japan, China, and the United States (Reich, 1995). Universal Declaration of Ethical Principles for Psychologists The conclusion of this study was that, although they may be (2008). Begun in 2002, this document was a joint endeavour of the expressed in different words and in different ways across civiliza- International Union of Psychological Science (IUPsyS), the Inter- tions and across the centuries, the principles and values of the national Association of Applied Psychology (IAAP), and the In- ternational Association for Cross-Cultural Psychology. The work- Universal Declaration of Ethical Principles for Psychologists have ing group was under the leadership of Dr. Janel Gauthier from deep roots and can be considered fairly universal and timeless. Université Laval. (Dr. Gauthier is a former CPA President and a Details of the fourth avenue of research can be found in Sinclair current member of CPA’s Committee on Ethics.) The Declaration (2012), but the following are examples of some of the statements was not intended to be an ethics code. No specific ethical standards found in the historical documents: are included. Rather, it was intended to provide a moral framework Physicians should be ever ready to respond to any calls of patients, of ethical principles and values (similar to EFPA’s Meta-code) to high or low, rich or poor. He should treat them all equally. (Five help psychologists and psychology organisations around the world Commandments and Ten Requirements, China, 1617 CE) to (i) evaluate their current ethics codes, (ii) guide development or evolution of their ethics codes, (iii) encourage global thinking A physician must study medical books constantly and never grow about ethics, while encouraging action and standards that are tired of research. (Haly Abbas’ Advice to a Physician, Persia, circa sensitive and responsive to local needs and values, and (iv) help 950 CE) the global psychology community speak with a collective voice on Do not say of (what is) good; it is bad, nor of (what is) bad; it is good. matters of ethical concern. (Hebrew Oath of Asaph, Middle East, unknown country, circa Responding to the concern that previous ethical frameworks and 600 CE) codes for psychology tended to reflect primarily Western philos- ophy and Western worldviews, members of the working group You should always seek, whether standing or sitting, the good of all were drawn from the major regions and cultures of the world and living creatures. (Ayurvedic Instruction, India, circa 500 –300 BCE)  ETHICS IN PSYCHOLOGY 27 The impact of the Universal Declaration is growing. It has been widespread discrimination; cultural and other forms of adopted or endorsed by several other national and regional psy- oppression; economic exploitation; serious inequities in chology organisations (e.g., CPA, Interamerican Society of Psy- access to needed services, legal protection, and educa- chology, Psychological Society of South Africa), has been used in tion). We have a much better understanding now of what the development or revision of several codes of ethics (e.g., the issues are than we had several decades ago. However, Australia, Guatemala), and has been applied in responding to as recently expressed by four Maori psychologists, it is specific ethical problems (e.g., Ferrero, 2014; Fitzgerald, Hunter, an area which has and will continue to challenge us: Hadjistavropoulos, & Koocher, 2010; Pettifor & Ferrero, 2012). It also has had an impact on CPA’s recent process of revision to its Psychology, which, as a discipline, has a fine record of defining and upholding ethical practice, has yet to make a serious impression on Code and, in my view, holds much promise for the future. (For injustices worldwide. (Tassell, Herbert, Evans, & Young, 2012, p. further detail regarding the development and use of the Universal 187) Declaration of Ethical Principles for Psychologists, see Gauthier & Pettifor, 2011, 2012; Gauthier, Pettifor, & Ferrero, 2010.) Conclusion The Future I believe the above travelogue demonstrates that we have evolved from being a discipline that was primarily self-focused And so we’ve come to the end of this travelogue (admittedly and paid little formal attention to ethics in the 19th and early 20th brief and selective) of modern psychology’s ethics journey from century, into a discipline with a keen interest in ethics and a the mid-19th century to the present. It is difficult to predict where heightened awareness of our discipline’s responsibility, both as that journey will take us and what our future challenges will be. individuals and as a collective, to serve the welfare of society over However, I think the following four areas will part of the picture self-interest. Although we still have a long way to go, there are in the immediate future: numerous examples of increasing attempts to integrate ethical awareness, training, and expectations into every form of psychol- 1. There is increased recognition that ethics education and ogy activity. Nevertheless, it is important for us to remember that training needs to be intensified and needs to prepare our journey is far from over. In fact, as it is for all disciplines, it students emotionally, not just cognitively, for the type of will never be over. challenges they will face (e.g., Pettifor et al., 2014; Rogerson, Gottlieb, Handelsman, Knapp, & Younggren, 2011). I believe one of our challenges will be to learn Résumé how to best train students and ourselves (as researchers, La psychologie moderne en a fait du chemin au cours des dernières practitioners, trainers, supervisors, administrators, etc.) to décennies en matière d’éthique. Dans le présent article, en exam- think and to act ethically in the midst of political, organi- inant différentes périodes de temps depuis le milieu du 19e siècle sational, collegial, and personal pressures to do other- jusqu’à aujourd’hui, je fournis un aperçu et des réflexions person- wise, and how to implement such training with the struc- nelles sur les principaux événements et changements de mentalité tures and resources it needs. qui se sont imposés au cours de ces époques, en plus de souligner certains des défis éthiques auxquels nous devrons faire face, à mon 2. There are many changes in society that are occurring avis, dans un proche avenir. J’y explore le rôle des événements around us, and which will continue to do so. For Cana- locaux et mondiaux ainsi que le rôle des scandales, des préoccu- dian psychologists, for instance, this includes continuing pations communautaires, des évolutions juridiques en matière de rapid development of technology, changes in Canadian réglementation, de la mondialisation et des changements de men- law regarding end-of-life decision making and use of talité concernant les prises de décisions éthiques et les règles vs cannabis, and changes in the Canadian demographic l’éthique fondée sur les aspirations. J’ai porté une attention par- around aging. These types of changes will not stop, and ticulière aux scènes nationale et internationale, dont les contribu- we as a discipline will be challenged to deal with them tions à l’Association canadienne de psychologie, au Code canadien with care and thoughtfulness, rather than becoming over- de déontologie professionnelle des psychologues et à la déclaration whelmed by them. universelle des principes de déontologie à l’intention des psycho- logues. 3. In spite of many advances in awareness of the importance of culture in every aspect of psychology, I believe that we Mots-clés : code d’éthique, prise de décision éthique, lignes direc- still have a good distance to go. 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