Twenty-First Century Ethical Challenges for Psychology
Gerald P. Koocher Simmons College
Foreseeable social and technological changes will force us to reevaluate our thinking about ethically appropriate ways to fulﬁll our mission of using psychology to advance human health and welfare in the twenty-ﬁrst century. Three categories of challenge related to societal andtechnological changes have become particularly evident. First, increasing patterns of delivering services over substantial distances by electronic means (i.e., telepsychology) demand consideration. Second, we must parse our ethical obligations to individuals, to groups, and to society at large as our inﬂuence working behind the scenes as “invisible” psychologists grows. Finally, as we witness theaccelerating demise of psychiatry, we must take care not to follow a similar path. As we face new ethical challenges, we must continually ask ourselves where our responsibilities lie as individuals and as a profession. We must learn not to repeat the mistakes of the past and focus instead on optimizing the future for a science and practice of psychology focused on human health and welfare.Keywords: conﬁdentiality, ethics, psychiatry, telehealth, telepsychology
And I believe These are the days of lasers in the jungle Lasers in the jungle somewhere Staccato signals of constant information . . . —Paul Simon, “The Boy in the Bubble”
parsing our ethical obligations to individuals, to groups, and to society at large as many of our colleagues practice outside the view of those affected bytheir work. Finally, as we watch the decline of psychiatry as a profession, we must learn from its errors.
Rapid advances in microelectronics have made portable communication devices, data, image, and sound storage devices, and a wide range of transmission devices affordable and readily available in much of the world. A broad array of personal communications and businesstransactions now occur in the realm of cyberspace. We must expect that psychologists will increasingly face expectations by our clients to provide services in the context of their preferred modes of communication. As we move away from the traditional context of sitting face to face with our clients across a room, the Greek preﬁx tele, meaning from a distance, comes to mind and leads naturally to aconsideration of the ethics of telepsychology. What we traditionally agreed to as we formed alliances and contracts with clients in the past will certainly require rethinking, as will our traditional professional standards. From the perspective of professional ethics, we need to consider four Cs: contracting, competence, conﬁdentiality, and control. What contracts or agreements for providing serviceswill we make with our clients? What competencies will we need in order to offer services remotely? What new factors will constrain conﬁdentiality protections? Who will control the practice of telepsychology (i.e., the regulation of practice and data access)? Contracting Psychotherapists now offer clinical services around the world by telephone and via the Internet through e-mail, chat rooms, Websites, and interactive audio and video
Editor’s note. Gerald P. Koocher was president of the American Psychological Association (APA) in 2006. This article is based on his presidential address, delivered in New Orleans, Louisiana, at APA’s 114th Annual Convention on August 11, 2006. Author’s note. Correspondence concerning this article should be addressed to Gerald P. Koocher, School for HealthStudies, Simmons College, 300 The Fenway, Boston, MA 02115. E-mail: firstname.lastname@example.org
lthough written more than two decades ago, Paul Simon’s (1986) lyrics for “The Boy in the Bubble” highlight many of the issues we face as twenty-ﬁrst century psychologists. His words call our attention to the horrors of terrorism in the daily lives of ordinary people, dramatic advances in science and medicine,...