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Empowering psychologists to evaluate revisions to the APA ethics code

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Empowering psychologists to evaluate revisions to

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Samuel Knapp , Michael C. Gottlieb & Mitchell M. Handelsman

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Empowering psychologists to evaluate revisions to the APA ethics code, Ethics & Behavior, DOI:
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ETHICS & BEHAVIOR
https://doi.org/10.1080/10508422.2020.1778479

Empowering psychologists to evaluate revisions to the APA ethics

code
Samuel Knappa, Michael C. Gottliebb, and Mitchell M. Handelsmanc
a
PA Psychological Association; bIndependent Practice; cDepartment of Psychology, University of Colorado Denver

ABSTRACT KEYWORDS
The authors argue that individual psychologists have an obligation to Ethics; ethics code;
understand, review, and comment on upcoming revisions of the Ethical aspirational ethics
Principles of Psychologists and Code of Conduct. Psychologists may want to
consider several factors as they review and prepare comments on these
revisions. Among other things, commenting psychologists should consider
(a) the purposes of ethics codes and how the writing of a code can meet or
balance these often-conflicting purposes; (b) the overarching ethical theory
or theories that should form the basis of the APA Ethics Code; and (c) the
extent to which individual standards are useful and comprehensive, and
avoid unnecessary harm to both the public and psychologists. The authors
provide examples from the current and recent APA Ethics Codes to illustrate
the types of decisions that psychologists must make when evaluating
revisions to the APA Ethics Code.

Professions are occupations that require advanced training, responsibility to others, the use of
judgment in daily practice (as opposed to the application of predetermined procedures), and an
obligation to advance public well-being (Cruess et al., 2004). At this writing, the American
Psychological Association has appointed a task force to begin drafting revisions to its Ethical
Principles of Psychologists and Code of Conduct (American Psychological Association, 2017; herein­
after referred to as the APA Ethics Code, or Code). The membership will have the opportunity for
input before the APA Council of Representatives officially votes to approve the Ethics Code. The
purpose of this article is to assist psychologists in identifying some of the issues they should consider
when they evaluate the forthcoming revisions.
Because of the complexity of the Code and its applicability across the wide range of psychological
practice and research, our review cannot be comprehensive. Instead, we identify some of the major
issues to be considered, based upon four assumptions. First, we assume that the final version of the
Code will turn out to be more useful, be less ambiguous, and avoid more inadvertent harm if many
psychologists review and comment on the draft changes to the Code. Members of the American
Psychological Association represent a great diversity in age, income levels, gender, gender identifica­
tion, cultural backgrounds, religious beliefs, and work experiences that no small deliberative group
can match. Only those who engage in those areas of practice, teaching, or research will fully
understand the unique ethical issues found in their domain of work. Consequently, the Ethics
Code will avoid inadvertently problems by having a wide variety of psychologists review it and
offer perspective that may not seem obvious to others.
Second (and in addition to being a matter of enlightened self-interest), we assume that all
psychologists have an obligation to review potential changes to the Code, stemming from their
obligations to practice ethically and to understand the ethical implications of their professional
behavior. One’s responsibility for ethical behavior, and therefore to review changes to the Code,

CONTACT Samuel Knapp SamuelKnapp52@yahoo.com 1220 Tasman Drive, SPC 106, Sunnyvale, CA 94089
Copyright © 2020 Taylor & Francis Group, LLC
2 KNAPP ET AL.

cannot be delegated to others. Doctoral programs commonly include provisions in their student
handbooks that students agree to comply with the APA Ethics Code as a condition of enrollment as
a student. In addition, psychologists who retain membership in APA agree to abide by these
standards. Also, psychologists who become licensed agree to abide by the standards of the licensing
board which are either identical to the APA Ethic Code or a modified version of the Ethics Code. It
would seem reasonable that psychologists should understand the standards that they have committed
themselves to follow and object and seek to change proposed standards that they deem unwise.
Finally, not all psychologists can be experts on ethics, but all psychologists should have some
familiarity with the goals and structure of the APA Ethics Code and the types of decisions that are
made when revising it. Psychologists who study the revisions of the Ethics Code should be better
prepared to understand and implement the new version of the Ethics Code more effectively. They
are more likely to act ethically if they understand the moral foundations of the APA Ethics Code and
the reasons why the standards are written the way they are.
In this article we consider some of the factors that psychologists should consider when they
evaluate and prepare comments to proposed revisions to the APA Ethics Code. By necessity, this
review cannot consider all the potential factors that need to be considered. Nonetheless, we suggest
that psychologists should consider whether the standards of the APA Ethics Code fulfill the purposes
of an ethics code, whether the standards are based on an overarching ethical theory, whether the
individual standards of the APA Ethics Code are useful and comprehensive, and whether they avoid
unnecessary harms. We review the purposes of the APA Ethics Code and then we consider factors
involved in writing individual enforceable standards.

PURPOSES OF THE APA ETHICS CODE

Ethics codes serve many purposes. Promoting public welfare is an essential goal of any ethics code
(Francis, 2009; Lindsay, 1996; Pettifor, 2004). The Preamble of the APA Ethics Code states that one
of its goals is to promote “the welfare and protection of the individuals and groups with whom
psychologists work” (American Psychological Association, 2017). The Preamble also identifies
another purpose of the APA Ethics Code, which is “the education of its members, students, and
the public regarding ethical standards of the discipline.” Other goals include expressing the highest
ideals of the profession (Fisher, 2012), guiding ethical decision making (Hadjistavropoulos et al.,
2002), assisting and protecting psychologists, and furthering the political, economic, and scientific
interests of the profession.
Although these goals may conflict with each other at times, the different purposes of the APA
Ethics Code complement each other, in part because the other goals may serve public welfare in
indirect ways. For example, the highest ideals of the profession, if they are based on well-established
ethical theories and reflect good ethical decision making, should promote public welfare to the extent
that they improve the behavior of psychologists toward their service recipients. Educating students
and trainees regarding their professional obligations is also consistent with public protection. Even
the goals of assisting psychologists and furthering their interests do not conflict with public
protection to the extent that the code helps guide psychologists away from behaviors that harm
the public.
In this section, we now expand on each of the major purposes the APA Ethics Code, describe the
Code’s scope, consider criticisms of ethics codes, and describe the role of an overarching ethical
theory in brokering conflicts that may arise among its different goals.

Promoting or protecting public welfare

At their core, the enforceable standards of the APA Ethics Code protect the public to the extent that
they prohibit psychologists from engaging in activities that could harm it and mandate that
psychologists engage in other activities that could benefit it. For example, the APA Ethics Code
 EMPOWERING PSYCHOLOGISTS TO EVALUATE REVISIONS TO THE APA ETHICS CODE 3

prohibits psychologists from engaging in sexual harassment (Standard 3.02) and mandates that
psychologists protect the public by demonstrating competence when delivering services (Standard
2.01) and seeking the informed consent of psychotherapy patients (Standard 10.01). As researchers
and scholars, psychologists agree to seek the informed consent of research participants (Standard
8.02, albeit with a few exceptions, Standard 8.05), treat animals humanely (Standard 8.09), and avoid
plagiarism (Standard 8.11) among other obligations.
In addition, most state boards of psychology – in an effort to fulfill their public protection
mission – have adopted the APA Ethics Code, or some variation of it, as part of their regulations
governing their licensees. Although all members of APA (both practitioners and researchers) are
expected to adhere to the APA Ethics Code, licensed nonmembers of APA must also follow it to the
extent that it is embodied in the regulations of state boards of psychology.

Expressing ideals of the profession

Ethics codes can express the highest ideals of the profession and exhort professionals to act
responsibly. The APA Ethics Code contains General (aspirational) Principles specifically intended
to “inspire psychologists toward the very highest ideals of the profession” (American Psychological
Association, 2017). The General Principles are distinct from the enforceable standards in that they
cannot be used as a basis to discipline psychologists, but they delineate major values of the culture of
psychology that trainees and practitioners should learn and integrate into their professional iden­
tities (Handelsman et al., 2005).

Promoting psychology as a profession

The APA Ethics Code protects the profession of psychology and promotes psychology as a scientific
discipline. The Code functions as a public relations statement with the intent to reassure the public
regarding psychology’s standards of behavior (Martin, 2000). As such, it may increase public trust
and encourage legislative and public support for psychology (Dunbar, 1998). Ethics codes can also
help restrain unscrupulous members of the profession who could act to give themselves an unfair
economic advantage over others (Martin, 2000) or otherwise harm the image of psychology to the
extent that they harm or exploit the public.

Assisting and protecting psychologists

The APA Ethics Codes supports and assists those who strive to act responsibly (Martin, 2000). For
example, when organizations or other external sources pressure professionals to act unethically,
those professionals may cite the Code to justify their resistance to the organization’s policy.
In addition, The APA Ethics Code can help psychologists become more effective and efficient
because it aides them in thinking through ethical issues they may encounter. Psychologists who face
difficult ethical issues can refer to the Code and rely upon the collective judgment of the profession
for guidance, because the conclusions derived from the reflective deliberations of their professional
association are likely to have greater ethical justification than those reached by a single practitioner
or researcher acting alone and under pressure.
The APA Ethics Code can help psychologists think through ethical dilemmas, but no ethics code
can anticipate every ethical dilemma that psychologists may encounter. When faced with such
dilemmas, the aspirational principles “should be considered by psychologists in arriving at an ethical
course of action” (American Psychological Association, 2017, Introduction and Applicability).
In a few situations, the APA Ethics Code assists psychologists by explicitly protecting them. For
example, Standard 10.10b states that “psychologists may terminate therapy when threatened or
otherwise endangered by the client/patient or another person with whom the client/patient has
a relationship.” One could argue that this standard is not self-serving because it is ethically justified
4 KNAPP ET AL.

to protect psychologists from harm to themselves from dangerous persons in the same way that
psychologists have a duty to protect members of the public from dangerous patients. Nonetheless,
psychologist self-protection is explicitly recognized in this standard.

Educating students and professionals

Because of their importance to the profession, ethics codes are also educational tools (Lindsay, 1996)
that “sensitize practitioners and educate novices to see moral obligations” (Kallenberg, 2002, p. 50)
and to help them form their professional identities. Students will learn that technical skills are not
sufficient to be an effective psychologist. They need to implement these skills in the context of a well-
considered value system (Handelsman et al., 2005). A review of syllabi of ethics courses in doctoral
programs in psychology showed that almost all of them required reading the APA Ethics Code, and
some also required reading the codes of the National Association of School Psychologists or the
American Counseling Association (Rodriguez et al., 2014).

THE SCOPE OF THE APA ETHICS CODES

The APA Code, like any ethics code, is not, nor is it intended to be, entirely synonymous with ethics.
For example, the Code places social justice issues in aspirational terms. However, some of the most
pressing ethical issues of our profession deal with matters of social justice, such as unequal access to
psychological services, racial/ethnic tensions within society, discrimination against sexual minorities
and historically marginalized groups, or social conditions that increase the risk of mental illness.
These issues are not addressed fully or directly in the APA Ethics Code but should be considered
important by any ethical psychologist. “The highest levels of ethical excellence, found in outstanding
therapists, go well beyond what codes can spell out” (Tjeltveit, 1999, p. 165).
No ethics code could ever include all the ethical issues that should be of concern to a professional
(Beauchamp & Childress, 2019). The Preamble to the APA Ethics Code states that it addresses “most
situations encountered by psychologists.” Nonetheless, society changes rapidly, and no ethics code
could accurately predict all the issues or dilemmas that may arise in the future. For example, the
framers and reviewers of the 2002 APA Ethics Code could not have predicted the extensive and rapid
proliferation of telehealth services or social media. However, the APA Ethics Code contains
principles and standards that psychologists can apply to novel situations.
Another aspect of scope is a decision-making model. The inherent inability of an ethics code to
cover all possible situations requires psychologists to use their decision-making skills when the
course of action is not obvious. The reviewers of the APA Ethics Code need to determine whether it
should include a specific, preferred, decision-making model, or whether it should (continue to)
encourage individual psychologists to rely on their own decision-making model.
Furthermore, ethics codes alone cannot ensure ethical behavior (Bazerman & Tenbrunsel, 2011),
because unethical behavior often results from individual characteristics and/or situational pressures
(Kish-Gephart et al., 2010). For example, emotional and cognitive biases, such as loyalty to friends,
self-interest, fear of reprisals, and biases such as the confirmation bias may lead psychologists to act
in ways that they know (or would recognize upon reflection) are not right (Rogerson et al., 2011;
Smith et al., 1991).

CRITICISMS OF ETHICS CODES IN FULFILLING THEIR PURPORTED GOALS

Some older versions of ethics codes, at least from our current perspective, appear obviously self-
serving and contrary to the goal of promoting public welfare. For example, earlier versions of
medical codes did not permit physicians to criticize the behavior of other physicians, thus depriving
patients of the benefit of an honest second opinion and protecting incompetent physicians from
criticisms (Beauchamp & Childress, 2019). For many years, the ethics codes of engineers and
 EMPOWERING PSYCHOLOGISTS TO EVALUATE REVISIONS TO THE APA ETHICS CODE 5

attorneys prohibited them from advertising their fees; courts later banned these restrictions (Martin,
2000), and the APA was forced to make similar changes to the APA Ethics Code at that time
(Koocher, 1994.) These and similar problems with ethics codes led Dunbar (1998) to claim that
ethics codes provide only a veneer of respectability with little intent to improve the behavior of its
members. Pope (2016) made similar charges that the 2002 APA Ethics Code largely protected guild
interests.
These criticisms need to be taken seriously, as it is possible that any profession could, either
deliberately or inadvertently, include provisions in a code that promotes its own interests at the
expense of public welfare. No ethics code can be entirely free of self-serving elements, but these
elements can be kept in check if the ethics code rests upon a foundation derived from an overarching
ethical theory. More specifically, the drafters of any ethics code should be able to point to an ethical
theory to justify the enforceable standards within the code, because ethics codes “are justified by
general moral requirements” (Beauchamp & Childress, 2019, p. 7). For example, informed consent
standards derive from the foundational principle of respect for autonomy, which itself could be
justified by deontological theory.

WHAT SHOULD BE THE FOUNDATION OF THE APA ETHICS CODE?

Since its 1992 revision, the APA Ethics Code has used principle-based ethics as its basis.1 Nothing
requires that new iterations of the APA Ethics Code should continue to rely on this ethical theory,
although principle-based ethics is the primary ethical theory relied upon in health care today.
According to principle-based ethics, moral agents should follow overarching ethical principles –
sometimes called prima facie principles – because, on their face, they seem like reasonable values to
have (Ross, 1998). According to some authorities, the overarching principles most relevant to
professional services include beneficence (promoting the well-being of service recipients), nonma­
leficence (not harming service recipients), respecting patients’ autonomous right to make their own
decisions, justice (treating persons fairly; Beauchamp & Childress, 2019), fidelity or faithfulness to
promises (Kitchener, 1984), and public beneficence (promoting the well-being of the public in
general), which was added later (Knapp et al., 2015; Knapp & VandeCreek, 2004).2 This approach
does not list these prima facie principles in any particular order, as do other approaches, although
some would argue that nonmaleficence should trump the others (Beauchamp & Childress, 2019).
An ethical dilemma arises if one or more of these prima facie principles conflicts with another. At
that point, a decision-making process must determine which principle takes precedence (Ross, 1998).
When one principle overrides the others, an effort must then be made to minimize harm to the
offended moral principle or principles (Beauchamp & Childress, 2019).

Writing specific enforceable standards

Many of the practical implications of the prima facie principles can be found through the specific
standards of the Ethics Code. We can better understand how the APA Ethics Code can fulfill its
purposes through the enforceable standards if we understand the three different types of standards
found in the Ethics Code and how they derive from ethical principles.

1
Other organizations may have differing theoretical foundations for their ethics codes. For example, the American Association of
Christian Counselors states that a foundational source of their code is The Holy Scriptures (American Association of Christian
Counselors, 2014) and the Feminist Code of Ethics is rooted in feminist ethics which gives special emphasis to issues of
oppression and social activism (Larsen & Rave, 1995).
2
These six principles correspond roughly, but not exactly, to the five aspirational principles of the APA Ethics Code. For example,
the APA Ethics Code combines beneficence and nonmaleficence into one principle. Nonetheless, the content of these principles
is largely congruent.
6 KNAPP ET AL.

Standards that link directly to prima facie principles

Certain standards, such as 2.01a (Boundaries of Competence); 3.04 (Avoiding Harm); 3.10a
(Informed Consent); and 3.01 (Unfair Discrimination), connect directly to prima facie principles.
Knapp et al. (2017) called these key or foundational standards.
For example, Standard 2.01a (Boundaries of Competence) is closely linked to the prima facie
principle of beneficence in that it requires psychologists to promote the well-being of service
recipients by ensuring that psychologists are competent in their work.3 Standard 3.10a (Informed
Consent) relates primarily to the overarching ethical principle of respect for patient autonomy. It
requires psychologists to encourage or at least accept the autonomous decision making of service
recipients or research participants by ensuring that they have accurate information upon which to
make decisions (obtaining informed consent).

Standards that amplify or apply foundational standards

Other standards in the APA Ethics Code expand upon or apply the foundational standard to specific
situations. The amplifying standards can help educate psychologists by providing important exam­
ples of how to apply the foundational standards and the prima facie principles behind them.
For example, informed consent applies not just to professional services such as treatment and
assessment (Standards 10.01 and 9.03), but to forensic work (Standard 3.10 c), organizational
consulting (Standard 3.11), and research (Standard 8.02). One could argue that Standards 3.10 c
(informed consent in forensic work), 3.11 (informed consent when psychological services are
delivered to or through organizations), 8.02 (informed consent to research), 9.03 (informed consent
in assessments), and 10.01 (informed consent in psychotherapy) are unnecessary because careful and
thoughtful psychologists could infer how to apply Standard 3.10 in these specific situations.
However, the additional standards fulfill an educational purpose by explaining how psychologists
should apply the prima facie principle in differing situations.

Standards that balance competing ethical principles

Some standards modify or qualify the obligations or prohibitions found in the foundational
standards. For example, the requirement that psychologists must be competent in all the work
that they do can be modified in certain situations, such as in emergencies (Standard 2.02). Consistent
with principle-based ethics, a prima facie principle can only be overridden if it conflicts with another
prima facie principle. As it applies to emergencies, psychologists may intervene in an emergency in
an area outside of their ordinary field of competence to ensure the stability of a person in crisis.
Here, the principle of nonmaleficence (avoiding harm to another person) overrides beneficence
(promoting the well-being of service recipients). In addition, efforts should be made to minimize
harm to prima facie principles when they are trumped (Beauchamp & Childress, 2019). In emer­
gencies, when psychologists deliver a service in an area of practice outside of their ordinary sphere of
competence, “the services are discontinued as soon as the emergency has ended, or appropriate
services are available” (Standard 2.02).

BALANCING USEFULNESS, COMPREHENSIVENESS, AND AVOIDANCE OF HARM

In addition to linking the standards to overarching ethical principles, the purposes of an ethics code
are better fulfilled if its standards are useful (understandable and teachable), are comprehensive, and
avoid unintended negative consequences. Standards are useful when they inform the public and
professionals exactly what is prohibited or required. That is, both psychologists and the public
3
In each of these examples, one might be able to find several principles that support or relate to an enforceable standard. For
example, one could argue that 2.01a relates to respect for patient autonomy because patients tend to do better in treatment
when their preferences are respected. For purposes of the present discussion, however, we are focusing on the prima facie
principle that appears most closely related to the foundational standard.
 EMPOWERING PSYCHOLOGISTS TO EVALUATE REVISIONS TO THE APA ETHICS CODE 7

should understand when a psychologist has violated or fulfilled a standard. Standards are compre­
hensive when they are written in a sufficiently broad manner to cover the anticipated behaviors.
At first glance, these criteria seem straightforward and noncontroversial. Some standards can
meet all the criteria easily, such as the foundational standard that prohibits psychologists from
engaging in unfair discrimination (3.01), and application standards such as those that prohibit sexual
harassment (3.02), sexual exploitation (10.05), harm to research participants involved in experiments
involving deception (8.06b), or fabricating research data (8.10a).
In other situations, standards must balance usefulness, comprehensiveness, and avoidance of
unnecessary harm. A standard might not be entirely comprehensive without losing some of its
usefulness, or a standard might be comprehensive but create or increase the possibility of an
avoidable harm. In this section, we provide examples of how the current or previous versions of
the APA Ethics Code have managed some of these conflicts.

USEFULNESS VERSUS COMPREHENSIVENESS

One challenge in writing and revising standards is to determine when or how to include useful
standards that derive clearly from overarching ethical principles or which amplify or apply specific
foundational concepts. On one hand, the usefulness of the Code is enhanced when its standards are
short and straightforward. On the other hand, the comprehensiveness of the Code is enhanced when
it covers a wide range of topics, goes into some detail in the topics that it covers, and amplifies how
to apply the code in real-life situations. Thus, the standards that apply the overarching principles
may explain the purpose of the code in situations that might not be obvious to the average reader.
Although adding amplifying standards may have value, adding such standards could have the
drawback of creating a seemingly endless list of possible applications. “Any attempt to specify in
advance the manner in which a code be read and followed seemingly leads to an infinite regress; one
needs a rule for interpreting the rules of interpretation for interpreting the code, and so on”
(Kallenberg, 2002, p. 51). At some point, students and professionals must learn how to think
through some problems or dilemmas on their own; they should not expect an ethics code to do
everything for them. That is, a principle-based ethics code does not only tell psychologists what to
do, but what issues to think about and what factors to consider.
To extrapolate from the findings of Goldilocks, we believe that an ethics code should strive for
standards that are neither too broad nor too short. Below we offer some examples of how this applies
in the standards of the APA Ethics Code, although readers could identify many other examples. For
example, Standard 2.01a is a foundational standard that requires psychologists to actualize the
overarching ethical principle of beneficence by performing their duties competently. One could
argue, therefore, that Standard 2.01b (Competence with Diverse Populations) and other standards in
Section 2 are unnecessary because competence logically requires emotional, technical, cultural, and
all other aspects of competence. However, here it appears that the framers of the APA Ethics Code
appeared to emphasize the educational function of the Code; they might have believed it was
important to emphasize cultural competence because not all psychologists think of cultural diversity
when they think of competence.
Usefulness also competes with comprehensiveness in Standard 3.06, which requires psychologists
to avoid conflicts of interest. One conflict of interest could affect APA members who are school
psychologists employed by a public school and in independent practice. They could provide
a psychological service in their independent practice to a student who lives in their district, without
informing the parents that the school district could offer the service for free. However, the code of
ethics of the National Association of School Psychologists (NASP) explicitly states that school
psychologists “are obligated to inform parents or other potential clients of any psychological and
educational services available at no cost from the schools prior to offering such services for
remuneration” (National Association of School Psychologists, 2010, Standard III.4.9). Of course,
some parents may have good reasons to hire the school psychologist independently. However, the
8 KNAPP ET AL.

NASP standard requires school psychologists to tell them of the possibility that they could get free
services from the district.
Such a detail may be appropriate in a code of ethics for school psychologists, but reviewers of the
APA Ethics Code need to consider whether such details would be appropriate in a code of ethics for
all psychologists, or whether it would be better addressed in guidelines or commentaries on the APA
Ethics Code. If such details should be included in the APA Ethics Code, should the Code attempt to
identify and address common conflicts of interest for I/O, forensic, child, sports, or other psychol­
ogists? To do so would increase the comprehensiveness of the Code; however, this and similar
additions could greatly expand the length of the APA Ethics Code to the point of it being unwieldly,
thereby detracting from its usefulness. In addition, the expansion of the list risks reducing the APA
Ethics Code to a checklist and minimizes the importance of professional judgment and decision
making. The drafters and reviewers of the Code need to determine if increased comprehensiveness
would outweigh the usefulness of brevity. The APA guidelines may serve a function here, to the
extent that they can expand upon the application of enforceable principles in specific areas of
practice.
The wording of a standard may require balancing usefulness with comprehensiveness. For
example, Lindsay (1996) commented that Standard 1.17 of the 1992 APA Code, which addressed
multiple relationships, was too long because it enumerated persons for whom multiple relationships
should be avoided (“persons such as patients, clients, students, supervisors, or research participants”;
American Psychological Association, 1992). He claimed that listing these exemplars should be
avoided, because the wording is redundant, adds to the length of the code unnecessarily, and
precludes thoughtful deliberation. On the other hand, Martindale (2007) praised standard 1.17 of
the 1992 version of the APA Ethics Code and criticized the 2002 revision, which deleted references to
examples of the groups that could be impacted by a multiple relationship.
The drafters of the 2002 revision appear to have reached the same conclusion as Lindsay, deleting
the list of persons with whom multiple relationships should be avoided. The Code simply notes that
such relationships should be avoided if they “could reasonably be expected to impair the psychol­
ogist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist,
or otherwise risk exploitation or harm to the person with whom the professional relationship exists”
(Standard 3.05a). Listing all the impacted persons will not increase the comprehensiveness or
applicability of the code, but it does increase its length and may reduce its usefulness. Revisions of
the APA Ethics Code must continue to balance the benefits of comprehensiveness with the draw­
backs of having an unacceptably long and detailed code that inadvertently may reduce the need for
professional judgment.

Usefulness versus harmful consequences

The standards in the APA Ethics Code are useful to the extent that they clarify the prohibitions and
obligations placed on psychologists and inform psychologists and members of the public about what
conduct can be reasonably expected of them. However, drafters and reviewers of the APA Ethics
Code must balance usefulness with potential harmful consequences to either service recipients or
psychologists. Ethics codes often achieve this balance by using modifiers or qualifiers such as
“reasonable” or “foreseeable.” Nonetheless, others have criticized the APA Ethics Code because it
had too many “lawyer-driven ‘weasel words’” (Bersoff, 1994, p. 384; Pope, 2016).
The APA Ethics Code addresses the use of qualifiers in its Introduction and Applicability Section,
explaining that it includes modifiers when

they would (1) allow professional judgment on the part of the psychologist; (2) eliminate injustice or inequality
that would occur without the modifier, (3) ensure applicability across the broad range of activities conducted by
psychologists; or (4) guard against a set of rigid rules that might be quickly outdated.
 EMPOWERING PSYCHOLOGISTS TO EVALUATE REVISIONS TO THE APA ETHICS CODE 9

This perspective on including qualifiers rests on the belief that “no moral theory or professional
code of ethics has successfully presented a system of moral rules free of conflicts and exceptions”
(Beauchamp & Childress, 2019, p. 16).
Modifiers in standards allow psychologists to use their discretion when necessary to implement
the code. For example, psychologists should initiate the informed consent process consistent with the
principle of respect for patient autonomy. However, sometimes the principle of respect for auton­
omy may conflict with beneficence. For example, psychologists may have initial sessions with
patients who exhibit an imminent danger of harming themselves. Here, the obligations to protect
the safety of the patients by creating suicide management strategies quickly (consistent with the
principle of beneficence) may conflict with the obligation to inform the patient of the many facets of
treatment and office policies (consistent with the principle of respect for patient autonomy).
As one example of the use of modifiers, psychologists who focus conscientiously on fulfilling the
obligations of respecting patients’ autonomy before treatment begins (informed consent) may risk
violating their moral obligation to promote the well-being of their patients. Consequently, Standard
10.01a balances these potentially competing obligations by requiring psychologists to have the
informed consent discussions “as early as feasible.” This phrasing avoids the absurd situation
where a psychologist would violate the APA Ethics Code by working to save the life of a suicidal
patient instead of spending the time reviewing the informed consent document’s information about
office forms, use of credit cards, and other mundane billing and office details. Although beneficence
(providing services to the patient) trumps respect for patient autonomy (informed consent), an effort
is made to minimize harm to respect for patient autonomy by having the informed consent
discussions “as early as feasible.”

SUMMARY AND CONCLUSION

In this article we have tried to identify some of the more salient issues that psychologists will need to
consider as they fulfil their obligation to review and understand the revisions of the APA Ethics
Code. We have presented information on the types of decisions that psychologist/reviewers will have
to make and given examples, with minimal comment on the desirability of the options. We contend
that psychologists should recognize that the Ethics Code serves many functions, and to the extent
possible, it should be anchored by an overarching ethical theory. Apparent conflicts of interest
between the promotion of professional welfare and public welfare should be considered by analyzing
the conflict from the standpoint of an ethical theory and anchoring enforceable standards on some
overarching ethical value. Proposed standards and changes can better fulfill their function if they
balance usefulness, comprehensiveness, and an attempt to avoid harms. Although we take no stand
on how these issues can be resolved, we encourage psychologists to recognize the issues themselves.

PUBLIC IMPACT STATEMENT

All psychologists should strive to review and comment on the proposed revisions to the APA Ethics Code. This article
reviews some of the issues that psychologists should consider as they evaluate these revisions.

DISCLOSURE STATEMENT
No potential conflict of interest was reported by the authors.

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