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PRACTICUM IN HUMAN SERVICES

Ethics in Psychological and Psychiatric Therapy


Katherine Estrada Spring Semester 2013

Like many other fields, psychology and psychiatry require various ethical guidelines. Psychiatrists and psychologists are forced to the same ethics as any other physician. Professionals in these fields are faced with the difficulty of creating an intimate bond with highly vulnerable individuals while remaining detached. Along with this, professionals are forced to keep high regard for human dignity while preventing themselves from straying away from the middle ground between professionalism and empathy. The Ethical Principles of Psychologists and Code of Conduct, along with the American Psychiatric Associations Principles of Medical Ethics, outlines the ethical expectations of each respective field. Both documents enforce and reinstate the need for patient confidentiality, requirement to keep relationships ethical, the need to inform patients of certain records, and competence. Having a patients full trust is crucial in therapy and professionals must abide by confidentiality rules. Despite this, confidentiality rules in both fields state that the physician is required to inform others of certain confidential information if the patient is a threat to their self or others around them. It is stressed that professionals in each field keep their personal issues aside and give the best treatment possible. Professionals are to conduct himself with respect towards patients, employees, and colleagues in order to act in the best interest of the patients treatment. Deception in psychological cases is frowned upon, such as the "John/Joan" case in which the patient, David Reimer, born Bruce Reimer, underwent sex reassignment at only 22 months old under the directions of the psychologist, Dr. John Money. When Money was informed his patient had a twin brother he could use as a control, he saw the opportunity to prove his theory that children are not feminine or masculine by nature, but rather through nurture are socialized to become girls or boys. Now going by the name of Brenda, Reimers gender reassignment, did not

go as planned as she rejected girls clothing and toys at the tender age of 2. Moreover, Moneys techniques have been regarded as unethical due to the over sexualisation of their therapy sessions. Dr. Money reported on the case successful, claiming Brendas behavior was distinctly feminine, differing completely different [the] behavior of [her] twin brother." On the contrary, growing up, Brenda failed to identify as female until about the age of 10 and eventually began to undergo sex reassignment surgery at 14, when he now began to identify as David. Despite having his theory disproven, Money still reported his theory correct and the case as successful, never reported on it again in the seventies. Cornelia B. Wilburs Sybil case is tainted with accusations of a lack of ethical treatment. The book Sybil documents the treatment of Sybil, a woman with dissociative identity disorder who manifests sixteen personalities. Shirley Ardell Mason, Sybil, had confessed in a letter to have created the case for attention and excitement. Mason and her psychiatrist, Cornelia B. Wilbur, had lived together for a couple of years as they became friends. Moreover, it is also reported that Wilbur employed Mason as a secretary and personal assistant. Ethics is the foundation of psychology and psychiatry, both which are fields faced with radicalism. Despite this, many psychologists and psychiatrists violate these rules in order to get ahead or to benefit their personal lives. Despite already having a recognized carrier as a psychologist, Dr. John Money resorted to controlling the life of his patient under false pretenses. Like Dr. Money, Dr. Cornelia B. Wilbur, she resorted to unethical procedures but while her patient consented to do so throughout the rest of her lifetime.

Works Cited
American Psychological Association ethical principles of psychologists and code of conduct. (2002). Retrieved February 27, 2012, from American Psychological Association: http://www.apa.org/ethics/code/index.aspx Ethics Resources and Standards. (2012). Retrieved from American Psychiatric Association: http://www.psychiatry.org/practice/ethics/resources-standards Colapinto, J. (2004, June 3). What were the real reasons behind David Reimer's suicide? Retrieved March 1, 2014, from Slater: http://www.slate.com/articles/health_and_science/medical_examiner/2004/06/gender_gap.single.html Money, John, and Anke A. Ehrhardt. Man & Woman, Boy & Girl: Gender Identity from Conception to Maturity. Northvale, NJ: Jason Aronson, 1996. Print. Nathan, D. (2011). Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case. New York: Free Press.