Table Of ContentSECOND
EDITION
PROFESSIONALISM
THIS NEW EDITION of Professionalism and Ethics: Q & A Self-Study Guide
for Mental Health Professionals thoroughly updates the highly regarded and
groundbreaking frst edition, offering the contemporary reader clinical wis- S P
AND ETHICS
dom and ethical guidance for challenging times. Like its predecessor, the e R
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second edition features commentaries by leaders in psychiatric ethics, plus f- O
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two foundational chapters on ethics and professionalism in the feld of mental F
t
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health. These commentaries and introductory chapters provide an overview
d S
of essential ethical principles and concepts, the professional obligations of y
S
the mental health clinician, common ethical tensions found in practice, ethical G I
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aspects of caring for special populations, and ethical issues in professional u
training and research. The introductory chapters are followed by case-orient- id N
ed questions and answers on core concepts and topics in clinical care, medi- e A
f L
cal research, and interactions with colleagues and trainees. Topics explored o
I
in-depth include authorship, disclosure, and ethical peer review for scientifc r S
M M
publications; assisted suicide and euthanasia; professional voyeurism ver-
sus patient privacy online and on social media; the appropriate process for e
n A
reporting an impaired colleague; and problems of burnout, work-life balance,
t N
a
and professional well-being.
l D
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Professionalism and Ethics: Q & A Self-Study Guide for Mental Health e E
Professionals poses and plumbs critically important ethical dilemmas in a a T
compelling, down-to-earth way for today’s practitioners and learners. lt H
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LAURA WEISS ROBERTS, M.D., M.A., is Katharine Dexter McCormick fe Q
and Stanley McCormick Memorial Professor of Stanford University. Dr. Rob- Self-Study Guide
s
erts has served as the Chair of the Department of Psychiatry and Behavioral s &
i
Sciences in the School of Medicine at Stanford University School of Medicine o A for Mental Health
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since 2010.
a
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s Professionals
GABRIEL TERMUEHLEN, B.A., is an editor in the Department of Psychiatry
and Behavioral Sciences in the School of Medicine at Stanford University in
Stanford, California.
T
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mo
ub SECOND EDITION
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Laura Weiss Roberts, M.D., M.A.
Cover design: Rick A. Prather
Cover image: © SDI Productions
Gabriel Termuehlen, B.A.
Used under license from iStock
WWW.APPI.ORG
Cover design: Rick A. Prather
PROFESSIONALISM AND
ETHICS
Q & A SELF-STUDY GUIDE FOR
MENTAL HEALTH PROFESSIONALS
Second Edition
PROFESSIONALISM AND
ETHICS
Q & A SELF-STUDY GUIDE FOR
MENTAL HEALTH PROFESSIONALS
Second Edition
Laura Weiss Roberts, M.D., M.A.
Gabriel Termuehlen, B.A.
Note: The authors have worked to ensure that all information in this book is ac-
curate at the time of publication and consistent with general psychiatric and
medical standards, and that information concerning drug dosages, schedules,
and routes of administration is accurate at the time of publication and consis-
tent with standards set by the U.S. Food and Drug Administration and the gen-
eral medical community. As medical research and practice continue to advance,
however, therapeutic standards may change. Moreover, specific situations may
require a specific therapeutic response not included in this book. For these rea-
sons and because human and mechanical errors sometimes occur, we recom-
mend that readers follow the advice of physicians directly involved in their care
or the care of a member of their family.
Books published by American Psychiatric Association Publishing represent the
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ily represent the policies and opinions of American Psychiatric Association
Publishing or the American Psychiatric Association.
If you wish to buy 50 or more copies of the same title, please go to www.appi.org/
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Copyright © 2022 American Psychiatric Association Publishing
ALL RIGHTS RESERVED
Second Edition
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Library of Congress Cataloging-in-Publication Data
Names: Roberts, Laura Weiss, 1960- author. | Termuehlen, Gabriel, author. |
American Psychiatric Association Publishing, publisher.
Title: Professionalism and ethics : Q & A self-study guide for mental health
professionals / Laura Weiss Roberts, Gabriel Termuehlen. \
Description: Second edition. | Washington, DC : American Psychiatric Association
Publishing, [2022] | Includes bibliographical references and index.
Identifiers: LCCN 2021028088 (print) | LCCN 2021028089 (ebook) | ISBN
9781615373352 (paperback ; alk. paper) | ISBN 9781615373963 (ebook)
Subjects: MESH: Mental Health Services—ethics | Health Personnel—ethics |
Professional Role
Classification: LCC RC455.2.E8 (print) | LCC RC455.2.E8 (ebook) | NLM WM 21 |
DDC 174.2/9689—dc23
LC record available at https://lccn.loc.gov/2021028088
LC ebook record available at https://lccn.loc.gov/2021028089
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
Contents
Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix
Introductory Comments . . . . . . . . . . . . . . . . . . .xi
PART I: Ethics and Professionalism
1
Ethics, Professionalism, and the
Field of Mental Health
An Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Laura Weiss Roberts, M.D., M.A.
Max Kasun, B.A.
Gabriel Termuehlen, B.A.
2
Ethics in the Mental Health Professions. . . . 27
Laura Weiss Roberts, M.D., M.A.
Max Kasun, B.A.
Gabriel Termuehlen, B.A.
PART II: Questions and Annotated Answers
3
Core Concepts in Ethics and
Professionalism . . . . . . . . . . . . . . . . . . . . . . 125
4
Ethics and Professionalism in
Clinical Care. . . . . . . . . . . . . . . . . . . . . . . . . 165
5
Ethics and Professionalism in
Medical Research . . . . . . . . . . . . . . . . . . . . 211
6
Ethics and Professionalism in Interactions
With Colleagues and Trainees . . . . . . . . . . 239
PART III: Self-Assessment and Further Study
7
Ethics and Professionalism Questions for
Review. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 273
References. . . . . . . . . . . . . . . . . . . . . . . . . . 315
Subject Index . . . . . . . . . . . . . . . . . . . . . . . 349
Q&A Index . . . . . . . . . . . . . . . . . . . . . . . . . . 359
CONTRIBUTORS
Paul S. Appelbaum, M.D.
Elizabeth K. Dollard Professor of Psychiatry, Medicine, and Law; Direc-
tor, Center for Law, Ethics, and Psychiatry, Columbia University Vagelos
College of Physicians and Surgeons, New York, New York
Glen O. Gabbard, M.D.
Clinical Professor of Psychiatry, Baylor College of Medicine, Houston,
Texas
Max Kasun, B.A.
Roberts Ethics Lab, Department of Psychiatry and Behavioral Sciences,
Stanford University School of Medicine, Stanford, California
Jane Paik Kim, Ph.D.
Clinical Assistant Professor, Department of Psychiatry and Behavioral
Sciences, Stanford University School of Medicine, Stanford, California
Laura Weiss Roberts, M.D., M.A.
Katharine Dexter McCormick and Stanley McCormick Memorial Pro-
fessor, Stanford University; Chair, Department of Psychiatry and Be-
havioral Sciences, Stanford University School of Medicine, Stanford,
California
Gabriel Termuehlen, B.A.
Editor, Department of Psychiatry and Behavioral Sciences, Stanford
University School of Medicine, Stanford, California
Thomas N. Wise, M.D., FACP
Professor of Psychiatry, Johns Hopkins University School of Medicine,
Baltimore, Maryland; Professor of Psychiatry, George Washington Uni-
versity School of Medicine, Washington, D.C.
vii
PREFACE
E
very era of medicine has ethical challenges—some new, such as those
we have experienced with the COVID-19 pandemic and effects of recent
extreme weather events caused by climate change, and some not as new,
such as those we face when determining how to uproot systemic barriers
to equity in the workplace and in the provision of care, and how best to
demonstrate respect for patients' cultural values, self-governance, and pri-
vacy. Psychiatrists, psychologists, therapists, and clinicians caring for
people with mental health concerns encounter additional and specific
ethical concerns, also both modern and ancient. Should a psychiatrist
consider including artificial intelligence decision tools in her clinical prac-
tice, for example? How does one intervene with an exhausted, care-worn
clinical colleague while maintaining appropriate boundaries? What are
the best ways to support the autonomy of a patient who is living with a
severe but intermittent disorder affecting mood and cognition? These are
hard questions, and the answers are nuanced and dependent on multi-
ple factors and context. For these reasons, mental health clinicians and
trainees as well as practitioners in related health fields must understand
the requirements of professionalism and cultivate a strong set of ethical
decision-making skills.
This book is a second edition of an earlier text that sought to help cli-
nicians and clinical trainees across the health professions to prepare for
professional and ethical issues in their everyday work and education. We
have structured the second edition to provide commentaries on the role
of professionalism and ethics in clinical care, training, research, and
leadership activities of mental health professionals. The first two chapters
provide a brief overview of key elements of professionalism and ethics.
These first chapters give essential guidelines, strategies, and best practices
for mental health clinicians and trainees. Subsequent chapters proffer
questions and answers based on terms, principles, and clinical, training,
and research scenarios. The last chapter of the book provides dozens of
questions that draw on content throughout the entire text.
We hope that this second edition will continue to be a resource of
value to mental health professionals of different backgrounds and ex-
periences at different points in their professional developmental paths.
ix
