The current Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association (APA, 2002a) places increased emphasis on respect for different cultures. For example, culture has been added as an important factor in respecting the rights and dignity of those with whom psychologists work (Principle E). APA has also released guidelines meant to influence psychologists' sensitivity and behavior toward multicultural issues in various aspects of professional work (APA, 2002b). The purpose of this article is to discuss cultural issues in the context of rehabilitation practice. The authors focus on Latinos, the fastest growing minority group in the United States. The case example of Cesar Garza is used as a vehicle for discussing how to integrate consideration of cultural factors into rehabilitation practice, consistent with sound ethical decision making. The case illustrates missed opportunities, for which the authors offer concrete solutions that reflect appropriate ethical conduct. The authors also hope to demonstrate that integration of cultural issues is consistent with overall rehabilitation psychology practice.
Rehabilitation psychology should engage in the competency movement at the predoctoral and postdoctoral level. The application of the Ethical Principles as a foundational competency to rehabilitation psychology represents a first step in this dialog.
General bioethical principles, such as autonomy, nonmalfeasance, justice, and care, provide the foundation for ethical decision making in health care. Aspiring to uphold the ethical principles is a fluid process, based on advances in health care, social and cultural pressures, and applications of the principles both to specific clinical situations and policy making. In this paper, we review the principles and discuss their application in rehabilitation and in health care. We argue that rehabilitation psychologists have unique expertise to impact ethical decision making at all levels of social structure, and that rehabilitation represents a critical forum in which this role definition of psychologists manifests itself. In addition, the principles themselves, if given substantive meaning in their practical application, can and should drive adaptive legislation in support of rehabilitation and health care goals in developing ethical care alternatives.The development of ethical thought in health care has provided an appropriate scheme for evaluating clinical decision making, professional conduct, policy development, and legislation. Using ethical principles to establish moral groundwork, and as an aspirational rationale for health care, ensures that higher order purposes are the umbrella for both action and evolution in the field. In this paper, we first overview the basic principles from which ethical thought and decision making in health care evolved. We then provide a discussion of the applications of these principles to rehabilitation and the
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