Ethical decision making for psychology trainees in the clinical pediatric setting: Case examples and practical solutions for trainees and supervisors.

Abstract

The opportunity for psychology trainees to provide services on multidisciplinary teams in the pediatric medical setting offers unique opportunities and ethical challenges (e.g., deciding which information to disclose to medical team). The developmental process of integrating ethical principles learned from general ethics training in the classroom with ethical decision making for issues that present in the pediatric medical setting can be challenging for trainees. In this article the authors will highlight ethical issues related to working in a pediatric medical setting. In particular, ethical issues unique to the pediatric setting are highlighted, including (a) working with children with medical conditions and potentially life-threatening illnesses and (b) working on multidisciplinary teams. Case examples illustrate potential ethical concerns, and suggestions for both trainees and supervisors are discussed.

Ethics in pediatric psychology: Considerations for trainees transitioning to the medical setting.

“…Trainees are responsible for reviewing available literature that may include summaries of ethical codes, discussion of considerations for ethical decision-making, and clinical recommendations. In addition, trainees are responsible for regularly reviewing the APA Ethical Principles of Psychologists and Code of Conduct (APA, 2016), state laws, and facility-specific regulations (Fehr et al, 2017). There is also a growing body of literature published in journals that provides guidance regarding ethical decision making and specific ethical challenges.…”

“…This approach sets up the supervisor-trainee relationship for success by reducing the likelihood for trainee defensiveness when provided with feedback. When ethical transgressions occur, supervisors should aim to be supportive while also assisting the trainee in reporting or otherwise addressing the issue (Fehr et al, 2017). Remaining supportive throughout this process will ensure trainees come to their supervisor when 10 FEHR, CHAMBERS, AND VANDERWOUDE This document is copyrighted by the American Psychological Association or one of its allied publishers.…”

“…For example, when a medical provider asks, “How is (patient) doing?” prepared trainees understand what the provider needs to know, and thereby can discern information that is helpful and appropriate to share from information that is unnecessary and inappropriate. Trainees should feel empowered to tell medical professionals that they need to meet with their supervisor before proceeding to ensure they can respond and proceed in an ethical manner (Fehr et al, 2017). Importantly, when supervisors give feedback to trainees, trainees should strive to be responsive to the feedback.…”

“…Fehr and colleagues (2017) discuss the important role supervisors play by assessing the ethical competency of supervisees. A developmental model can be helpful as the ethical competency of students is assessed and supervision can be modified as needed in response to student development.…”

“…In addition to encouraging the trainee’s critical thinking, this allows the supervisor to assess what the trainee is considering and their competency in identifying relevant ethical factors. Supervisors should also support and encourage trainee self-assessment of ethical skills (Falender & Shafranske, 2007; Fehr et al, 2017). Although discussion of these skills ahead of time is helpful, it does not replace actually seeing and doing it, and trainees may need additional support to translate the skills they have learned to this setting as they work toward independent practice.…”