Should the American Psychiatric Association Abandon Ethics Enforcement?

Psychiatric News   |   January 15, 2010

Volume 45 Number 2 page 21-21

American Psychiatric Association

Lea Defrancisci Lis, M.D.; Wade Myers, M.D.

“During recent discussions about the APA budget, a proposal to cut financial support for ethics enforcement was raised as one way to lower costs. At first blush this proposal appears reasonable in light of APA’s efforts to trim the budget. In times of economic crisis, even sacred cows must justify their existence as organizations strive to remain financially viable. But what would be the effects of such a budget cut? If it resulted in the end of ethics enforcement, would that necessarily be a bad outcome? Would it not be better for the APA Office of Ethics and district branch (DB) ethics committees to abandon enforcement and focus on ethics education instead? Has the idea of eliminating ethics enforcement been considered before?”

In brief, the APA ethics process works in the following way. Charges raised by a complainant against an APA member are received at the DB level and investigated and resolved according to APA’s “Procedures for the Handling of Complaints of Unethical Conduct.”

The idea of eliminating ethics enforcement is not new. Critics of enforcement have generally cited three reasons why it should be eliminated: (1) it is too expensive, (2) the enforcement process is not evenly applied from one DB to another, and (3) psychiatrists are physicians, not prosecutors.

Jeremy Lazarus, M.D., chaired the Task Force on Ethics Regulations and Ethics Educationargued for maintaining it on several grounds. The task force noted that without ethics enforcement it would be difficult to drop members who committed serious unethical behavior .. and complainants would hesitate to bring ethics charges forward if there would be no penalties.

Also key to consider is that ethics enforcement is important for the stature of APA as a self-regulating organization. By holding our members to the highest standards of conduct, we are communicating our commitment to the safety of our patients and society. If we stop policing ourselves, then another entity will fill the vacuum for us, namely state medical boards.

Policing ourselves is a difficult and unpleasant task, but if we stop doing so, we risk lessening our individual and organizational professionalism.

Retrieved 01-05-14. Full article

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