Confidentiality, informed consent, and multiple relationships in four emerging regions

Abstract

There has been a rapid increase in the globalization of professions since the turn of the century, and this has been true for the psychology profession as well. Psychological research evidence, theories and practice have spread rapidly, influenced in no small part by ever-widening access of diverse people to technologies, as well as increased dissemination and sharing of training and resources. There is also an evidence base of increased mental health concerns (e.g., Furukawa & Kessler, 2019) in many contexts, and in the spread of ideas from psychology to ameliorate symptoms and tackle these occurrences more widely than before. In parallel, psychologists have faced increasing demands to demonstrate their accountability both to the people with whom they consult (often as their clients become more aware of their rights), as well as to organizational or institutional settings in which they work (Greenberg & Smith, 2008). Ethics is therefore a central element of their work. Ethical practice is at the core of the discipline of psychology and is often one of the first modules covered in introductory training. Francis (2009) wrote of the need to expose aspiring professionals to ethics in the formative stages of their training, as a means to set the foundation of expected professional behaviors. The nature of the content of what is ethically covered in training as well as continued professional development is thus of important interest. Codes of ethics comprise an important component of ethics training. Sinclair (2012) traced a number of historical influences upon the development of ethical codes of practice, highlighting both the influence of existing medical codes, as well as events that have underscored the need for such. She noted that prior to the Modern Era, there were ethical documents such as the “Ayurvedic Oath of Initiation” from India; the Hebrew “Oath of Asaph”; the Persian “Holy Abbas’s Advice to a Physician”; the “Seventeen Rules of Enjuin” from Japan; and the “Five Commandments and Ten Requirements” influenced by Confucian thought in China. These documents all pre-date modern developments and contain elements that overlap with more recent professional ethics codes. Unfortunately, over the past few decades many of the ethical codes for psychologists were initiated by national psychological organizations influenced by predominant thinking in the developed or “Western” world, also characterized as White, Educated, Industrialized, Rich and Democratic (WEIRD; e.g., Azar, 2010). Leach and Gauthier (2012) commented on the need for culturecenteredness of codes of ethics, because these are developed within a specific cultural milieu and are reflective of the values of that culture. That said, when developing ethics codes, there has been a lot of borrowing of ethics standards and principles across countries, but it is unknown how they are actually interpreted and implemented across countries, given the influences of different cultures. For example, though a principle such as integrity or a standard such as confidentiality may be commonly found across psychological ethics codes, because they are common components of the psychology profession internationally, the extent to which they have the same meanings given cultural (as well as political, historical, legal, and religious) contexts is unknown. There have been a few ethical documents that are regional and assist national psychological associations with the development of their ethics codes (e.g., those provided by the European Federations of Psychologists’ Associations [EFPA]). While these types of documents offer guidance for ethical development across countries, the interpretation of specific components of national psychological ethics codes has yet to be examined. In part because of this complexity, and as more countries have developed codes of ethics over the past few decades, it became important to develop an international document to help psychologists consider their ethics from a principled perspective. A landmark event occurred through the publication of a multi-national ethical declaration, which ETHICS & BEHAVIOR 2023, VOL. 33, NO. 3, 175–182 https://doi.org/10.1080/10508422.2022.2152339