Children, Ethics, and the Law

1 Preface Please cite as: Koocher, G. P. & Keith-Spiegel, P. C. (1990). children , ethics , and the Law: professional Issues and Cases. Lincoln, Nebraska: University of Nebraska Press. Gerald P. Koocher and Patricia Keith-Spiegel, 1990, all rights reserved i children , ethics , and the Law: professional Issues and Cases Gerald P. Koocher and Patricia C. Keith-Spiegel We dedicate this volume to our children Abby Greenwald Koocher and Gary Brian Spiegel Preface The intended readership of this volume is the full range of behavioral scientists, mental health professionals, and students aspiring to such roles who work with children .

2 This includes psychologists (applied, clinical, counseling, developmental, school, including academics, researchers, and practitioners), family counselors, psychiatrists, social workers, psychiatric nurses, child protection workers, and any other mental health professionals who work with children , adolescents, and their families. Working with children is both rewarding and demanding. The work is fraught with more acceptance of responsibility, confusions, intrusions, and potential ambiguity among the various players in the system than with any other clinical population. Although unfortunate, it is perhaps no wonder that many mental health professionals attempt to avoid working with children altogether, often citing concern about potential legal and ethical dilemmas.

3 It is not that such professionals dislike or are unsympathetic towards children . Rather, they are concerned about what people who are legally defined as minors bring along, and not usually by their own choice, into a professional relationship. Those who work with children cannot always count on dealing with loving and cooperative parents who will make appropriate sacrifices for their children or give mental health professionals appropriate latitude to do their work according to their own best judgment. Professionals cannot rely on local, state, or federal laws and policies related to children to say This original manuscript was published by the University of Nebraska Press, but is currently out of print.

4 The un-copy-edited raw manuscript is made available to students and scholars in this form at no charge. The authors retain all rights to the material. Preface Please cite as: Koocher, G. P. & Keith-Spiegel, P. C. (1990). children , ethics , and the Law: professional Issues and Cases. Lincoln, Nebraska: University of Nebraska Press. Gerald P. Koocher and Patricia Keith-Spiegel, 1990, all rights reserved iiwhat they mean in easily interpretable language or to never contradict or preempt each other. Nor can we assume that community agencies and the courts will provide prompt, highly competent, compassionate and well-orchestrated services.

5 We cannot even rely on our own professional associations to have ethics codes or other information that deliver clear guidance as to how a member of the profession should proceed in a given circumstance related to children . All of these factors combine with continuing disagreements about the meaning and desirability of increasing children 's rights to self-determination. Although there is a growing recognition of the autonomy of children and respect for their input to matters affecting them, there remains a general lack of consensus as to when and how children 's input should be considered, even in everyday matters. Despite the risks and uncertainties that surround professional work with children , the need for such professionals is greater than ever before.

6 Demand for such services in increasing, even as the number of individuals in training as child specialists declines. This book introduces the reader to a variety of ethical and legal dilemmas that may arise for mental health professionals in the course of their everyday work with children , adolescents, and their families. Although we are not always able to offer a definitive action that will be successfully applicable in every similar instance, we aspire to give sound general advice, to aid the reader in identifying the key factors to take into account, and to help with the formulation of decision-making strategies. We have attempted to cover a broad spectrum of professional functions and work setting contexts such as counseling in the schools, psychotherapy in private practice, research in the university laboratory, and serving as an expert witness in court.

7 We also attempted to cover a wide range of ethical-legal dilemmas reflecting the peculiar twists that unavoidably occur when children are involved. These include special considerations related to confidentiality and record keeping, consent to treatment and research, and psychological assessment of children . It was, of course, impossible to cover every conceivable topic in a single volume, so no inference about the lesser importance of uncovered materials should be made. We make frequent use of case vignettes to illustrate the ethical and legal dilemmas under discussion. Many of these incidents are based on ethics files of professional associations or public domain sources, usually litigated cases.

8 The authors' own consultation experiences provide another major source of case material. In instances where the sources are confidential, we have used a variety of techniques to disguise the incident and the identity of the actual people involved. Specific reference to actual persons living or dead is not intended. The use of bogus names in case material is meant to enhance readability of the text, and is in no way intended to trivialize the significance of the ethical issues involved. Preface Please cite as: Koocher, G. P. & Keith-Spiegel, P. C. (1990). children , ethics , and the Law: professional Issues and Cases. Lincoln, Nebraska: University of Nebraska Press.

9 Gerald P. Koocher and Patricia Keith-Spiegel, 1990, all rights reserved iii We are also grateful to our students and to the large number of colleagues (listed below) who contributed ethical dilemmas or problems to us via the ethics casebook project of the Section of Clinical Child Psychology (of APA's Division of Clinical Psychology). Kristi Alexander Russell Bauer Frank H. Boring Emily Bronfman Debra Carmichael Robert Cornnoyer Sheila M. Eyberg Edward D. Farber Eileen Fennell Jacqueline Goldman McKenzie D. Louise Mebane Michael D. Miller Linda L. Reed Elizabeth C. Rickitt Peter Goldenthal Nancy Grace Linda J. Gudas David Hayes Kenneth D.

10 Herman William F. Hodges Jane Irion Grace R. Kalfus Sophie L. Lovinger Ramasamy Manikam Audrey Ricker Lois J. Rifner Michael C. Roberts Gloria M. Roque Lanning S. Schiller Audrey Sistler F. Beth Stone Elaine Sweeney, RSM June M. Tuma Margaret Witecki Deborah Young-Hyman Virginia Youngren The routine methods of designating the principals in disguised case materials ( , "Dr. B." or "the child") were avoided in favor of contrived names. We have found this technique useful in teaching and improving the readability of the text. We do not in any way intend to trivialize the importance of the issues at hand, yet we also wanted to assure that the names of our characters were unlikely to correspond to the names of real people.