Clinician's Digest - Page 4

Taken together, the Lancet metanalyses remind us that automatically prescribing new meds can make treatment more expensive and sidetrack the kind of careful decision-making that ought to be based on patients' specific symptoms, tolerance for side effects, and financial situation. That's the difference between practicing good medicine and succumbing to strong marketing.

The APA's Tortured Ethics

A national furor accompanied the release of memos from the Bush administration's Office of Legal Counsel (OLC) that revealed the questionable legal arguments for "enhanced interrogations" put forward by the White House's lawyers, prompting calls for professional legal organizations to discipline or disbar them. However, there was little public attention devoted to what the memos revealed about psychologists' participation in these interrogations and how, like the attorneys, they engaged in activities that many believe violated the spirit, if not the letter, of their profession's code of ethics.

Much of the controversy concerning the psychologists' involvement focused on the ethical stance taken by the American Psychological Association (APA). Post-9/11, the APA revised its ethics code to assert that when ethical responsibilities were in irreconcilable conflict with laws or other forms of state authority, psychologists could adhere to "the requirements of the law, regulations, or other governing legal authority," a position that critics claimed recalled the legal defense of the Nuremberg defendants. In 2005, the APA affirmed that psychologists could "serve in the role of supporting an interrogation" and "as a consultant to an interrogation," insisting that psychologists' presence actually protected prisoners. It was not until 2008 that the APA proscribed psychologists from working in detention centers that violate international law—a position that still remains weaker than that of the American Medical Association, which prohibits physicians from participating directly in any interrogations of detainees.

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