Commentary on Opinions of APA Ethics Committee II

Continued from:  Commentary on Opinions of APA Ethics Committee I

Surely the Ethics Committee of the APA could have published this document free of jargon. It starts with my pet peeve, the term "therapist," and gets worse.

Somehow, probably thanks mostly to Sigmund Freud, who was a neurologist, not a psychiatrist, the primary treatment modality of psychiatrists, at least those practicing outside of hospitals, was historically psychotherapy. We were, and decreasing numbers of us still are, psychotherapists. Shorten that term, and you get "therapist." This ambiguous term also applies to massage therapists, physical therapists, and a host of others. It may seem trivial, but I have a lot of respect for psychotherapists and psychiatrists. The word "therapist" demeans us as well as those other kinds of -therapist professionals. Which would you rather be called, therapist or physician, therapist or psychiatrist, therapist or psychotherapist? We should drop "therapy" and "therapist" from use, and so should the APA ethics committee.

A.1.g. (2008, page 7)
The question, as simplified and incorporated into the opinions at least, refers to practice of psychiatry. The answer refers first to "doctor-patient relationship" then degenerates to "therapist," even though psychotherapy is not mentioned. The admonition to avoid mixing roles is correct, but the role should have been labeled psychiatrist, physician, or even psychotherapist, rather than therapist.

A.2.c. (1978, page 8)
In this case, also addressed in my last post, the question uses the term "therapy." It sounds as though the case occurred in the context of psychotherapy. Why not say so? To remain more general we might say "treatment," which may be the only term for which the term therapy might be appropriately substituted.

R.4.b. (1993, page 80)
In this case the questioner asks about presenting the patient's "therapy" in educational settings, presumably to other professionals. At least the question earlier referred to psychotherapy, but how much ink do we save by leaving off the first six letters?

L.5.b. (1990, page 55)
Even 20 years ago psychiatrists questioned the ethics of accepting gifts from drug companies. The answer to this one, citing an AMA ethics opinion (8.061), allows that an ethical psychiatrist can accept a "modest" meal with no cash, provided, however, that she adopts a "squinty-eyed attitude" toward the material presented. Since the quotes do not appear in the APA opinion I assume this esoteric term must have originated with the APA ethics committee. I did not read the original AMA opinion. Perhaps squinty-eyed attitude is some sort of arcane psychoanalytic term. I can imagine it means "with a skeptical attitude," but the committee wanted to have fun that day.

G.7.b. (1983, page 35)
Everyone knows what the Goldwater rule is, right? The APA ethics committee seems to think so. Regardless, the ethics committee should avoid using this label for an annotation which should not be associated with Barry, or anyone else named Goldwater. I understand that the committee adopted annotation 3 of Section 7 after a number of psychiatrists speculated publicly about Barry Goldwater's psychiatric status. Although the answer to this question claims consideration of potential damage to the reputation of an "unsuspecting public figure," the original annotation includes no such justification. I suspect the real object was to keep psychiatrists from looking silly.

Professional ethics is too important a subject to be addressed so unprofessionally in what should be a serous and unambiguous document.

Commentary on Opinions of APA Ethics Committee III