Informed consent, multiple relationships, and confidentiality: a comparison across four countries

Abstract

There are approximately 60 codes of ethics developed by national and regional psychological associations around the world, and there is wide variability in their structures, formats, lengths, and degree to which they can be enforced. Enforcement implies that there is sufficient infrastructure within a particular psychological association to intervene should a psychologist engage in unethical behaviors. Many ethics codes include principles and standards, though they are not always structured and indicated as such. In many countries principles are considered aspirational and include constructs such as beneficence, integrity, and respect. They are generally not considered enforceable because of the non-behavioral specification associated with them. Standards, however, are often considered enforceable and include behavioral components. Recent works investigating international components of professional psychological ethics include developments in the area of principles and standards. The most notable development in the area of principles is the Universal Declaration of Ethical Principles for Psychologists (see, Gauthier, 2022). This document represents common principles found in most countries and cultures around the world. It includes the principles of Respect for the Dignity of Persons and Peoples, Competent Caring for the WellBeing of Persons and Peoples, Integrity, and Professional and Scientific Responsibilities to Society. It has been directly implemented into different ethics codes (e.g., Guatemala) and is a source of foundational principles from which psychological associations can draw when developing codes of ethics. The internationalization of ethical standards has received some attention over the years, yet little is still known about their cross-cultural relevance. Leach and colleagues have engaged in the majority of work in this area, by comparing ethics codes and determining which standards are found most and least often internationally. Comparisons have been made to determine the overlap in areas such as competencies (Kuo & Leach, 2017), duty to protect (Leach, 2009), and research (Leach et al., 2012). This research area indicates consistencies across ethics documents internationally and common values and practices found for the psychology profession, regardless of country. However, this research line has its limitations. While this area of research allows for insights into common practices within psychology across the globe, it has not investigated the meanings attached to terms and their applications in sufficient depth. National codes of ethics may share common ethical standards (e.g., competence), but what is not known is how such standards are interpreted across different cultures and countries. This paper is the first known attempt to delve into the interpretation of different ethical standards. More specifically, practically all codes have standards of care regarding informed consent, multiple relationships, and confidentiality. Much has been written on these three standards from primarily western perspectives, but how these are interpreted within other cultural contexts in which psychologists practice is not known. The papers of this special issue examined these three standards from four different countries, representing different cultural and religious perspectives. Authors from China, Lebanon, Ukraine, and the United Arab Emirates were asked to address how these three ethical standards are interpreted and applied in their countries, offering insights into similarities and differences among the different countries and compared to previous, western-focused, literature. Each of the articles representing primarily four countries, specifically noted that the history of psychology in these countries influenced professional ethical principles and standards, regardless of how formalized and developed the field. These countries were chosen, in part, because, as Khoury and Akoury-Dirani (in press) indicated, Western more individualistic codes of ethics may not translate well to non-Western, and by extension, collectivist societies. The authors appropriately noted that psychology in their countries ETHICS & BEHAVIOR 2023, VOL. 33, NO. 3, 231–238 https://doi.org/10.1080/10508422.2022.2152340