The American Psychological Association apologized on Friday for its actions that allowed psychologists to participate in the torture of military detainees. Those actions are detailed in the extensive “Independent Review Relating to APA Ethics Guidelines, National Security Interrogations, and Torture” (otherwise known simply as the Hoffman report). It is the most thorough examination to date of how APA staffers, aiming to remain in the good graces of the Central Intelligence Agency and (especially) the Department of Defense, actively sought to create ethics policies that allowed psychologists to be involved with torture and shielded them from consequences for doing so.
While the report does not make specific recommendations, APA has committed to a number of actions in response to the report’s findings. But this isn’t the first response to the involvement of psychologists in torture. The APA changed their ethics code in 2010 in response to what was known at the time about psychologists being involved with the torture of detainees. APA’s 2002 ethics code included a massive loophole that allowed psychologists to be involved in DoD and CIA torture programs, even if those programs would otherwise be considered unethical:
1.02 If the demands of an organization with which psychologists are affiliated or for whom they are working are in conflict with this Ethics Code, psychologists clarify the nature of the conflict, make known their commitment to the Ethics Code, and to the extent feasible, resolve the conflict in a way that permits adherence to the Ethics Code.
While that language was largely consistent with prior versions of the Code, it essentially gave psychologists an escape hatch from accusations of ethical misconduct for being involved in military torture. All they would need to do is establish that they had made known their commitment to the Code and taken “reasonable steps” to resolve the conflict. A psychologist who said to their superiors “this might not be right,” only to hear the superior say, “duly noted,” would arguably be free to then continue their involvement. In 2010, largely because of what was known then about psychologists’ involvement in torture, the APA changed that language to include this sentence:
Under no circumstances may this standard be used to justify or defend violating human rights.
It is arguable the degree to which that really resolves the torture issue — as the most recent report describes, the psychologists involved with torturing detainees subscribed to what was, at the time, the military’s narrow view of what constituted torture (and therefore would be considered a human rights violation). But it certainly suggests that psychologists should not be involved in the torture of detainees or any other activities that would reasonably violate human rights.
Interestingly, so far APA is the only major mental health professional association to make such a change. The ethics codes of ACA, AAMFT, and NASW all have language similar to the old APA language, effectively allowing therapists to continue to work for employers whose policies and practices force them to violate their professional code of ethics. Here’s what each code says therapists are to do in such a situation:
American Counseling Association (Standard I.2.d):
[S]pecify the nature of such conflicts and express to their supervisors or other responsible officials their commitment to the ACA Code of Ethics, and, when possible, work through the appropriate channels to address the situation.
American Association for Marriage and Family Therapy (Preamble):
[M]ake known to the organization their commitment to the AAMFT Code of Ethics and take reasonable steps to resolve the conflict in a way that allows the fullest adherence to the Code of Ethics.
National Association of Social Workers (Preamble):
[M]ake a responsible effort to resolve the conflict in a manner that is consistent with the values, principles, and standards expressed in this Code. If a reasonable resolution of the conflict does not appear possible, social workers should seek proper consultation before making a decision.
In each case, the therapist needs to take “reasonable” or “responsible” steps to try to resolve the situation, but if an ethical resolution cannot be reached, the codes appear to essentially punt.
While there is no evidence that counselors, MFTs, or social workers have been involved in military torture programs, this specific ethical issue stretches far beyond the military. The language of the ACA, AAMFT, and NASW codes could have the unintended consequence of protecting therapists who engage in blatantly unethical behavior if the therapist can make a case that their employer made them do it. So long as the therapist can say that they raised the issue to their superior, and made an effort to resolve it, they may be protected even when those efforts failed. This allows for “passing the buck” of ethical responsibility to bosses and organizations who are not bound to therapists’ ethical standards.
Each professional organization has grappled with the struggles faced by therapists who are employed in settings where the standards and expectations don’t necessarily fit with what the therapy field would want. But through the language that exists now, each of these ethics codes places a therapist’s continued employment over the well-being of those the therapist is serving. That’s a loophole big enough to fit almost anything through. And it’s one that should be closed.