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July 6, 2009

Psychologists with a Conscience?

I'm so happy that my brother is an unemployed recent college grad right now, because it means he has lots of free time to write guest blogs. I'm also happy that his degree happens to be in psychology, so he can comment better than me on why this story is so screwed up. There's been a lot of talk about so-called "conscience" rules for doctors, pharmacists, and other health care workers that would allow them to refuse to do things like dispense birth control or provide abortion services or referrals if they decide that those things violate their morals or religious beliefs. Well, one group in Nebraska is trying to extend that idea to psychologists as well, and I'll let Astaroth take it from there.

Given the flippant nature of my previous contribution, I figured that this one should take a somewhat more serious tone by addressing an issue that I feel capable of commenting on. In this case I’ll be discussing a recent licensing rules hearing at the Nebraska Psychology Association prompted by the Nebraska Catholic Conference's proposed rule that would allow Psychologists to refuse to treat *and* refer patients based on “religious or moral convictions.” I intend to start this article on a somber, serious note, so here goes...


Phew, glad that’s over! Essentially what’s going on here is the Catholic Conference wants to give therapists the right to violate the core ethical codes regarding the establishment of a therapist/patient relationship. Considering that empathy between therapist and patient has consistently proven to be the number one indicator of success in therapy, this resolution just sounds dandy doesn’t it? Let’s run through a test scenario if this new plan is implemented…

Therapist: Well, what issues do you feel would need to be addressed over the course of therapy?

There’s a few that really impact my life. My relationship with my parents has always been strained, I’ve been in abusive romantic situations before, and I think a lot of it is tied up with my sexuality since I’m gay, so-…

Therapist: I’m sorry, did you say gay? As in homosexual?

Patient: Well yes, that’s a big part-…

Therapist: I’m afraid that your issues conflict with my religious beliefs, so we won’t be able to work together.

Patient: I…I’m sorry to hear that. Could you refer me to-…

Therapist: No, by law I am not required to do that either. Have a nice day.

Sound kinda sucky? A bit harsh? Perhaps cruel and unusually idiotic? That’s because it is. As a therapist, it is absolutely vital that you discuss with any new patient what issues they need to address in therapy and then decide for yourself whether or not you are comfortable with those issues. The therapist needs to be open with the client, and if he or she will feel conflicted (instead of challenged) then that needs to be addressed right away, before a contract is signed and certainly before a relationship can be formed. If there is some glaring issue that simply can’t be worked through, then ethically it is the duty of that therapist to refer the patient to someone who will better meet his or her needs. To ignore that duty due to “religious or moral convictions” is to commit, to borrow from Catholic lingo, a mortal sin of therapy, to place the therapist above the patient. It’s a RELATIONSHIP, you douchebags!

Now, traditionally Catholic Priests have served their community by acting as counselors on all sorts of issues, but counseling is very different from therapy. There’s a reason why you can get a counseling job with a GED and you need a Masters or Doctorate to be a therapist. And priests are traditionally expected to discuss issues of “religious and moral conviction,” but the fact that they have a traditional role doesn’t make them specialists, nor does it make them qualified to tell therapists how to do their jobs.

Also, how the fuck is refusing to help people in any way ethical or Christian? Therapists may not take the Hippocratic Oath, but they have standards and regulations to live by and any violation of them can potentially get your license revoked. You know, since it's only people's
sanity at stake. And while I’m certainly not the most religious guy in the world, after 14 years of Catholic schooling I can say with a fair degree of authority that in this case Jesus would have done everything he could to help that person, and breaking out a goddamn Rolodex to see which of the apostles would be willing to spare some time every week would’ve been his worst case scenario! Religion pisses me off sometimes.

Anyway, it sounds like most Psychologists in Nebraska think this whole thing is bullshit, so I’m really hoping it goes down in flames. As in the flames of HELL, MWAHAHAHAHAHA! Sorry, couldn’t help m’self. But seriously, Psychologists have enough to worry about with their ethics, don’t give the few self-absorbed crap therapists a way to cop out and give them all a bad name.


ceirdwenfc said...

Maybe instead of going through all of that, they could just hang a sign out announcing their issues. Perhaps, they feel a moral obligation against multi-ethnic marriage. Maybe they won't take people with accents into their practice because they're harder to understand.

Why are the Catholics in charge of psychology in Nebraska? What about the Presbyterians? Or the Jews? Or heaven forbid, Muslims?

Maybe psychologists should decide what's appropriate.

As it is, some pharmacists decide who can get birth control.

It's crazy. If you don't like the parameters of your job morally, go into another field and don't worry about other people's morals.

You could avoid this whole thing by working at Walmart. No moral conflict there.

(Sorry, I got a little out of hand.)

FEMily! said...

First, I just want to say, before anyone else does, that there is a big difference between a pharmacist denying to fill out a prescription for birth control and a psychologist refusing to provide counseling services to a gay person. A pharmacist's attitude about birth control has absolutely nothing to do with how effectively he or she can perform the job. A psychologist who doesn't make their negative attitudes about homosexuality known to their gay clients is completely unethical, since their attitudes can make them ineffective counselors. So it's best for a Catholic psychologist to deny gay people counseling services if they have a problem with homosexuality, because the psychologist's services would no doubt be inferior and potentially harmful.

The real problem is making a law that makes it OK for psychologists and other mental health professionals not to refer gay clients to a competent counselor who will provide services to gay people. Doing so makes unethical behavior legal. Gay clients who can't get mental health treatment have no basis for a lawsuit, and professional organizations cannot suspend or revoke the licenses of those professionals who refuse to refer.

ceirdwenfc said...

I would like to comment on something that FEMily said. First, I agree with the comment and it was (obviously) much better said than my original comment.

The one thing I would say is to the point that "A pharmacist's attitude about birth control has absolutely nothing to do with how effectively he or she can perform the job."

If a pharmacist refuses to fill a valid prescription by a licensed doctor, then they are NOT effectively doing their job. In fact, they are not doing their job at all, and should find a different line of work.

That was the only point I was trying to make.

If you can't fulfill your job in an unbiased way, go into another line of work.

FEMily! said...

Yes, you're right. What I meant by that is that a pharmacist who doesn't want to give out birth control pills isn't going to hand poison to their patients instead. Their reasoning for not giving out birth control is that it's against their personal beliefs, not because the pills are truly harmful to the person. But when it comes to heterosexist mental health professionals refusing to give treatment gays and lesbians, it's ultimately to protect the client from the counselor's biases that can potentially harm the client.

Of course, pharmacists and counselors who take their professions and ethical guidelines seriously put their clients first and don't mind if they take their business elsewhere. Healthcare workers who want to pass these laws that allow them to refuse referrals enter the profession to change it to suit their needs and to give them more power to oppress the groups of people they don't like.