Wk 5 Discussion - Using Deception: Ethical Decision-Making [due Thurs]

This week we take a deeper dive into the application of the APA Ethics Code and the process of making appropriate, ethical decisions.

Wk 5 Discussion - Using Deception: Ethical Decision-Making

Appendix A Case Studies for Ethical Decision MakingCase 1. Assessment of Intellectual Disability and Capital Punishment: A Question of Human Rights?Dr. Eduardo Romaro, a clinically trained forensic psychologist, has been retained by the prosecution to evaluate the intellectual competence of John Stone, a 50-year-old man convicted of first-degree murder of a guard during a bank robbery. John claimed throughout the trial that he was innocent. In the state in which the trial was conducted, individuals convicted of first-degree murder face the death penalty. John's attorney has challenged the death penalty option for his client, claiming that the defendant is intellectually disabled. The US Supreme Court ruled in Atkins v. Virginia (2002) that the execution of those with mental retardation (currently termed intellectual developmental disorder in the DSM-5) is unconstitutional. Dr. Romaro has worked with the prosecution before on intellectual disability cases, but this is the first time he has been retained for a capital punishment case. He is personally ambivalent about whether states should implement the death penalty.The psychologist meets John in a private room in the prison and administers a battery of intellectual and adaptive behavior tests with proven psychometric validity for determining forensically relevant intellectual ability. Just as he ends the formal test administration, John becomes distraught and appears to be experiencing an anxiety attack. The psychologist hears the prisoner in his distress repeatedly asking God for forgiveness for killing the guard and for murdering another person, whom he keeps calling "the boy waiting for the bus." The psychologist shifts into an emergency crisis intervention mode to help calm the defendant and rings for assistance. Dr. Romaro was shocked to hear John "confess" not only to the bank murder but also to the murder of a "boy waiting for a bus."The DSM-5 (APA, 2013) diagnosis of intellectual developmental disorder (IDD) requires that individuals demonstrate significantly subaverage intellectual functioning and impairments in adaptive functioning and that these conditions must begin during the developmental period. Similarly, in the state where John was convicted, the standard for intellectual disability includes a developmental history of intellectual impairment. Prior to testing John, Dr. Romaro had asked the prosecutor for all available childhood mental health or school records to determine whether John meets these criteria. No formal educational or psychological evaluations were included in the materials he received. The records indicated that John had a poor academic record, was retained in fifth grade, was suspended several times for coming to school drunk, and left school when he was 15. State criteria also include an IQ score less than 70 and poor adaptive skills.That evening Dr. Romaro scores the test battery. John's IQ score is 71, and his performance on other cognitive tests falls close to the IDD cutoff score (some scores above, some below). His adaptive functioning score is a standard deviation below average. However, given the prisoner's age, without a more detailed set of childhood records, it is difficult to clearly conclude that he meets the DSM-IV-TR or state legal criteria for intellectual disability. Dr. Romaro has not been asked to administer assessments for mood, schizophrenia, or other psychotic disorders that might impair intellectual and adaptive performance.Ethical DilemmaDr. Romaro is not sure what forensic opinion to give regarding whether or not John meets the legal criteria for intellectual developmental disorder. Without evidence of intellectual disability in his youth, a diagnosis of intellectual disability may not be possible and, thus, could not be used to support John's death penalty appeal. Dr. Romaro is also unsure whether he has an ethical responsibility to include in his report John's "confession" as informing the "ultimate issue" before the court or to include John's statement about the "boy waiting for a bus."'

Discussion Questions

Review this week's course materials and learning activities, and reflect on your learning so far this week. Respond to one or more of the following prompts in one to two paragraphs:

1. Provide citation and reference to the material(s) you discuss. Describe what you found interesting regarding this topic, and why.
2. Describe how you will apply that learning in your daily life, including your work life.
3. Describe what may be unclear to you, and what you would like to learn.