Ethical issues related to psychology in India are an important and complex topic, as psychology is a discipline that involves working with individuals who may be vulnerable and in need of support.
The ethical principles that guide the practice of psychology in India are based on the codes of conduct and guidelines established by the Indian Psychological Association and the Board of Psychology. These codes of conduct and guidelines aim to ensure that the rights and welfare of individuals are protected and that psychological services are provided responsibly and ethically.
According to Agarwal (2019), ethical issues in this field arise in the following sectors −
All therapeutic relationships involve parties with similar degrees of autonomy regarding what treatment modalities are used. Psychotherapy and psychiatry differ in this regard as the practitioner hold a significant degree of authority over the patient as there is an implicit assumption that the person is incapable of making sound decisions. This power dynamic puts a great deal of responsibility on the practitioner, who has to ensure that the treatment is carried out purely for the patient's benefit. They also need to ensure that the patient, as they are in a vulnerable state, is not exploited emotionally, physically, financially, and sexually in due course of treatment.
The relationship between the therapist and patient is intimate, as the former is privy to the personal details of one's life. What may follow is the development of feelings of love or hatred on one or either side, and the therapist should be equipped to navigate them.
Unlike treatment for physiological illnesses, psychological treatment does not have clear lines of consent. A person assumed to be incapable of making sound decisions will not know whether a fourth treatment is needed or not. There may be a possibility that the person lacks insight into their illness and deny that they need treatment.
The Mental Healthcare Act of 2017 has considered the possibility of this condition and declared the provision of involuntary hospitalization with the consent of a caring relative or through legal procedure. Unfortunately, most mentally ill are treated either as outpatients or in psychiatric units of general hospitals. These patients are either treated with a relative's consent or made to sign a consent that they do not understand. Szasz calls this practice of voluntary admission an unacknowledged example of medical fraud. The current situation in India can lead to unethical practices where a person's autonomy is restricted without legal safeguards.
Confidentiality is an important issue in psychology, as it protects sensitive information shared by clients during therapy sessions or assessments. This information may include personal details, mental health diagnoses, and other sensitive information that should not be shared without the client's consent.
Psychologists have a professional and ethical responsibility to maintain confidentiality and protect their client's privacy. However, exceptions exist, such as if the client poses a danger to themselves or others or if there is a court order to disclose information. The cases where the ethics of confidentiality may be ordered are −
Patients consent to release information to third parties for documentation purposes.
Tarasoff duty − When a patient's acts are likely to harm others, it is the doctor's responsibility to protect others from harm.
Emergencies − When a patient's life is at stake.
Mandatory reporting − Whenever any human rights violation is observed, like child abuse or female abuse, it must be reported to the appropriate authorities.
Court order − A practitioner can disclose information to the court only after consent from the client.
The patient initiates litigation against the psychiatrist − The psychiatrist can reveal confidences that are directly relevant to the case.
India differs greatly from individualistic Western countries where psychotherapy and psychiatry were initially formalized. Therapist has to adapt themselves to the niches of Indian culture to provide effective therapeutic intervention. Cultural sensitivity also includes being aware of one's own cultural biases and how they may affect the therapeutic relationship or research findings.
It also involves being knowledgeable about the cultural background and beliefs of clients or participants and using this knowledge to tailor interventions and research methods in a culturally appropriate manner. For example, the smallest social unit in India is usually the family rather than the individual. Cultural sensitivity is important in providing effective and ethical psychological services and research.
All therapeutic relationships involve parties with similar degrees of autonomy regarding what treatment modalities are used. Psychotherapy and psychiatry differ in this regard as the practitioner hold a significant degree of authority over the patient as there is an implicit assumption that the person is incapable of making sound decisions. This power dynamic puts a great deal of responsibility on the practitioner, who has to ensure that the treatment is carried out purely for the patient's benefit. They also need to ensure that the patient, as they are in a vulnerable state, is not exploited emotionally, physically, financially, and sexually in due course of treatment.
The relationship between the therapist and patient is intimate, as the former is privy to the personal details of one's life. What may follow is the development of feelings of love or hatred on one or either side, and the therapist should be equipped to navigate them.
Fraud in psychology refers to any instance of deception or dishonesty in the conduct of psychological research or practice. This can take many forms, including −
Fabricating or falsifying data
Plagiarism
Falsifying research credentials
Misrepresenting research findings
Providing false information on grant applications
Fraud in psychology is considered a serious ethical violation and can have serious consequences for both the individuals involved and the field. It can damage the reputation of the individuals and institutions involved and call into question the validity of the research or treatment being conducted. It is common to hear clinical psychologists promote themselves through a brand image akin to an astrologist rather than a scientific practitioner. They may often use scientifically questionable practices like Neurolinguistic Programming and promote such as a quick cure for mental disorders.
It is important to note that psychological research is often self-regulated, meaning it is up to the scientific community to police itself and identify and report any instances of fraud. In addition, professional organizations in psychology have codes of ethics that prohibit fraud and provide guidance for detecting and preventing it.
Ethical issues related to psychology in India are complex and multifaceted. They include informed consent, confidentiality, cultural sensitivity, technology use, and psychological research. Psychological practitioners, researchers, and policy-makers must address these ethical issues and provide psychological services responsibly and ethically.
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