Transgender and gender non-conforming communities face a number of various healthcare challenges, both social and medical, including “stigma, discrimination and lack of access to quality healthcare.”
For LGBT resources, please visit RELAY (Research and Education for LGBT and Allied Youth). RELAY is a project of Fordham University’s Center for Ethics Education which looks to advance the conversation about health for lesbian, gay, bisexual, and especially trans youth. Please also visit the resource page for creating an LGBTQ-inclusive classroom.
The Federal Policy for the Protection of Human Subjects, or the Common Rule was revised earlier this year and is set to be effective on January 19th, 2018. The Common Rule was created in 1991 to “better protect human subjects involved in research, while facilitating valuable research and reducing burden, delay, and ambiguity for investigators.” Departments and agencies including, but not limited to, the Department of Homeland Security, the Department of Health and Human Services and the National Science Foundation made these revisions in an effort to “modernize, simplify, and enhance the current system of oversight.”
According to Dr. Fisher, the first change, stating that investigators are permitted to obtain broad consent from participants for future use of identifiable biospecimens by the original investigator or other investigators, “increases the ability of scientists to combine large data sets to explore important medical questions.” However, she says, “it is unclear whether hacking or the use of the identifiable information…will pose a social or economic risk to participants.” Dr. Fisher continues that it could be additionally problematic if “identifiable data is used to inform policies that promote medical discrimination of already vulnerable groups” without the research participants understanding how their data will be used in the future.
The second revision of the Common Rule that will impact informed consent practices states that investigators are required to give prospective participants a brief summary of “key points” that a reasonable person would want to know to make an informed choice. Dr. Fisher notes that this revision “can be an advantage over the current risk-averse legal language in informed consent materials,” but the revision does not state who will be deciding what the key points are which could be potentially problematic considering participants, investigators and IRB members may have different ideas of what “important information” is.
To read the full article and October’s Issue of Medical Ethics Advisor, please visit their website here. To subscribe to the journal, please visit AHC Media.
Psychologists are awarded the APA Ethics Committee Ethics Educator Award for demonstrating outstanding and innovative contributions to the profession of psychology through ethics education activities. These ethics education activities include presentations, workshops, publications and more.
The American Psychoanalytic Association announced earlier this month that members of the association no longer need to abide by the long-established “Goldwater Rule” named after 1964 presidential candidate Barry Goldwater. The rule, which can be found in Section 7.3 of the American Psychiatric Association’s (APA) Ethics Code, cautions against most psychiatrists and other mental health professionals offering opinions about an individual publicly – including the President of the United States.
In an interview with Fordham News, Dr. Fisher stated, “Revising ethical standards to address a particularly problematic political figure or to condone the publication of a book does not reflect well on the association.The public should be aware that the American Psychoanalytic Association organization does not represent the field of psychiatry per se, but a group of professionals who practice a particular therapeutic orientation within the mental health profession known as psychoanalysis.”
“Responsible diagnosis in psychoanalysis, as in other mental health fields, relies on assessment techniques that are characterized by interactions with and analysis of patient responses to specific established questions. A professionally and ethically responsible diagnosis cannot be determined in the absence of such interactions or assessments.For example, although the American Psychological Association has not adopted a “Goldwater Rule,” the importance of appropriate assessments are intrinsic in its ethics code, which forbids psychologists from providing opinions of the psychological characteristics of individuals if they have not “conducted an examination of the individuals adequate to support their statements or conclusions”. To be sure, the mental health profession can and should share their knowledge with the public, but irresponsible “diagnosis” diminishes the profession and does not serve the public it seeks to inform.”
The American Psychoanalytic Association’s Statement on “Goldwater Rule” can be found on their website.
The Fordham University HIV and Drug Abuse Prevention Research Ethics Training Institute (RETI), now in its 7th year, is a training grant sponsored by the National Institute on Drug Abuse (NIDA) (R25 DA031608-07), Principal Investigator, Dr. Celia B. Fisher, Director, Center for Ethics Education). The RETI provides early-career investigators in the social, behavioral, medical and public health fields with an opportunity to gain research ethics training. In doing so, RETI addresses the urgent need for HIV and drug use investigators who can identify and address ethical issues, engage drug using and other at-risk communities in the construction and evaluation of population sensitive research protections, and generate empirical data to inform ethical practice and policies for HIV prevention science. Through their funded Mentored Research Projects (MRP), RETI fellows generate empirical data, publish their findings in a variety of high-impact academic journals, and are trained to apply for increasing grant opportunities.
The program’s aims are to: (1) increase trainees’ knowledge of and capacity to address key ethical issues in HIV and drug abuse prevention research; (2) increase trainees’ capacity to ethically engage participants and communities in the construction of participant protections that reflect the values and merit the trust of all stakeholders in HIV and drug abuse prevention research.; (3) increase trainees’ capacity to conduct research that will generate data to inform HIV and drug abuse prevention research practices and policies; and (4) create and sustain an information and communication network for trainees, faculty and others in the field for enhancing ethical knowledge, ethical dialogue and future professional collaborations in HIV and drug abuse prevention research ethics.
President Donald Trump’s first week in office was spent signing executive orders regarding the Dakota Access and Keystone XL Pipelines, visa and refugee programs and a wall along the U.S.-Mexico border, all which sparked nationwide demonstrations and protests. Since the beginning of Trump’s campaign and more frequently over the past week, media outlets and select “experts” have been gaining attention by diagnosing Trump with various mental or personality disorders. However, is it ethical for experts in psychology and psychiatry to offer professionals diagnoses of Trump and what are the political implications?
A recent article published in U.S. News & World Report titled, “Temperament Tantrum,” featured a professional assessment of the 45h President from John D. Gartner, a practicing psychotherapist who previously taught psychiatric residents at Johns Hopkins University. Gartner told U.S. News & World Report that Trump has “malignant narcissism,” an incurable narcissistic personality disorder. Despite the Goldwater Rule, in Section 7.3 of the American Psychiatric Association’s (APA) Ethics Code, which cautions against offering a professional opinion about an individual in the public eye who has not been formally evaluated, Gartner argues that in the case of Trump, he can “make this diagnosis indisputably” and the breaking of the [Goldwater Rule within the] ethics code is warranted.
According to Dr. Celia Fisher, Professor of Psychology and Director of the Fordham University Center for Ethics Education, however, such misleading statements by mental health professionals “helps the Trump administration hide their strategic intent to undermine traditional democratic principles under the guise of a President whose impulses often get the better of him.”
Discussing her NIH-funded research on ethical issues in research involving LGBT youth, Dr. Fisher discussed the “interfamilial, regulatory and ethical tensions” that emerge in HIV prevention studies striving to recruit sexual and gender minority adolescents under 18 years of age.
