Digital Ethics: There’s No App for That

(Yet!)

Fred Provenzano, Ph.D., NCSPPrivate Practice, Seattle, WA

Teaching Associate, University of Washington

Workshop Objectives

1. Recognize the importance of sound professional judgment.

2. Become familiar with a comprehensive ethical decision-making model.

Workshop Objectives, continued

3. Increase knowledge of ethical considerations related to electronic storage & transmission of confidential data.

4. Appreciate benefits and risks related to digital communications.

Professional Ethics, v…..

• Employer Codes of Conduct• Licensing and Certification

Law• State and Federal Case and

Statute Law

Laws v. Ethical CodesLaw: • Typically specifies clearly what you can and

cannot do.• That which it does not specifically prohibit or

require, it does not restrict.• Innocent until proven guilty.

Laws v. Ethical Codes, continued

Ethical Standards:• Often more general, vague.

• Typically expect/require professional judgment.

• Often burden of proof on professionals, to show that their behavior was appropriate.

Ethical & Legal Decision Making Model

1. Describe the parameters of the situation.2.  Define the potential ethical-legal issues involved.3.  Consult ethical and legal guidelines and district policies that

might apply to the resolution of each issue. Consider broad ethical principles as well as specific mandates involved.

4.  Evaluate the rights, responsibilities, and welfare of all affected parties (e.g., child, service providers, other children, other staff, parents, siblings). Consider cultural characteristics of affected parties that might be salient to the decision.

Ethical & Legal Decision Making Model, continued

5. Generate a list of alternative decisions possible for each issue. 6. Enumerate the consequences of making each decision.

Evaluate the short-term, ongoing, and long-term consequences of each possible decision, considering the possible psychological, social, and economic costs to affected parties. Consider how each possible course of action would affect the dignity of and responsible caring for all of the people involved. Consultation with colleagues may be helpful.

7. Consider any evidence that the various consequences or benefits resulting from each decision will actually occur (i.e., a risk-benefit analysis).

8. Make the decision.

Online Communication• Email• Facebook/Twitter• Texting/Skype• Apps• Online test administration/scoring• Websites

Evolution of Digital Communication

• 1890: Keypunch cards

• 1942: First modern computer

• 1946: Dick Tracy 2-Way Wrist Radio

• 1973: Bill Gates graduates high school

• 1973: First Hand-held Mobile Phone

Predicting the Future

“There’s no reason for any individual to have a computer in their home.”

“640K ought to be enough for anybody.”

Get your feet off my desk, get out of here, you stink, and we’re not going to buy your product.”* Quoted from The Experts Speak by Christopher Cerf & Victor Navatsky. Random House, 1998.

Privacy & Privileged Communication

• Are communications by e-mail, Facebook, Twitter considered protected by privacy & practitioner-client privilege?

• When is privilege invalidated?

Email Benefits

• Quick• Easy• Immediate Dissemination• Ease in Disseminating to Group• Ease in Garnering Response

Email Risks

• Casual nature of communication• Speed of communication• Risk of primary dissemination• Risk of others’ dissemination• Security

Skype

• Advantage of direct interaction with other(e.g. parent diagnostic interview/feedback)• Disadvantages of – not knowing where the data from communication

is stored.– Diminished quality of social interaction & non-

verbal communication

Facebook Benefits• Half a BILLION users

(National Public Radio, 12/1/10)

• Ease of connection with others• Casual• Offers specific, limited connections for

groups such as classes of students

Facebook Problems

• Requires sign-up• Too casual? • Restricts how you can present yourself• Little control re what’s posted about

you• Little control re who can access

Cell Phones & Texting

Can you hear me now?v.

Who can hear me now?

Just how secure are those calls & texts?

Electronic Storage Forecast:

Cloudy, with a chance of violations of confidentiality

Healthcare Insurance Portability & Accountability Act (HIPAA)

• Standardizing privacy protections for Protected Health Information (PHI).

• HIPAA includes:–The Privacy Rule–The Transaction Rule–The Security Rule

HIPAA: Privacy Rule

• Triggered once any PHI is transmitted electronically regarding any patient/client.

• Applies to all electronic communication, including faxes.

• Once triggered, it applies to all communication regarding all clients.

• Provide PHI only with specific authorization• Only provide PHI needed for specific

requested purpose.

HIPAA: Security Rule

• Availability: The PHI can be accessed as needed by authorized persons.

• Confidentiality: The PHI cannot be accessed by unauthorized persons, intentionally or unintentionally.

• Encompasses administrative, physical and technical safeguards.

HIPAA Transmission Rule

• Intended to set standards relative to submitting electronic claims.

• Requires compliance with Privacy Rule:– PHI is only transmitted to those meant to receive

it.– PHI is transmitted in a manner that protects or at

least reduces the risk of it being forwarded in a manner that violates confidentiality.

Sensible Digital Rules

• Send pdf files of you don’t want work altered.• Encrypt sensitive files that you email.• Use flash drives with passwords or encrypt

everything on them.• Password-protect smart phones, iPads, etc. if

they hold sensitive information. • Password-protect your home network.

More Sensible Digital Rules

• Logout and delete originals with digital copiers.

• Be cautious about sensitive data on cloud services such as Dropbox.

• Assume IT folks don’t fully appreciate professional standards in mental health.

• Help your agency be compliant but don’t put your job on the line.

• Be sensible but not paranoid.

References

American Psychological Association (2010). Ethical principles of psychologists and code of conduct. Available at www.apa.org.

American Psychological Association (2007). Record keeping guidelines. American Psychologist, 62, 993-1004. Available at www.apa.org.

Canadian Psychological Association (2000). Canadian code of ethics for psychologists 3rd ed.). Available at http://www.cpa.ca.

Family Educational Rights and Privacy Act of 1974, 20 U.S.C.A. Regulations appear at 34 C.F.R. Part 99. Available at http://ecfr.gpoaccess.gov.

References, continuedJacob, S., Decker, D. & Hartshorne, T. (2011). Ethics

and law for school psychologists, 6th ed. Hoboken, NJ: John Wiley & Sons.

Health Insurance Portability & Accountability Act of 1996 (Pub. L. No. 104-191), 26 U.S.C. -294, 42 U.S.C.-201, 1395b-5.

Koocher, G. P. & Keith-Speigel, P. (2008) Ethics in psychology and the mental health professions: Standards and cases. New York: Oxford University Press.

National Association of School Psychologists. (rev. 2010). Principles for professional ethics. Available at www.nasponline.org.

References, continuedSchwab, N.C. & Gelfman, M.H. (2005). Legal

issues in in school health services: A resource for school administrators, school attorneys, school nurses. New York: Authors Choice Press.

U.S. Dept. of Health & Human Services and U.S. Dept. of Education (November 2008). Joint guidance on the application of the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) to student health records. Available at http://www.ed.gov/policy/gen/guid/fpco/doc/ferpa-hipaa-guidance.pdf.

Contact Information

• Presenter:Fred Provenzano, Ph.D., NCSP

5506 33rd Ave. NE, Suite D Seattle, WA 98105

Office: 206/361-2343 e-mail: fredipro@comcast.net

• Dr. Provenzano is the Western Regional Representative to the NASP Ethics & Professional Practices Committee.