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The Ethics Code seeks to avoid harm and protect autonomy, informed by solid clinical thinking and good research. Stephen Behnke APA Ethics Director December 2004, Vol 35, No.11 Print version: page 76 The APA Ethical Principles of Psychologists and Code of Conduct--our ethics code--consists of general principles and standards of conduct, as its title reveals.The medical profession does not have a firm rule prohibiting all sexual relationships with former patients, nor does it have anything like the inflexible two-year rule now applicable to psychologists.I know of no other profession that has such a rule, and I suspect that only the priesthood has a stricter rule.10.08 SEXUAL INTIMACIES WITH FORMER THERAPY CLIENTS/PATIENTS (a) Psychologists do not engage in sexual intimacies with former clients/patients for at least two years after cessation or termination of therapy.

From the ethical perspective, a conflict arises between General Principle A, Beneficence and Nonmaleficence, and General Principle E, Respect for People's Rights and Dignity.

A member of a profession who for purely personal reasons accedes to a client’s request, and thereby obtains a personal benefit, knowing that to do so will jeopardise the client’s objectively and professionally ascertained interests, exploits the professional relationship, and therefore exploits the client: on this hypothesis, the opportunity to obtain the personal benefit arises from the fact of the professional relationship.

A psychologist who enters into a sexual relationship with a client or former client at that person’s request, and who does so when he knows or ought to know that he is thereby putting the other’s health (mental or otherwise) at risk, acts unprofessionally.

The conflict arises because Principle A exhorts psychologists to do good and not do harm, while Principle E exhorts psychologists to respect individuals' right to self-determination.

Note how the code settles this conflict in the case of sexual involvements with current clients and patients; harm is so likely to occur, and autonomy so likely to be compromised in the therapy relationship, that the code establishes an absolute prohibition against sexual relationships.

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When conflicts arise between values, the standards must negotiate among the competing values.

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  1. Regardless of the subject, the theme is recurrent: GPs are not providing a service that the public has been told it should expect. It's a hard battle to fight alone, with no quick comeback to shed some perspective on the frontline experience of actually doing the job. Exasperated by yet another criticism of not only the waiting time to see a GP, but also the suggestion that the patient might wish to invoice us for the 17 minutes we were running behind, I lost my resolution to not take it personally.