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The Canadian Code of Ethics and the Prescription Privilege Debate
SIMON MCCREA MICHAEL ENMAN JEAN PETTIFOR University of Calgary
Abstract
The appearance of the prescription privileges debate in a recent issue of Canadian Psychology presents an opportunity to examine prescription privileges from a Canadian perspective. The principles of the Canadian Code of Ethics for Psychologists (CCE) were applied to a number of key arguments offered in the debate and were found useful in evaluating their application to the Canadian context. The ethical principles provided direction in examining the full range of prescription privilege issues. The CCE may prove to be a valuable guide in providing a moral framework for the eventual development of Canadian policy on prescription privileges for psychologists.
The prescription privileges debate has generated arguments touching upon such values - based issues as public interest, professional competency, psychology's heritage and the evolution of the profession (e.g., Pagliaro, 1995; Dozois & Dobson, 1995). Perhaps the most prominent of these has been serving the public interest. Proponents of prescription privileges have suggested that the privilege would permit and encourage psychologists to address the needs of under served and vulnerable populations by increasing their access to more available mental health services (e.g., DeLeon, Fox, and Graham, 1991). Opponents of the privilege have noted that this is not necessarily true, since psychologists with or without prescription privileges are not inherently more oriented towards attending to under served and/or vulnerable populations than are other health professions (e.g., Hayes, Walser and Follette, 1995; Dozois and Dobson, 1995). Moreover, it is quite possible that psychologists with prescription privileges would tend to gravitate towards urban areas, as do medical specialists. As for the ethical principles of respect for the dignity of persons and responsible caring, both sides of the debate argue that the public interest is best served by their position.
The Canadian Code of Ethics for Psychologists (CCE), and its decision - making process (Sinclair and Pettifor, 1992), suggests a proactive course of action on the social issue of vulnerable and under served populations. The code states "...if [social] structures or policies seriously ignore or oppose the principles of respect for the dignity of persons, responsible caring, integrity in relationships, or responsibility to society, the psychologists involved have a responsibility...