The Balance Between Providing Support, Prolonging Suffering, and Promoting Death: Ethical Issues Surrounding Psychological Treatment of a Terminally Ill Client

Abstract

A psychologist with a client who is terminally ill and wishes to discuss end-of-life options, specifically the option of hastening death, is faced with an ethical dilemma as to how to proceed with treatment. Specifically, he or she is bound by the American Psychological Association's (2002) potentially conflicting Principles A and E, which advise a psychologist to “do no harm” as well as “respect … self-determination.” In addition, Standard 4 (Privacy and Confidentiality) mandates that a client's personal information is to remain private, unless that client could be in danger of harming himself or herself or others. This article discusses such a nuanced case and provides considerations as well as guidelines for psychologists to effectively navigate through this sensitive and important dilemma.

Keywords:

• end-of-life decisions
• ethics
• terminal illness
• suicide

ACKNOWLEDGMENTS

This article was the paper chosen for the 2011 APA Graduate Student Ethics Prize.