This chapter covers the common ethical and legal issues that arise in psychiatry. It begins with an overview of the four ethical principles guiding medical practice: autonomy, beneficence, nonmaleficence, and justice. A brief discussion of parens patriae and police power follow, highlighting their particular applications in psychiatry. The chapter then goes on to illustrate how the balancing of these principles guides everyday ethical and legal issues. Confidentiality and its exceptions in the interests of safety and prevention of abuse/neglect are covered in detail. Next, informed consent and decision-making are explored. The requirements for informed consent are reviewed, leading into a discussion of those instances when an individual lacks capacity for informed consent (surrogate decision-making, involuntary admission and treatment, and exceptions). Finally, the chapter closes with an examination of the prohibitions against dual relationships, including sexual relationships, with patients.

Clinical psychology trainees embarking on a professional career are faced with the prospect of work that, daily, has ethical questions and challenges to respond to people from varied cultures and social groups. The chapter describes how to provide a culturally-sensitive clinical psychology practice. It evaluates the current evidence-base antecedencesguiding practice. The chapter suggests how Structured Problem Solving can be applied to help acquire greater skills in engaging with people from different cultures and groups (e.g., the elderly). The same Structured Problem Solving approach is then applied to ethical decision-making and illustrated with a discussion on confidentiality and dual relationships. The chapter outlines how these approaches may help the clinical psychologist respect the humanity of their clients in all facets of their engagement.