Ethical Considerations in the Neuropsychological Assessment of Older Adults

Ethical practice in forensic neuropsychology.

“…In addition, failure to consider quality of education, particularly among older adult minorities, can result in overpathologizing findings (e.g., Byrd & Manly, 2012). These authors, citing prior scholars, noted, Factors such as whether African Americans attended school before or after the Supreme Court's 1954 Brown v. Board of Education decision banning segregation in public schools, unequal distribution of educational funds, variable teacher education, shorter length of school year, and lower attendance due to required work had a profound effect on the quality of education received by African Americans.…”

Ethics in the Practice of Clinical Neuropsychology: Foundations and New Horizons

“…Professional ethics codes are by nature evolutionary, reflecting changes in the profession and the sociocultural context in which the profession functions. There have been numerous works in neuropsychology discussing the application of the Ethics Code to clinical practice issues (e.g., Binder and Thompson 1994;Russo et al 2013).…”

“…test security and thirdparty observers" represent other ethical risks (Bush et al 2008, p. 340). Similarly, use of neuropsychological assessment in older adults warrants multiple ethical considerations, ranging from appropriately preparing the client and selecting reasonably normed tests to discussing distressing news and providing feedback to third parties (Russo et al 2013). Thorough foundational and functional competency training, continuing education, experience applying the APA Ethics Code, and setting appropriate role boundaries are all required to minimize ethical risk, Ethics in the Practice of Clinical Neuropsychology: Foundations and New Horizons, Table 1 Ethics decisionmaking model (Hanson et al 2005) Steps especially when one faces the potentially adversarial nature of the legal system Bush et al 2008).…”

“…Adequate informed consent must account for the individual's cognitive processing ability, prioritizing the components of the communication pertinent to the professional service to be rendered, incorporating potential sensory accommodations such as those required by many older adults, the nature of the biological impairment that may call capacity into question, and cultural factors that may impact effective communication of information vital to allow consent. Careful inquiry into the individual's understanding of the issues, deliberation of alternatives and consequences, and demonstrated ability to communicate a decision remain primary goals in achieving adequate informed consent (Appelbaum and Grisso 1988;Russo et al 2013). Other issues of relevance may be the referral source and limits of confidentiality.…”