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Killing as a Psychological Service Martin H. Williams, Ph.D. One might assume that the overriding mission of psychology is to help the individuals with whom the psychologists work. One envisions the caring psychotherapist looking after patients, or the committed university teacher looking after students. However, this rosy view may be a rather narrow one. Psychologists use their skills to perform many roles, the beneficence of which are debatable, depending, sometimes, on where one stands politically. Further, this beneficence does not always fall to the individual or group towards which the psychologist’s services are directed. The principle of beneficence is complex. A psychology professor works to serve his or her students, but this service may take paradoxical forms. A student who deserves a failing grade in a psychology course and is given that grade by the professor may experience distress. Despite this, the psychologist’s belief in the overall beneficence of the university system supercedes the impact of that system on a particular student, who may receive a failing grade and experience personal distress. Indeed, even a hypothetical student who commits suicide after receiving a failing grade from a psychology professor, and who cites that grade in a suicide note as the precipitator, is no exception to the principle of beneficence. The furtherance of the science of psychology or the education of society at large are taken to be the targets of that principle. As recently discussed in Gerald Koocher’s Presidential Address to the American Psychological Association Convention in New Orleans, psychologists sometimes take as their client someone other than the individual at whom services are directed. Sometimes, for the perceived good of society, the individual who is the object of the psychological services may suffer harm, or, indeed, be killed, on behalf of the client who has contracted to receive the psychological services. Koocher provided a variety of examples of the ethical challenges faced when psychologists direct their services towards targeted individuals who are not their clients. In one example, a psychologist serves as a police hostage negotiator-- the client being the police department--and facilitates an intervention by the SWAT team when a student takes hostages at a school. The hostage-taker is the object of the psychologist’s services but is by no means the psychologist’s client. In Dr. Koocher's example, the hostage-taking student is captured with the assistance of the police psychologist. One can easily envision a modified version of Dr. Koocher’s scenario in which the end result of the psychologist’s services is that the hostage-taker is killed. For example, the police psychologist talks on the phone with the hostage-taker, fails to convince him to surrender but does provide sufficient distraction to enable a SWAT team sharpshooter to take a deadly shot. The psychologist may be credited with assisting in saving the hostages at the school. At the same time, it should be noted, the psychologist also assisted in the taking of a life, however justified. To say that psychologists strive for beneficence is correct. In many cases, though, the beneficence is received by the greater society at the expense of a particular individual whose life circumstances are worsened, e.g., if the psychologist’s efforts result in imprisonment of the individual or even his or her death. During the Second World War the forerunner of the CIA was called the Office of Strategic Services, or OSS. Psychologists were recruited by the OSS to carry out personality assessments using the best minds that the science of personality research and the practice of clinical psychology had to offer. This endeavor later evolved to form to the Institute for Personality Assessment and Research at the University of California, Berkeley. The end product of these personality assessments was to be no ivory tower publication: The OSS used personality assessment to select spies. Undoubtedly, some of the men and women chosen by the psychologists at the OSS carried out missions that involved the taking of lives. This exemplifies an early instance of psychological work being used to support killing. Perhaps no one at the time perceived a moral quandary, as our country was at war, and the free world was fighting to avoid a future under Nazism. Still, killing was a probable end product of the practice of psychology. Today, the CIA recruits psychologists to provide a wide range of services, including working as part of clandestine operations. The public is unaware of the specific missions carried out by psychologists under the auspices of the CIA, but, considering the mission of the CIA, it is not a far stretch to imagine that these psychologists, in some ways, facilitate the taking of lives. Today, the use of psychological methods to further our war efforts has become more controversial, undoubtedly because the Iraq War is unpopular and is not necessarily perceived as necessary for the survival of the United States. Psychologists can use their skills to assist in interrogation and even torture. The American Psychological Association has condemned this practice, has joined with the United Nations in this condemnation, has defined it broadly to include non-lethal forms of torture, and has determined that psychologists even have an affirmative obligation to intervene and stop torture when they know of its occurrence. This specific condemnation of torture by organized psychology may be an exception to our acceptance of many other endeavors in which psychologists serve in legally sanctioned organizations that engage, not merely in torture, but in killing. Police departments have already been mentioned. They are given the authority by society to use deadly force to protect society from harm. Psychologists serve on police departments in a variety of ways, ranging from screening police office candidates (see, for example, the web site for Law Enforcement Services Incorporated www.lesi.com), providing clinical services to officers and their families, to criminal profiling and hostage negotiations. The use of psychological methods in the service of police work appears to be widely accepted. Related to law enforcement is sentencing, including capital punishment. On June 22, 2002, the United States Supreme Court determined that execution of a mentally retarded offender constitutes cruel and unusual punishment, in violation of the Eighth Amendment. This has opened the door for a new role in forensic psychology, determining an individual's intelligence for the purpose of determining whether that individual is suitable for execution. For a psychologist who considers the death penalty to be barbaric, intelligence testing to determine suitability for execution may be seen as the moral equivalent of Hitler’s eugenics “experiments,” in which German scientists used scientific methods to determine who would live and who would die. The expressed goal was the betterment of society. In the present case, the psychologist administering the WAIS understands that a single IQ point can lead the person being examined to immanently lose his or her life. How many psychologists wish to participate in such a process? If they do chose to participate, they are protected by the APA Ethics Code which states, in the section on Conflicts Between Ethics and Law, Regulations, or Other Governing Legal Authority: If psychologists' ethical responsibilities conflict with law, regulations, or other governing legal authority, psychologists make known their commitment to the Ethics Code and take steps to resolve the conflict. If the conflict is unresolvable via such means, psychologists may adhere to the requirements of the law, regulations, or other governing legal authority. Because execution is legally sanctioned, the psychologist who uses psychological testing to give the stamp of approval for the condemned inmate to die, is not violating the Ethics Code. What makes execution of mentally retarded individuals cruel is the presumption that they are not able to understand why they are being executed and the connection between the punishment of execution and the crimes they committed. This has also been extended to individuals who are not mentally retarded but who are so gravely disabled by their mental illness--typically paranoid schizophrenia--that they fail to appreciate their circumstances, including that they are being executed for crimes they have committed. Some death row inmates remain unaware that they committed the crimes for which they are slated. Ethically, this has become an immediate challenge for psychiatrists rather than non-prescribing psychologists. Some of these death row inmates could be transformed from unsuitable for execution to suitable for execution if they were to be treated with psychotropic medications. Making this more complex are recent court decisions asserting the right of the state to force inmates to take medications that will render them sane enough to be executed. Specifically, on January 6, 2004, Charles Singleton was executed in Arkansas after a court order led him to receive medication for schizophrenia that he had previously refused to take. One of the Court of Appeals judges who ruled in favor of the forced medication ironically referred to Singleton’s inevitable execution as “the only unwanted consequence of the medication,” as if the overall improvement in Singleton’s mental health was somehow relevant under the circumstances. Medications that were developed to enhance the quality of life of those suffering from paranoid schizophrenia can be used in death row cases in a two-step process to take the life of the mentally ill inmate. In this ironic set of circumstances, the inmate is given the psychotropic medication for the sole purpose of rendering him suitable for the medication the state will give him next-- a lethal injection. Undoubtedly, psychologists will assist in these scenarios, both later when they become licensed to prescribe and sooner as part of treatment teams that use psychological methods to, in effect, "grease the skids," allowing the scenario of medication followed by execution to run smoothly. In a related forensic role, psychologists have been part of so-called "competency schools" that train mentally ill prisoners to become competent to stand trial. A criminal defendant who has been found incompetent to stand trial will spend an indeterminate amount of time at a mental hospital and will avoid trial and sentencing by virtue of his or her inability to understand even the rudiments of the judicial process and his or her consequent inability to assist the attorney in putting on a meaningful defense. Such an approach of staying the trials of mentally incompetent defendants has been part of English Common Law since at least the 18th century. Incompetency, however, is not static. Defendants may become competent. Once a defendant is declared competent, he or she can be tried and sentenced. Competency training has been used, for example, at Eleanor Slater Hospital in Rhode Island. Because psychologists may have strong ethical convictions that mentally ill individuals belong in hospitals rather than in prisons, they may find it morally reprehensible to participate in any such competency training. Or, they may find this endeavor more acceptable for nonWilliams capital crimes and less acceptable when the death penalty can be a foreseeable outcome of the process. Psychological skills can be used for a wide variety of purposes. Increasing numbers of psychologists are finding roles within the realms of the military, law enforcement and the legal system. These psychologists may believe they are working for the betterment of society, and they may well be. However, we must broaden our understanding of what we mean by psychologists’ beneficence. Psychologists’ actions that may well benefit society at large can also result in harm or death to individuals who are directly impacted by the psychologists’ skills. Martin H. Williams is a clinical and forensic psychologist in San Jose, California. He testifies nationally on psychotherapy malpractice and is a forensic evaluator for the Superior Court of California. His address is 2033 Gateway Place; Suite 500; San Jose, CA 95110. 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