Can a Cup of Coffee Prevent a Suicide?

A photo of a group conducting psychotherapy.

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When I was completing courses for a Phd at York University in Toronto, I had to apply to the psychology department for special permission to take the graduate psychology ethics class. Since my focus was experimental research, more specifically data quality of online surveys, and not counseling ill patients, the ethics class wasn’t deemed necessary for me.  Now, years later, I recall one story the professor shared of his own life as a counseling psychologist.

A gentleman showed up for counseling one day. He was depressed and, at times, suicidal. He desperately needed someone to help him through a difficult period. The psychologist took his case and they began weekly counseling sessions. Over time, however, the man became unable to pay the psychologist’s bill. (In Canada, psychologists are not always covered by health plans.)
The psychologist knew that this man must continue his treatment or suicide was a clear possibility. He decided to offer his services for free to ensure the safety of this man. Besides, pro bono work is something that every psychologist (and everyone) should do.

But, the man had pride. He did not want to be a charity case. He didn’t want to take advantage of the psychologist’s good nature. He was a responsible person who paid for his services. He did not mooch off people. As a result, he refused to accept free psychological treatment. But refusing treatment was not acceptable to the psychologist. How could he sleep at night knowing it was simply money preventing a man from receiving essential, life saving services.

So between the two of them, they figured out a solution. Every week, the man would buy a cup of coffee for the psychologist. Sure, the coffee only cost a buck and that was nowhere near the price of the counselling sessions. But it was a barter of goods meaning the service wasn’t really free. On the other hand, accepting the coffee could be considered a bribe under the psychologist’s code of ethics. In this case, the psychologist resigned that yes, he was going to break the code of ethics. But, weighing a weekly cup of coffee against one more week of life, his moral code let this transgression pass.

Though a cup of coffee saved this man’s life, it could have cost the psychologist his, for had this transgression been discovered, he could have lost his license.

What would you have done? Save a life or lose your livelihood?

2 responses

  1. Stuart Daciuk

    The current edition of the canadian code of ethics for psychologists states:

    “II.32 Provide a client, if appropriate and if desired by the client, with
    reasonable assistance to find a way to receive needed services in
    the event that third party payments are exhausted and the client
    cannot afford the fees involved.”

    I think hes off the hook. I could have cited a number of other passages to boost this one that support the rights of the client to ethical treatment, safety, or protection from descrimination. I believe the BC code also states that bartering is acceptable if done in an ethical manner.

  2. I’m not sure I understand why the cup of coffee counts as a bribe. If the insurance company doesn’t pay, the practitioner charges the patient directly. Can’t he charge whatever the patient agrees to pay?

    Whatever, it’s a no-brainer. I’d treat the patient and tell the licensing bureau to get real.

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