By Dr. Bob Uttl (April 26, 2024)
Numerous ethics codes require that psychologists first meet a person about whom they intend to pronounce their professional opinion. For example, Canadian Psychological Association‘s Code of Ethics for Psychologists (2017) makes it clear that psychologists are required to seek “as full and active participation as possible from individuals … in decisions that affect them…”:
Informed consent I.16 Seek as full and active participation as possible from individuals and groups (e.g., couples, families, organizations, communities, peoples) in decisions that affect them, respecting and integrating as much as possible their opinions and wishes…
CPA Code of Ethics for Psychologists (2017), CPA Code of Ethics for Psychologists (2000)
Seeking “as full and active participation as possible” would require at the bare minimum a psychologist contacting an individual about whom a psychologist intends to pronounce some professional opinions. However, it requires more than “some contact” with the person affected. An interested reader may wish to examine the CPA Code of Ethics for Psychologists (2017) as well as, for example, the College of Alberta Psychologist‘s Practice Guidelines on informed consent: CAP Practice Guidelines Informed Consent (2008), CAP Practice Guidelines Informed Consent (2014), CAP Professional Guidelines for Psychologists Informed Consent:(2008). (see the most current guidelines at College of Alberta Psychologists).
In addition to the ethics codes, there are also standards of practice. For example, the College of Alberta Psychologists introduces their Standards of Practice (2019) as “the minimum standards of professional behavior and conduct expected of all regulated members…” (College of Alberta Psychologists Standards of Practice 2019, Introduction). Not surprisingly, the Standards of Practcie make it clear that “Psychologists shall obtain the informed consent….” (Standards of Practice, 2005; Standards of Practice, 2013; Standards of Practice 2019). Equally importantly, the informed consent must be obtained by “a psychologist”, and cannot be obtained by a non-psychologist, for example, by a technician, an employer, or a gas station attendant.
Dr. Suffield rendered an opinion about Ms. T without ever meeting her, without any consent
On October 19, 2011, Dr. John Braxton Suffield faxed his duly signed report (Suffield October 19, 2011 Report) on Ms. T’s ability to perform her elementary teacher duties to the SD5 without ever meeting her. The fax was 22 pages long including 19 page report plus 1 page appendix, a cover letter, and a fax transmittal sheet. Dr. Suffield based his report primarily on his review of Dr. TK, Dr. Westcott and Dr. K’s reports and his numerous ex-parte secret conversations with the SD5. Dr. Suffield typically did not keep any notes of these conversations, did not mention them in his report, did not inform Ms. T about them. Ms. T learned about these conversations only years after the fact, only after the relevant documents were disclosed by the School District No. 5 (SD5) in ongoing human rights proceedings. In the report, Dr. Suffield provided his professional opinion about Ms. T’s intellect, cognitive abilities, personality traits, and ability to perform her job duties. Dr. Suffield did that without ever meeting with Ms. T. Dr. Suffield’s ultimate conclusion was that Ms. T “is [emphasis of Dr. Suffield’s] prevented from performing her regular teaching duties, through a combination of the cognitive deficits … and her pre-existing personality traits…”
Dr. Suffield arrived to his opinion that Ms. T was “prevented from performing her regular teaching duties” even though just a few pages earlier in his report Dr. Suffield concluded that Ms. T was a Canadian woman of average intelligence and cognitive abilities. Dr. Suffiel wrote: “Dr. K’s summary (page 9), that Ms. T’s overall cognitive skills are average compared to similarly-aged [emphasis of Dr. Suffield] Canadians, is correct.”
In the opening paragraph of his October 19, 2011 Report, Dr. Suffield also noted that he never met Ms. T and that this was consistent with professional ethical standards. Dr. Suffield wrote:
… I should point out that I have not met Ms. T; rather, in keeping with professional ethical standards, I conducted a review of notes and reports your provided, and data provided by Drs. TK, W, and K….
Dr. J. Braxton Suffield, Suffield’s October 19, 2011 Report
All psychologists, including Dr. J. Braxton Suffield, ought to know that pronouncing professional opinions about persons without ever meeting them is NOT “in keeping with professional ethical standards.”
Dr. Suffield reminded himself of his professional obligations
About a week later, on or just prior to October 26, 2011, Dr. Suffield reminded himself of his professional ethical obligation to meet Ms. T prior to forming and disseminating his opinions about her. On October 26, 2011, Dr. Suffield called Ms. Cynthia Stuart/SD5 and sent her an urgent message including the College of Alberta Psychologists Standards of Practice:
Good afternoon again.
Further to our call, I re-reviewed my obligations under the College of Alberta Psychologists. In our Standards of Practice, attached, I reminded myself of the following:
8.2 Psychologists rendering a professional opinion about a person that has or could have implications for that person’s legal or civil rights (for example, about the fitness of a parent in a custody hearing) shall not do so without a direct and substantial professional contact with or a formal assessment of that person.
I do not want to overstep my bounds. In June, I indicated I would need to see Ms. T before giving a formal opinion on her employability. I would like to exercise that option now.
J. Braxton Suffield, Ph.D., R. Psych
Dr. J. Braxton Suffield, October 26, 2011, Email to Ms. Cynthia Stuart/SD5
Dr. Suffield’s email ignored the plainly obvious fact that Dr. Suffield already gave a formal opinion on Ms. T’s employability seven days earlier in writing (and at least twice before that in phone calls with the SD5).
Dr. Suffield consulted with Dr. Joanna Dabrowski, Deputy Registrar, about his professional obligations (but only after he rendered his opinion)
On October 28, 2011, Dr. Suffield consulted with Dr. Joanna Dabrowski, Deputy Registrar & Director of Professional Guidance, College of Alberta Psychologists. According to Dr. Suffield’s notes, Dr. Suffield told her that he “was doing a review of other psychologists’ data”, that Ms. T “consented to another assessment”, and that he wondered “how much ‘direct and substantial professional contact’ with her [Ms. T] was required to meet the standard [8.2 — see above]?’. Dr. Dabrowski advised Dr. Suffield that he has to “base his opinion on impressions gathered from the data, both others’ and my [Dr. Suffield’s] own.” Verbatim, Dr. Suffield’s notes state in their entirety:
28 October 2011
Consultation with Dr. Joanna Dabrowski, CAP Deputy registrar & Director of Professional Guidance.
I told her I was doing a review of other psychologists’ data, in the context of a fitness for duty assessment. She has been assessed 3 times, but had consented to another assessment.
Given CAP Standards of Practice (2005), 8.2., how much “direct and substantial professional contact” with her was required to meet the standard?
She advised that in my report I:
She indicated that ultimately I was to base my opinionsd on impressions gathered from the data, both others’ and my own.
- State that I obtained and reviewed others’ test data;
- comment on whether or not I was confident in that data;
- determine through interview whether or not additional testing was required;
- State whether I was confident or not confident in my own data;
Dr. J. Braxton Suffield, Notes of consultation with Dr. Joanna Dabrowski, dated October 28, 2011
Not surprisingly, Dr. Dabrowski made it clear to Dr. Suffield that he had to meet with Ms. T himself.
Interestingly, Dr. Suffield’s notes state that he “was doing a review” and do not mention that he had already done/completed his review, disseminated it, and had no contact with Ms. T prior to the dissemination of his opinions about her. Quite obviously, Dr. Suffield also never obtained Ms. T’s informed consent for whatever it was he — Dr. Suffield — thought he was doing. Accordingly, Dr. Dabrowski likely had no idea that Dr. Suffield already completed and disseminated his professional opinions about Ms. T about 10 days prior to consulting with her.
Dr. Suffield issued a new report — December 30, 2011 Report — and pretended he never opined about Ms. T without meeting her
Dr. Suffield eventually met Ms. T on November 30, 2011, for the first time, and shortly thereafter issued another report, Dr. Suffield’s December 30, 2011 Report. The new report made no mention of Dr. Suffield’s October 19, 2011 Report. In fact, Dr. Suffield pretended that he never formed any opinion about Ms. T prior to meeting her for the first time on November 30, 2011. Dr. Suffield wrote in his December 30, 2011 Report:
5.1 Though I had reviewed this background information [Dr. TK, W, and K’s Reports], I was not able to form an opinion as to Ms. T’s cognitive, interpersonal, and occupational functioning without having direct and substantial professional contact with her…
Dr. J. Braxton Suffield, December 30, 2011 Report
Dr. Suffield’s statement that he “was not able to form an opinion as to Ms. T’s cognitive, interpersonal, and occupational functioning without having direct and substantial professional contact with her” was a bold-faced lie. As detailed above, Dr. Suffield was able to and did form such opinions without ever meeting Ms. T and disseminated his opinions to the SD5 in at least October 19, 2011 Report.
Dr. Suffield’s ingenious explanation for his failure to comply with the Standards of Practice (2005)
Ten years after he reminded himself of his professional obligations, Dr. Suffield offered an ingenious explanation for his failure to comply with the Standards of Practice 8.2 (2005).
My opinion as to Ms. T’s employability – which could have implications for her legal or civil rights – was based on review of three formal psychological assessments, along with the raw data underpinning those assessments. Although I did not conduct these assessments myself, I felt that in combination the three reports and data sets met the criteria set out in Standard 8.2 of “a formal assessment.”
This is because the phrasing of Standard 8.2 allowed the criteria of Sufficient Professional Knowledge to be met by “direct and substantial professional contact” or “a formal assessment of that person.” The Standard made no mention of who was to have conducted the formal assessment. [p. 56; CAP/D-JBS001065]
…
It is true that I had formed opinions about my colleagues’ reports regarding Ms. T before I met her in November, 2011. This is entirely in keeping with CAP Standard 8.3, regarding file reviews. It is also true that I formed some opinions about Ms. T herself, as I interpreted CAP Standards 8.2 regarding “sufficient professional knowledge” to be established through my review of three formal psychological assessments, along with the raw data underpinning those assessments. As noted above, the wording of Standard 8.2 was disambiguated in the 2013 revision of the Standards. [p.61; CAP/D-JBS001070]
…
While my opinion was based on muliple formal psychological assessments of Ms. T, in accordance with the College of Alberta Psychologists Standards of Practice (2005) 8.2, I had not had direct and substantial professional contact with her. After consultation with a senior colleague, I determined I needed to gather additional information from and about her, through an interview, as my opinion as to her employability could have implication for her legal or civil rights.
Dr. J. Braxton Suffield’s Respone to Ms. T’s Complaint #1, May 24, 2021
Thus, ten years after reminding himself of his professional obligations, Dr. Suffield said he came to believe that “a formal assessment” requirement of Standard 8.2 was met by Dr. Suffield having three reports written by some other psychologists about Ms. T.
If Dr. Suffield’s “explanation” was acceptable, the Standard 8(2) would mean that Dr. Suffield can render opinions about persons without meeting them and without doing any assessment at all as long as (a) someone else – say the person’s dentist – had “direct and substantial professional contact with” the person while fixing their cavities, or (b) someone else – say a driving examiner — did “formal assessment of that person” ‘s driving. The Standard 8(2) “made no mention of who was to have conducted the formal assessment” (as Dr. Suffield argues) and the standard also made no mention as to who was to have “direct substantial professional contact with” the person. Nevertheless, the Standard 8(2) has to be read in context.
The College of Alberta Psychologists defined “formal assessment” in Fall 2009
To be sure, the College of Alberta Psychologists disambiguated any perceived ambiguity as to what the “formal assessment” is and what it requires in Fall 2009. Dr. Suffield had over a decade to catch up with the definition of the formal assessment. In the CAP Monitor 2009 Fall Issue, the CAP notified its members that “the definition for the professional activity of formal assessment has been created” “to ensure that all regulated members… share a common understanding of these terms.” The College of Alberta Psychology definitions of “formal assessment” and “general assessment” are:
FORMAL ASSESSMENT
NEW DEFINITION
The definition for the professional activity of formal assessment has been changed and a new professional activity of general assessment has been created. These changes are necessary to ensure that all regulated members, including provisional psychologists, share a common understanding of these terms during both the registration process and active practice. If you have a question about the changes, please feel free to contact the College. All relevant forms will be amended and provisional psychologists will be required to follow the new definition by April 10, 2010.
The definitions are as follows:
Formal assessment is the professional activity of gathering, analyzing, and synthesizing information about an individual or group of individuals sufficient to draw supportable psychological conclusions. It entails the use of standardized instruments that are criteria and norm referenced with commonly accepted psychometric properties, direct client contact by the assessor with the person being assessed [emphasis added], AND one or more of the following: interview; personal history; behaviour observations; anecdotal information or substantive collateral information. Formal assessment is aimed at providing an understanding that will inform a practical plan of action or provide information about a person’s mental health, emotional or developmental functioning. It may result in a diagnostic classification or the identification of strengths, weaknesses and competencies, and may be communicated in a written psychological assessment report.
General assessment is the professional activity of gathering, analyzing, and synthesizing information about an individual or group of individuals sufficient to draw supportable psychological conclusions. It entails a process of gathering information through direct personal contact with the person being assessed [emphasis added], AND utilizing one or more of the following methods: interview; observations; checklists; formal or anecdotal record; personal history and other commonly accepted professional methods. It may result in a diagnostic classification or the identification of strengths, weaknesses, and competencies and may be communicated in a written report.
The College of Alberta Psychologists, the CAP Monitor, Fall 2009, p. 2
The College of Alberta Psychologists made it clear for all psychologists, not just Dr. Suffield, that if Dr. Suffield wanted “to draw supportable psychological conclusions” about someone such as Ms. T, Dr. Suffield had to do “formal assessment” HIMSELF or had to do “general assessment” HIMSELF, and could NOT rely on what some other individuals gathered, reported, misrepresented, or fabricated. These definitions were in effect since April 10, 2010 or more than a year prior to Dr. Suffield’s involvement with Ms. T’s matter and more than a decade before Dr. Suffield came up for the first time with his ingenious explanation of his conduct.
Dr. Troy Janzen, apparently ignorant of what “formal assessment” requires, concluded that Dr. Suffield was not required to meet with Ms. T before rendering his professional opinion about her
Dr. Troy Janzen, the Deputy Registrar and Complaints Director, College of Alberta Psychologists, demonstrated his astonishing ignorance and/or failure to understand Standards of Practice (2005), Code of Ethics (2000), and the College of Alberta Psychologists’s definition of “formal assessment”. Dr. Janzen wrote:
… On October 19, 2011 he [Dr. Suffield] faxed his consultation nores [Suffield October 19, 2011 Report] regarding his preliminary review [nothing in Suffield Octobver 19, 2011 Report indicated it was “preliminary”] of the three assessment reports. He stated that his was in accordance with Standard of Practice 8.2…
…
After consultation with several colleagues including the Director of Professional Guidance at CAP and an advisor at PAA, Dr Suffield decided that, while his consultation report was produced in accordance with Standard 8.2 (2005), since he had not had direct and substantial professional contact with you that he would need to gather additional information directly from you through interview. He made this decision as he recognized that any opinion he expressed might have implications for your legal or civil rights…
…
… The fact that he [Dr. Suffield] offered his preliminary written review of the three assessments prior to his in-person contact is somewheat unusual in that he offered some preliminary opinions based on the reports of others prior to seeing you. However, I observe that he couched his original opinion [October 19, 2011] as tentative, that he expressed the limits of his original opinion on the three reports, and that in the name of being thorough, and ensuring he was adhering to the higher principles of ethics by seeing you directly, he offered a second opportunity to solidify his initial opinion.
Standards 8(2) and 8(3) state:
(2) Psychologists rendering a professional opinion about a person that has or could have implications for that person’s legal or civil rights (for example, about the fitness of a parent in a custody hearing) shall not do so without direct and substantial professional contact with or a formal assessment of that person.
(3) Notwithstanding subsection 2 above, psychologists may render an opinion about reports prepared by other practitioners, providing that the limits on available information are clearly identified.
I would note once again that Dr. Suffield was not required to have seen you in person as Standard 8(3), which was in effect at that time, permitted him to offer an opinion based on reports of otehrs alone…
Dr. Troy Janzen, Deputy Registrar and Complaints Director, College of Alberta Psychologists, September 22, 2022
Dr. Janzen‘s reasoning and conclusions demonstrate Dr. Janzen’s failure to comprehend Code of Ethics (2000), Standards of Practice (2005), College of Alberta Psychologists definition of “formal assessment”, and are nothing short of astonishing:
First, there was nothing “tentative” about Dr. Suffield’s opinions as stated in Dr. Suffield’s October 19, 2011 Report. Moreover, Dr. Suffield’s opinions in October 19, 2011 and in December 30, 2011 Reports were nearly verbatim identical.
Second, Dr. Suffield’s December 30, 2011 Report was not an amendment of Dr. Suffield’s October 19, 2011 Report but was presented as the only report. As noted above, Dr. Suffield’s statement that he “was not able to form an opinion as to Ms. T’s cognitive, interpersonal, and occupational functioning without having direct and substantial professional contact with her” was a bold-faced lie. Dr. Suffield was able to form it and did form it 2.5 months before December 30, 2011.
Third, Standard 8(3) did not allow Dr. Suffield to render “a professional opinion about a person. The Standard 8(3) merely allowed him to render “an opinion about reports”. What psychologists must do when rendering opinions about a person is prescribed by Standard 8(2).
Fourth, Standard 8(2) clearly required Dr. Suffield to meet Ms. T just as Dr. Suffield reminded himself on or about October 26, 2011 and as Dr. Dabrowski explained to him on October 28, 2011. The Standard 8(2) requires “direct and substantial professional contact with or a formal assessment of that person” before a psychologist can render “a professional opinion about a person.”
Fifth, the “formal assessment” had to be conducted by Dr. Suffield himself as per the College of Alberta Psychologists definitions in force since Fall 2009 (see above).
Dr. Janzen‘s dismissal of Ms. T’s complaint that Dr. Suffield pronounced professional opinions about her in Dr. Suffield’s October 19, 2011 Report without ever meeting Ms. T is an astonishing demonstration of the College of Alberta Psychologists’ inability to regulate its members and to prevent harm to the public. If the Deputy Registrar and the Complaints Director is so uninformed that he believes it is ok for a psychologist to render professional opinions about others without ever talking to them what can the public expect from regular members of the College of Alberta Psychologists such as Dr. J. Braxton Suffield?
College of Alberta Psychologists does know that pronouncing professional opinions about persons without ever meeting them is unprofessional conduct
The College of Alberta Psychologists does know that if a psychologist renders an opinion about someone without ever talking to them (and therefore also not assessing them) the psychologist is guilty of unprofessional conduct. For example, as summarized in M.N. v. Froberg, 2009 ABQB 145, a psychologist failed to meet minimum professional standards by not speaking to a person prior to issuing the report:
[11] At no time prior to providing either report did the Defendant speak with or interview the Plaintiff.
[12] The Plaintiff made a complaint to the College of Alberta Psychologists because the Defendant had prepared the reports without speaking to him. The College found that the Defendant had failed to meet minimum professional standards because she had not spoken to the Plaintiff before issuing her reports. [emphasis added]
[13] Section 6 of the Alberta Psychologists Code of Conduct provides as follows:
Psychologists rendering a formal professional opinion about a person that has implications for that person’s legal or civil rights (for example, about the fitness of a person in a custody hearing) shall not do so without direct and substantial professional contact with or a formal assessment of that person.
M.N. v. Froberg, 2009 ABQB 145, paras 11 to 13
Similarly, in T.P. v. Dr. B, 2016 ABQB 158, the College of Alberta Psychologists found Dr. B was guilty of unprofessional conduct, in part, because he did not have “any professional contact with” a mother but produced a report that affected her rights. As the Court wrote:
[5] Dr. B. admitted to unprofessional conduct before the College of Alberta Psychologists, which made the following findings concerning Dr. B:
(i) he provided psychological services to the 13 year old daughter without taking any steps to obtain court documentation which could inform the analysis of which party was authorized to provide informed consent on behalf of the daughter.
(ii) he failed to sufficiently document the informed consent process … particulars of which include failure to sufficiently document one or more of the following:
a. the purpose and nature of his professional services,
b. likely benefits and risks,
c. likely consequences of non-action,
d. the option to refuse services or withdraw at any time, and
e. how to rescind consent if desired.
(iii) he inappropriately undertook his own child protection investigation.
(iv) he rendered a professional opinion regarding the daughter’s custody and/or access arrangements without any professional contact with her mother, particulars of which include:
a. advising the father’s lawyer that he supported the daughter changing her residence to live with her father in another province where the father lived, and
b. recommending to the father’s lawyer that the daughter’s visits with her mother be supervised and monitored.
(v) he inappropriately delayed reporting his child protection concerns for 3 days until after he had provided his professional opinion to the father’s lawyer concerning custody and/or access.
T.P. v. Dr. B, 2016 ABQB 158, para 5
Epic ethics fail, bias, and/or sweeping complaints under the proverbial rug
On September 27, 2022, Dr. Janzen dismissed all of Ms. T’s complaints against Dr. Suffield, including the complaint that Dr. Suffield rendered a professional opinion about Ms. T on October 19, 2011 without ever meeting her. Epic ethics fail? Apparently, in Dr. Janzen’s mind, there is no need for psychologists to meet with persons about whom the psychologists are rendering professional opinions. If Dr. Janzen believes this, Dr. Janzen likely has no idea what ethics is and no understanding of basic ethical principles such as respect for the dignity of persons and people (see CPA Code of Ethics).
Yet, as the reported court cases show, the College of Alberta Psychologists knows it is unprofessional conduct to render professional opinions about persons without meeting them. This raises questions about the College of Alberta Psychologists’ ability to regulate its members in an unbiased way. Does the College of Alberta Psychologists enforce the Code of Ethics and the Standards of Practice against some but not other psychologists, perhaps depending on who knows who in the upper echelons of the College?
It is also possible that the College of Alberta Psychologists simply attempts to sweep all complaints under the proverbial rug and sometimes they do not succeed.