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Essential Steps for Ethical Problem-Solving |
Is there a conflict of values, or rights, or professional responsibilities? (For example, there may be an issue of self-determination of an adolescent versus the well-being of the family.) 2. IDENTIFY the key values and principles involved. What meanings and limitations are typically attached to these competing values? (For example, rarely is confidential information held in absolute secrecy; however, typically decisions about access by third parties to sensitive content should be contracted with clients.) 3. RANK the values or ethical principles which - in your professional judgment - are most relevant to the issue or dilemma. What reasons can you provide for prioritizing one competing value/principle over another? (For example, your client’s right to choose a beneficial course of action could bring hardship or harm to others who would be affected.) 4. DEVELOP an action plan that is consistent with the ethical priorities that have been determined as central to the dilemma. Have you conferred with clients and colleagues, as appropriate, about the potential risks and consequences of alternative courses of action? Can you support or justify your action plan with the values/principles on which the plan is based? (For example, have you conferred with all the necessary persons regarding the ethical dimensions of planning for a battered wife’s quest to secure secret shelter and the implications for her teen-aged children?) 5. IMPLEMENT your plan, utilizing the most appropriate practice skills and competencies. How will you make use of core social work skills such as sensitive communication, skillful negotiation, and cultural competence? (For example, skillful colleague or supervisory communication and negotiation may enable an impaired colleague to see her/his impact on clients and to take appropriate action.) 6. REFLECT on the outcome of this ethical decision making process. How would you evaluate the consequences of this process for those involved: Client(s), professional(s), and agency (ies)? (Increasingly, professionals have begun to seek support, further professional training, and consultation through the development of Ethics review Committees or Ethics Consultation processes.) From discussion by Frederick Reamer & Sr. Ann Patrick Conrad in Professional Choices: Ethics at Work (1995), video available from NASW Press 1-800-227-3590 Format developed by Sr. Vincentia Joseph & Sr. Ann Patrick Conrad NASW Office of Ethics and Professional Review, 1-800-638-8799 750 1st Street, NE, Suite 700, Washington, DC 20002
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plus-circle Add Review comment Reviews47 Previews Better World Books DOWNLOAD OPTIONSNo suitable files to display here. EPUB and PDF access not available for this item. IN COLLECTIONSUploaded by Lotu Tii on August 27, 2015 SIMILAR ITEMS (based on metadata)" style=" object-fit:cover;object-position:50.0% 50.0%; " > yourceus.comEth3338 - section 2: best practice models of ethical decision making. This course will now present a number of ethical decision making models, covering current and best practices strategies from the social work and counseling arenas, as well as from the private business sector. Each of these models will be presented in an easily printable form, allowing the trainee to print and store the models for easy later reference. Models are arranged in order of increasing complexity, from the simplest model to the most detailed model. The clinician who wishes to operate from the most defensible and responsible ethical position would do well to have a comprehensive knowledge of all of these models, operate using the combined principles and understandings of these best practices models - applying them with integrity and skill - while carefully documenting the work and noting which model or models were utilized to arrive at the ethical decision. Model I: Elaine Congress ETHIC Model of Decision Making In her article, What Social Workers Should Know About Ethics: Understanding and Resolving Practice Dilemmas, (Advances in Social Work Practice, Vol. 1 No 1 Spring 2000, pgs 1 – 25), Congress discusses the major tenets of the newly revised NASW Code of Ethics. In addition to her review, Congress also presents the ETHIC model of decision making: “This easy to use five step process includes examining personal, agency, client, and professional values, thinking about ethical standards and relevant laws, hypothesizing about consequences, identifying the most vulnerable, and consulting with supervisors.” This model, described in more detail below, is meant to be a quick and as effective as possible approach to resolving ethical dilemmas. E – Evaluate relevant personal, societal, agency, client and professional values T – Think about what ethical standard of the NASW Code of Ethics applies, as well as relevant laws and case decisions H – Hypothesize about possible consequences of different decisions I - Identify who will benefit and who will be harmed in view of social work’s commitment to the most vulnerable C – Consult with supervisor and colleagues about the most ethical choice Congress, Elaine P., What Social Workers Should Know About Ethics: Understanding and Resolving Practice Dilemmas, Advances in Social Work Practice, Vol. 1 No 1 Spring 2000, pgs 1 – 25 Model II: American Counseling Association Approach to Ethical Decision Making In its statement of purpose, the ACA Code of Ethics states that counselors are expected to use a credible decision making approach to resolving dilemmas: “When counselors are faced with ethical dilemmas that are difficult to resolve, they are expected to engage in a carefully considered ethical decision-making process. Reasonable differences of opinion can and do exist among counselors with respect to the ways in which values, ethical principles, and ethical standards would be applied when they conflict. While there is no specific ethical decision making model that is most effective, counselors are expected to be familiar with a credible model of decision making that can bear public scrutiny and its application.” A Practitioner’s Guide to Ethical Decision Making ( 2006) developed by Holly Forester-Miller and Thomas Davis for the American Counseling Association presents an ethical decision making model for ACA members. This model is summarized below. ACA Ethical Decision Making Model 1. Identify the problem. 2. Apply the ACA Code of Ethics. 3. Determine the nature of the dimensions of the dilemma. 4. Generate potential courses of action. 5. Consider the potential consequences of all options, choose a course of action. 6. Evaluate the selected course of action. 7. Implement the course of action. Forester-Miller and Davis conclude that: “It is important to realize that different professionals may implement different courses of action in the same situation. There is rarely one right answer to a complex ethical dilemma. However, if you follow a systematic model, you can be assured that you will be able to give a professional explanation for the course of action you chose.” Citing Van Hoose and Paradise (1979) they go on to say: “a counselor ‘is probably acting in an ethically responsible way concerning a client if: (1) he or she has maintained personal and professional honesty, coupled with (2) the best interests of the client, (3) without malice or personal gain, and (4) can justify his or her actions as the best judgment of what should be done based upon the current state of the profession.’” Forrester-Miller, H. and Davis, T. (1996). A practitioner’s guide to ethical decision making. Alexandria, VA. American Counseling Association. Van Hoose, W. H. and Paradise, L.V. (1979). Ethics in counseling and psychology: Perspectives in issues and decision-making. Cranston, RI: Carroll Press. Model III: Essential Steps for Ethical Problem-Solving – Frederic Reamer and Sr. Ann Patrick Conrad The following approach, discussed by Reamer and Conrad, was included in a video developed by the NASW Office of Ethics and Adjudication and produced by NASW Press and the NASW Insurance Trust as a tool for use by practitioners, faculty members and students, agency administrators, and licensing boards. 1. DETERMINE whether there is an ethical issue or/and dilemma. Is there a conflict of values, or rights, or professional responsibilities? (For example, there may be an issue of self-determination of an adolescent versus the well-being of the family.) 2. IDENTIFY the key values and principles involved. What meanings and limitations are typically attached to these competing values? (For example, rarely is confidential information held in absolute secrecy; however, typically decisions about access by third parties to sensitive content should be contracted with clients.) 3. RANK the values or ethical principles which - in your professional judgment - are most relevant to the issue or dilemma. What reasons can you provide for prioritizing one competing value/principle over another? (For example, your client's right to choose a beneficial course of action could bring hardship or harm to others who would be affected.) 4. DEVELOP an action plan that is consistent with the ethical priorities that have been determined as central to the dilemma. Have you conferred with clients and colleagues, as appropriate, about the potential risks and consequences of alternative courses of action? Can you support or justify your action plan with the values/principles on which the plan is based? (For example, have you conferred with all the necessary persons regarding the ethical dimensions of planning for a battered wife's quest to secure secret shelter and the implications for her teen-aged children?) 5. IMPLEMENT your plan, utilizing the most appropriate practice skills and competencies. How will you make use of core social work skills such as sensitive communication, skillful negotiation, and cultural competence? (For example, skillful colleague or supervisory communication and negotiation may enable an impaired colleague to see her/his impact on clients and to take appropriate action.) 6. REFLECT on the outcome of this ethical decision making process. How would you evaluate the consequences of this process for those involved: Client(s), professional(s), and agency (ies)? (Increasingly, professionals have begun to seek support, further professional training, and consultation through the development of Ethics Review Committees or Ethics Consultation processes.) From discussion by Frederick Reamer & Sr. Ann Patrick Conrad in Professional Choices: Ethics at Work (1995), video available from NASW Press , Retrieved 1/21/08 from: http://www.socialworkers.org/pubs/code/oepr/steps.asp Model IV: Steinman, Richardson and McEnroe Ethical Decision-Making Process The Ethical Decision-Making Manual for Helping Professionals, by Steinman et al. states that before you can begin a decision making process you need to identify the problem. Once the problem is identified, their model includes the following steps: Step 1: Identify the Ethical Standard Involved - What are the codes or laws that apply? If there are none, then why is it a problem? Step 2: Determine the Ethical Trap Possibilities - Possible Ethical Traps to avoid include: a. a belief that there is an easy “commonsense, objective” solution b. conflicting values, such as between personal or religious values and professional values c. the circumstances are so unique they must be taken into consideration, and d. confusion about who will benefit from a decision Step 3: Frame a Preliminary Response – What do the code and the law say you should do; what circumstances, if any, should influence the response; and what is your preliminary response? Step 4: Consider the Consequences – What will happen if you take that action? What are the short and long term consequences? Could there be any unintended consequences? Are the consequences ethically defensible? Step 5: Prepare Ethical Resolution a. What is the situation, including possible relevant circumstances? b. What ethical codes or laws are involved? c. What do these codes or laws suggest I or others do? d. If I have consulted with colleagues, supervisors, or professional ethics boards, at this point, what do they suggest I or others do? e. What are the consequences of taking this action on the client, on me, on my employer, and on others in the community? f. In light of these considerations, here is what I propose……. Step 6: Get feedback – Discuss with your supervisor, respected peer, and/or attorney if legal issues involved Step 7: Take Action – Use feedback to amend the resolution as needed and then take action. Steinman, Sarah, Richardson, Nan Franks and McEnroe, Tim, The Ethical Decision-Making Manual for Helping Professionals, Brooks/Cole Publishing Company, New York, 1998 Model V: Dolgoff, Loewenberg and Harrington – A General Decision Making Model In presenting his model for making ethical decisions, Dolgoff states that “Ethical decision making is far too complex to permit the development of a simple “how-to” problem-solving model…… A model is a permissible didactic devise as long as it is understood that in real life every decision is preceded and followed by other decisions, many of which have a direct bearing on the matter under consideration.” (pgs. 57 – 58) A General Decision-Making Model Step 1. Identify the problem and the factors that contribute to its maintenance Step 2. Identify all of the persons and institutions involved in this problem, such as clients, victims, support systems, other professionals and others Step 3. Determine who should be involved in the decision making Step 4. Identify the values relevant to this problem held by the several participants identified in Step 2, including the client’s and worker’s Step 5. Identify the goals and objectives whose attainment you believe may resolve (or reduce) the problem Step 6. Identify alternate intervention strategies and targets Step 7. Assess the effectiveness and efficiency of each alternative in terms of the identified goals Step 8. Select the most appropriate strategy Step 9. Implement the strategy selected Step 10. Monitor the implementation, paying particular attention to unanticipated consequences Step 11. Evaluate the results and identify additional problems To assist social workers using Dolgoff’s Decision Making Model, he offers the Ethical Assessment Screen to “help social workers further clarify and integrate the ethical aspects of decision making in social work practice.” (pg 58) Ethical Assessment Screen 1. Identify your own relevant personal values in relation to this ethical dilemma 2. Identify any societal values relevant to the ethical decision to be made 3. Identify the relevant professional values and ethics What can you do to minimize conflicts between personnel, societal, and professional values? 4. Identify alternative ethical options that you may take 5. Which of the alternative ethical actions will protect to the greatest extent your client’s and others’ rights and welfare? 6. Which alternative action will protect to the greatest extent possible society’s rights and interests? What can you do to minimize conflicts between your client’s, others’ and society’s rights and interests? 7. Which alternative action will result in your doing the “least harm” possible? 8. To what extent will alternative actions be efficient, effective and ethical? 9. Have you considered and weighed both the short and long term ethical consequences? Ethical Rules Screen With the Ethical Rules Screen, Dolgoff provides a step to help social workers understand that the Code takes precedent over their own personal values. This concept is relevant to counselors and marriage and family therapists, as well. A social worker who has done an ethical self- assessment, such as the one provided above, will have a better appreciation of the values they hold that are personal versus those that they hold as a professional. The Ethical Rules Screen suggests that if one or more provisions of the Code apply, the Code should be followed. If the Code does not cover the specific issue or if conflicting provisions of the Code apply, Dolgoff offers the social worker a way to rank the provisions of the Code as they apply to that particular situation in the Ethical Principles Screen provided below. Since the NASW Code of Ethics does not place any one particular value, principle or standard above another and recognizes that there will be reasonable differences of opinion, it is important that social workers attempting to apply any decision making model have a justifiable approach for how they have ranked the principles. Ethical Rules Screen Examine the Code of Ethics to determine if any of the Code rules are applicable. These rules take precedence over the worker’s personal value system. If one or more of the Code rules apply, follow the Code rules. If the Code does not address the specific problem, or several Code rules provide conflicting guidance, use the Ethical Principles Screen. Ethical Principles Screen (EPS) 1. Protection of life 2. Equality and inequality 3. Autonomy and freedom 4. Least harm 5. Quality of life 6. Privacy and confidentiality 7. Truthfulness and full disclosure Dolgoff, Ralph, Loewenberg, Frank, and Harrington, Donna, Ethical Decisions for Social Work Practice, Brooks/Cole – Thompson Learning, Belmont, CA, 2005 NEXT SECTION>>> An official website of the United States government The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site. The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
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Examination of Ethical Decision-Making Models Across Disciplines: Common Elements and Application to the Field of Behavior AnalysisVictoria d. suarez. 1 Endicott College, Beverly, MA USA Videsha Marya2 Village Autism Center, Marietta, GA USA Mary Jane Weiss3 Behavioral Health Center of Excellence, Los Angeles, CA USA Human service practitioners from varying fields make ethical decisions daily. At some point during their careers, many behavior analysts may face ethical decisions outside the range of their previous education, training, and professional experiences. To help practitioners make better decisions, researchers have published ethical decision-making models; however, it is unknown the extent to which published models recommend similar behaviors. Thus, we systematically reviewed and analyzed ethical decision-making models from published peer-reviewed articles in behavior analysis and related allied health professions. We identified 55 ethical decision-making models across 60 peer-reviewed articles, seven primary professions (e.g., medicine, psychology), and 22 subfields (e.g., dentistry, family medicine). Through consensus-based analysis, we identified nine behaviors commonly recommended across the set of reviewed ethical decision-making models with almost all ( n = 52) models arranging the recommended behaviors sequentially and less than half ( n = 23) including a problem-solving approach. All nine ethical decision-making steps clustered around the ethical decision-making steps in the Ethics Code for Behavior Analysts published by the Behavior Analyst Certification Board ( 2020 ) suggesting broad professional consensus for the behaviors likely involved in ethical decision making. Ethical decision making is operant behavior involving a behavior chain of complex responses (Marya et al., 2022 ). As behavior analysts, we make difficult ethical decisions daily. Behavior analysts are typically taught to respond to ethical scenarios via vignettes or descriptions of real-world ethical dilemmas (e.g., Bailey & Burch, 2016 ; Sush & Najdowski, 2019 ). However, the variability in ethical dilemmas that behavior analysts contact can be extensive and often contains contextual information not included in past training. Such contextual variables (e.g., impact of and on stakeholders, organizational variables, perspective of the funding source) might alter one’s course of action. Ethical decision-making models can equip behavior analysts with the needed tools to navigate varied and complex dilemmas. Thus, behavior analysts can benefit from models that allow an analysis of contextual variables because those variables often impact solutions. Ethical conduct of board certified behavior analysts is governed by the Behavior Analyst Certification Board (BACB) ethical codes. Since its inception, the BACB has disseminated three major codes— Guidelines for Responsible Conduct for Behavior Analysts (BACB, 2004 , 2010 ), the Professional and Ethical Compliance Code for Behavior Analysts (BACB, 2014 ), and most recently the Ethics Code for Behavior Analysts (BACB, 2020 ). Although versions prior to 2020 outlined specific ethical obligations and provided a framework and reference for considering paths of action when confronted with ethical challenges, no ethical decision-making tool was embedded until the most recent Code iteration. Within applied behavior analysis (ABA), several ethical decision-making models have been published to guide behavior analysts to make optimal decisions (BACB, 2020 ; Bailey & Burch, 2013 , 2022 ; Brodhead, 2015 ; Brodhead, Quigley, & Wilczynski, 2018 ; Newhouse-Oisten et al., 2017 ; Rosenberg & Schwartz, 2019 ; Sush & Najdowski, 2019 ). These models unanimously share the common goal of providing readers with a systematic approach to ethical decision making, yet include unique elements that provide varying contextual recommendations. Some models offer a generalizable approach affording wider applicability to a variety of ethical situations (BACB, 2020 ; Bailey & Burch, 2013 , 2016 , 2022 ; Brodhead et al., 2018 ; Rosenberg & Schwartz, 2019 ; Sush & Najdowski, 2019 ), and other models provide guidance to navigate specific ethical situations (Brodhead, 2015 ; Newhouse-Oisten et al., 2017 ). Moreover, some models incorporate a problem-solving approach wherein multiple behaviors are considered along with their possible outcomes to aid decision making in ethical contexts (Rosenberg & Schwartz, 2019 ). Existing models within the behavior analytic literature have all emerged in the last 7 years and offer a discipline-specific approach. However, many other allied disciplines (e.g., medicine, psychology) have published literature offering models for ethical decision making for a longer period than the field of behavior analysis. Recently, there have been calls to action where behavior analysts have been looking to and learning from related professions (LaFrance et al., 2019 ; Miller et al., 2019 ; Pritchett et al., 2021 ; Taylor et al., 2019 ; Wright, 2019 ). Learning from other disciplines may help the field of behavior analysis rule out ineffective approaches or derive novel effective solutions more quickly. The purpose of this systematic literature review was to conduct a descriptive analysis of ethical decision-making models across behavior analysis and allied disciplines. This literature review aimed to identify similarities and differences in approaches to ethical decision making that could inform future ethical decision-making models and aid the development of ethical decision-making skills in behavior analysts. Inclusion CriteriaArticles included in this systematic review met the following three criteria: published in peer-reviewed journals through June 2020, written in English, and the title or abstract included keywords from the search (described below). We began the review in July 2020 and completed it in August 2021. Search ProcedureWe conducted a systematic review of the literature on ethical decision-making models for the fields of applied behavior analysis, education, medicine, occupational therapy, psychology, social work, and speech language pathology using the Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (Moher, Liberati, Tetzlaff, Altman, & Prisma Group, 2009 ). We chose these fields because of their similarities to behavior analysis’ mission in serving vulnerable populations. The following procedures were completed in accordance with the PRISMA guidelines: (1) potential articles meeting inclusion criteria were identified; (2) the identified articles were comprehensively screened; (3) the eligibility of each article was evaluated across dependent measures; and (4) the included articles were analyzed. The first and second authors completed primary database searches using PsycINFO and PubMed. The keywords used to identify potential articles to be included in this analysis were: applied behavior analysis, clinical psychology, counseling psychology, decision mak*, educat*, ethic*, model, medicine, nursing, occupational therapy, speech and language*, and social work. In particular, the key words “ethic*”, “decision mak*”, and “model” were used in combination with the terms “applied behavior analysis,” or “clinical psychology,” or “counseling psychology,” or “medicine,” or “nursing,” or “occupational therapy,” or “speech,” or “language.” The initial PsycINFO and PubMed searches yielded 635 articles. Of these, 46 were duplicates. The titles and abstracts of the remaining 589 articles were read by the first and second authors to evaluate the inclusion of keywords. Full-text articles were retrieved for studies that included the words ethics or ethical , decision making , or model in their abstracts or titles ( n = 249). Of these, a total of 173 articles were selected for full-text review. The articles selected for full-text review ( n = 173) were read in their entirety to evaluate whether they met these criteria: (1) included humans as the population of interest; (2) mentioned decision making; (3) mentioned ethics; (4) provided at least three identifiable steps to be followed as a part of a model in either a text or figure format; and (5) the provided model addressed how to respond to ethical dilemmas. The first and second authors scored each of the 173 articles across the aforementioned criteria to determine whether they would be included in the final analysis. Articles ( n = 27) for which it was unclear whether they met any of the criteria were coded as needing additional review, and the third and fourth authors completed an additional full-text review to determine whether they would be included in the final analysis. A total of 126 articles were removed for not meeting all five of the criteria. Thus, 47 articles remained to be included in the analysis. Next, the first and second authors conducted a manual search (i.e., identification through other sources) of the references ( n = 1,354) for the remaining 47 articles. The screening criteria for this search was identical to the initial screening in which the title and abstract were searched for the inclusion of the words ethics or ethical , decision making , and model . Seventy-nine additional articles were identified through this process. Of these 79 articles, 16 were identified as duplicates from the initial PsycINFO and PubMed searches. Twelve articles were inaccessible to us online or through available library loans and were thus excluded. A list of these articles is not included in this article but is available upon request. Upon reviewing the full text of the remaining 51 articles, 26 additional articles met eligibility to be included in the analysis. In sum, a total of 60 articles met all inclusion criteria and were included. Interrater reliability was scored using a consensus-based approach. In particular, all four authors collaboratively scored each of the models across the various measures described in the section below. If there was disagreement on scoring at any point, the authors collaboratively reviewed the model using figures provided within the article and any available text describing the model until consensus in scoring was reached. Dependent MeasuresArticles that met criteria for inclusion were evaluated across four dependent measures. First, we evaluated the steps included within the models from each article. Second, we categorized the model by the professional discipline or field of study. Third, we evaluated whether the model author presented the model in a specific order or sequence (i.e., linear or sequential model). Lastly, we scored whether the model included a problem-solving approach. We provide greater detail on each of these dependent measures below. Decision-Making StepsThe models from each article were evaluated across nine steps (Table (Table1). 1 ). These steps were developed during the process of data synthesis. We read the included articles and identified common themes based on their prevalence in the examined literature. Next, we began classifying articles by the inclusion of these steps, indicating whether each article contained each of the identified steps. Then, we began tracking additional steps that appeared in articles. If those steps appeared in multiple articles, we added them as official steps in the analysis. When this was done, all previously coded articles were recoded for these additional steps. For the purpose of the current review, we identified the following nine components of ethical decision making: (1) ethical radar; (2) urgent detour; (3) pinpoint the problem; (4) information gathering; (5) available options/behaviors; (6) ranking and weighing; (7) analysis; (8) implementation; and (9) follow-up. Details on scoring criteria for each of these steps can be found in Appendix Table Table4. 4 . We scored models included in each article as either including or not including the steps listed above. This was done by using the text description of the model, if provided, or the figure representation of the model if descriptive text was not included. Steps from the Decision-Making Model from the Ethics Code for Behavior Analysts ( 2020 ) and from the Current Literature Review
*Step 4 of the BACB model aligns with components from Step 6 of current literature review. Decision-making Steps
Field of StudyThe field of study of each article was recorded (e.g., psychology). Where possible, we also included a secondary field of study (e.g., school psychology). The primary field of study of the article was determined based on the journal that it was published in and the intended audience of the article. Secondary fields of study were coded to further gather information about the specific subfield. For example, if the article was published in a psychology journal and the audience of the article was specifically school psychologists. Problem SolvingModels within each article were scored as including a problem-solving component or approach if the model author(s) guided the model users to identify two or more possible solutions and likely outcomes or consequences to the possible solutions. Models that did not include more than one possible solution and did not anticipate outcomes to solutions were scored as not including a problem-solving component. Linear or SequentialWe coded whether the proposed model was linear or sequential in nature. That is, the model author(s) indicated that steps in the model followed a certain order or sequence wherein each preceding step in the model was to be considered prior to moving on to subsequent steps. If a model was not linear or sequential, this was also recorded. Number of ModelsA total of 55 ethical decision-making models across 60 peer-reviewed journal articles were analyzed. Models included in more than one article were counted as duplicates, and papers that included more than one model resulted in each unique model being coded. Table Table2 2 shows the number of models that included each of the nine steps. None of the steps were present in all models and the step that was included in the greatest number of models was ranking and weighing information ( n = 51; 93%). After ranking and weighing information, the steps found in the most-to-least number of models were: affected parties and available options/behaviors ( n = 49; 89%); reference other codes of ethics (e.g., personal, religious, organizational; n = 44; 80%); analysis ( n = 43; 78%), reference of professional codes ( n = 40; 73%); case specific information ( n = 38; 69%); implementation and pinpoint the problem (29 models each; 52%); follow up ( n = 26; 47%); ethical radar ( n = 21; 38%); urgent detour ( n = 16; 29%); and, information gathering ( n = 11; 20%). Steps Included in Each Model
Figure Figure1 1 shows a stacked bar chart of the primary and secondary fields of the ethical decision-making models. Medicine dominated the resulting set of models, followed by psychology, education, business, then child and youth care and organizational behavior management (OBM). Nevertheless, 23 different subspecialties were represented in the secondary field of the ethical decision-making models. Stacked-Bar Graph Showing the Number of Ethical Decision-Making Models Based on the Primary and Secondary Literatures from which It Came Table Table3 3 presents a list of the synthesized models and their respective fields of study. The most common field of study across the 55 models was medicine ( n = 34; 62%). Seventeen of the models from medicine were specific to the subfield of nursing (50%) and three were specific to the subfield of psychiatry (9%). Of the remaining models from the field of medicine, one each was specific to critical care (3%), dentistry (3%), emergency medicine (3%), geriatrics (3%), internal medicine (3%), and oncology (3%). The remaining models from the field of medicine were coded as “general medicine” because they did not indicate a specific subfield. Field of Study of Included Models
Thirteen models were specific to the field of psychology (24%). Four of the psychology specific models were from the subfield of counseling (31%) and two were specific to the subfield of school psychology (15%). Other specified psychology subfields included coaching ( n = 1; 8%), industrial/organizational psychology ( n = 1; 8%), pediatric psychology ( n = 1; 8%), and psychobiography ( n = 1; 8%). The remaining models were coded as “general psychology” because they did not indicate a specific subfield. Three models were specific to the field of education (5%). Two of these were specific to the subfield of teaching (67%) and one was specific to the subfield of administration and leadership (33%). Two models were specific to the field of business (4%); one of these was specific to the subfield of management (50%) and the other to the subfield of leadership (50%). One model was specific to the field of child and youth care (2%), one was specific to engineering (2%), and one was specific to OBM (2%). Figure Figure2 2 shows the number of models that contained a problem-solving approach. A total of 23 models included a problem-solving approach (42%) and 32 did not (58%). Most of the models with a problem-solving component came from medicine ( n = 15; 65%), followed by psychology ( n = 7; 30%), and engineering ( n = 1; 43%). No models from the fields of business, education, or OBM included a problem-solving component. Bar Graph Showing the Number of Decision-Making Models with and without a Problem-Solving Component, and Models that were Sequential or Nonsequential Figure Figure2 2 also shows the number of models that were sequential. A total of 52 models were linear or sequential in nature (95%), whereas 3 were not (5%). Most of the models that were sequential came from medicine ( n = 32; 62%), followed by psychology ( n = 14; 27%), education ( n = 3; 58%), business ( n = 2; 4%), engineering ( n = 1; 2%), and child and youth care ( n = 1; 2%). The goal of this literature review was to identify and analyze published ethical decision-making models in behavior analysis and allied disciplines to determine consistency in recommended approaches. We examined 55 ethical decision-making models to collect data on what recommended steps were included and what approaches were most frequently emphasized. Three general themes within ethical decision-making models arose from our analysis. These include: (1) What steps were included within models; (2) Whether the steps were sequential (i.e., a behavior chain); and (3) Whether the entire process could be labeled as problem solving (i.e., Szabo, 2020 ). We discuss each of these findings in turn. Behaviors Involved in Ethical Decision MakingThe first main finding surrounds the variability in recommended steps of ethical decision making across models. We found that each of the nine steps coded appeared in an average (arithmetic mean) of 58% of the articles (range: 20%–93%). This suggests that some consistency exists in what behaviors various scholars recommend practitioners should engage in when faced with an ethical decision. However, the wide variability in how frequently each behavior appeared also highlights that ABA practitioners would benefit from researchers clarifying at least three important characteristics of ethical decision-making models. These are: (1) What behaviors are necessary and sufficient to make an optimal ethical decision in ABA contexts (i.e., component analysis)? (2) What are the conditions under which specific steps are and are not needed (i.e., conditional discrimination analysis)? (3) Is there an optimal functional result of ethical decision making that is more important than the specific topographies a practitioner uses to contact that outcome (i.e., functional analysis; see Cox, 2021 )? Practitioners and researchers may begin to explore some of these questions when engaging in ethical decision making. More than half of the articles examined emphasized the need for consulting ethical codes. It is interesting that more ethical models recommended practitioners reference codes of ethics from outside their discipline ( n = 44; 80% of models; e.g., personal, religious, organizational) than their own discipline’s code of ethics ( n = 40; 73%). To our knowledge, the conflict between personal and professional codes of ethics is an underexplored topic in the ABA literature. Nevertheless, the slightly greater emphasis on other codes of ethics in addition to one’s own discipline suggests this might be an important area where practitioners could use guidance. Also, the field of ABA would likely benefit from future research and scholarship surrounding the conditions and functional outcomes of ethical decisions where personal and professional values conflict. It is important to mention that our review was done prior to the publication of the BACB’s ( 2020 ) ethical decision-making model. The BACB’s model was published in the analysis and writing stage of this review. Our findings suggest a robust literature spanning 40+ years, 60+ articles, and 50+ models all clustered around similar ethical decision-making steps published by the BACB. Perhaps most intriguing is that we identified the nine steps from our review prior to the publication of the BACB’s model, and no previous models had incorporated all nine ethical decision-making steps until the BACB published their decision model (BACB, 2020). Practicing behavior analysts would benefit from future component analyses, conditional discrimination analyses, functional analyses, and empirical support surrounding the BACB’s ethical decision-making model. Our analysis also suggests that behavior analysts and allied professionals approach ethical decision making similarly. Given the complexity of ethical decision making and the shared types of dilemmas human service professionals contact, some convergence is expected. However, there are many reasons that two professionals from different disciplines may come into disagreement (Boivin et al., 2021 ; Bowman et al., 2021 ; Cox, 2019 ; Gasiewski et al., 2021 ). Having familiar systems with empirical support for how to navigate ethical dilemmas might improve the likelihood that a positive resolution occurs. Further, such interprofessional similarities in ethical decision-making processes allows future interdisciplinary dialogue to focus more on specific areas of agreement because what and how information will be used to make a decision is already agreed upon. Behavior Chains and Behavior TopographyWe found that 95% of the ethical decision-making models could be described as a behavior chain (e.g., Catania, 2013 ). Framing ethical decision making as a behavior chain might be useful as it highlights the interrelated and sequential nature of ethical decision making. That is, completing one step in an ethical decision-making behavior chain leads to a context wherein the next response in the chain is more likely to contact reinforcement. For example, until you have gathered all relevant information about how the decision will affect all relevant parties, your ranking and weighing of information seems less likely to lead to the best outcome. That said, the temporally delayed nature of behaviors and consequences involved in ethical decision making is different than how behavior chains have been studied in laboratory settings (e.g., Baum, 2017 ; Cox, 2021 ; Slocum & Tiger, 2011 ). Future research will likely be needed to better understand the effects of temporal relations on behavior chains and thus determine what approach best provides a behavioral description of ethical decision making. It is interesting that the order in which steps were proposed differed across models. We are unaware of any research that compares the effectiveness of different sequential ethical decision-making models to understand whether the order of behaviors recommended as a chain are more or less useful. Nevertheless, future research that identifies the extent to which rigid sequences of behaviors need to occur to optimize decision making would be helpful for the field of ABA. Such information would likely improve behavior analytic training programs and prove useful for clinical directors, ethics committee chairs, case supervisors (e.g., BCBAs), and direct staff (e.g., RBTs). Ethical Decision Making as Problem SolvingRecent attention has been given to the common-sense problem-solving approach (Szabo, 2020 ), which we used to score models within the current analysis. This problem-solving approach may offer great utility and is observed across various fields (e.g., cognitive psychology; Szabo, 2020 ). Within behavior analysis, this problem-solving approach has increasingly been applied to teach complex skills (e.g., Suarez et al., 2021 ). Our review involves an interesting extension of this analysis to ethical decision making and indicates the steps of the models may also point to additional precurrent behaviors or mediating strategies that could prove to be important elements of the behavioral chain. We found that 42% of the ethical decision-making models could be described as including problem solving (e.g., Kieta et al., 2019 ). Framing ethical decision making as involving problem solving is advantageous because of the existing empirical literature on how to teach problem-solving skills and recognition of the importance of verbal stimuli and verbal behavior (e.g., Kieta et al., 2019 ). However, this also might have the drawbacks of adding complexity and less empirical support specific from the behavior analytic literature on describing, predicting, and controlling problem solving. This suggests that there are either components of ethical decision making outside of problem solving or that there are components of problem solving that might be missing from current decision-making models. Future research using concept analysis (e.g., Layng, 2019 ) combined with laboratory experiments may help clarify which of the above scenarios is more likely (or if there’s an unknown third!). We also found that 58% of the ethical decision-making models could not be described as including problem solving. We are unaware of any research that has directly compared the effectiveness of ethical decision-making models with and without problem-solving components. Nevertheless, a practically useful set of empirical questions might identify the conditions under which ethical decision-making models with and without problem-solving components are more helpful for practitioners. Behavior analytic training programs subsequently could teach fluency toward ethical decision making via problem solving under some conditions and ethical decision making without problem solving under other conditions. Limitations and Final ThoughtsThe current study included several limitations. One limitation centers on the procedures used for rater agreement. Article ratings were completed in a group format and by consensus among the authors. It is possible that reactivity to other members of the group affected overall ratings (e.g., Asch, 1956 ). It is also possible that the search terms we used failed to capture relevant ethical decision-making models or that additional search terms would have led to different results. Further, we also restricted our inclusion criteria to specific human service fields allied to ABA. Thus, it is possible that a more comprehensive search of ethical decision-making models across more varied professions would lead to different outcomes. Finally, we did not include ethical decision-making models published in books mainly due to access issues and a typical lack of peer-review for books. Regardless, these limitations may provide greater support for our primary findings that the existing variability in ethical decision-making steps and overall lack of empirical support suggest this area is ripe for future research. The development of an ethical decision-making skill set is vital for behavior analysts and for other human service providers. Dilemmas present as complex circumstances, with specific and unique contextual variations that require nuanced assessment. The process of training behavior analysts to meet these demands is daunting. There is a need to identify strategies for navigating dilemmas and for making ethical decisions. Allied professions and behavior analysis have identified steps in this process. Many of these models use problem-solving techniques. The BACB’s Decision Making Model overlaps substantially with existing literature across professions, and uses a problem-solving, sequential approach. These results are especially interesting as we had completed identifying the decision-making steps scored in the current article before the BACB model was released. It seems that the field has built a model that is entirely aligned with and built upon this interprofessional database. It will be important to empirically evaluate this new model. It will also be important to explore other decision-making approaches, to compare models, and to (potentially) match models to the contextual variables embedded in the presenting dilemma. The field of behavior analysis has, at times, been insular, and this has been a source of internal and external criticism. However, this review of the literature supports the substantial overlap across fields and provides concrete hope for mutually beneficial interdisciplinary collaboration. So, although decision-making models can be field-specific, ethical dilemmas appear to be universal and so are the intended outcomes. As behavior analysis tackles this complex skill set, it is important to learn from colleagues in allied disciplines, examine the component skills likely to be crucial to the development of this behavioral repertoire, and develop procedures for measuring, teaching, and training clinicians to methodically approach ethical dilemmas. Data AvailabilityThe datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request. No funding was received to assist with the preparation of this manuscript. DeclarationsThe authors do not have any potential conflicts of interest to disclose and have no relevant financial or nonfinancial interests to disclose. No human participants were involved in this research, and therefore informed consent was not obtained. Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. All articles with an asterisk indicate the final articles included in the review
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al Decision Making Framework - Frederic Reamer (2012)Identify the ethical issues, i. luding the social work values and ethics that conflict.Identify the individuals, groups, and organization. that are likely to be affected by the ethical decision.Tentatively identify all possible courses of action and the participants involved.
From discussion by Frederick Reamer & Sr. Ann Patrick Conrad in Professional Choices: Ethics at Work (1995), video available from NASW Press 1-800-227-3590. Format developed by Sr. Vincentia Joseph & Sr. Ann Patrick Conrad. NASW Office of Ethics and Professional Review, 1-800-638-8799. 750 1st Street, NE, Suite 700, Washington, DC 20002.
SOC 160: Introduction to Social Work Learning Unit 2: Handout Guides to Ethical Decision-Making Model III: Essential Steps for Ethical Problem-Solving - Frederic Reamer and Sr. Ann Patrick Conrad The following approach, discussed by Reamer and Conrad, was included in a video developed by the
Essential Steps for Ethical Problem Solving - Frederic Reamer and Sr. Ann Patrick Conrad (NASW 2020. Essential steps for ethical problem-solving. Retrieved from ... Kenyon's Ethical Decision-Making Model (Kenyon, P. (1999). What would you do? An ethical course
7. Monitor, evaluate, and document the decision. What may appear to be a final decision is not the end of the ethical decision-making process. Once the decision is made, the social worker should keep track of both immediate and more distant consequences and respond to them conscientiously.
Reamer F. 3. Ethical Dilemmas and Decision Making: A Framework. In: . New York Chichester, West Sussex: Columbia University Press; 2018. p.51-108. Please login or register with De Gruyter to order this product.
Back Matter. Download. XML. For more than a decade, teachers and practitioners have turnedto Frederic G. Reamer's Social Work Values and Ethics forits comprehensive introduction to et...
For decades, teachers and practitioners have turned to Frederic G. Reamer's Social Work Values and Ethics as the leading introduction to ethical decision making, dilemmas, and professional conduct in practice. A case-driven, concise, and comprehensive textbook for undergraduate and graduate social work programs, this book surveys the most critical issues for social work practitioners.
Frederic G. Reamer. Columbia University Press, 1990 - Business & Economics - 266 pages. Through provocative case studies, Ethical Dilemmas in Social Service introduces social work professionals to a wide range of complex and controversial concerns in ethical theory and practice. Reamer illuminates the ethical concerns involved in working with ...
This is the leading introduction to professional values and ethics in social work. Frederic G. Reamer provides social workers with a succinct and comprehensive overview of the most critical issues relating to professional values and ethics, including the nature of social work values, ethical dilemmas, and professional misconduct. Conceptually rich and attuned to the complexities of ethical ...
7. thical Decision Making and BehaviorAs we practice resolving dilemmas we find ethics to be less a goal than a pathway, less a destination than a trip. cist Rushworth KidderWHAT'S AHEADThis chapter surveys the components of ethical behavior—moral sensitivity, moral judgment, moral motivation, and moral character—and introduces systematic a.
Ethical dilemmas in social service by Reamer, Frederic G., 1953-Publication date 1990 Topics Social service, Social workers, Social service, Ethics, Professional, Social Work Publisher New York : Columbia University Press Collection internetarchivebooks; inlibrary; printdisabled
Professor of Social Work, Rhode Island College - Cited by 8,112 - ethics - professional ethics - social work ethics - malpractice - liability ... F Reamer. Columbia University Press, 2018. 1176: 2018: Ethical standards in social work: A review of the NASW code of ethics. FG Reamer.
Robinson. Today's podcast features a discussion with Dr. Frederic Reamer on ethics and social work. Dr. Reamer is a professor in the School of Social Work at Rhode Island College where he has been on the faculty since 1983. His areas of expertise include social work ethics forensics social work criminal justice as well as research and program ...
Much less common is comprehensive education on ethics-related risk management. Ethics risk management in social work includes steps practitioners can take to help protect clients and prevent lawsuits, licensing board complaints, and criminal charges associated with ethical decisions and misconduct. This article introduces the concept of risk ...
Reamer's ethical decision-making framework is used to document the decision-making process (Reamer, 2013). 7. Monitor, evaluate and document the decision. I would monitor Emily through constant informal meetups at least twice a week. I would evaluate by scheduling a follow-up meeting with the manger in another two weeks.
Model III: Essential Steps for Ethical Problem-Solving - Frederic Reamer and Sr. Ann Patrick Conrad The following approach, discussed by Reamer and Conrad, was included in a video developed by the NASW Office of Ethics and Adjudication and produced by NASW Press and the NASW Insurance Trust as a tool for use by practitioners, faculty members ...
Abstract. Although clients do not have a right to effective treatment, they do a have a right to competent and ethical treatment. Clients have a right to expect that social workers will provide services in a manner consistent with prevailing practice and ethical standards. This article explores social workers' obligation to provide service ...
This problem-solving approach may offer great utility and is observed across various fields (e.g., cognitive psychology; Szabo, 2020). Within behavior analysis, this problem-solving approach has increasingly been applied to teach complex skills (e.g., Suarez et al., 2021). Our review involves an interesting extension of this analysis to ethical ...
Reamer & Conrad: Essential Steps for Ethical Problem-Solving. DEVELOP an action plan that is consistent with the ethical priorities that have been determined as central to the dilemma. IMPLEMENT your plan, utilizing the most appropriate practice skills and competencies. REFLECT on the outcome of this ethical decision-making process.
work view ethics through a harm-reduction example of a sound ethical decision-making approach (Reamer, 2001a) has resulted model in that an is easily taught and applied. Table 1. ethics code that is technical, with terminology provides a condensed summary of basic ethical that has strong legal implications for practice decision making.