Ethics Module 1

What is ethics?

The emission of behavior compliance/coordination with the verbally stated rules and behavior analytic culture practices guiding practitioner behavior that are espoused by ethics code in ABA.

What is an ethical dilemma?

Any situations that meets the following criteria: You must make a choice between multiple incompatible behaviors The incompatible behaviors are each supported by different ethics code items By selecting any behavior, you will still violate some code item regardless of the behavior selected.

How were ethic codes developed?

3-5 BCE: hippocratic oath was developed, which focused on good qualities of good physician and behavior expectations. 1803: medical ethics by Thomas Percival which summarized the virtues and duties of physicians. 1847: AMA issue code of medical ethics added necessity of evidence-base and training 1966: Principles of medical ethics, revised code of 1847: patient rights, clinical competency, being a good citizen, respecting the profession, Late 1960s: Behavioral modification begins 1976: Reforms were instituted across the state of Florida under guidance of Charles Cox, included strict guidelines for practice, 1980: First Work Session of Behavior Analysis in Retardation, the first behavior analysis conference was held to establish the first regulatory body in behavior analysis, FABA 1988: FABA adopts their code of ethics for behavior analysis.

What was the state of ABA in the 1960s and 70s?

No formal regulation of the profession known as B-Mod, marketed as cure all where practitioners acting more like salespeople, single day work hops were popular, teaching participants how to use crude reinforcement and punishers, when discussing punishment, participants were told to be creative.

What was Sunland?

A clinic for individuals with disabilities in 1965. 4 years in, attorneys office began investigating cases of abuse Organizations were staffed by psychologists and behavior scientists. Direct staff were typically college students. Strategies used at sunland were shaped over the four years before investigation began Staff were following through on instructions of highly trained supervisors to, emphasized natural consequences, respond immediately and devise your own strategy when instructions don't cover the situation “Follow through on every contingency” - don’t make threats unless you intend to follow through Written policies in handbook forbid abusive tactics, but there was major observer drift

What was a major behavior factor from the supervisors at the root of the Sunland (and others) scandals?

observer drift

How do we study ethical decision-making?

Two topographical branches to consider: descriptive ethics and normative ethics.

What is descriptive ethics?

Focuses on what is considered right or wrong, usually found in rules

What is normative ethics?

Focuses on why behavior is considered right or wrong. Includes a focus on 3 different ethical paradigms : virtue theory, consequentialism, deontology

What is virtue theory?

Certain behaviors are ethical “right” or good in and of themselves- regardless of context or outcomes. A person is ethical if their behavior is consistent with the socially agreed-upon label Behavior is fluent and maintained by non social reinforcement.

What is consequentialism?

A behavior is deemed ethically appropriate if and only if the behavior causes the greatest happiness for the greatest number. Outcome is most important of ethical decision Can discriminate against those in the minority

What is deontology?

What is good or right depends on the function of behavior and the context in which that behavior occurs. Anti-virtue anti -consequentialism Determined by the people in power.

What is the struggle with the 3 dimensions of ethical paradigms?

They are not compatible with one another, and they don't say what to do.

How are we actually making ethical decisions?

Due to personal learning history and context of decision making (from Cox’s) study.

Normative and descriptive ethical behaviors are…

Functionally distinct.

What factor contributed to the differences in normative ethics and decision making in the Cox study?

Learning history.

What was the Tuskegee Syphilis Study? 1932-1972?

600 black men in rural Alabama were used to study the progression of syphilis Coerced into having a blood test, determine ⅔ of the mend had the disease Did not consent to be studied and were not told they had syphilis and denied access to medical care. Ban from joining the draft for WWII Purpose was to justify funds towards finding a cure by allowing syphilis to profess in the subjects and then publish papers on the health effects Whistle blowers sounded the alarm in 1968 however organizations did nothing News article published in 1972 led to end of the study

What is The Belmont Report?

The basic ethical principles resulting from the Tuskegee Study. Guiding principles: respect, beneficence, justice

What is respect for Persons?

All people should be treated as independently functioning individuals that have a fundamental right to autonomy. People with diminished autonomy are entitled to protection

What is beneficence?

We have an obligation to improve the well-being of others, we must do not harm, and when harm cannot be avoided, we must minimize it while maximizing the benefits.

What is justice?

Benefit others Treat others with compassion, dignity, and respect Behave with integrity Ensure their competence.

What are some applications of ethics codes?

Relevant laws (HIPAA, FERPA), reporting process (understanding the appropriate procedure), medical billing (not all behavior analysts bill insurance, but it occurs frequently enough)

Lack of awareness/understanding of a code is NOT

A defense against an ethics violation.

Ethic codes are NOT and cannot be

exhaustive

The BACB takes a functional and contextual approach to ethical issues and

Will refer back to the core standards and specific items as needed.

Before filing a report with an oversight body

Confirm Ensure that you understand the code clearly and can provide documentation to support the alleged violation Consult Find an experienced analyst to talk about the situation. PROTECT CONFIDENTIALITY. Contact You need to talk to the alleged violator first to attempt to resolve most ethical issues. Consider After the conversation, determine if it is still necessary to file a notice of alleged violation  Collect Gather the necessary documentation and witness required for filing you report Conclude File your notice of alleged violation with specified ABA oversight body

What are some resources if you’re witnessing ethically questionable behavior?

ABA ethics hotline, state-specific mandated reporting, licensure and professional boards, professional organizations/associations (APBA), external subject matter experts and colleagues, professional legal consultants.

What are some applications of ethics?

• Behavior analysts must know and follow the code; ignorance is not an excuse

• Must comply with laws, licensure rules, and reporting requirements

• Ethical decisions should be contextual and client-centered, considering diversity and risk

• Analysts should document concerns

What are some takeaways from the BACB ethics code?

Being truthful Legal requirements Accountability Scope of competence Maintaining skills Cultural responsiveness Non harassment Personal bias Define role

What are some notes about the scope area of the ethics code?

Applicability (BCBA, BCaBA, RBTS and applications) for certification Settings and communications Professional activities Personal behavior  Defines terms like clients and stakeholders)

What are some notes of ethical decision making process?

Define the issue and assess risk Identify all involved parties Gather and verify information Reflect on personal biases Identify relevant principles/standards Consult resources Develop actions to minimize harm Evaluate option Choose the best action Implement and document Evaluate and adjust as needed.

What is ethical conduct?

Defined by both the quality of actions and their ultimate impact on stakeholders.