reamers ethical problem solving model

Staff and Board
Mission and Strategic Plan
Berkshire Region
Central Region
Northeast Region
Pioneer Valley Region
Southeast Region
Shared Interest Groups / Activities / Task Forces
Donate to NASW-MA Chapter
Membership Benefits
Student Membership
Join or Renew
Action Center
Legislative Agenda & Priority Bills
Legislative Education & Advocacy Day (LEAD)
Political Action for Candidate Election (PACE)
Additional Advocacy Resources
Employment Lawyers and Legal Resources
Clinical Alerts
Private Practice
Supervision
Workplace Safety
Social Work Assistance Network (SWAN)
Therapy Matcher
FOCUS CE Mailer PDF Archive
CE Webinars
MLK Jr. Forum 2025 - coming soon
Virtual School Social Work Conference 2024
Virtual Symposium 2025 Call for Proposals
Nursing Home & Elder Issues Conference 2024
CE Events Calendar
Online CE Institute
CE Authorization by NASW-MA
CE Frequently Asked Questions
CE Advertisements
Student Resource Center
BIPOC Student Membership Program
Graduation Cords
Legislative Education and Advocacy Day (LEAD)
Licensing Test Prep
Career Services
Professional Mentoring
Loan Forgiveness
Scholarships / Fellowships
Student Ambassador Program
Intern with NASW-MA
Social Work Voice (member only)
Email Newsletter (member only)
Office Space
CE Programs & Trainings
Supervision, Groups, and Services
Volunteer, Research, Other
Place an Ad
Awards 2023
Awards Information and History


Name:
Category:
Share:

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

Ethics Resources:

(formerly COI)

Other Ethics Information:

8/14/2024 Member Verification Postcards from National NASW

8/5/2024 NASW-PACE Endorses Vice President Kamala Harris for President

7/25/2024 Raise the age advocacy happening NOW!

7/23/2024 SUPER Act is in Conference Committee!

9/3/2024 Webinar - Living in the In-Between: Unpacking Mental Health, Assimilation... (1.5 CEUs)

9/12/2024 Webinar - Childhood Trauma & Emotional Eating: A Trauma-Informed... (1.5 CEUs)

9/14/2024 Virtual License Test Prep Course

9/17/2024 Webinar - Unmasking Gambling Disorder: History, Risk Factors, and Pathways to Help... (1.5 CEUs)

National Association of Social Workers - Massachusetts Chapter 6 Beacon Street, Suite 915, Boston MA 02108 tel: (617)227-9635 fax: (617)227-9877 email: chapter [email protected] Copyright 2020, NASW-MA. All rights reserved.

Recently, I received a phone call from a seasoned social worker seeking consultation. The social worker is employed by a community mental health center where she provides clinical services to people with chronic mental illness. Two days earlier, one of her clients, Alice M., committed suicide. According to the social worker, Alice struggled for many years with depression and cocaine addiction.

Immediately following the suicide, Alice’s parents—who had participated in her treatment at various times in the context of family counseling—contacted the social worker to discuss this tragic turn of events. The social worker met with her parents, with whom she had considerable rapport, and they talked about Alice’s lifelong triumphs and challenges. Alice’s parents spoke at length about how much they appreciated the social worker’s earnest efforts to help their daughter. The parents also talked about how difficult it would be for them to bury their daughter the following day.

Toward the end of the conversation, Alice’s parents told the social worker that they wanted to ask a special favor. They explained that the social worker was an important person in their family’s life and that it would mean a lot to them if the social worker would deliver a eulogy at their daughter’s funeral.

The social worker was touched by the parents’ sentiments and their poignant request. She felt close to the family and wanted to be supportive. At the same time, however, the social worker quickly recognized the ethical dilemma facing her. She was especially concerned about violating Alice’s privacy and confidentiality. The social worker was also concerned about managing the boundaries in her relationship with the family; she wanted to avoid entering into an inappropriate “dual relationship.” The social worker was deeply ambivalent and unsure about how to resolve this ethical dilemma—a situation in which professional values, duties, and obligations clash.

In recent years, social workers have refined their approach to ethical decision making. Although many practitioners completed their formal education at a time when content on ethical dilemmas and ethical decision making was not a prominent component in the social work education curriculum, continuing education on the subject is now common. Today’s social workers and social work students are being introduced to state-of-the-art frameworks to help them identify ethical dilemmas and make difficult decisions.

Ethical dilemmas come in all shapes and sizes. Many involve social workers’ delivery of services to individuals, families, couples, and small groups. Typical examples involve disclosing confidential information without a client’s consent (for example, when a client threatens to harm himself, herself, or someone else); limiting a client’s right to self-determination against his or her wishes (for example, when a social worker pursues involuntary psychiatric hospitalization of a troubled client); or social contact with a former client.

Other ethical dilemmas pertain to agency administration, community work, social policy, and research. Examples include administrators’ decisions about the allocation of scarce or limited agency resources (what moral philosophers refer to as distributive justice issues), conflicts of interest among staff, and the use of ethically questionable marketing strategies to solicit clients. Still other ethical dilemmas involve relationships among professional colleagues. Common examples involve a social worker’s response to a colleague who has behaved unethically or who is impaired or incompetent (the ethics of “whistle-blowing”).

The literature in most professions now contains thoughtful discussions of conceptually based frameworks designed to guide practitioners’ ethical decisions. These frameworks do not guarantee easy solutions to hard ethical choices, of course; rather, they provide useful guideposts to help professionals who face daunting ethical circumstances. Although the frameworks vary, they tend to contain common elements.

In the case involving the social worker who faced a decision about delivering a eulogy at the funeral of her client who committed suicide, the practitioner would focus primarily on conflicting values and duties related to the deceased client’s privacy and dignity, the parents’ right to self-determination, the social worker’s commitment to client well-being, and ethical standards related to informed consent and dual relationships.

In this case, those most likely to be immediately affected include the deceased client (with respect to her dignity and right to privacy and confidentiality), the deceased client’s parents, and the social worker. In addition, the social worker’s colleagues at the community mental health center where she is employed and the social work profession itself could be affected. That is, the social worker’s actions might be viewed by the public as an extension of the agency or the social work profession and their respective policies and standards.

Put simply, the social worker can agree to deliver the eulogy or reject the parents’ request. Between these stark options are more subtle possibilities that include attending but not speaking at the funeral and speaking at the funeral without disclosing to attendees any information concerning the nature of the social worker’s relationship with the deceased client.

If the social worker delivers the eulogy, she may provide comfort to the deceased client’s parents and others who attend the funeral. The social worker, too, may gain some solace in the process.

On the other hand, delivering the eulogy may compromise the deceased client’s privacy and confidentiality. Further, those who attend the funeral may feel uncomfortable hearing the social worker’s comments, particularly if the social worker discloses the nature of her relationship with the deceased. Also, the social worker’s reputation may be harmed—along with that of her agency and the social work profession—if those in attendance are critical of the social worker’s decision to deliver the eulogy.

If the social worker declines, the deceased client’s parents may be angry and hurt and may suffer emotionally. Also, the social worker may feel some misgivings as a result, especially if the social worker’s relationship with the parents becomes strained.

In recent years, social work students and practitioners have been introduced to the rudiments of ethical theory—grounded in moral philosophy—as a tool in the analysis of ethical dilemmas. Briefly, classic ethical theory involves various schools of thought concerning what constitutes morally right and wrong action in the face of ethical dilemmas.

For example, according to the deontological perspective—often associated with 18th-century German philosopher Immanuel Kant—certain actions are inherently right or wrong, or good or bad. Deontological statements include the following: Always tell the truth, always obey the law, and never kill an innocent person. Thus, a deontologist might argue that the deceased client has a fundamental right to privacy and that it would be unethical for the social worker to speak at the funeral about any aspect of the client’s life or the parties’ therapeutic relationship.

In contrast, a teleological perspective in moral philosophy asserts that one’s ethical obligation is determined by the goodness of the consequences that are likely to result. That is, the decision maker’s emphasis should be on likely outcomes rather than on conclusions about what is the morally right or wrong action.

From this vantage point, the social worker should conduct a utilitarian calculus (a phenomenon introduced more than a century ago by philosophers Jeremy Bentham and John Stuart Mill), weighing the potential benefits and costs of each possible course of action. Although there are several versions of utilitarianism—also known as consequentialism—the most common states that when faced with an ethical dilemma, one should act in a manner that produces the greatest balance of good over bad consequences. Thus, if the social worker concludes that more harm than good would result if she delivers the eulogy, she would not honor the parents’ request.

In addition to considering pertinent ethical theories and their respective strengths and limitations, the social worker should also consult relevant codes of ethics and legal principles. The National Association of Social Workers’ (NASW) , for example, contains a number of explicit standards related to client self-determination (standard 1.02), informed consent (standards 1.03 [a][c]), conflict of interest (standards 1.06 [a][c]), and privacy and confidentiality, including the rights of deceased clients (standards 1.07 [a][b][g][r]). In addition, the code makes specific reference to a social worker’s obligation to consult with colleagues when necessary to make sound decisions in complex circumstances (standards 2.05 [a-c]).

The social worker in this case must also be cognizant of legal issues. State laws and licensure regulations often address clients’ privacy and confidentiality rights, informed consent requirements, and dual relationship issues. In addition, the social worker should be aware of the possibility, albeit perhaps a remote one, that disgruntled parties who are upset with the social worker’s handling of this circumstance could file an ethics complaint (for example, with the state licensing board or NASW) or lawsuit alleging unethical conduct or malpractice.

Of course, the social worker should also draw on his or her knowledge of pertinent ethical theory and principles, especially concerning key ethics concepts and clinical phenomena related to grief and loss. Also relevant are the social worker’s own values, in this case related perhaps to personal loyalty and respecting individuals’ dignity.

Any social worker who faces difficult, complex ethical decisions should make a concerted effort to consult with knowledgeable colleagues and ethics experts. Some human services agencies now sponsor ethics committees—formally known as institutional ethics committees—whose members have training in ethics-related matters and provide collegial consultation. In addition to offering consultation, many ethics committees sponsor in-service training and facilitate the development of agencies’ ethics-related guidelines and policies. In some settings—usually healthcare agencies such as teaching hospitals and rehabilitation facilities—professional ethicists may be available for consultation. Typically, ethics consultants are human services professionals who have received advanced training in ethics or moral philosophers who have become knowledgeable about professional practice. Finally, when ethical dilemmas pose legal questions—for example, related to interpretation of state laws or regulations, or potential lawsuits—social workers would be wise to consult with an attorney who specializes in professional malpractice and risk management.

Once the decision is made, social workers should document the process carefully. Not only is this act consistent with sound social work practice and documentation standards, but also careful documentation can protect social workers in the unlikely event that ethics complaints or lawsuits are filed against them. Thorough notes describing the social worker’s decision-making steps and rationale provide compelling evidence of the practitioner’s prudence and professionalism.

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. For example, if the social worker in this case decides to attend but not speak at the client’s funeral, the social worker should monitor the parents’ reactions to ensure that there are no untoward or harmful clinical repercussions.

Ethical decision making is a complex process. Today’s social workers are learning much about the nature of ethical dilemmas and sound decision-making procedures. There is no guarantee, of course, that even the clearest set of decision-making guidelines will yield simple solutions to complex ethical problems. No set of guidelines can produce such outcomes. In the final analysis, even the most thoughtful and reasonable practitioners may disagree about the most ethical course of action. In this respect, ethical decisions are no different from complex clinical or other social work decisions. Conceptual frameworks are useful and help to guide practitioners’ decisions; however, they do not guarantee clearcut solutions or collegial consensus. What they do ensure is systematic, thorough analysis and reflection—essential elements of competent practice.

Social Work Today magazine

Architecture and Design
Asian and Pacific Studies
Business and Economics
Classical and Ancient Near Eastern Studies
Computer Sciences
Cultural Studies
Engineering
General Interest
Geosciences
Industrial Chemistry
Islamic and Middle Eastern Studies
Jewish Studies
Library and Information Science, Book Studies
Life Sciences
Linguistics and Semiotics
Literary Studies
Materials Sciences
Mathematics
Social Sciences
Sports and Recreation
Theology and Religion
Publish your article
The role of authors
Promoting your article
Abstracting & indexing
Publishing Ethics
Why publish with De Gruyter
How to publish with De Gruyter
Our book series
Our subject areas
Your digital product at De Gruyter
Contribute to our reference works
Product information
Tools & resources
Product Information
Promotional Materials
Orders and Inquiries
FAQ for Library Suppliers and Book Sellers
Repository Policy
Free access policy
Open Access agreements
Database portals
For Authors
Customer service
People + Culture
Journal Management
How to join us
Working at De Gruyter
Mission & Vision
De Gruyter Foundation
De Gruyter Ebound
Our Responsibility
Partner publishers

Your purchase has been completed. Your documents are now available to view.

3. Ethical Dilemmas and Decision Making: A Framework

From the book social work values and ethics.

Frederic Reamer
X / Twitter

Supplementary Materials

Please login or register with De Gruyter to order this product.

Internet Archive Audio

This Just In
Grateful Dead
Old Time Radio
78 RPMs and Cylinder Recordings
Audio Books & Poetry
Computers, Technology and Science
Music, Arts & Culture
News & Public Affairs
Spirituality & Religion
Radio News Archive

Flickr Commons
Occupy Wall Street Flickr
NASA Images
Solar System Collection
Ames Research Center

All Software
Old School Emulation
MS-DOS Games
Historical Software
Classic PC Games
Software Library
Kodi Archive and Support File
Vintage Software
CD-ROM Software
CD-ROM Software Library
Software Sites
Tucows Software Library
Shareware CD-ROMs
Software Capsules Compilation
CD-ROM Images
ZX Spectrum
DOOM Level CD

Smithsonian Libraries
FEDLINK (US)
Lincoln Collection
American Libraries
Canadian Libraries
Universal Library
Project Gutenberg
Children's Library
Biodiversity Heritage Library
Books by Language
Additional Collections

Prelinger Archives
Democracy Now!
Occupy Wall Street
TV NSA Clip Library
Animation & Cartoons
Arts & Music
Computers & Technology
Cultural & Academic Films
Ephemeral Films
Sports Videos
Videogame Videos
Youth Media

Search the history of over 866 billion web pages on the Internet.

Mobile Apps

Wayback Machine (iOS)
Wayback Machine (Android)

Browser Extensions

Archive-it subscription.

Explore the Collections
Build Collections

Save Page Now

Capture a web page as it appears now for use as a trusted citation in the future.

Please enter a valid web address

Donate Donate icon An illustration of a heart shape

Ethical dilemmas in social service

Bookreader item preview, share or embed this item, flag this item for.

Graphic Violence
Explicit Sexual Content
Hate Speech
Misinformation/Disinformation
Marketing/Phishing/Advertising
Misleading/Inaccurate/Missing Metadata

plus-circle Add Review comment Reviews

47 Previews

Better World Books

DOWNLOAD OPTIONS

No suitable files to display here.

EPUB and PDF access not available for this item.

IN COLLECTIONS

Uploaded by Lotu Tii on August 27, 2015

" style=" object-fit:cover;object-position:50.0% 50.0%; " > yourceus.com

Eth3338 - 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.

Publications
Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

Advanced Search
Journal List
Behav Anal Pract
v.16(3); 2023 Sep
PMC10480129

Examination of Ethical Decision-Making Models Across Disciplines: Common Elements and Application to the Field of Behavior Analysis

Victoria d. suarez.

1 Endicott College, Beverly, MA USA

Videsha Marya

2 Village Autism Center, Marietta, GA USA

Mary Jane Weiss

3 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 Criteria

Articles 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 Procedure

We 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 Measures

Articles 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 Steps

The 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

Steps from BACB code	Steps from current literature review
1. Clearly define the issue and consider potential risk of harm to relevant individuals.	1. Ethical radar ( ).
	2. Urgent detour
	3. Pinpoint the problem ( ).
2. Identify all relevant individuals.	4. Information gathering ( ?) 4a. Affected parties ( ). 4b. Reference professional code of ethics. 4c. Reference other codes of ethics ( ). 4d. Case specific information ( ).
3. Gather relevant supporting documentation and follow-up on second-hand information to confirm that there is an actual ethical concern.
4. Consider your personal learning history and biases in the context of the relevant individuals.*
5. Identify the relevant core principles and Code standards.
6. Consult available resources (e.g., research, decision-making models, trusted colleagues).
7. Develop several possible actions to reduce or remove risk of harm, prioritizing the best interests of clients in accordance with the Code and applicable laws.	5. Available options/behaviors
8. Critically evaluate each possible action by considering its alignment with the “letter and spirit” of the Code, its potential impact on the client and stakeholders, the likelihood of it immediately resolving the ethical concern, as well as variables such as client preference, social acceptability, degree of restrictiveness, and likelihood of maintenance.	6. Ranking/weighing of information
9. Select the action that seems most likely to resolve the specific ethical concern and reduce the likelihood of similar issues arising in the future.	7. Analysis
10. Take the selected action in collaboration with relevant individuals affected by the issue and document specific actions taken, agreed-upon next steps, names of relevant individuals, and due dates.	8. Implementation
11. Evaluate the outcomes to ensure that the action successfully addressed the issue.	9. Follow up

*Step 4 of the BACB model aligns with components from Step 6 of current literature review.

Decision-making Steps

Steps	Description
Ethical radar	This step was coded if the author(s) referenced a signal-detection component in the process of decision making. Signal detection refers to the experience of detecting an ethical dilemma. In particular, the individual may feel that something is unusual, that something is out of the ordinary, or they may feel some vague discomfort. This step was coded to be present if the model made a reference to the practitioner coming into contact with a situation wherein they suspected there might be an ethical issue present. For example, if a practitioner was instructed by their supervisor to round up the time they actually spent delivering services. Encountering such a situation might lead a practitioner to be uncomfortable such that further analysis is warranted.
Urgent detour	This step was coded if the model author(s) referred to situations in which a practitioner would need to report the issue to a legal or other governing body prior to taking any other actions or analyzing the situation further. For example, if a practitioner encountered a situation in which they had reasons to suspect abuse of their client by the parent. Provided that the practitioner had enough evidence to support their suspicion, it would be essential for them to report the abuse to child services prior to taking any other action.
Pinpoint the problem	This step was coded if the model author(s) referred to the practitioner explicitly identifying the ethical issue. The distinguishing feature of this step as compared with the earlier step of ethical radar is the precise identification of the ethical issue beyond a general suspicion that an ethical issue might be present. For example, in the case of a practitioner who is approached by a client to purchase an item from the client’s business, pinpointing the problem would include labeling the actions as the potential development of a dual relationship.
Information gathering	This step was coded when the model author(s) recommended gathering contextually relevant information that would be needed to make an ethical decision. The information collected was further divided into the following subcategories where appropriate: a. : This step was coded if the model author(s) included any language that mentioned different people involved in the situation or how the situation might impact different parties. For example, if parents, teachers, or other affected individuals are relevant to the ethical dilemma or decision. b. This step was coded if the model author(s) guided the model users to follow their professional code of ethics. c. This step was coded if the model author(s) guided the model users to follow other codes of ethics that differ from the code of ethics from their professional affiliation(s). For example, if the practitioner is prompted to refer to the rules and regulations specific to their organization, or a reference is made to their religious or personal values. d. This step was coded if the model author(s) referenced any other information that might be specific to the situation but was not captured in the other subcategories listed above. For example, issues of client preferences, quality of life, contexts and settings, and assessment of the practitioners’ understanding of the circumstances all fell into this category.
Available options/behaviors	This step was coded if the model author(s) guided the model users to consider information that would limit or constrain the practitioners’ set of available behaviors. For example, if there were any medical indications that required consideration or if colleagues should be consulted.
Ranking and weighing	This step was coded if the model author(s) guided the model user to consider the influence of their learning history, the impact of personal values, application of guidelines, or the results of a risk-benefit analysis.
Analysis	This step was coded if the model author(s) guided the model user to consider and synthesize the information from the prior steps to make a decision.
Implementation	This step was coded if the model author(s) guided the model user to implement the decided plan of action.
Follow up	This step was coded if the model author(s) guided the model user to evaluate the solution or action after it was implemented.

Field of Study

The 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 Solving

Models 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 Sequential

We 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 Models

A 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

Steps	No. of models (%)	Models
Ethical radar ( )	21 (38%)	Boccio, ; Bommer et al., ; Cassells et al., ; Cassells & Gaul, ; Christensen, ; DeWolf, ; Duff & Passmore, ; Ehrich et al., ; Fan, ; Forester-Miller & Davis, ; Grundstein-Amado, ; Hayes, ; Heyler et al., ; Hill et al., ; Hough, ; Kaldjian et al., ; Kanoti, ; Kirsch, ; Macpherson et al., ; Ponterotto & Reynolds, ; Zeni et al.,
Urgent detour	16 (29%)	Boccio, ; Bolmsjö, Sandman, & Andersson., ; Bommer et al., ; Candee & Puka, (Deontology); Cassells et al., ; Cassells & Gaul, ; DeWolf, ; Ehrich et al., ; Fan, ; Forester-Miller & Davis, ; Greipp, ; Hill et al., ; Hughes & Dvorak, ; Sileo & Kopala, ; Soskolne, ; Tymchuk,
Pinpoint the problem ( )	29 (53%)	Boccio, ; Bolmsjö et al., ; Bommer et al., ; Christensen, ; Fan, ; Green & Walker, ; Grundstein-Amado, ; Haddad, ; Harasym et al., ; Hill et al., ; Hough, ; Johnsen et al., ; Johnson et al., ; Jones, ; Kaldjian et al., ; Kanoti, ; Kirsch, ; Laletas, ; Liang et al., ; Marco et al., ; Murphy & Murphy, ; Park, ; Phillips, ; Shahidullah et al., ; Soskolne, ; Sullivan & Brown, ; Toren & Wagner, ; Tsai & Harasym, ; Zeni et al.,
Information gathering	11 (20%)	Cassells et al., ; DeWolf, ; Ehrich et al., ; Harasym et al., ; Hayes, ; Hough, ; Hughes & Dvorak, ; Jones, ; Sileo & Kopala, ; Tsai & Harasym, ; Tymchuk,
Affected parties	49 (89%)	Boccio, ; Bolmsjö et al., ; Bommer et al., ; Candee & Puka, (Deontology); Candee & Puka, (Utilitarian); Cassells et al., ; Cassells & Gaul, ; Christensen, ; Cottone, ; du Preez & Goedeke, ; Duff & Passmore, ; Fan, ; Ferrell et al., ; Forester-Miller & Davis, ; Green & Walker, ; Greipp, ; Grundstein-Amado, ; Haddad, ; Harasym et al., ; Hayes, ; Heyler et al., ; Hill et al., ; Hough, ; Hughes & Dvorak, ; Hundert, ; Johnsen et al., ; Johnson et al., ; Jones, ; Kaldjian et al., ; Kanoti, ; Kirsch, ; Laletas, ; Liang et al., ; Macpherson et al., ; Murphy & Murphy, ; Nekhlyudov et al., ; Phillips, ; Park, ; Ponterotto & Reynolds, ; Schaffer et al., ; Schneider & Snell, ; Siegler, ; Shahidullah et al., ; Sileo & Kopala, ; Soskolne, ; Sullivan & Brown, ; Tsai & Harasym, ; Tunzi & Ventres, ; Tymchuk, ;
Reference professional code of ethics	40 (73%)	Boccio, ; Bolmsjö et al., ; Cassells et al., ; Cassells & Gaul, ; Christensen, ; Cottone, ; DeWolf, ; du Preez & Goedeke, ; Duff & Passmore, ; Ehrich et al., ; Fan, ; Forester-Miller & Davis, ; Green & Walker, ; Greipp, ; Haddad, ; Harasym et al., ; Hayes, ; Heyler et al., ; Hill et al., ; Hough, ; Hughes & Dvorak, ; Johnsen et al., ; Kaldjian et al., ; Kirsch, ; Laletas, ; Liang et al., ; Macpherson et al., ; Marco et al., ; Park, ; Phillips, ; Ponterotto & Reynolds, ; Schaffer et al., ; Schneider & Snell, ; Shahidullah et al., ; Siegler, ; Sileo & Kopala, ; Soskolne, ; Sullivan & Brown, ; Toren & Wagner, ; Tsai & Harasym,
Reference other codes of ethics	44 (80%)	Boccio, ; Bolmsjö et al., ; Bommer et al., ; Candee & Puka, (Deontology); Cassells et al., ; Cassells & Gaul, ; Christensen, ; Cottone, ; du Preez & Goedeke, ; Duff & Passmore, ; Ehrich et al., ; Fan, ; Ferrell et al., ; Forester-Miller & Davis, ; Garfat & Ricks, ; Green & Walker, ; Greipp, ; Haddad, ; Harasym et al., ; Hayes, ; Heyler et al., ; Hill et al., ; Hough, ; Hundert, ; Johnson et al., ; Jones, ; Kaldjian et al., ; Kirsch, ; Laletas, ; Liang et al., ; Macpherson et al., ; Marco et al., ; Nekhlyudov et al., ; Park, ; Phillips, ; Schaffer et al., ; Schneider & Snell, ; Shahidullah et al., ; Sileo & Kopala, ; Sullivan & Brown, ; Toren & Wagner, ; Tsai & Harasym, ; Tymchuk, ; Zeni et al., ;
Case specific information	38 (69%)	Bommer et al., ; Candee & Puka, (Deontology); Cassells et al., ; Cassells & Gaul, ; Christensen, ; Cottone, ; DeWolf, ; Ehrich et al., ; Ferrell et al., ; Forester-Miller & Davis, ; Greipp, ; Grundstein-Amado, ; Haddad, ; Harasym et al., ; Hayes, ; Hughes & Dvorak, ; Hundert, ; Johnsen et al., ; Johnson et al., ; Jones, ; Kaldjian et al., ; Kanoti, ; Laletas, ; Liang et al., ; Murphy & Murphy, ; Nekhlyudov et al., ; Park, ; Phillips, ; Ponterotto & Reynolds, ; Schneider & Snell, ; Shahidullah et al., ; Siegler, ; Sileo & Kopala, ; Soskolne, ; Sullivan & Brown, ; Tsai & Harasym, ; Tunzi & Ventres, ; Zeni et al.,
Available options / behaviors	49 (89%)	Boccio, ; Bolsmjö et al., ; Candee & Puka, (Deontology); Candee & Puka, (Utilitarian); Cassells et al., ; Cassells & Gaul, ; Christensen, ; Cottone, ; DeWolf, ; du Preez & Goedeke, ; Duff & Passmore, ; Fan, ; Ferrell et al., ; Forester-Miller & Davis, 1996; Garfat & Ricks, ; Greipp, ; Grundstein-Amado, ; Harasym et al., ; Hayes, ; Heyler et al., ; Hill et al., ; Hough, ; Hughes & Dvorak, ; Hundert, ; Johnsen et al., ; Johnson et al., ; Jones, ; Kaldjian et al., ; Kanoti, ; Kirsch, ; Laletas, ; Liang et al., ; Macpherson et al., ; Marco et al., ; Murphy & Murphy, ; Nekhlyudov et al., ; Park, ; Phillips, ; Ponterotto & Reynolds, ; Schaffer et al., ; Schneider & Snell, ; Shahidullah et al., ; Siegler, ; Sileo & Kopala, ; Soskolne, ; Toren & Wagner, ; Tsai & Harasym, ; Tunzi & Ventres, ; Tymchuk,
Ranking / weighing of information	51 (93%)	Boccio, ; Bolsmjö et al., ; Bommer et al., ; Candee & Puka, (Deontology); Candee & Puka, (Utilitarian); Cassells et al., ; Cassells & Gaul, ; Christensen, ; Cottone, ; du Preez & Goedeke, ; Duff & Passmore, ; Ehrich et al., ; Fan, ; Ferrell et al., ; Forester-Miller & Davis, ; Garfat & Ricks, ; Green & Walker, ; Greipp, ; Grundstein-Amado, ; Haddad, ; Harasym et al., ; Hayes, ; Heyler et al., ; Hill et al., ; Hughes & Dvorak, ; Hundert, ; Johnsen et al., ; Johnson et al., ; Jones, ; Kaldjian et al., ; Kanoti, ; Kirsch, ; Laletas, ; Liang et al., ; Macpherson et al., ; Marco et al., ; Murphy & Murphy, ; Nekhlyudov et al., ; Park, ; Phillips, ; Ponterotto & Reynolds, ; Schaffer et al., ; Schneider & Snell, ; Shahidullah et al., ; Siegler, ; Soskolne, ; Sullivan & Brown, ; Tsai & Harasym, ; Tunzi & Ventres, ; Tymchuk, ; Zeni et al.,
Analysis	43 (78%)	Bolsmjö et al., ; Bommer et al., ; Candee & Puka, (Utilitarian); Cassells et al., ; Cassells & Gaul, ; Christensen, ; Cottone, ; du Preez & Goedeke, ; Duff & Passmore, ; Ehrich et al., ; Fan, ; Ferrell et al., ; Forester-Miller & Davis, ; Green & Walker, ; Grundstein-Amado, ; Haddad, ; Harasym et al., ; Heyler et al., ; Hill et al., ; Hughes & Dvorak, ; Hundert, ; Johnsen et al., ; Johnson et al., ; Jones, ; Kaldjian et al., ; Kanoti, ; Kirsch, ; Laletas, ; Macpherson et al., ; Murphy & Murphy, ; Nekhlyudov et al., ; Park, ; Phillips, ; Ponterotto & Reynolds, ; Schaffer et al., ; Shahidullah et al., ; Soskolne, ; Sullivan & Brown, ; Toren & Wagner, ; Tsai & Harasym, ; Tunzi & Ventres, ; Tymchuk, ; Zeni et al.,
Implementation	29 (53%)	Bolsmjö et al., ; Cassells & Gaul, ; Christensen, ; DeWolf, ; du Preez & Goedeke, ; Duff & Passmore, ; Ehrich et al., ; Ferrell et al., ; Forester-Miller & Davis, ; Garfat & Ricks, ; Haddad, ; Harasym et al., ; Heyler et al., ; Hill et al., ; Hough, ; Jones, ; Kanoti, ; Kirsch, ; Laletas, ; Macpherson et al., ; Murphy & Murphy, ; Park, ; Phillips, ; Ponterotto & Reynolds, ; Soskolne, ; Sullivan & Brown, ; Toren & Wagner, ; Tsai & Harasym, ; Tymchuk,
Follow up	26 (47%)	Bolsmjö et al., ; Bommer et al., ; Cassells & Gaul, ; Christensen, ; DeWolf, ; du Preez & Goedeke, ; Ferrell et al., ; Forester-Miller & Davis, ; Garfat & Ricks, ; Harasym et al., ; Heyler et al., ; Hill et al., ; Hough, ; Johnsen et al., ; Kanoti, ; Kirsch, ; Liang et al., ; Macpherson et al., ; Murphy & Murphy, ; Park, ; Phillips, ; Ponterotto & Reynolds, ; Soskolne, ; Sullivan & Brown, ; Toren & Wagner, ; Tymchuk,

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.

An external file that holds a picture, illustration, etc.
Object name is 40617_2022_753_Fig1_HTML.jpg

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

Primary field	Secondary field	Models
Business	Leadership	Zeni et al.,
Business	Management	Jones,
Child and Youth Care	Not Specified	Garfat & Ricks,
Education	Administration	Green & Walker,
Education	Teaching	Ehrich et al., ; Johnson et al.,
Engineering	Not Specified	Fan,
Medicine	Critical care	Kanoti,
	Dentistry	Johnsen et al.,
	Emergency medicine	Marco et al.,
	Epidemiology	Soskolne,
	Family medicine	Tunzi & Ventres,
	Geriatrics	Kirsch,
	Internal medicine	Kaldjian et al.,
	Nursing	Bolmsjö, Sandman, & Andersson, ; Cassells et al., ; Cassells & Gaul, ; Christensen, ; DeWolf, ; Ferrell et al., ; Greipp, ; Haddad, ; Hough, ; Hughes & Dvorak, ; Macpherson et al., ; Murphy & Murphy, ; Park, ; Phillips, ; Schaffer et al., ; Sullivan & Brown, ; Toren & Wagner,
	Oncology	Nekhlyudov et al.,
	Psychiatry	Grundstein-Amado, ; Hayes, ; Hundert,
	Not Specific	Candee & Puka, (Deontology); Candee & Puka, (Utilitarian); Harasym et al., ; Schneider & Snell, ; Siegler, ; Tsai & Harasym,
Organizational behavior management	Business	Bommer et al.,
Psychology	Coaching	Duff & Passmore,
	Counseling	Cottone, ; Forester-Miller & Davis, 1996; du Preez & Goedeke, ; Sileo & Kopala,
	I/O psychology	Heyler et al.,
	Pediatric psychology	Shahidullah et al.,
	Psychobiography	Ponterotto & Reynolds,
	School psychology	Boccio, ; Laletas,
	Not Specified	Tymchuk, ; Hill et al., ; Liang et al.,

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.

An external file that holds a picture, illustration, etc.
Object name is 40617_2022_753_Fig2_HTML.jpg

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 Making

The 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 Topography

We 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 Solving

Recent 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 Thoughts

The 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 Availability

The 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.

Declarations

The 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

Asch SE. Studies of independence and conformity: I. A minority of one against a unanimous majority. Psychological Monographs: General & Applied. 1956; 70 (9):1–70. doi: 10.1037/h0093718. [ CrossRef ] [ Google Scholar ]
Bailey, J., & Burch, M. (2013). Ethics for behavior analysts (2nd expanded ed).
Bailey J, Burch M. Ethics for behavior analysts . 3. Routledge; 2016. [ Google Scholar ]
Bailey J, Burch M. Ethics for behavior analysts . 4. Routledge; 2022. [ Google Scholar ]
Baum WM. On Human Nature . Academic Press; 2017. Behavior analysis, Darwinian evolutionary processes, and the diversity of human behavior; pp. 397–415. [ Google Scholar ]
Behavior Analyst Certification Board. (BACB, 2004, 2010). Guidelines for responsible conduct for behavior analysts. https://www.bacb.com/wp-content/uploads/2020/09/2010-Disciplinary-Standards_.pdf
Behavior Analyst Certification Board. (BACB, 2014). Professional and ethical compliance code for behavior analysts . https://www.bacb.com/wp-content/uploads/2022/05/BACB-Compliance-Code-10-8-15watermark.pdf
Behavior Analyst Certification Board. (BACB, 2020). Ethics code for behavior analysts . https://bacb.com/wp-content/ethics-code-for-behavior-analysts/
Boccio DE. Does use of a decision-making model improve the quality of school psychologists’ ethical decisions? Ethics & Behavior. 2021; 31 (2):119–135. doi: 10.1080/10508422.2020.1715802. [ CrossRef ] [ Google Scholar ]
Boivin, N., Ruane, J., Quigley, S. P., Harper, J., & Weiss, M. J. (2021). Interdisciplinary collaboration training: An example of a preservice training series. Behavior Analysis in Practice, 1–14 . 10.1007/s40617-021-00561-z [ PMC free article ] [ PubMed ]
Bolmsjö IÅ, Edberg AK, Sandman L. Everyday ethical problems in dementia care: A teleological model. Nursing Ethics. 2006; 13 (4):340–359. doi: 10.1191/0969733006ne890oa. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Bolmsjö IÅ, Sandman L, Andersson E. Everyday ethics in the care of elderly people. Nursing Ethics. 2006; 13 (3):249–263. doi: 10.1191/0969733006ne875oa. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Bommer M, Gratto C, Gravander J, Tuttle M. A behavioral model of ethical and unethical decision making. Journal of Business Ethics. 1987; 6 (4):265–280. doi: 10.1007/BF00382936. [ CrossRef ] [ Google Scholar ]
Bowman KS, Suarez VD, Weiss MJ. Standards for interprofessional collaboration in the treatment of individuals with autism. Behavior Analysis in Practice. 2021; 14 :1191–1208. doi: 10.1007/s40617-021-00560-0. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Brodhead MT. Maintaining professional relationships in an interdisciplinary setting: Strategies for navigating nonbehavioral treatment recommendations for individuals with autism. Behavior Analysis in Practice. 2015; 8 (1):70–78. doi: 10.1007/s40617-015-0042-7. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Brodhead MT, Quigley SP, Wilczynski SM. A call for discussion about scope of competence in behavior analysis. Behavior Analysis in Practice. 2018; 11 (4):424–435. doi: 10.1007/s40617-018-00303-8. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Candee D, Puka B. An analytic approach to resolving problems in medical ethics. Journal of Medical Ethics. 1984; 10 (2):61–70. doi: 10.1136/jme.10.2.61. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Cassells JM, Gaul AL. An ethical assessment framework for nursing practice. Maryland Nurse. 1998; 17 (1):9–21. [ Google Scholar ]
*Cassells, J. M., Jenkins, J., Lea, D. H., Calzone, K., & Johnson, E. (2003). An ethical assessment framework for addressing global genetic issues in clinical practice. Oncology Nursing Forum, 30 (3): 383–392. Oncology Nursing Society. [ PubMed ]
Catania, A. C. (2013). Learning (5 th ed.). Sloan. ISBN 10: 1-59739-023-7
Christensen PJ. An ethical framework for nursing service administration. Advances in Nursing Science. 1988; 10 (3):46–55. doi: 10.1097/00012272-198804000-00006. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Cottone RR. A social constructivism model of ethical decision making in counseling. Journal of Counseling & Development. 2001; 79 (1):39–45. doi: 10.1002/j.1556-6676.2001.tb01941.x. [ CrossRef ] [ Google Scholar ]
Cottone RR. Displacing the psychology of the individual in ethical decision-making: The social constructivism model. Canadian Journal of Counselling & Psychotherapy. 2004; 38 (1):5–9. [ Google Scholar ]
Cottone RR, Claus RE. Ethical decision-making models: A Review of the literature. Journal of Counseling & Development. 2000; 78 (3):275–283. doi: 10.1002/j.1556-6676.2000.tb01908.x. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Cox DJ. Ethical considerations in interdisciplinary treatments. In: Rieske RD, editor. Handbook of interdisciplinary treatments for autism spectrum disorder . Springer; 2019. pp. 49–61. [ Google Scholar ]
Cox DJ. Descriptive and normative ethical behavior appear to be functionally distinct. Journal of Applied Behavior Analysis. 2021; 54 (1):168–191. doi: 10.1002/jaba.761. [ PubMed ] [ CrossRef ] [ Google Scholar ]
DeWolf MS. Ethical decision-making. Seminars in Oncology Nursing. 1989; 5 (2):77–81. doi: 10.1016/0749-2081(89)90063-6. [ PubMed ] [ CrossRef ] [ Google Scholar ]
du Preez E, Goedeke S. Second order ethical decision-making in counselling psychology: Theory, practice and process. New Zealand Journal of Psychology. 2013; 42 (3):44–49. [ Google Scholar ]
Duff M, Passmore J. Ethics in coaching: An ethical decision making framework for coaching psychologists. International Coaching Psychology Review. 2010; 5 (2):140–151. doi: 10.53841/bpsicpr.2010.5.2.140. [ CrossRef ] [ Google Scholar ]
Eberlein L. Introducing ethics to beginning psychologists: A problem-solving approach. Professional Psychology: Research & Practice. 1987; 18 (4):353–359. doi: 10.1037/0735-7028.18.4.353. [ CrossRef ] [ Google Scholar ]
Ehrich LC, Kimber M, Millwater J, Cranston N. Ethical dilemmas: A model to understand teacher practice. Teachers & Teaching: Theory & Practice. 2011; 17 (2):173–185. doi: 10.1080/13540602.2011.539794. [ CrossRef ] [ Google Scholar ]
Fan LC. Decision-making models for handling ethical dilemmas. Proceedings of the ICE-Municipal Engineer. 2003; 156 :229–234. doi: 10.1680/muen.2003.156.4.229. [ CrossRef ] [ Google Scholar ]
Ferrell BR, Eberts MT, McCaffery M, Grant M. Clinical decision making and pain. Cancer Nursing. 1991; 14 (6):289–297. doi: 10.1097/00002820-199112000-00002. [ PubMed ] [ CrossRef ] [ Google Scholar ]
*Forester-Miller, H., & Davis, T. E. (1996). A practitioner's guide to ethical decision making . American Counseling Association. https://www.counseling.org/docs/ethics/practitioners_guide.pdf?sfvrsn=2
Garfat T, Ricks F. Self-driven ethical decision-making: A model for child and youth care workers. Child & Youth Care Forum. 1995; 24 (6):393–404. doi: 10.1007/BF02128530. [ CrossRef ] [ Google Scholar ]
Gasiewski K, Weiss MJ, Leaf JB, Labowitz J. Collaboration between behavior analysts and occupational therapists in autism service provision: Bridging the gap. Behavior Analysis in Practice. 2021; 14 (4):1209–1222. doi: 10.1007/s40617-021-00619-y. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Green J, Walker K. A contingency model for ethical decision-making by educational leaders. International Journal of Educational Leadership Preparation. 2009; 4 (4):1–10. [ Google Scholar ]
Greipp ME. Ethical decision making and mandatory reporting in cases of suspected child abuse. Journal of Pediatric Health Care. 1997; 11 (6):258–265. doi: 10.1016/S0891-5245(97)90081-X. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Grundstein-Amado R. An integrative model of clinical-ethical decision making. Theoretical Medicine. 1991; 12 (2):157–170. doi: 10.1007/BF00489796. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Grundstein-Amado R. Ethical decision-making processes used by healthcare providers. Journal of Advanced Nursing. 1993; 18 (11):1701–1709. doi: 10.1046/j.1365-2648.1993.18111701.x. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Haddad AM. Ethical considerations in home care of the oncology patient. Seminars in Oncology Nursing. 1996; 12 (3):226–230. doi: 10.1016/S0749-2081(96)80040-4. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Harasym PH, Tsai TC, Munshi FM. Is problem-based learning an ideal format for developing ethical decision skills? Kaohsiung Journal of Medical Sciences. 2013; 29 (10):523–529. doi: 10.1016/j.kjms.2013.05.005. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Hayes JR. Consultation-liaison psychiatry and clinical ethics: A model for consultation and teaching. General Hospital Psychiatry. 1986; 8 (6):415–418. doi: 10.1016/0163-8343(86)90022-8. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Heyler SG, Armenakis AA, Walker AG, Collier DY. A qualitative study investigating the ethical decision making process: A proposed model. The Leadership Quarterly. 2016; 27 (5):788–801. doi: 10.1016/j.leaqua.2016.05.003. [ CrossRef ] [ Google Scholar ]
Hill M, Glaser K, Harden J. A feminist model for ethical decision making. Women & Therapy. 1998; 21 (3):101–121. doi: 10.1300/J015v21n03_10. [ CrossRef ] [ Google Scholar ]
Hough MC. Learning, decisions and transformation in critical care nursing practice. Nursing Ethics. 2008; 15 (3):322–331. doi: 10.1177/0969733007088430. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Hughes KK, Dvorak EM. The use of decision analysis to examine ethical decision making by critical care nurses. Heart & Lung. 1997; 26 (3):238–251. doi: 10.1016/S0147-9563(97)90061-3. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Hundert EM. A model for ethical problem solving in medicine, with practical applications. Focus. 2003; 144 (4):839–435. doi: 10.1176/foc.1.4.427. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Johnsen DC, Flick K, Butali A, Cunningham-Ford MA, Holloway JA, Mahrous A, Marchini L, Clancy JM. Two critical thinking models—Probing questions and conceptualization—Adding 4 skill sets to the teacher's armamentarium. Journal of Dental Education. 2020; 84 (7):733–741. doi: 10.1002/jdd.12177. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Johnson RL, Liu J, Burgess Y. A model for making decisions about ethical dilemmas in student assessment. Journal of Moral Education. 2017; 46 (2):212–229. doi: 10.1080/03057240.2017.1313725. [ CrossRef ] [ Google Scholar ]
Jones TM. Ethical decision making by individuals in organizations: An issue-contingent model. Academy of Management Review. 1991; 16 (2):366–395. doi: 10.5465/amr.1991.4278958. [ CrossRef ] [ Google Scholar ]
Kaldjian LC, Weir RF, Duffy TP. A clinician’s approach to clinical ethical reasoning. Journal of General Internal Medicine. 2005; 20 (3):306–311. doi: 10.1111/j.1525-1497.2005.40204.x. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Kanoti GA. Ethics and medical-ethical decisions. Critical Care Clinics. 1986; 2 (1):3–12. doi: 10.1016/S0749-0704(18)30620-1. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Kieta AR, Cihon TM, Abdel-Jalil A. Problem solving from a behavioral perspective: Implications for behavior analysts and educators. Journal of Behavioral Education. 2019; 28 (2):275–300. doi: 10.1007/s10864-018-9296-9. [ CrossRef ] [ Google Scholar ]
Kirsch NR. Ethical decision making: Application of a problem-solving model. Topics in Geriatric Rehabilitation. 2009; 25 (4):282–291. doi: 10.1097/TGR.0b013e3181bdd6d8. [ CrossRef ] [ Google Scholar ]
LaFrance DL, Weiss MJ, Kazemi E, Gerenser J, Dobres J. Multidisciplinary teaming: Enhancing collaboration through increased understanding. Behavior Analysis in Practice. 2019; 12 (3):709–726. doi: 10.1007/s40617-019-00331-y. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Laletas S. Ethical decision making for professional school counsellors: Use of practice-based models in secondary school settings. British Journal of Guidance & Counselling. 2018; 47 (3):283–291. doi: 10.1080/03069885.2018.1474341. [ CrossRef ] [ Google Scholar ]
Layng TJ. Tutorial: Understanding concepts: Implications for behavior analysts and educators. Perspectives on Behavior Science. 2019; 42 (2):345–363. doi: 10.1007/s40614-018-00188-6. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Liang B, Chung A, Diamonti AJ, Douyon CM, Gordon JR, Joyner ED, Meerkins TM, Rene MK, Seinkiewicz SA, Weber AE, Wilson ES. Ethical social justice: Do the ends justify the means? Journal of Community & Applied Social Psychology. 2017; 27 (4):298–311. doi: 10.1002/casp.2323. [ CrossRef ] [ Google Scholar ]
Macpherson I, Roqué MV, Segarra I. Moral dilemmas involving anthropological and ethical dimensions in healthcare curriculum. Nursing Ethics. 2020; 27 (5):1238–1249. doi: 10.1177/0969733020914382. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Marya VG, Suarez VD, Cox DJ. Ethical decision-making and evidenced-based practices. In: Fisher WW, Piazza CC, Roane HS, editors. Handbook of applied behavior analysis interventions for autism . Springer; 2022. pp. 47–70. [ Google Scholar ]
Newhouse-Oisten MK, Peck KM, Conway AA, Frieder JE. Ethical considerations for interdisciplinary collaboration with prescribing professionals. Behavior Analysis in Practice. 2017; 10 (2):145–153. doi: 10.1007/s40617-017-0184-x. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Marco CA, Lu DW, Stettner E, Sokolove PE, Ufberg JW, Noeller TP. Ethics curriculum for emergency medicine graduate medical education. Journal of Emergency Medicine. 2011; 40 (5):550–556. doi: 10.1016/j.jemermed.2010.05.076. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Miller KL, Re Cruz A, Ala'i-Rosales S. Inherent tensions and possibilities: Behavior analysis and cultural responsiveness. Behavior & Social Issues. 2019; 28 (1):16–36. doi: 10.1007/s42822-019-00010-1. [ CrossRef ] [ Google Scholar ]
Moher D, Liberati A, Tetzlaff J, Altman DG, Prisma Group Reprint—preferred reporting items for systematic reviewsand meta-analyses: the PRISMA statement. Physical Therapy. 2009; 89 (9):873–880. doi: 10.1093/ptj/89.9.873. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Murphy MA, Murphy J. Making ethical decisions—Systematically. Nursing. 1976; 6 (5):CG13–CG14. doi: 10.1016/j.jemermed.2010.05.076. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Nekhlyudov L, Braddock CH., III An approach to enhance communication about screening mammography in primary care. Journal of Women's Health. 2009; 18 (9):1403–1412. doi: 10.1089/jwh.2008.1184. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Park EJ. An integrated ethical decision-making model for nurses. Nursing Ethics. 2012; 19 (1):139–159. doi: 10.1177/0969733011413491. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Park EJ. The development and implications of a case-based computer program to train ethical decision-making. Nursing Ethics. 2013; 20 (8):943–956. doi: 10.1177/0969733013484489. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Park EJ, Park M. Effectiveness of a case-based computer program on students’ ethical decision making. Journal of Nursing Education. 2015; 54 (11):633–640. doi: 10.3928/01484834-20151016-04. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Phillips S. Ethical decision-making when caring for the noncompliant patient. Journal of Infusion Nursing. 2006; 29 (5):266–271. doi: 10.1097/00129804-200609000-00005. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Ponterotto JG, Reynolds JD. Ethical and legal considerations in psychobiography. American Psychologist. 2017; 72 (5):446–458. doi: 10.1037/amp0000047. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Pritchett, M., Ala’i-Rosales, S., Cruz, A. R., & Cihon, T. M. (2021). Social justice is the spirit and aim of an applied science of human behavior: Moving from colonial to participatory research practices. Behavior Analysis in Practice, 1–19 . 10.1007/s40617-021-00591-7 [ PMC free article ] [ PubMed ]
Rosenberg NE, Schwartz IS. Guidance or compliance: What makes an ethical behavior analyst? Behavior Analysis in Practice. 2019; 12 (2):473–482. doi: 10.1007/s40617-018-00287-5. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Schaffer MA, Cameron ME, Tatley EB. The value, be, do ethical decision-making model: Balancing students’ needs in school nursing. Journal of School Nursing. 2000; 16 (5):44–49. doi: 10.1177/105984050001600507. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Schneider GW, Snell L. CARE: An approach for teaching ethics in medicine. Social Science & Medicine. 2000; 51 (10):1563–1567. doi: 10.1016/S0277-9536(00)00054-X. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Shahidullah JD, Hostutler CA, Forman SG. Ethical considerations in medication-related roles for pediatric primary care psychologists. Clinical Practice in Pediatric Psychology. 2019; 7 (4):405. doi: 10.1037/cpp0000285. [ CrossRef ] [ Google Scholar ]
Siegler M. Decision-making strategy for clinical-ethical problems in medicine. Archives of Internal Medicine. 1982; 142 (12):2178–2179. doi: 10.1001/archinte.1982.00340250144021. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Sileo FJ, Kopala M. An A-B-C-D-E worksheet for promoting beneficence when considering ethical issues. Counseling & Values. 1993; 37 (2):89–95. doi: 10.1002/j.2161-007X.1993.tb00800.x. [ CrossRef ] [ Google Scholar ]
Slocum SK, Tiger JH. An assessment of the efficiency of and child preference for forward and backward chaining. Journal of Applied Behavior Analysis. 2011; 44 (4):793–805. doi: 10.1901/jaba.2011.44-793. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Soskolne CL. Ethical decision-making in epidemiology: The case study approach. Journal of Clinical Epidemiology. 1991; 44 (1):125–130. doi: 10.1016/0895-4356(91)90187-E. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Suarez, V. D., Najdowski, A. C., Tarbox, J., Moon, E., St Clair, M., & Farag, P. (2021). Teaching individuals with autism problem-solving skills for resolving social conflicts. Behavior Analysis in Practice, 1–14 . 10.1007/s40617-021-00643-y [ PMC free article ] [ PubMed ]
Sullivan PA, Brown T. Common-sense ethics in administrative decision making. Part II. Proactive steps. Journal of Nursing Administration. 1991; 21 (11):57–61. doi: 10.1097/00005110-199111000-00013. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Sush, D., & Najdowski, A. C. (2019). A workbook of ethical case scenarios in applied behavior analysis . Academic Press.
Szabo, T. (2020). Problem solving. In M. Fryling, R. Rehfeldt, J. Tarbox, & L. Hayes (Eds.), Applied behavior analysis of language and cognition: Core concepts and principles for practitioners. Context Press.
Taylor BA, LeBlanc LA, Nosik MR. Compassionate care in behavior analytic treatment: Can outcomes be enhanced by attending to relationships with caregivers? Behavior Analysis in Practice. 2019; 12 (3):654–666. doi: 10.1007/s40617-018-00289-3. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Toren O, Wagner N. Applying an ethical decision-making tool to a nurse management dilemma. Nursing Ethics. 2010; 17 (3):393–402. doi: 10.1177/0969733009355106. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Tsai TC, Harasym PH. A medical ethical reasoning model and its contributions to medical education. Medical Education. 2010; 44 (9):864–873. doi: 10.1111/j.1365-2923.2010.03722.x. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Tunzi M, Ventres W. Family medicine ethics: An integrative approach. Family Medicine. 2018; 50 (8):583–588. doi: 10.22454/FamMed.2018.821666. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Tymchuk AJ. Guidelines for ethical decision making. Canadian Psychology/Psychologie Canadienne. 1986; 27 (1):36. doi: 10.1037/h0079866. [ PubMed ] [ CrossRef ] [ Google Scholar ]
Wright PI. Cultural humility in the practice of applied behavior analysis. Behavior Analysis in Practice. 2019; 12 :805–809. doi: 10.1007/s40617-019-00343-8. [ PMC free article ] [ PubMed ] [ CrossRef ] [ Google Scholar ]
Zeni TA, Buckley MR, Mumford MD, Griffith JA. Making “sense” of ethical decision making. The Leadership Quarterly. 2016; 27 (6):838–855. doi: 10.1016/j.leaqua.2016.09.002. [ CrossRef ] [ Google Scholar ]

IMAGES

PPT
Solving ethical problems
CHAPTER TWO ETHICAL DILEMMAS AND CRITICAL PROCESSES
7 Step Ethical Decision Making Model
ETHICAL PROBLEM SOLVING MODELS
Home Office Ethical Decision Making Model Ethical Decision-making Model

COMMENTS

PDF Ethical Decision Making Framework Frederic Reamer (2012)
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.
Essential Steps for Ethical Problem-Solving
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.
PDF Guides to Ethical Decision-Making
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
PDF Decision Making Models for Managing Ethical Dilemmas in Social Work
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
Making Difficult Decisions
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.
3. Ethical Dilemmas and Decision Making: A Framework
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.
Social Work Values and Ethics, Fourth Edition on JSTOR
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...
Social Work Values and Ethics
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.
Ethical Dilemmas in Social Service
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 ...
Social Work Values and Ethics
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 ...
PDF Ethical Decision Making and Behavior
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 : Reamer, Frederic G., 1953- : Free
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
‪Frederic Reamer‬
‪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.
PDF inSocialWork Podcast Series Episode 24
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 ...
Ethics Risk Management in Social Work: A Primer
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 ...
Decision-Making Process of Ethical Dilemma Using Reamer's Framework
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.
SECTION 2: BEST PRACTICE MODELS OF 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 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 ...
Clients' Right to Competent and Ethical Treatment
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 ...
Examination of Ethical Decision-Making Models Across Disciplines
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 ...
PPTX The Ethics of Social Justice
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.
PDF Teaching Ethical Decision Making Using Dual Relationship
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.