4 step problem solving process of ethical analysis

Ethical Decision Making Models and 6 Steps of Ethical Decision Making Process

By Andre Wyatt on March 21, 2023 — 10 minutes to read

In many ways, ethics may feel like a soft subject, a conversation that can wait when compared to other more seemingly pressing issues (a process for operations, hiring the right workers, and meeting company goals). However, putting ethics on the backburner can spell trouble for any organization. Much like the process of businesses creating the company mission, vision, and principles ; the topic of ethics has to enter the conversation. Ethics is far more than someone doing the right thing; it is many times tied to legal procedures and policies that if breached can put an organization in the midst of trouble.

A general definition of business ethics is that it is a tool an organization uses to make sure that managers, employees, and senior leadership always act responsibly in the workplace with internal and external stakeholders.
An ethical decision-making model is a framework that leaders use to bring these principles to the company and ensure they are followed.
Importance of Ethical Standards Part 1
Ethical Decision-Making Model Approach Part 2
Ethical Decision-Making Process Part 3
PLUS Ethical Decision-Making Model Part 4
Character-Based Decision-Making Model Part 5

The Importance of Ethical Standards

Leaders have to develop ethical standards that employees in their company will be required to adhere to. This can help move the conversation toward using a model to decide when someone is in violation of ethics.

There are five sources of ethical standards:

Utilitarian

Common good.

While many of these standards were created by Greek Philosophers who lived long ago, business leaders are still using many of them to determine how they deal with ethical issues. Many of these standards can lead to a cohesive ethical decision-making model.

What is the purpose of an ethical decision-making model?

Ethical decision-making models are designed to help individuals and organizations make decisions in an ethical manner.

The purpose of an ethical decision-making model is to ensure that decisions are made in a manner that takes into account the ethical implications for all stakeholders involved.

Ethical decision-making models provide a framework for analyzing ethical dilemmas and serve as a guide for identifying potential solutions. By utilizing these models, businesses can ensure they are making decisions that align with their values while minimizing the risk of harming stakeholders. This can result in better decision-making and improved reputation.

Why is it important to use an ethical decision making model?

Making ethical decisions is an integral part of being a responsible leader and member of society. It is crucial to use an ethical decision making model to ensure that all stakeholders are taken into account and that decisions are made with the highest level of integrity. An ethical decision making model provides a framework for assessing the potential consequences of each choice, analyzing which option best aligns with personal values and organizational principles, and then acting on those conclusions.

An Empirical Approach to an Ethical Decision-Making Model

In 2011, a researcher at the University of Calgary in Calgary, Canada completed a study for the Journal of Business Ethics.

The research centered around an idea of rational egoism as a basis for developing ethics in the workplace.

She had 16 CEOs formulate principles for ethics through the combination of reasoning and intuition while forming and applying moral principles to an everyday circumstance where a question of ethics could be involved.

Through the process, the CEOs settled on a set of four principles:

self-interest
rationality

These were the general standards used by the CEOs in creating a decision about how they should deal with downsizing. While this is not a standard model, it does reveal the underlying ideas business leaders use to make ethical choices. These principles lead to standards that are used in ethical decision-making processes and moral frameworks.

How would you attempt to resolve a situation using an ethical decision-making model?

When facing a difficult situation, it can be beneficial to use an ethical decision-making model to help you come to the best possible solution. These models are based on the idea that you should consider the consequences of your decision, weigh the various options available, and consider the ethical implications of each choice. First, you should identify the problem or situation and clearly define what it is. Then, you must assess all of the possible outcomes of each choice and consider which one is most ethical. Once you have identified your preferred option, you should consult with others who may be affected by your decision to ensure that it aligns with their values and interests. You should evaluate the decision by considering how it affects yourself and others, as well as how it meets the expectations of your organization or institution.

The Ethical Decision-Making Process

Before a model can be utilized, leaders need to work through a set of steps to be sure they are bringing a comprehensive lens to handling ethical disputes or problems.

Take Time to Define the Problem

Consult resources and seek assistance, think about the lasting effects, consider regulations in other industries, decide on a decision, implement and evaluate.

While each situation may call for specific steps to come before others, this is a general process that leaders can use to approach ethical decision-making . We have talked about the approach; now it is time to discuss the lens that leaders can use to make the final decision that leads to implementation.

PLUS Ethical Decision-Making Model

PLUS Ethical Decision-Making Model is one of the most used and widely cited ethical models.

To create a clear and cohesive approach to implementing a solution to an ethical problem; the model is set in a way that it gives the leader “ ethical filters ” to make decisions.

It purposely leaves out anything related to making a profit so that leaders can focus on values instead of a potential impact on revenue.

The letters in PLUS each stand for a filter that leaders can use for decision-making:

P – Policies and Procedures: Is the decision in line with the policies laid out by the company?
L – Legal: Will this violate any legal parameters or regulations?
U – Universal: How does this relate to the values and principles established for the organization to operate? Is it in tune with core values and the company culture?
S – Self: Does it meet my standards of fairness and justice? This particular lens fits well with the virtue approach that is a part of the five common standards mentioned above.

These filters can even be applied to the process, so leaders have a clear ethical framework all along the way. Defining the problem automatically requires leaders to see if it is violating any of the PLUS ethical filters. It should also be used to assess the viability of any decisions that are being considered for implementation, and make a decision about whether the one that was chosen resolved the PLUS considerations questioned in the first step. No model is perfect, but this is a standard way to consider four vital components that have a substantial ethical impact .

The Character-Based Decision-Making Model

While this one is not as widely cited as the PLUS Model, it is still worth mentioning. The Character-Based Decision-Making Model was created by the Josephson Institute of Ethics, and it has three main components leaders can use to make an ethical decision.

All decisions must take into account the impact to all stakeholders – This is very similar to the Utilitarian approach discussed earlier. This step seeks to do good for most, and hopefully avoid harming others.
Ethics always takes priority over non-ethical values – A decision should not be rationalized if it in any way violates ethical principles. In business, this can show up through deciding between increasing productivity or profit and keeping an employee’s best interest at heart.
It is okay to violate another ethical principle if it advances a better ethical climate for others – Leaders may find themselves in the unenviable position of having to prioritize ethical decisions. They may have to choose between competing ethical choices, and this model advises that leaders should always want the one that creates the most good for as many people as possible.

There are multiple components to consider when making an ethical decision. Regulations, policies and procedures, perception, public opinion, and even a leader’s morality play a part in how decisions that question business ethics should be handled. While no approach is perfect, a well-thought-out process and useful framework can make dealing with ethical situations easier.

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The PLUS Ethical Decision Making Model

Seven Steps to Ethical Decision Making – Step 1: Define the problem (consult PLUS filters ) – Step 2: Seek out relevant assistance, guidance and support – Step 3: Identify alternatives – Step 4: Evaluate the alternatives (consult PLUS filters ) – Step 5: Make the decision – Step 6: Implement the decision – Step 7: Evaluate the decision (consult PLUS filters )

Introduction Organizations struggle to develop a simple set of guidelines that makes it easier for individual employees, regardless of position or level, to be confident that his/her decisions meet all of the competing standards for effective and ethical decision-making used by the organization. Such a model must take into account two realities:

Every employee is called upon to make decisions in the normal course of doing his/her job. Organizations cannot function effectively if employees are not empowered to make decisions consistent with their positions and responsibilities.
For the decision maker to be confident in the decision’s soundness, every decision should be tested against the organization’s policies and values, applicable laws and regulations as well as the individual employee’s definition of what is right, fair, good and acceptable.

The decision making process described below has been carefully constructed to be:

Fundamentally sound based on current theories and understandings of both decision-making processes and ethics.
Simple and straightforward enough to be easily integrated into every employee’s thought processes.
Descriptive (detailing how ethical decision are made naturally) rather than prescriptive (defining unnatural ways of making choices).

Why do organizations need ethical decision making? See our special edition case study, #RespectAtWork, to find out.

First, explore the difference between what you expect and/or desire and the current reality. By defining the problem in terms of outcomes, you can clearly state the problem.

Consider this example: Tenants at an older office building are complaining that their employees are getting angry and frustrated because there is always a long delay getting an elevator to the lobby at rush hour. Many possible solutions exist, and all are predicated on a particular understanding the problem:

Flexible hours – so all the tenants’ employees are not at the elevators at the same time.
Faster elevators – so each elevator can carry more people in a given time period.
Bigger elevators – so each elevator can carry more people per trip.
Elevator banks – so each elevator only stops on certain floors, increasing efficiency.
Better elevator controls – so each elevator is used more efficiently.
More elevators – so that overall carrying capacity can be increased.
Improved elevator maintenance – so each elevator is more efficient.
Encourage employees to use the stairs – so fewer people use the elevators.

The real-life decision makers defined the problem as “people complaining about having to wait.” Their solution was to make the wait less frustrating by piping music into the elevator lobbies. The complaints stopped. There is no way that the eventual solution could have been reached if, for example, the problem had been defined as “too few elevators.”

How you define the problem determines where you go to look for alternatives/solutions– so define the problem carefully.

Step 2: Seek out relevant assistance, guidance and support

Once the problem is defined, it is critical to search out resources that may be of assistance in making the decision. Resources can include people (i.e., a mentor, coworkers, external colleagues, or friends and family) as well professional guidelines and organizational policies and codes. Such resources are critical for determining parameters, generating solutions, clarifying priorities and providing support, both while implementing the solution and dealing with the repercussions of the solution.

Step 3: Identify available alternative solutions to the problem The key to this step is to not limit yourself to obvious alternatives or merely what has worked in the past. Be open to new and better alternatives. Consider as many as solutions as possible — five or more in most cases, three at the barest minimum. This gets away from the trap of seeing “both sides of the situation” and limiting one’s alternatives to two opposing choices (i.e., either this or that).

Step 4: Evaluate the identified alternatives As you evaluate each alternative, identify the likely positive and negative consequence of each. It is unusual to find one alternative that would completely resolve the problem and is significantly better than all others. As you consider positive and negative consequences, you must be careful to differentiate between what you know for a fact and what you believe might be the case. Consulting resources, including written guidelines and standards, can help you ascertain which consequences are of greater (and lesser) import.

You should think through not just what results each alternative could yield, but the likelihood it is that such impact will occur. You will only have all the facts in simple cases. It is reasonable and usually even necessary to supplement the facts you have with realistic assumptions and informed beliefs. Nonetheless, keep in mind that the more the evaluation is fact-based, the more confident you can be that the expected outcome will occur. Knowing the ratio of fact-based evaluation versus non-fact-based evaluation allows you to gauge how confident you can be in the proposed impact of each alternative.

Step 5: Make the decision When acting alone, this is the natural next step after selecting the best alternative. When you are working in a team environment, this is where a proposal is made to the team, complete with a clear definition of the problem, a clear list of the alternatives that were considered and a clear rationale for the proposed solution.

Step 6: Implement the decision While this might seem obvious, it is necessary to make the point that deciding on the best alternative is not the same as doing something. The action itself is the first real, tangible step in changing the situation. It is not enough to think about it or talk about it or even decide to do it. A decision only counts when it is implemented. As Lou Gerstner (former CEO of IBM) said, “There are no more prizes for predicting rain. There are only prizes for building arks.”

Step 7: Evaluate the decision Every decision is intended to fix a problem. The final test of any decision is whether or not the problem was fixed. Did it go away? Did it change appreciably? Is it better now, or worse, or the same? What new problems did the solution create?

Ethics Filters

The ethical component of the decision making process takes the form of a set of “filters.” Their purpose is to surface the ethics considerations and implications of the decision at hand. When decisions are classified as being “business” decisions (rather than “ethics” issues), values can quickly be left out of consideration and ethical lapses can occur.

At key steps in the process, you should stop and work through these filters, ensuring that the ethics issues imbedded in the decision are given consideration.

We group the considerations into the mnemonic PLUS.

P = Policies Is it consistent with my organization’s policies, procedures and guidelines?
L = Legal Is it acceptable under the applicable laws and regulations?
U = Universal Does it conform to the universal principles/values my organization has adopted?
S = Self Does it satisfy my personal definition of right, good and fair?

The PLUS filters work as an integral part of steps 1, 4 and 7 of the decision-making process. The decision maker applies the four PLUS filters to determine if the ethical component(s) of the decision are being surfaced/addressed/satisfied.

Does the existing situation violate any of the PLUS considerations?
Step 2: Seek out relevant assistance, guidance and support
Step 3: Identify available alternative solutions to the problem
Will the alternative I am considering resolve the PLUS violations?
Will the alternative being considered create any new PLUS considerations?
Are the ethical trade-offs acceptable?
Step 5: Make the decision
Step 6: Implement the decision
Does the resultant situation resolve the earlier PLUS considerations?
Are there any new PLUS considerations to be addressed?

The PLUS filters do not guarantee an ethically-sound decision. They merely ensure that the ethics components of the situation will be surfaced so that they might be considered.

How Organizations Can Support Ethical Decision-Making Organizations empower employees with the knowledge and tools they need to make ethical decisions by

Intentionally and regularly communicating to all employees:
Organizational policies and procedures as they apply to the common workplace ethics issues.
Applicable laws and regulations.
Agreed-upon set of “universal” values (i.e., Empathy, Patience, Integrity, Courage [EPIC]).
Providing a formal mechanism (i.e., a code and a helpline, giving employees access to a definitive interpretation of the policies, laws and universal values when they need additional guidance before making a decision).
Free Ethics & Compliance Toolkit
Ethics and Compliance Glossary
Definitions of Values
Why Have a Code of Conduct?
Code Construction and Content
Common Code Provisions
Ten Style Tips for Writing an Effective Code of Conduct
Five Keys to Reducing Ethics and Compliance Risk
Business Ethics & Compliance Timeline

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1 A Model for Ethical Problem Solving

Published: April 2017
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Chapter 1 begins with a five-step model for analyzing a case posing ethical questions in pharmacy: (1) responding to a “sense” or feeling that something is wrong, (2) gathering information and making an assessment, (3) identifying the ethical problem, (4) seeking a resolution, and (5) working with others to choose a course of action. This five-step model is illustrated by the book’s first case, one involving reporting a possibly lethal medical error. A patient dies after mistakenly being given heparin intended for another patient. The case is followed by commentary applying the model and concluding with possible resolutions of the dilemma. The pharmacist might share the information with all those involved, including the family of the now-deceased patient, or tell only the pharmacist who prepared the drugs. The implications of the ethical principles involved, such as nonmaleficence and veracity, are explored.

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4 step problem solving process of ethical analysis

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Essential Steps for Ethical Problem-Solving

Is there a conflict of values, or rights, or professional responsibilities? (For example, there may be an issue of self-determination of an adolescent versus the well-being of the family.)

2. IDENTIFY the key values and principles involved. What meanings and limitations are typically attached to these competing values? (For example, rarely is confidential information held in absolute secrecy; however, typically decisions about access by third parties to sensitive content should be contracted with clients.)

3. RANK the values or ethical principles which - in your professional judgment - are most relevant to the issue or dilemma. What reasons can you provide for prioritizing one competing value/principle over another? (For example, your client’s right to choose a beneficial course of action could bring hardship or harm to others who would be affected.)

4. DEVELOP an action plan that is consistent with the ethical priorities that have been determined as central to the dilemma. Have you conferred with clients and colleagues, as appropriate, about the potential risks and consequences of alternative courses of action? Can you support or justify your action plan with the values/principles on which the plan is based? (For example, have you conferred with all the necessary persons regarding the ethical dimensions of planning for a battered wife’s quest to secure secret shelter and the implications for her teen-aged children?)

5. IMPLEMENT your plan, utilizing the most appropriate practice skills and competencies. How will you make use of core social work skills such as sensitive communication, skillful negotiation, and cultural competence? (For example, skillful colleague or supervisory communication and negotiation may enable an impaired colleague to see her/his impact on clients and to take appropriate action.)

6. REFLECT on the outcome of this ethical decision making process. How would you evaluate the consequences of this process for those involved: Client(s), professional(s), and agency (ies)? (Increasingly, professionals have begun to seek support, further professional training, and consultation through the development of Ethics review Committees or Ethics Consultation processes.)

From discussion by Frederick Reamer & Sr. Ann Patrick Conrad in Professional Choices: Ethics at Work (1995), video available from NASW Press 1-800-227-3590

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Thinking Ethically

Markkula Center for Applied Ethics
Ethics Resources
Ethical Decision Making

Moral issues greet us each morning in the newspaper, confront us in the memos on our desks, nag us from our children's soccer fields, and bid us good night on the evening news. We are bombarded daily with questions about the justice of our foreign policy, the morality of medical technologies that can prolong our lives, the rights of the homeless, the fairness of our children's teachers to the diverse students in their classrooms.

Dealing with these moral issues is often perplexing. How, exactly, should we think through an ethical issue? What questions should we ask? What factors should we consider?

The first step in analyzing moral issues is obvious but not always easy: Get the facts. Some moral issues create controversies simply because we do not bother to check the facts. This first step, although obvious, is also among the most important and the most frequently overlooked.

But having the facts is not enough. Facts by themselves only tell us what is ; they do not tell us what ought to be. In addition to getting the facts, resolving an ethical issue also requires an appeal to values. Philosophers have developed five different approaches to values to deal with moral issues.

The Utilitarian Approach Utilitarianism was conceived in the 19th century by Jeremy Bentham and John Stuart Mill to help legislators determine which laws were morally best. Both Bentham and Mill suggested that ethical actions are those that provide the greatest balance of good over evil.

To analyze an issue using the utilitarian approach, we first identify the various courses of action available to us. Second, we ask who will be affected by each action and what benefits or harms will be derived from each. And third, we choose the action that will produce the greatest benefits and the least harm. The ethical action is the one that provides the greatest good for the greatest number.

The Rights Approach The second important approach to ethics has its roots in the philosophy of the 18th-century thinker Immanuel Kant and others like him, who focused on the individual's right to choose for herself or himself. According to these philosophers, what makes human beings different from mere things is that people have dignity based on their ability to choose freely what they will do with their lives, and they have a fundamental moral right to have these choices respected. People are not objects to be manipulated; it is a violation of human dignity to use people in ways they do not freely choose.

Of course, many different, but related, rights exist besides this basic one. These other rights (an incomplete list below) can be thought of as different aspects of the basic right to be treated as we choose.

The right to the truth: We have a right to be told the truth and to be informed about matters that significantly affect our choices.

The right of privacy: We have the right to do, believe, and say whatever we choose in our personal lives so long as we do not violate the rights of others.

The right not to be injured: We have the right not to be harmed or injured unless we freely and knowingly do something to deserve punishment or we freely and knowingly choose to risk such injuries.

The right to what is agreed: We have a right to what has been promised by those with whom we have freely entered into a contract or agreement.

In deciding whether an action is moral or immoral using this second approach, then, we must ask, Does the action respect the moral rights of everyone? Actions are wrong to the extent that they violate the rights of individuals; the more serious the violation, the more wrongful the action.

The Fairness or Justice Approach The fairness or justice approach to ethics has its roots in the teachings of the ancient Greek philosopher Aristotle, who said that "equals should be treated equally and unequals unequally." The basic moral question in this approach is: How fair is an action? Does it treat everyone in the same way, or does it show favoritism and discrimination?

Favoritism gives benefits to some people without a justifiable reason for singling them out; discrimination imposes burdens on people who are no different from those on whom burdens are not imposed. Both favoritism and discrimination are unjust and wrong.

The Common-Good Approach This approach to ethics assumes a society comprising individuals whose own good is inextricably linked to the good of the community. Community members are bound by the pursuit of common values and goals.

The common good is a notion that originated more than 2,000 years ago in the writings of Plato, Aristotle, and Cicero. More recently, contemporary ethicist John Rawls defined the common good as "certain general conditions that are...equally to everyone's advantage."

In this approach, we focus on ensuring that the social policies, social systems, institutions, and environments on which we depend are beneficial to all. Examples of goods common to all include affordable health care, effective public safety, peace among nations, a just legal system, and an unpolluted environment.

Appeals to the common good urge us to view ourselves as members of the same community, reflecting on broad questions concerning the kind of society we want to become and how we are to achieve that society. While respecting and valuing the freedom of individuals to pursue their own goals, the common-good approach challenges us also to recognize and further those goals we share in common.

The Virtue Approach The virtue approach to ethics assumes that there are certain ideals toward which we should strive, which provide for the full development of our humanity. These ideals are discovered through thoughtful reflection on what kind of people we have the potential to become.

Virtues are attitudes or character traits that enable us to be and to act in ways that develop our highest potential. They enable us to pursue the ideals we have adopted. Honesty, courage, compassion, generosity, fidelity, integrity, fairness, self-control, and prudence are all examples of virtues.

Virtues are like habits; that is, once acquired, they become characteristic of a person. Moreover, a person who has developed virtues will be naturally disposed to act in ways consistent with moral principles. The virtuous person is the ethical person.

In dealing with an ethical problem using the virtue approach, we might ask, What kind of person should I be? What will promote the development of character within myself and my community?

Ethical Problem Solving These five approaches suggest that once we have ascertained the facts, we should ask ourselves five questions when trying to resolve a moral issue:

What benefits and what harms will each course of action produce, and which alternative will lead to the best overall consequences?

What moral rights do the affected parties have, and which course of action best respects those rights?

Which course of action treats everyone the same, except where there is a morally justifiable reason not to, and does not show favoritism or discrimination?

Which course of action advances the common good?

Which course of action develops moral virtues?

This method, of course, does not provide an automatic solution to moral problems. It is not meant to. The method is merely meant to help identify most of the important ethical considerations. In the end, we must deliberate on moral issues for ourselves, keeping a careful eye on both the facts and on the ethical considerations involved.

This article updates several previous pieces from Issues in Ethics by Manuel Velasquez - Dirksen Professor of Business Ethics at Santa Clara University and former Center director - and Claire Andre, associate Center director. "Thinking Ethically" is based on a framework developed by the authors in collaboration with Center Director Thomas Shanks, S.J., Presidential Professor of Ethics and the Common Good Michael J. Meyer, and others. The framework is used as the basis for many programs and presentations at the Markkula Center for Applied Ethics.

Step 7: Decide & Act
Ultimately, resolving any ethical dilemma requires decision and action. Ideally, your personal ethical values will be consistent with those of other team members and consistent with the guiding legal and professional standards of practice. Given the nature of ethical decision-making, however, you are more likely to find yourself facing internal and/or external conflicts. Having completed the previous steps of this systematic process, you should be able to select the course of action that is best supported by your analysis. More importantly, you will be able to articulate a concrete foundation from which to defend your decisions.

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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.

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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.

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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

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Five steps in an Ethical Analysis

The recommended procedure for analyzing ethical cases is to apply a variant of the design/problem-solving loop. In the process, one attempts to reason systematically to a rationally defensible moral judgment using ethical principles and moral rules. The basic steps in the procedure are as follows:

Identify the Issues,
Outline the Options,
Construct Ethical Arguments,
Evaluate the Arguments,
Make a Decision.

Step 1: Identify the Issues –

(a) What are the major moral or ethical issues raised by this case?

(b) What are the major factual issues raised by this case?

(d) Who are the major stakeholders in this case? (Stakeholders refer to all individuals whose interest could be affected by the decision made in the case).

(e) How the issues are in this case related to the application of technology?

Step 2: Outline the Options

(a) What are the main alternative actions or policies that might be followed in responding to the ethical issues in this case?

(b) What are the major views on the conceptual issues raised by this case?

(c) What facts are unknown or controverter that might be relevant to deciding this case (may require research to determine some facts)?

Step 3: Construct Ethical Arguments –

(a) Determine which of the four moral standards discussed by Harris (egoism, natural law, utilitarianism, and respect for persons) apply to this case?

(b) Identify the moral principles or high-level rules that can be invoked to support a conclusion as to what ought to be done ethically in this case or similar cases?

(c) Determine whether the different moral standards yield converging or -diverging judgments about what ought to be done?

Step 4: Evaluate the Arguments for each Option –

(a) Weigh the ethical reasons and arguments for each option in terms of their relative importance, assigning weights to each consideration where:

very important consideration,
somewhat important consideration,
a consideration of the only minor importance

(b) Determine whether there are any unwarranted factual assumptions that need to be examined in each argument.

Step 5: Make a Decision –

(a) Decide which of the identified options you would recommend or judge to be the ethically best way to deal with the issue presented in this case based on which option has the strongest ethical reasons behind it.

(b) Determine how a critic of your position might try to argue against it using other ethical reasons, and present a rebuttal or counter-argument in defense of your judgment.

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DOI: 10.1097/TGR.0b013e3181bdd6d8
Corpus ID: 76019615

Ethical Decision Making: Application of a Problem‐Solving Model

Nancy R. Kirsch
Published 1 October 2009
Medicine, Philosophy
Topics in Geriatric Rehabilitation

10 Citations

An integrated ethical decision-making model for nurses.

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Examination of ethical decision-making models across disciplines: common elements and application to the field of behavior analysis.

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Ethics in independent nurse consulting: Strategies for avoiding ethical quicksand

Contextual influences on nurses’ decision-making in cases of physical restraint, a study of pre-hospital emergency care personnel's perception of ethical dilemmas in the field: a qualitative study, ethics support in institutional elderly care: a review of the literature, clinical ethical consultation in decision making process, the other side of the coin: nurses' views and behavior on physical restraint, dylematy etyczne w pielęgniarstwie geriatrycznym — wybrane zagadnienia, 5 references, employing ethical codes and decision‐making models: a developmental process, disciplinary split: a threat to geriatrics interdisciplinary team training, clinical ethical decision making: an investigation of the rationales used to justify doing less than one believes one should., problems with ethics training by "osmosis.", ethical decision-making and psychologists' attitudes toward training in ethics., related papers.

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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).
Five steps in an Ethical Analysis
Five steps in an Ethical Analysis. The recommended procedure for analyzing ethical cases is to apply a variant of the design/problem-solving loop. In the process, one attempts to reason systematically to a rationally defensible moral judgment using ethical principles and moral rules. The basic steps in the procedure are as follows:
The Foursquare Protocol
The Foursquare Protocol is a process for making ethical decisions. It was created by lawyer Stephen Goldman, author of the 2008 book, "Temptations in the Office." It's a four-step process for deciding what's truly relevant and significant in any decision-making situation, so that you can clearly see the best way forward. The steps are as follows:
Chapter 24- Ethical and legal issues Flashcards
explain the four-step problem-solving process of ethical analysis. (1) identifying the problem. (2) developing alternative solutions. (3) selecting the best solution. (4) defending the selection. what are two sources of moral judgement that underlie ethical decision making. consequentialism - evaluates the rightness or wrongness of ethical ...
Ethical Decision Making: Application of a Problem‐Solving Model
A 4-step ethical decision-making model is presented including the Realm-Individual Process-Situation's process and a case involving rehabilitation professionals and limitations on care is presented and discussed by using the 4- steps framework. Ethical decision making is a challenge to professionals, with an increase in the number of issues and situations that are increasingly complicated.
The 4 steps in Solving Ethical dilemma.pdf
Step 4. Making a decision and planning the implementation A. Make a defensible ethical decision. Based on the analysis in Step 3, respond to the question in Step 2. Indicate the letters of the categories that best support your respeonse. Add any arguments justifying your choice of these ethical principles to support your decision.
Final Exam Review Ch 24+ 26 Flashcards
Study with Quizlet and memorize flashcards containing terms like Differentiate the systems of ethics, laws, and morals., Explain the four-step problem-solving process of ethical analysis., Explain two sources of moral judgment that underlie ethical decision making. and more.
How to Solve a Problem in Four Steps: The IDEA Model
A highly sought after skill, learn a simple yet effective four step problem solving process using the concept IDEA to identify the problem, develop solutions...
Radiologic Sciences and Patient Care
Name the 4 steps in ethical analysis. 1. identify the problem ... C. ethical dilemmas can be resolved by problem solving D. Ethical dilemmas invite a wide range of personal opinions. ... Which is NOT a step in the problem solving process? A. identifying the problem B. developing alternative solutions