Chapter 29: Ethical Considerations for Applied Behavior Analysts

Cooper, Heron, & Heward 2007Instructor: Heather Walker, MS, BCBA

Definition of Ethics• Behaviors, practices, and decisions that

address three fundamental questions:• What is the right thing to do?• What is worth doing?• What does it mean to be a good behavior

analyst?• End goal: Further the welfare of the client.

What is the right thing to do?• Our personal history influences our decision

making– Personal experiences– Cultural or religious upbringing– Professional training and experiences– To ensure that personal experiences and

cultural/religious beliefs don’t take over:• Consult supervisors or colleagues, review the research

literature, consult case studies to determine past courses of successful action, or excuse yourself from the case

What is worth doing?• Questions of social validity ask:– Are the goals acceptable for the planned behavior

change intervention?– Are the procedures acceptable and aligned with

best treatment practices?– Do the results show meaningful, significant, and

sustainable change?

What is worth doing?• What is the Cost/Benefit Ratio:– Does the potential benefit to the individual justify

the short- and long-term cost for providing the service?• Decisions should be made by committee• Person with the highest stake in the outcome should

be given greatest consideration

What is worth doing?• Existing Exigencies– Behaviors that are more serious warrant

intervention consideration before behaviors that are less problematic

– Must still consider long-term ramifications for treatments that result in quick change

The good behavior analyst…• Adheres to professional codes of conduct,

keeps the client’s welfare in mind at all times, and follows the Golden Rule

• Most importantly an ethical BA is self-regulating– Calibrates decisions over time to meet changing

cultural values and contingencies

Professional Standards• Written guidelines or rules of practice that provide

direction for the practices associated with an organization

• See…– APA: Ethical Principles of Psychologists and Code of

Conduct– ABA: The Right to Effective Behavioral Treatment and The

Right to Effective Education– BACB: Guidelines for Responsible Conduct for Behavior

Analysts and The BCBA and BCABA Behavior Analyst Task List

Ensuring Professional Competence• Academic training that includes:– Formal coursework– Supervised practica– Mentored professional experience

• Accreditation and Certification– Behavior Analyst Certification Board

• Keep practice within your areas of professional training, experience, and competence

Maintaining and Expanding Professional Competence•Attending training events offering continuing education credits (CEUs)•Attending and presenting at conferences•Self-study: routinely reading research and other behavioral publications in your field•Participating in oversight and peer review opportunities

Making and Substantiating Professional Claims• Avoid making unsubstantiated claims (e.g., “I

am certain I can help your son”)– Stay familiar with professional literature on

treatment effectiveness for target behaviors, client populations, and behavioral functions

• Only present yourself with valid credentials (never claim to have certifications, licenses that you don’t have)

Informed Consent• The potential recipient of services or a

participant in a research study gives his or her explicit permission before any assessment or treatment is provided

• Permission must follow full disclosure and information has been provided to the individual

Three Tests for Informed Consent• Person must demonstrate the capacity to

decide• Person’s decision must be voluntary• Person must have adequate knowledge of all

salient aspects of treatment

Capacity to Decide• The person must have:– Adequate mental process or faculty by which he/she

acquires knowledge– Ability to select and express his or her choices– Ability to engage in a rational process of decision

making• These are often difficult questions to answer and

vary depending on the individual and/or the proposed procedure

Surrogate/Guardian Consent• When a person is deemed incapacitated, consent

may be obtained through a surrogate or guardian• Surrogate: a legal process by which another

individual is authorized to make decisions for a person deemed incompetent based on the knowledge of what the incapacitated person would have wanted– Family members or close friends often serve as

surrogates• Guardian: legal custodian of the individual

Voluntary Decision• Voluntary consent is given in the absence of

coercion, duress, or any undue influence– No bargaining to obtain consent

• Consent can be withdrawn at any time

Knowledge of Treatment• Treatment must be presented in clear, non-

technical language that includes:– All important aspects of the planned

treatment– All potential risks and benefits of the planned

procedure– All potential alternative treatments– The right to refuse continued treatment at any

time

Treatment Without Consent• Consent may be granted in the case of a life-

threatening emergency• Consent may be granted when there is an

imminent risk of serious harm• In school settings, treatment cannot be provided

without consent. In situations when parents simply refuse, school systems often have progressive recourse through legal system

Confidentiality• Information regarding an individual receiving

services may not be discussed with or made available to third parties (unless explicit permission has been given)

• Limits– Suspected abuse– Possibility of imminent, severe harm to

individual or other person

Protecting Dignity, Health, and Safety• Do I honor the person’s choices?– Do I help the client make choices in his or her day

to day life?

• Do I provide adequate space for privacy?• Do I look beyond the person’s disability and

treat the person with respect?

Advocating for the Client• Is the problem amendable to behavior

treatment?– Ensure the problem is not one with a medical cause– Ensure the problem is with the client and not with

someone else and that there is, indeed, a problem– Ensure that other interventions have been attempted

and that the problem can’t be solved simply or informally or by another discipline.

Advocating for the Client• Is the proposed intervention likely to be

successful?– Client, caregivers, and those surrounding the client

are willing and able to participate– Research literature support for treatment– Public support for treatment– Behavior analyst has the appropriate experience and

training to implement the intervention– Environmental contingencies can be controlled

Embracing the Scientific Method• “In science keeping an open mind is a virtue,

but not so open that your brains fall out” (James Oberg)

• When selecting interventions, behavior analysts should rely on– Peer-reviewed scientific reports published in

reputable, well-established outlets– Direct and frequent measurements of behavior

Conflict of Interest• Occurs when a principle party, alone or in

connection with family, friends or associates, has a vested interest in the outcome of the interaction.

• Direct and frequent observation puts behavior analysts in close contact with the client and family members in natural settings

• Must be cautious not to cross any personal or professional boundaries