Practitioner Development

A Guide to Establishing Ethics Committees in Behavioral Health Settings

Cox (2020) · Behavior Analysis in Practice 2020
★ The Verdict

Replace your solo ethics coordinator with a small committee using Cox’s ready-made blueprint.

✓ Read this if BCBAs who run or work in clinics, schools, or home-based agencies.
✗ Skip if Researchers looking for experimental data on ethics outcomes.

01Research in Context

01

What this study did

Cox (2020) wrote a how-to guide for ABA agencies.

The paper compares two ways to handle ethics: one person in charge versus a whole team.

It gives step-by-step instructions to build an ethics committee from scratch.

02

What they found

A single ethics coordinator can miss blind spots.

A committee spreads the load and catches more problems.

The guide lists who to invite, how often to meet, and what to document.

03

How this fits with other research

Valentino et al. (2025) picked up where Cox left off. They updated an agency Ethics Network and added a hotline after new BACB rules came out.

Contreras et al. (2022) gives you the thinking tool. They say use evidence-based practice—best data, client values, and your skill—to make daily ethical calls.

Henderson et al. (2023) shows why you need the committee. They found that working with OTs, SLPs, and teachers raises new ethical questions that one person cannot solve alone.

04

Why it matters

If your clinic only has one ethics contact, you are one sick day away from no support. Use Cox’s checklist to form a small team this quarter. Start with three staff, one family voice, and a standing monthly slot. You will catch issues faster and model ethical culture for your RBTs.

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→ Action — try this Monday

Email three colleagues and one parent to set the first ethics committee meeting for next month.

02At a glance

Intervention
not applicable
Design
narrative review
Finding
not reported

03Original abstract

Ethical statements typically involve rules. All rules can vary in accuracy and specificity depending on the context to which they are applied. Codes of ethics often involve ethical rules that are written generally to cover the wide-ranging set of possible situations that any one member of the profession may encounter. But, despite being written generally, codes of ethics are applied to specific situations that professional members encounter. The application of general rules to specific contexts can sometimes be challenging and complex. Health care organizations have several options to help their employees behave ethically. One approach is to appoint a single ethics coordinator. In contrast, the dominant approach in most health care organizations is to develop an organizational ethics committee (Moon Pediatrics, 143(5), e20190659, 2019). Despite the popularity of the ethics committee in other professions, the extent to which organizations that provide applied behavior analysis services have established and operate ethics committees is unknown. Ethics coordinator roles and ethics committees both have benefits and drawbacks. This article reviews the benefits and drawbacks of appointing an ethics coordinator and establishing an ethics committee. And, for interested organizations, this article outlines the steps and considerations that organizations can use to guide the creation of an ethics committee.

Behavior Analysis in Practice, 2020 · doi:10.1007/s40617-020-00455-6