These answers draw in part from “Finding Our Way Together: Ethical Problem Solving in Autism Care” by Amanda Karsten, PhD, BCBA-D (BehaviorLive), and extend it with peer-reviewed research from our library of 27,900+ ABA research articles. Clinical framing, BACB ethics code references, and cross-links below are synthesized by Behaviorist Book Club.
View the original presentation →The five steps are detect (recognize that an ethical issue exists), define (precisely articulate the ethical tension), generate solutions (brainstorm multiple possible courses of action), assess pros and cons (evaluate each solution against the four core ethical principles), and implement and evaluate (carry out the selected solution while monitoring outcomes and adjusting as needed). This process continues iteratively until the dilemma is resolved. Each step serves a distinct function and skipping any step increases the risk of a poorly reasoned decision.
Standards provide specific behavioral expectations for professional conduct, such as requirements about informed consent, confidentiality, and supervision. Foundational principles (benefit others, respect, integrity, competence) provide the values framework that explains why those standards exist and guides decision-making when situations do not map neatly onto specific standards. In practice, most clear-cut situations can be resolved by reference to specific standards, while ambiguous or novel situations require returning to foundational principles for guidance.
Ethical issues that are not detected cannot be addressed. Many ethical dilemmas in autism care do not present as obvious violations but are embedded in routine clinical, administrative, and interpersonal situations. A BCBA who has not developed a strong detection repertoire may not recognize the ethical content in a scheduling change, a family's offhand comment about treatment dissatisfaction, or a colleague's description of their caseload pressure. Detection training involves deliberately scanning routine situations for ethical dimensions and discussing these observations in supervision.
Principle conflicts are a normal feature of ethical practice, not a sign that something has gone wrong. When beneficence conflicts with respect for autonomy, or when integrity conflicts with the desire to maintain a collaborative relationship, the resolution requires weighing the relative stakes of each principle in the specific context. Generally, client welfare provides the organizing priority, but this does not mean other principles are ignored. The goal is to find the solution that best balances all relevant principles while prioritizing the client's wellbeing.
Proactive strategies address the conditions that give rise to ethical dilemmas before they develop. Clear communication expectations established during intake reduce misunderstandings about treatment scope and family involvement. Documented informed consent processes ensure that families understand their rights and the treatment plan from the outset. Regular satisfaction check-ins identify emerging concerns before they escalate into conflicts. Written policies about session procedures, cancellation, and confidentiality prevent the ambiguity that allows ethical drift to develop unnoticed.
Start by assuming good faith and seeking to understand the other professional's reasoning and evidence base. Express your concerns using professional language that focuses on the client's welfare rather than criticizing the other professional's competence. If direct conversation does not resolve the disagreement, document your concerns and consult with your supervisor. Maintaining collaborative relationships is important but should not override your obligation to advocate for the client's best interests when you believe a recommended approach is inappropriate or harmful.
Seek consultation whenever an ethical situation feels uncertain, when you cannot identify a clearly preferable course of action, when the stakes for the client are high, or when the situation involves areas outside your expertise. Consultation is also valuable as a routine practice rather than a crisis response. Regular ethics-focused peer consultation normalizes the process and builds the collective reasoning capacity of your professional community. Document consultations and the input received as part of your ethical decision-making record.
Effective ethical documentation includes the situation that triggered ethical analysis, the ethical tension as you defined it, the alternative courses of action you considered, the principles you weighed for each alternative, the decision you reached and the reasoning behind it, and your plan for monitoring outcomes. This documentation should be concise, typically one paragraph per decision, and should be stored in a professional file or case record. Over time, this practice creates both a risk management record and a personal development resource.
Supervision is the primary context for developing ethical reasoning skills. Effective supervisors integrate ethical analysis into routine case review, model the five-step process, highlight ethical dimensions that supervisees may miss, and provide constructive feedback on supervisees' reasoning. Rather than discussing ethics only when problems arise, supervision should include regular ethical analysis of cases that contain embedded tensions. This deliberate practice builds the detection and reasoning skills that supervisees need to navigate ethical situations independently.
Like any behavioral repertoire, ethical problem-solving becomes more fluent with practice. Initially, working through the five-step process may feel deliberate and time-consuming. With repeated practice across diverse scenarios, the detection step becomes more automatic, the definition step becomes faster, and the principles-based evaluation becomes a natural part of clinical thinking. The goal is not to eliminate deliberation but to reduce the effort required for routine ethical analysis while preserving the capacity for careful reasoning when novel or high-stakes situations demand it.
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Finding Our Way Together: Ethical Problem Solving in Autism Care — Amanda Karsten · 1 BACB Ethics CEUs · $25
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1 BACB Ethics CEUs · $25 · BehaviorLive
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All behavior-analytic intervention is individualized. The information on this page is for educational purposes and does not constitute clinical advice. Treatment decisions should be informed by the best available published research, individualized assessment, and obtained with the informed consent of the client or their legal guardian. Behavior analysts are responsible for practicing within the boundaries of their competence and adhering to the BACB Ethics Code for Behavior Analysts.