In a society where people have different perspectives of life and are from diverse cultural backgrounds, ethics has become an essential part of different professions. According to Aquinis and Henle (2004), ethics is defined as a subsidiary of philosophy based on morality, assessment of actions that is if it is good or bad and establishing rules for substantiating actions (p.34). Most professional organizations have ethical codes their members must abide by. It is important to note that these ethical codes serve as a set of rules and guidelines that govern professional practice. This ethical code review will be comparing the ethical codes of dentists (American Dental Association (ADA) code) to the ethical codes for behavior analysts. Both dentists and behavior analysts serve human populations and as such it is crucial they have these rules to protect themselves and the people they serve. The next five paragraphs would contain some similarities between the principles of ethics and code of professional conduct for dentists and the ethic code for behavior analysts. This will be followed by the differences between the ethical codes of the two professions and a conclusion will be last.
Both ethical codes elaborate on the importance of confidentiality. The ADA code section 1.B under Section 1 principle, the autonomy of the patient, spells out protection of confidentiality of patients’ records. 1.B.1 and 1.B.2 further explains the need for the dentist to send all patients record to new patient’s dentist in accordance with applicable law after obtaining a written consent from the patient. This is done to ensure new dentist receives all relevant details of the patient to better serve them. The written consent is also there to give the patient the power to choose what detail should be shared with the new dentist. For example, when it comes to disclosure of HIV status, every state has different laws regarding sharing this information with another dentist. In the case where there is no such law for the state the dentist is practicing in, the dentist must get the clients permission to share that information in writing. There may be a need to seek legal counsel if the client refuses before ending the client-dentist relationship. The ethical code of behavior analysts also prohibits sharing confidential information without a written consent from client, parent or caregiver. The ethical code 2.03 protecting confidential information,2.04 disclosing confidential information and 2.05 documentation protection and retention are noted to ensure this is followed. All these codes allow the behavior analyst to only share details of clients to third parties that the information is relevant to for example to colleagues with more experience with the case. With this, a written consent from client or parent is needed before any information can be shared. Furthermore, insurance, law enforcement or courts may also request for such information.
Additionally, the two ethical codes touch on competency and continuous education of their members. The ADA code discusses this in code 2.A. education under the section 2 principle nonmaleficence, which is do no harm. This ADA code dives into the necessity for dentist to update their knowledge and skills and keep knowledge and skills current. Also 5.E. professional announcement under section 5 veracity, also reiterates on dentists depicting themselves as what they specialize in and not falsifying their training or area of competence. For example, a dentist who received an online continuous education training for restorative care cannot claim to be a restorative specialist and open a practice that specializes in that. The ethical code 1.05 practicing within scope of competence and 1.06 maintaining competence for behavior analysts also supports competency and continuous education. Behavior analysts must provide interventions for client’s cases they have experiences in and must also complete CEUs every two years to be compliant with the BACB. They need the CEU to be up to date on current research and work with clients that they have experience with to ensure effective and safe care is being provided. For example, a BCBA cannot be practicing when their certificate has not been renewed.
Similarly, both require informed consent from clients, parents or caregivers. The ADA code 1.A. patient involvement under section 1 principle, patient autonomy, requires the client to be given any proposed treatment and other alternatives so clients make informed decisions. This promotes patient involvement in their care and to know other resources they may have. It prevents clients from feeling forced to get treatment. The ethical code for behavior analysts also has 2.11 obtaining informed consent which entails clarifying, documenting and getting clients, parents or caregivers to repeat whatever is said to ensure it is completely understood before signing a written consent form. This is done before any behavior interventions or change in behavior interventions. If consent is not given, treatment should not proceed in both ethical codes.
Consequently, both also obligate their members to refrain from dual or multiple relationships. In the ADA code 2.G. personal relationships with patients, under section 2 principle, members are advised to keep away from interpersonal relationships that could affect their professional judgement with their patients. However, the behavior analysts ethical code 1.11 multiple relationships, inform its members to keep away from going into or creating multiple relationships with colleagues, clients, client’s parents or caregivers, neighbors etc. This is because multiple relationships can make a dentist or behavior analyst subjective due to the personal connection. It may also make them potentially discriminate against others; they do not have a relationship with.
It is important to note that both ethical codes are against any form of discrimination towards clients regardless of their age, disability, ethnicity, gender, cultural background, marital status, religion etc. According to the ADA code 4.A. patient selection under section 4, justice, dentists cannot reject a patient because of age, disability, ethnicity, gender, cultural background, marital status, religion etc. This includes clients that are infected with Human Immunodeficiency Virus, Hepatitis B virus or any other blood-borne pathogen. The ethical code for behavior analysts 1.08 nondiscrimination states same and promotes no discrimination against others. In both codes clinicians cannot pick and choose who they want to work with and must work with everyone.
Now going into the differences, even though they both ask to refrain from multiple relationships, the dental ADA code 2.G. personal relationships with patients only focuses on multiple relationships with only clients and do not have any guidelines on colleagues or other familial relationships. This leaves room for dentists to be involved in dual relationships outside their clients. This can lead to the potential of the dentist taking advantage of the relationship. The ethical code for behavior analysts 1.11 focuses on all types of dual relationships not just clients and takes away any leeway.
Also, the ADA code 1.A. patient involvement only focuses on informed consent from client, parents or care givers and does not consider assent. This means that if the client is underage or has a guardian, the probability of the client being asked about the treatment would be low since they are not obligated to do so. On the other hand, the ethical code for behavior analysts 2.11 obtaining informed consent considers consent and assent. Even though assent is not a legal requirement, it helps clients to feel part of the decision making in their care especially when they have no legal power.
Another crucial difference is cultural sensitivity or responsiveness. Whilst the ADA code 4.A. patient selection under section 4, justice, preaches about not discriminating against clients, it does not highlight a cultural approach to the care they provide. However, the behavior analyst code 1.07 cultural responsiveness and diversity reiterates the need for behavior analysts to be culturally sensitive and to respect other cultures. When making interventions, behavior analysts must consider the cultural background of their clients and plan accordingly. This helps improve compliance among parents or caregivers and builds rapport.
Similarly, the ADA code has three main parts: the principles of ethics, the code of professional conduct and the advisory opinions. The principle of ethics serves as directions and provides assertion for the Code of Professional conduct and the advisory opinions. The advisory opinions elucidate the code of professional conduct on specific situations and the code of professional conduct are pronouncements of particular types of conduct that are required or forbidden. In contrast, the ethics code of the behavior analysts has the core principles, glossary section and ethical standards. The core principles are primitive concepts that should direct all the work of the behavior analysts, and the glossary section contains all the definitions of technical terms found in the code. The ethical standards are derived from the core principles.
Likewise, the ADA code has five primitive codes that form the base of the ADA code. These include patient autonomy, nonmaleficence, beneficence, justice and veracity. In contrast, the ethics code for behavior analysts has six sections: responsibility as a professional, responsibility in practice, responsibility to clients and stakeholders, responsibility to supervisees and trainees, responsibility in public statements and responsibility in research.
In conclusion, dentists and behavior analysts have ethical codes that they are required to uphold, and these are in place to prevent certain personal biases. Both fields are devoted to providing the best care for their clients and in maintaining the highest ethical standards.
References
Aguinis, H., & Henle, C. A. (2004). Ethics in research. Handbook of research methods in industrial and organizational psychology, 34-56.
The principles of ethics and code of professional conduct accessible through: https://www.ada.org/-/media/project/ada-organization/ada/ada-org/files/about/ada_code_of_ethics.pdf?rev=ba22edfdf1a646be9249fe2d870d7d31&hash=CCD76FCDC56D6F2CCBC46F1751F51B96
The Behaviour Analyst Certification Board Ethics Code for Behaviour Analysts accessible
through: https://www.bacb.com/wp-content/uploads/2022/01/Ethics-Code-for-Behavior-Analysts-240830-a.pdf
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