Ethics Discourse in a Recurring Journal Format: A Proposal to Increase Ethics Discussion and Supports for Ethical Decision-Making

Abstract

Ethics is broadly concerned with the right and wrong behavior of individuals. The standards of right and wrong may vary across societies and within societies, including within a behavior analytic society. Standards of right and wrong are often stated via written ethics codes for professionals, but differences might still exist. Resolution of the difference of standards within groups might occur through various written processes. Examples of written resources might include blogs, newsletters, books, and journal articles. Within behavior analysis, there is an absence of written resources, especially a recurring opportunity for discussion of ethics within a behavior analytic journal. The purpose of this manuscript is to propose guidelines for a behavior analytic journal to implement a recurring ethics discourse process.

Brittanica (2022) defines ethics as a discipline, “concerned with what is morally good and bad, and morally right and wrong.” Aguinis and Henle (2002) noted that the word “ethics” comes from the Greek word “ethos,” describing a person’s character or disposition. In the current day, ethics is generally perceived as obligations or rules that (1) tend to explain how individuals should behave, (2) set the standards for right and wrong, and (3) establish norms on these dimensions (Kitchener, 2000). Velasquez and colleagues (1987) developed a definition of ethics that is twofold: (1) a well-founded standard of right and wrong that prescribes what humans should do and (2) the study and development of one’s ethical standards.

Views about ethical standards—about what is right and what is wrong—vary across time, contexts, and societies. For example, what might have been perceived as ethically acceptable 50 years ago might be seen as unethical today. Consider the Watson and Rayner (1920) experiment with Little Albert. At that time, there seemed to be an acceptance of the methodology used with this child; however, owing to the potential harm the experiment caused, contemporary ethics would most likely judge the experimental design impermissible. The accepted standard of right and wrong related to social science research has changed over time.

Relatedly, there is variation in the accepted ethical standards both across and within cultures (Stace, 1994). Graham and colleagues (2016) described several variables that contribute to individuals disagreeing about what is right and wrong within and across different societies. Some factors noted were religion, social ecology (e.g., weather, crop conditions), and social institutions (e.g., economic markets). Additionally, intrapersonal characteristics (e.g., education level) also impact the behavior one takes to be ethical. For example, Durgel et al. (2012) found education level was an important predictor of parenting behavior. Knapp and Vandecreek (2007) recognized conflict between accepted ethical standards when providing cross-cultural psychological services. For example, in some societies, physical punishment may be an accepted way to shape child behavior; in other societies, physical punishment strategies may be condemned.

Consideration of standards for right and wrong is not new within behavior analysis. Skinner (1953) discussed the development of societal rules, laws, and norms, adhering to a radical-behavioral formulation of such standards. That formulation focuses on the influence of contingencies that shape operant behavior. Ethical behavior is behavior and, like all behavior, influenced by the social-physical environment. Rules, motivating operations, discriminative stimuli, and positive and negative consequences all act to shape the behavior of members of each particular culture or subculture. The codification of standards for the practice of behavior analysis and subsequent discussion of the code is not new either (e.g., Bailey & Burch, 2022; Brodhead et al., 2022).

Behavior analysts can be considered a subgroup within the larger society of healthcare providers, who have generally accepted their own rules governing ethics and morality (Skinner, 1953, 1966, 1981, 2001). As described above, there are likely to be agreements and disagreements for ethical standards across groups within the larger healthcare society. For example, medical professionals are provided considerations for gift acceptance from patients (American Medical Association [AMA], n.d.), whereas behavior analysts are also given a maximum dollar amount (BACB, 2020; Standard 1.12). Behavior analysts might be further divided due to differing standards of right and wrong. For example, some behavior analysts have different viewpoints regarding the credentialing standards for behavior technicians (Leaf et al., 2016).

Ethical behavior within behavior analysis is guided by several codes of conduct, some informal, some formal (e.g., Sidman, 1960). Consider the attitudes of science—parsimony, philosophic doubt, and empiricism (e.g., Cooper, et al., 2020) as an informal guide of conduct. These attitudes influence the behavior of behavioral scientists. More formalized codes of conduct—such as the American Psychological Association’s Ethics Code (American Psychological Association, 2017) —exerts great control over many behavioral scientists who consider themselves psychologists. The Behavior Analyst Certification Board’s Ethics for Behavior Analysts (BACB, 2020) is a “…list of enforceable rules…” (Rosenberg & Schwartz, 2019, p. 2; BACB) for those who are certified as a Board-Certified Behavior Analysts (BCBA). Although only those who are BCBAs are required to follow the code, as with many ethical codes, the obligations to act in ways congruent with formal and informal standards of right and wrong are typical. Whether one is a clinician or a researcher, all members of the behavioral science society are expected to maintain the standards of right and wrong.

Ethical behavior on the part of a behavior analysts is shaped by many different influences. As noted above, there are explicit ethical codes with which behavior analysts are obliged to comply. Professional training, either in academic institutions or in the form of professional continuing education, is a major source for the dissemination of ethical information and standards. Describing different written resources to support these selection processes would be helpful for the field.

Types of Written Ethics Resources

Blog

A blog is a website or webpage and contains personal reflections and comments by one or more authors, often focused on a particular topic (Merriam-Webster, n.d.). Within behavior analysis, there are several blogs by independent professionals (e.g., I Love ABA! and ABA Rocks: A Behavior Analysis Blog) presenting various topics (e.g., exam preparation, leadership, service delivery for autism). The BACB provides occasional certification updates via a blog (https://www.bacb.com/bacb-blog/). A recent development is the launch of seven blog topics (e.g., research, education, autism) hosted by the Association of Behavior Analysis International (see Behavior Science Dissemination (abainternational.org)). Notably missing is a behavior analytic blog specific to ethics discourse.

Other disciplines offer an example of an ethics focused blog. For example, the website, Bioethics Today (see About - Bioethics Today), is managed by the editorial staff of The American Journal of Bioethics. The website offers multiple ethics focused resources including a blog, where anyone may post commentary and analyses of ethics related to healthcare, research, law, and biotechnology, to name a few. The blog is reviewed by the editorial staff for compliance with submission guidelines (e.g., tone, length, focus). There were five, five, and four original blog posts for the months of May 2022, June 2022, and July 2022, respectively. Some posts within this resource might be of general interest to behavioral scientists and have application for the practice of behavior analysis (e.g., Blog - Do Bioethicists Care About Black Victims of Gun Violence? - Bioethics Today).

Newsletters

Professional organizations often communicate expectations to members via periodic newsletters. For example, the BACB publishes periodic newsletters. Some published newsletters contain ethics related information (August 2020), and in some cases, the entire newsletter was ethics related (July 2021). Additionally, the Association of Professional Behavior Analysts (APBA) used to publish a newsletter, The Reporter. The APBA newsletter contained a recurring section, Ethics Challenge, allowing members to consider examples of ethical dilemmas with commentary from authors and editors. The discontinuation of the publication creates a void of resources for practicing behavior analysts.

Published Books

Published books have an influence in shaping ethical behavior. In recent years, several different options have become available.1 Bailey and Burch (2022) have been the voice of ethics in behavior analysis since their original publication in 2005. Their book provides a comprehensive discussion of the BACB Ethics Code, considerations for maintaining adherence to the Code, and valuable insight from real-life ethical scenarios the authors have supported. The most recent edition has added material regarding ethical-decision making processes, organizational ethics, and considerations for identifying an ethical employer.

Brodhead and colleagues (2022) is a relatively new resource, also recently updated to reflect changes to the new BACB Code. This resource is focused upon ethical considerations within the autism spectrum service delivery realm. The book provides resources for topics such as ethical philosophies, ethical decision-making, systems approach to ethical behavior, competency, and collaboration. The most recent edition adds material regarding standardized decision-making and assessing quality of services.

Sush and Najdowski (2022) is also a newer resource. The authors provide a needed resource for practices ethical decision-making. The book contains a model for ethical decision-making and a myriad of case examples specific to the BACB Code. Case examples are organized to match Code items and there is also a chapter discussing how to handle complex scenarios involving multiple Codes.

Each of the above books represent a unique contribution to the behavior analytic ethics literature base. Books provide readers a broad resource that provide more content than a published journal article, which are typically limited in scope. A potential limitation of book resources is the presented information reflects the viewpoint of the authors, with little feedback from the audience consuming the information. For example, when discussing a specific Code, the authors may suggest or directly state a course of action. Members of the audience may disagree with the course of action but do not have a direct manner to discuss an alternate approach. Another limitation of these works is they are expository, rather than exploratory. As such, the application of the Code to concrete cases in both works is comparatively straightforward. However, the resources do acknowledge the complexity of contributing factors (e.g. culture), ethical viewpoints, and decision-making processes. This is not a criticism of the books—you do not teach the principles of ABA by introducing a case of multiply maintained aggression. Similarly, you do not teach readers ethics by giving them messy, unclear cases. However, once beyond the stage of being a student, messy and unclear cases are what behavior analysts need help with.

Published Journal Articles—Informal Process

In addition to books, professionals will find ethics training resources via articles published in behavior analytic journals. Ethics focused articles may provide a format where a refined topic is discussed in greater detail compared to a book. Specifically, a book may serve as a broad resource, connecting multiple ideas, whereas journal articles may provide more in-depth discussion on fewer topics. For example, Graber and O’Brien (2019) provided an in-depth discussion regarding the impact of reimbursement practices and healthcare policy on a university-based clinic.

Assuming a peer-review process for the journal, these types of publications may reflect more diversity of thinking. Additionally, readers have a more direct method of responding to journal publications (i.e., submitting a manuscript for consideration of publication to the journal). For example, Weatherly (2021) stated that practitioners within the sub-discipline of Organizational Behavior Management (OBM) should value ethical standards, the current OBM regulations, and called practitioners to action to maintain ethical standards. The journal has since published a number of responses (i.e., Hantula, 2022; McSween, 2022; Wine, 2021). This initial publication and subsequent responses constitute an informal dialogue on a particular topic (i.e., ethical standards and enforcement with OBM). Another example is dialogue initiated by Rosenberg and Schwartz (2019) and responded to by Brodhead (2019) and Sellers et al. (2020).

Published Journal Articles—Formal Process

Other disciplines offer options for formal dialogue for the dissemination of ethics. Consideration of the varied models for dissemination of work in biomedical ethics can be instructive for behavior analysis. Work in biomedical ethics is largely disseminated through peer-reviewed literature. Within the peer-reviewed literature, there are a number of distinct models for the dissemination of work in biomedical ethics. Many leading medical journals (e.g., The New England Journal of Medicine, Neurology, and The Journal of Emergency Medicine) publish short articles that provide a concise analysis of an issue in biomedical ethics. There is variation in both the article type and the word count limit on such articles. For example, the New England Journal of Medicine has an article type titled “Health Law, Ethics, and Human Rights or Health Policy Report,” with a maximum word count of 2500 (see https://www.nejm.org/author-center/article-types for additional details). By contrast, Neurology invites ethical discussion under the “Viewpoint” article type, with a maximum word count of 500 words (see https://www.neurology.org/neurology-journals-author-center for additional details). Neurology also publishes articles engaging with ethical questions as part of the “Contemporary Issues in Practice, Education, and Research” article type, which has a maximum length of 3500 words (see https://www.neurology.org/neurology-journals-author-center for additional details).

In addition to medical journals that publish work in biomedical ethics, there are also a number of journals dedicated specifically to disseminating work in biomedical ethics (e.g., The Journal of Medical Ethics, The American Journal of Bioethics, The Hastings Center Report, and Healthcare Ethics Committee Forum). Ethics discussions published in forums that specialize in biomedical ethics are generally longer than similar discussions published in medical journals. For example, articles published in The Hastings Center Report can have a maximum word count of 8000 words (see https://www.thehastingscenter.org/hcr-submission-guidelines-2/ for additional details) while articles published in The Journal of Medical Ethics have a word count of up to 7000 words (see https://jme.bmj.com/pages/authors/#submission_guidelines for additional details).

Within journals that specialize in the dissemination of work in biomedical ethics, there is some variation in the target audience. Some journals (e.g., Healthcare Ethics Committee Forum) make a special point to include healthcare providers and healthcare administrators within its readership (Springer, n.d.). While it is likely that the readers of journals such as The Journal of Medical Ethics and American Journal of Bioethics include healthcare providers and administrators, neither journal goes out of its way to emphasize their inclusion in the journal’s readership (BMJ Journals, n.d.; Taylor & Francis Online, n.d.).

Journals specializing in biomedical ethics go to varying lengths to foster intra-journal dialogue. The American Journal of Bioethics stands out in this regard. The journal relies on a “target article” model whereby accepted articles are published alongside a number of short commentaries (see https://www.tandfonline.com/action/authorSubmission?show=instructions&journalCode=uajb20 for additional details). Brief commentaries are invited from leading experts in the topic at hand and, for each target article, an open call for commentaries is disseminated. Authors of the target article are further given an opportunity to publish a response to these brief commentaries. The result is that each published target article facilitates a rich dialogue surrounding the topic at hand.

It is common for other biomedical ethics journals to encourage authors to submit articles responding to work previously published in that journal (see, e.g., SAGE Journals, n.d.). These response articles allow for a fairly rich discussion among interlocutors; however, because response articles are not directly solicited as they are for “target articles,” the target article publishing model more reliably generates intra-journal dialogue.

Behavior Analysis Needs a Resource for Ethics Discourse

The development, selection, and enforcement of ethical standards across and within societies is complex (i.e., several contingencies operating on individuals). Within behavior analysis, a number of tools have emerged to assist behavior analysts with the management of ethical concerns. Bailey and Burch provided a white water rafting analogy in earlier editions of their book (Bailey & Burch, 2016). Brodhead (2015) extended ethical decision making tools, focusing on how to approach non-evidence based treatments. Rosenberg and Schwartz (2019) highlighted the importance of ethical radar. The most recent version of the BACB Ethics Code (2020) provides a decision-making model for identifying the best response to ethical dilemmas. Suarez and colleagues (2022) conducted a literature review of ethical decision-making models, identifying nine common elements emphasized across models.

All of the resources taken together are limited by the lack of exploration of ethical dilemmas. Specifically, none of the resources support recurring discussion of how behavior analysts consider factors associated with ethical dilemmas, the decision process within a decision-making process, or establish a written record to facilitate ethical dilemma resolution for current and future behavior analysts. For example, what should a behavior analyst do when a client or interdisciplinary colleague push for an intervention that is of questionable consistency with behavior analytic principles or an intervention with a shaky evidential foundation? Behavior analysts need a formal resource for discussing and exploring ethical dilemmas from multiple perspectives. The purpose of this manuscript is to propose such a resource with a behavior analytic journal.

A Formal Ethics Discourse Proposal

There are several types of written resources behavior analysts may access to support ethics training and compliance. Missing from these resources is a formal, recurring journal resource specific to ethics. As noted above, there are several modalities within a formal journal process. Given the missing resource, the remainder of this manuscript is an outline of how a behavior analytic journal might arrange for a formal recurring publication specifically for ethical dialogue. The proposal does not consider or expand upon all factors (e.g., there is much to discuss regarding our proposal and impact upon tenure processes). It is our view these factors would be further considered by the editorial board (and employers requiring scholarly work) if implementing such a proposal. For convenience and clarity, the information presented is written as though Behavior Analysis in Practice (BAP) is the journal providing the proposed resource2.

Overview of Model

On the basis of models currently utilized within the broader bioethics literature, the following proposal is based upon the “target article” approach. Each edition of BAP would include a section to provide an outlet for critical thinking and analysis of ethical issues within the practice of behavior analysis. In line with the journal aim, submissions for the ethics section should represent intersection between ethics principles (e.g., justice, benevolence) and specific codes (e.g., Standard 1.01 Being Truthful), with the lived experiences of professionals within behavior analysis service delivery (e.g., front-line workers, school personnel). Behavior analysis as a science and as practice overlap (Cooper et al., 2020). Therefore it is up to the submitting author to make the case of how the submitted manuscript meets the practice guideline. Submissions would occur as all other submissions, at the author’s convenience and via the online portal. The journal may also occasionally post a call for papers for specified ethics topics that are relevant to a current practice need (e.g., ethical considerations for continuation of service delivery when a business is closing).

Most journals provide submission guidelines that include a prescription of length. BAP imposes a 40 double-spaced pages for research articles and discussion/review articles, 10 double-spaced pages for book reviews, 3000 words for brief practices, and no guideline for technical/tutorial. Lower page or word limits might improve editorial timelines and reader consumption but may impact the breadth and depth of a discussion. We recommend a 3000 word limit, with subsequent evaluation of pages/word count to refine guidelines is recommended (e.g., if most submissions are closer to 1500, reduce the word limit). It is these authors’ experience that submission guidelines are often flexible.

Given the uniqueness of the suggested format, a journal would need to consider potential additional declarations. For example, Behavior Analysis in Practice requires disclosure of conflict of interest, funding, and ethics oversight declarations for each submission. Consideration of special circumstances created by this type of format might be addressed through a new declaration category (e.g., confidentiality) or guidance on existing categories (e.g., acknowledging potential conflicts of interest that exist by taking a certain stance on an ethics topic—stating a practice is unethical, but that practice directly competes with a business for which the contributing authors work).

The discourse aspect is achieved via an alteration to the traditional peer review process3. The action editor would invite professionals with multiple years of practice, teaching, and training experience to review and respond to the original submission. The invitation would be equivalent to receiving a request to conduct a peer review of a submitted article. As with other non-experimental submissions, reviewers are expected to critically review the submission for adherence to logic, general scientific principles (e.g., parsimony), discipline specific principles (e.g., definition of evidence-based practice), implementation of the science in professional practice (e.g., providing supports in a school setting), etc. A notable difference in the review process would be the invited reviews would be made public alongside the published manuscript. Invited reviewers would utilize a template (described below) to ensure the submitted manuscript adheres to the submission guidelines. The purpose of these submissions is the creation of discourse for readers to explore and establish standards of behavior. As described below, the editorial review process ensures the submissions and responses encourage critical thinking within a framework of ethical decision-making, while maintaining professionalism and the absence of judgements of right and wrong. Given that language choice matters (i.e., stating the above process is “peer review”), consideration could be given to different language. As an example, the proposed review template utilizes “critical commentary” as an option for consideration.

Framework of Ethical Scenario Submissions

The current proposal is not only about increasing dialogue relative to ethics in the practice of behavior analysis. An additional outcome is creating a written record of complex problem solving specific to ethical practices issues, hopefully impacting the behavior of professionals. Presenting the dialogue in a manner that describes action taken and contingencies impacting selection of action is imperative. Utilizing the format of standard decision-making steps creates uniformity across submissions and the context for contingency analysis of complex behaviors (i.e., handling ethical dilemmas).

Decision-Making Process as a Template

A primary outcome of the recurring discourse would be a written record of the following areas across ethical dilemmas: (1) describe ethical scenarios (i.e., creates a context for establishing whether something is right or wrong; implement prevention strategies to minimize impact when encountered); (2) state the variables and conditions that alerted someone to the concern (i.e., ethical radar); (3) state specific ethical principles or standards being violated; (4) potential actions; (5) outcomes; and (6) considerations for application to similar events in the future. There is tremendous value in learning from the experiences, and from the decision process, of peers and mentors. To achieve these outcomes, ethical scenarios would be discussed in the context of a decision-making framework, thereby modeling how behavior analysts might approach ethical concerns, state relevant variables, state courses of action, and implement a course of action (i.e., the decision-making process). Lastly, to support consistency of information across the peer reviews, the submitting authors would provide key summary information (e.g., key words, ethics code; see Appendix 1).

Editorial Process

When a manuscript is received, the editorial team would (1) ensure the submitted manuscript meets submission guidelines (e.g., format compliance, word count); (2) ensure the topic is novel and has value for practitioners of behavior analysis (e.g., consent and assent practices—relevant to behavior analysis; use of tissue samples from placentas—not relevant to behavior analysis); and (3) ensure a focus upon variables associated with solution-focused ethical decision-making instead of barrier identification, blaming people or entities, or general calls to action. Lastly, the editorial team must provide up front guidance to maintain confidentiality of the dilemmas. The dilemmas need sufficient information to document the decision-making process, thereby creating a context for discussion. Once the submission has met these criteria the editorial team would invite two to four behavior analysts to provide a public peer review and formal response to the submission (see below for further details regarding the response format and process).

Framework of Responses

Multiple responses to the submitted ethical scenarios are required to generate dialogue for the purpose of building the written resource. Responses to the ethical scenario create a context for critical thinking about the presented information, in line with the peer review process.

Critical Thinking as a Format

Peer reviewers invited to respond to ethical dilemma submissions will complete a template with six questions (see Appendix 2). The questions are intended to evoke critical thinking from the responders, providing additional insight. For example, the author(s) of the original submission might not have considered a cultural variable related to the use of punishment by a parent of another culture (e.g., Knapp & Vandecreek, 2007). Consideration of this variable might have created a context to elicit different available actions (e.g., parent education about the preference of the society members to not use punishment strategies). In short, the peer reviewer critically evaluates the decision-making process presented. The peer reviewer is not stating whether the author(s) was right or wrong with their decision making. Rather, the peer reviewer is critically evaluating the decision-making process.

Editorial Process

When a review is received, the editorial team would (1) ensure the review meets submission guidelines (e.g., tone, format compliance, word count); (2) ensure the review critically evaluated the information, providing additional variables, actions, etc., without judgement of right or wrong of behavior; and (3) create consistency of language (e.g., title of reviews, focus of the ethical discussion subject). The reviews would be published as companion articles to the original submission. In addition to the template structure to encourage consistency of information, the editorial team should consider creating a consistent title structure for reviews (see the response template for an example).

Unsolicited Responses

The above description utilizes the current editorial process, with the change of public reviews. However, once a manuscript is published in the journal, any professional may choose to submit novel responses to the original submission and public peer reviews using the provided template. The selection of invited peer reviews is intended to start the discussion, providing a minimal analysis from multiple viewpoints. It is hoped that other professionals would further analyze the decision-making and offer additional insight to further refine the standards of behavior associated with the submitted scenario. Additionally, other professionals might have experienced closely related scenarios and have further insight to help generalize beyond the initial submission. All novel responses would follow the editorial process of the journal (e.g., submit to the portal, private peer review).

Other Responses Opportunities

As discussed above, there are other outlets available for ethics discourse in other fields (e.g., newsletter, podcast). The supporting journal might consider enhancing the discussion with other outlets. An example relevant to Behavior Analysis in Practice would be a podcast focused upon ethics dialogue. The podcast host might invite one to three guests to review and discuss several submissions and peer reviews. Another example would be creating a journal forum where professionals access a submission, peer reviews (i.e., the invited public responses), and subsequent responses. The professionals would have the opportunity to further the dialogue via forum chat features, creating more immediate opportunities for dialogue on topics already published.

Conclusion

Human service professions have always struggled to help practitioners navigate ethical challenges. In behavior analysis, this issue has been addressed by multiple ethics texts and a variety of decision trees and tools. These tools help practitioners to identify dilemmas, list options for solutions, choose the best alternative, and prevent future occurrences. Still, the skill set is complex, and the presenting issues encompass an endless array of variability. Contextual factors alter both the designation of the issue and the appropriate resolution. Teaching and training this skill set is nuanced, yet is not well defined. Permutations of the Ethics Code continually hone our understanding of certain issues, and the collective understanding of our professional obligations has increased over time.

Ethical conduct is an area in need of continuous attention in professional development; practitioners need resources to build their skills, to expand their problem-solving repertoires, and to prepare them for new challenges. In the field, there is a need for dialogue to address the issues involved in ethical conduct. Toward that end, we are proposing a new feature in the BAP journal, in which multiple clinicians will respond to an ethical dilemma. This format will provide multiple exemplars of how expert clinicians approach a novel concern. It will also diversify available resources and provide a forum that emphasizes the process of ethical navigation. Nuanced elements of the assessment and intervention proposed by multiple reviewers will help to expand our understanding of how ethical decisions are made, how complex circumstances are systemically approached, and how solutions are identified, implemented, and evaluated.

Appendix 1

Ethics Discourse Submission Template4

Summary Points—This information guides the reviewers and supports consistent language across reviews.

1. State the primary ethics standard of concern (e.g., Standard 1.01).

2. Provide a succinct statement of the scenario (e.g., treatment recommendation not supported by research). The running head should be based upon this succinct statement (e.g., treatment recommendation).

3. State the primary parties involved (e.g., behavior analyst, individual receiving services from the behavior analyst).

Decision-Making Questions—This information outlines the situation and the decision-making process followed.

1. Describe and summarize the situation (e.g., a coworker appears to be involved romantically with the parent of a client).

2. Describe the factors alerting you that something might not be right (e.g., observed a coworker and a parent of a client holding hands at a restaurant).

3. Describe any factors you considered for immediate action (e.g., legal reporting requirement; health and safety concern).

4. Specify the exact ethics concern citing ethical principles and/or codes (e.g., Standard 1.11 and 1.14). Describe what alternative viewpoints the other parties might present supporting the situation as ethical.

5. Describe at least two actionable steps that were considered given the above information (e.g., talk with your colleague; report the relationship to your boss; report the relationship to the licensing board).

6. Synthesize the information from points 1–5 indicating a preferred course of action. Describe what factors were most important in choosing the course of action.

7. Describe the anticipated outcomes (if hypothetical) or experienced outcomes (if based upon real events) of the action.

8. Describe how this type of event might be prevented. If a similar event were experienced again, what would be different or the same?

Appendix 2

Ethics Discourse: Critical Commentary Template

Please utilize the summary points provided by the authors to improve consistency of information across peer reviews.

Title formatting: 3–5 word summary of commentary: Critical Commentary of [Author Last Name] by [Reviewer first and last name]. Example: “Do no harm: Critical Commentary of Quigley et al., by Abraham Graber”

1. Describe any factors that might improve the ability to detect the situation sooner (e.g., flirting types of interactions between the coworker and parent).

2. Describe additional considerations for immediate reporting.

3. Describe additional factors for information gathering given the situation (e.g., reviewing social media of the parties involved).

4. Describe any additional principles or codes related to the situation. From your perspective, describe what principles and codes are most important and why.

5. What are other options for action? What would you choose and why?

6. What are recommendations for professionals encountering a similar situation? How does this scenario relate to other ethical scenarios?

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Data availability

Not applicable.

Code Availability

Not applicable.

Declarations

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Ethics Approval

Not applicable.

Consent to Participate

Not applicable.