BA285 Unit 10 Ethical Dilemma Case Analysis Example

Twenty-Five Authorized Hours and a Nap Called a Program: A BA285 Unit 10 Ethical Dilemma Case Analysis

[Student Name]

Purdue University Global

BA285: Ethics in Behavior Analysis

Unit 10 Ethical Dilemma Case Analysis

[Instructor Name]

[Date]

The writer, her agency, its manager and the family are composite; the codes and texts cited are real.

The Situation

I still work in families' homes in the countryside outside Bowling Green, Kentucky, under the direction of a supervising analyst. Since January I have worked with Lucas, a three-year-old autistic boy whose family's insurance authorized twenty-five hours of services a week. His mother, Ms. Mercer, began asking in March to reduce his hours to fifteen. He had started a half-day preschool program, he was exhausted by late afternoon, and she wanted time with him as a family.

In April, the agency's regional manager, who oversees scheduling and billing but is not a behavior analyst, told technicians in a team meeting that authorized hours should be delivered in full because the agency depends on them. Afterward, she told me privately that Lucas's sessions ran into his nap time, and that I could document the nap as a rest tolerance program, since he was learning to lie down calmly. When I hesitated, she said everyone does it and that the authorization was the family's to use.

Two separate problems are tangled together here. One is a real disagreement about how many hours Lucas should receive. The other is a request to document something that did not happen as treatment.

Using a Flowchart

Brodhead et al. (2018) describe practical ethics in autism treatment as a process of identifying the relevant standards, considering the perspectives of everyone involved and following a structured path to a decision, including when and how to raise concerns with others. Bailey and Burch (2022) offer a similar sequence. I used a simple flowchart built from those sources: identify each issue, find the applicable standards, determine whether I can resolve it within my role, consult my supervisor, raise concerns with the person involved, and escalate if the concern is not resolved.

Issue One: The Hours

Ms. Mercer's request raises a clinical question. The behavior analyst code asks practitioners to involve clients and stakeholders in decisions about services, to base recommendations on assessment and the client's needs, and to put the client's welfare ahead of other interests, including the organization's (Behavior Analyst Certification Board, 2020). The number of hours a child receives should be a clinical decision made with the family, not a scheduling target.

This issue is outside my role to resolve. Technicians implement plans; supervising behavior analysts recommend service intensity. My responsibility was to make sure Ms. Mercer's request reached my supervisor and to share what I observed, that Lucas was often too tired to engage after preschool.

Issue Two: The Nap

The second issue is not a disagreement. Documenting a nap as a treatment program would create a false record and, because the agency bills insurance for session time, could support false billing. The RBT ethics code requires technicians to document services accurately and truthfully and to report concerns about others' professional misconduct (Behavior Analyst Certification Board, 2021). The behavior analyst code holds supervisors and organizations to the same standard.

A disagreement about hours could be worked out with the family; writing a nap into the record as therapy could not be worked out at all.

Rosenberg and Schwartz (2019) argue that ethical behavior analysts act from an understanding of the values behind the rules, not only from fear of consequences. The value here is honesty with families and payers, who rely on records to know what services were delivered. "Everyone does it" is not a reason; if true, it is a reason for concern.

Consultation and Action

I called my supervisor that same evening from my car. On the hours, she agreed to meet with Ms. Mercer, review Lucas's data and progress, and recommend a schedule; she suspected fifteen to eighteen hours would serve him well. On the documentation, she was clear that I must not record the nap as a program, that sessions should end when Lucas falls asleep, and that unbilled time would be the agency's problem, not mine.

The code and agency policy direct practitioners to address concerns with the person involved when it is safe and appropriate. My supervisor and I met with the regional manager together. My supervisor explained that recording sleep as treatment would misrepresent services and that hours should follow clinical recommendations. The manager said she had only meant to keep schedules full and withdrew the suggestion. My supervisor documented the meeting and, because the manager had said other technicians did the same, informed the clinical director in writing, as agency policy requires for possible billing errors.

The Cost of Speaking Up

Raising the concern was not free. For about a month, the regional manager was cool toward me, and I noticed I was assigned fewer new clients. I mentioned this to my supervisor, who raised it with the clinical director, and my schedule returned to normal. The code protects people who report concerns in good faith, but protection depends on supervisors and agencies taking it seriously, and I was fortunate that mine did.

Outcome

The clinical director reviewed recent notes across the region and found several sessions where sleep had been documented as program time. The agency corrected the records, notified the insurer as its compliance policy requires, and retrained managers on documentation. Lucas's supervisor met with Ms. Mercer, and they agreed on eighteen hours a week, ending before his nap, with a review in three months.

What I Learned

The case taught me that ethical problems rarely arrive labeled. One instruction from a manager contained a clinical question I was not authorized to answer and a documentation request I was not permitted to follow. The flowchart helped me separate them, decide which were mine to act on, and find the right person for each. It also taught me that raising a concern can protect other families, not only the one in front of me.

Conclusion

Lucas's case combined a legitimate disagreement about service hours with a request to falsify records. The codes for behavior analysts and technicians, practical ethics frameworks and a structured flowchart showed that the first belonged to the supervisor and family, and that the second could not be negotiated. Consultation, a direct conversation with the manager and a written report produced an honest record, a schedule that fits the child and a correction that reached beyond one family.

References

Bailey, J. S., & Burch, M. R. (2022). Ethics for behavior analysts (4th ed.). Routledge.

Behavior Analyst Certification Board. (2020). Ethics code for behavior analysts. Author.

Behavior Analyst Certification Board. (2021). RBT ethics code (2.0). Author.

Brodhead, M. T., Cox, D. J., & Quigley, S. P. (2018). Practical ethics for effective treatment of autism spectrum disorder. Academic Press.

Rosenberg, N. E., & Schwartz, I. S. (2019). Guidance or compliance: What makes an ethical behavior analyst? Behavior Analysis in Practice, 12(2), 473-482. https://doi.org/10.1007/s40617-018-00287-5