Influence of Televisibility and Harm Probability on Clinical-Ethical Decision Making

Abstract

Researchers have recently begun to use a behavioral economics framework to study the clinicalethical decisions made by practicing behavior analysts. Much of this work, however, has examined broad patterns as opposed to isolating the underlying behavioral processes. In this study, we sought to extend past research by studying how clinical-ethical decisions would be influenced by a parametric manipulation of the probability that each available option would be televisible or cause short-term harm to the client. Behavior analysts (n=15) were largely influenced only by the probability of short-term harm. In contrast, the control group (n=30) was influenced by the probability each choice was televisible and the probability of short-term harm. Further, across all choices, control group participants showed a higher tendency than behavior analysts to not allow the individual to engage in the harmful behavior. Quantitative models built using machine learning algorithms were able to predict ~75% of choices made by participants using only the independent variables manipulated in this study. At the individual level, a probability loss discounting framework seemed to account for the data; however, deviations from traditional probability loss discounting methods provide many areas for future research. In total, the present experiment highlights the potential behavioral processes involved in clinical-ethical choices, similarities between individual (moral) and group-level (ethical) responding, and areas where practicing behavior analysts may have preferences that differ from their clients or their clients' caregivers.

Choice with Ethical Outcomes: Sign Effect, Commodity Effect, & Ethical Theory Preference

“…Across both studies in Cox (2021), the researcher also found that what people claimed as the right thing to do (descriptive ethical behavior) appeared functionally distinct from why they claimed it was the right thing to do (normative ethical behavior); a finding that has been challenged for replicability and relevance to clinical-ethical choice in behavior analysis (Bailey, 2021). Cox and Javed (2023a) extended the above work by examining the role of probability discounting in ethical decision-making at the individual level. These researchers recruited 15 practicing behavior analysts and 30 non-behavior analysts.…”

“…Ethical gains were framed as behavior that complies with the participant's personal morals and ethics; and ethical losses were framed as behavior that violates the participant's personal morals and ethics. Past research has found that behavior analysts and non-behavior analysts alike will discount probabilistic ethical outcomes (Cox & Javed, 2023a). Thus, 5-trial adjusting probability tasks were used given their efficiency in obtaining an indifference point that can be used to generate a rate of ethical probability discounting.…”

Initial Description of 3.9 Million Unique ABA Sessions

“…For example, researchers have asked about standard assessment practices such as practitioners' use of functional assessment methodologies (Oliver et al, 2015;Roscoe et al, 2015) and their use of preference and reinforcer assessments (Graff & Karsten, 2012). As another example, researchers have asked about how services are delivered such as task interspersal (Bottini et al 2019) and the variables that influence clinical and ethical decisions (e.g., Cox & Brodhead, 2021;Cox & Javed, 2023;Kelly et al, 2023;Saini et al, 2018;Vanselow et al, 2011).…”