Alright, I just need to say it; if I hear one more ethics conversation about a glass of water, I’m going to need crisis management services.
Don’t get me wrong here. I completely understand the conversation. We are specialists providing services to those in need, and as such, we should not put ourselves in the position to be a hardship on our clients. This includes accepting needed resources from said client.
The glass of water ISN’T the problem here. It’s the general conversation about ethics.
First and foremost, many of us are serving vulnerable, under-served individuals who have significant behavioral needs. I believe that we can all agree on this pretty comfortably. It’s one of the aspects of our field that makes us great.
So, why are many of our conversations geared toward that glass of water? Why aren’t we framing our ethical discussions around serious concerns, like why I just inherited a case where the child had no communication skills, but the only skill the previous analyst was working on was “good hands”? Or when we discuss caregiver buy-in, why aren’t we talking about contextual fit more?
Why does it seem that we spend more time framing our ethical discussions around a glass of water than disseminating behavior analysis in meaningful and effective ways? I’d argue that it is simply an easy example to use in the discussion, but it doesn’t highlight one of the most important parts of our field: none of us ACTUALLY prioritize water over our more serious ethical dilemmas.
It’s probably time to start thinking about how we prioritize our ethics discussions.
Another concern that I would like to express regarding the “water chatter” is that this conversation primes early behavior analytic learners for extremely rigid ethical boundaries. To such a degree, I might add, that it impacts their practice, and in particular, their interpersonal relationships.
Framing our ethics discussions around the glass of water implies that even the simplest slip-up could be so detrimental to practice that it’s not recoverable. It creates an ethical perspective so rigid that it could get in the way of more effective practice, and in turn, create a culture of problematic assumptions about behavior analysis.
For example, how do we account for cultural variations? What happens if you are offered coffee by a family, and you decline, but that single cup of coffee could mean the difference between that client getting services or not? Was it worth declining?
Maintaining strong ethical boundaries isn’t a problem. Professionally, I have a list of non-negotiable ethical decisions that I maintain in my own practice. I’m not saying that ethical rigidity is a totally bad thing. But when the practitioner is so rigid in their ethical decision making to such a degree that it starts to harm client relationships and ultimately harm client outcomes, it’s worth looking at how we are discussing ethics in general.
To me, the most glaring issue with the water conversation is that it doesn’t present a critical thinking component, truly. If the conversation is solely centered on set up of “when a client offers you water, don’t take it,” the black-and-white of ethical decision making comes to the forefront. The problem is that it doesn’t account for the gray area, and it doesn’t promote problem solving.
More complex ethical dilemmas in discussion DO account for this, which is a saving grace for our field. Ethical dilemmas are complex, and we actively live in the midst of ethical dilemmas each day (even when we’re “off” work). But the reductionist conversation surrounding accepting water is exactly that; a boiled down version of a decision making tree that potentially negates problem solving strategies in the practitioner.
The truth is this; even the water discussion is complex. Is it the priority? No, but it’s more complex than simply saying “no, thank you.” But if the conversation is that you simply do not accept, it’s removing a critical thinking component that would ultimately benefit the practitioner in every aspect of their practice.
"But, if you give an analyst the water…"
Is water the problem? Not even close. It’s the implication surrounding the discussion. The problem is that the conversation is reductionist at best, and crippling to the analyst and our field at worst. There are truly bigger challenges we face, day in and day out, that to hang our hat on the ethics of accepting water is absurd and dangerous. Framing our ethical discussions around a glass of water indicate that we prioritize molecular interpersonal issues rather than other clinical concerns that ultimately impact our individual practice as well as our field.
Going forward, consider this; does the water really matter when you are working with an individual who has no functional communication? Is it really important that you say, “No, thank you” when you begin working with a family that has involuntarily hospitalized their child 7 times in the last two months?
Forget the water for a second, will you?