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Ethical Decision-Making in Direct Service Funding: Lessons From a Toronto Developmental Services Organization
Andria Bianchi1, Cecile Recto2, Felix Camposano3
1Andria Bianchi, is the director of Research, Evaluation and Bioethics at Surrey Place in Toronto, ON, an assistant professor at the University of Toronto in Toronto, ON, and an adjunct scientist at KITE Research Institute in Toronto, ON.
Abstract:
Direct service funding is re-shaping Canada's developmental services sector and beyond, increasing individual choice while introducing new ethical challenges for providers. This paper examines one organization's transition to Ontario's needs-based autism program, where families receive direct funding to purchase services. Although the model enhances choice, it raises concerns about equity, two-tiered access and non-recommended service requests. In response, the organization used an ethics decision-making framework and developed nine ethics principles. These principles now serve as a compass that guides organizational decision-making for relevant ethical dilemmas. Sharing this experience aims to support others navigate ethical complexities associated with direct service funding.
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