- Direct service funding increases individual choice but raises ethical concerns about equity, two-tiered access and non-recommended service requests.
- The organisation applied an ethics decision-making framework and created nine guiding ethics principles to navigate dilemmas arising from direct funding.
- Sharing this experience provides practical guidance for other providers adapting to ethical complexities of needs-based direct funding programmes.
Healthc Q. 2026 Jul;29(2):41-45. doi: 10.12927/hcq.2026.27904.
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.
PMID:42669641 | DOI:10.12927/hcq.2026.27904
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