JCPSLP Vol 17 Supplement 1 2015_lores

Ethics in the workplace

Ethics in the workplace More than just using ethical decision-making protocols Lindy McAllister

This paper asks speech pathologists to reflect on what it means to think and act ethically in routine clinical practice. The purposes of the paper are fourfold. First, I discuss my views of the strengths and limitations of the current Code of Ethics of Speech Pathology Australia (2000) and Ethical Decision-Making Protocol contained in the Ethics Education Package (Speech Pathology Australia, 2002). Second, I discuss some pressures in contemporary practice which call for ethical thinking deeply embedded in daily practice rather than a focus just on ethical dilemmas. Third, routine challenges for speech pathologists in thinking ethically are considered, and finally I conclude with some suggestions for approaches to professional development of ethical thinking. T his paper is based on an invited presentation entitled Ethics: Why does it matter , delivered at the annual conference of Speech Pathology Australia in May 2005. While there are scholarly publications regarding ethics in speech pathology practice (see for example Pannbacker, Middleton & Vekovius, 1996; The Ethics Roundtables and other statements on ethics of the American Speech-Language Hearing Association (ASHA) over the years), these are not based on research into ethical reasoning and ethical conduct in speech pathologists. Smith (2002), Kenny, Lincoln and Reed (2004) and Wilson and McAllister (in progress) have researched the development of ethical reasoning in students. In the absence of research and a literature base on ethics in practicing speech-language pathologists, this paper reflects my opinions and experiences as: a co-author of the Code of Ethics (Speech Pathology Australia, 2000) and the Ethics Education Package (Speech Pathology Australia, 2002), as a university educator helping students learn to think and act ethically, and as a mentor to practising clinicians with a range of professional practice experience. I would like to acknowledge the contributions to the development of my thinking about ethics of Dr Teresa Anderson, Louise Brown and Meredith Kilminster, coauthors with me of the Code of Ethics and the Ethics Education Package. My critiques of the Code of Ethics and the Ethics Education Package

are in no way to be seen as a critique of their work, but rather as a reflection on my own growing understanding of what we mean by “ethics” and ethical conduct. Any misinterpretations or erroneous assertions are mine alone. The Code of Ethics of Speech Pathology Australia The Speech Pathology Australia Code of Ethics is based on a number of key principles of professional ethics (Beauchamp & Childress, 2001): • beneficence – we seek to benefit others; • non-maleficence – we seek to prevent harm to others; • truth – we tell the truth; • fairness – we strive for equal access to services for our clients and do not show bias or favouritism; • autonomy – we respect the rights of our clients to selfdetermination and autonomy; • professional integrity – we are respectful, courteous, competent and honour promises and commitments. As detailed on the Code of Ethics, these principles are enacted through attending to a range of duties to our clients and community, employers, profession and colleagues. These principles and duties are explained and application of them is illustrated in the Ethics Education Brown and Lamont (no date) developed a five-stage protocol which was included in the Speech Pathology Australia Ethics Education Package. Several case studies were developed to which this protocol was applied. The stages in the protocol are to ascertain: • the facts of the case and the ethical scenario; • whether an ethical problem exists which requires action; • the nature of the problem; • a proposed decision and action plan; • an evaluation plan to see if the ethical dilemma has been successfully managed. Strengths and weaknesses of the Code of Ethics and the Ethics Education Package In many ways our Code of Ethics is a powerful tool. The code uses a framework of aspirational ethics. That is, the code is expressed in language of “we aim to…” rather than the traditional “thou shalt not …” approach to writing codes Package (Speech Pathology Australia, 2002). The ethical decision-making protocol

KEYWORDS DECISION MAKING ETHICS MORAL REASONING THINKING

22

JCPSLP Volume 17, Supplement 1, 2015 – Ethical practice in speech pathology

Journal of Clinical Practice in Speech-Language Pathology