JCPSLP Vol 17 Supplement 1 2015_lores

Staying on top of the growing evidence base for our practice and maintaining fitness for practice are concerns for the whole profession, not just private practice. Earlier in this paper we raised the issue of responsibility for CPD, which becomes particularly important as consumer expectations and knowledge of our evidence base increase with rising Internet access and information literacy of the community. In this context, and also that of changing scope of practice, ensuring fitness for practice of new graduates, clinicians changing work sectors (e.g., from health to disability, from education to health), and rural and remote practitioners becomes a major ethical obligation for employers, individuals and the professional association. Ensuring the competence and standards of practice for allied health assistants and other support workers will also become a major ethical issue as reshaping of the workforce occurs and delegation of some speech pathology tasks becomes more common. The ethical issues involved in delegation should not be allowed to mask what Threats, writing in Body and McAllister (in press), refers to as “protectionism”, however. In the absence of evidence that speech pathologists deliver superior treatment to that provided by assistants under their supervision, Threats argues that there are ethical considerations (as well as economic considerations) in allowing the extension of speech pathology services using assistants and volunteers to reach a greater number of people than the speech pathology workforce alone could deliver. While fiscal constraints, workforce concerns, population trends and consumer preferences are driving shifts in resource allocations and modes of service delivery, increasing litigation is also driving management policies. As organisations seek to limit risk and litigation, some practitioners in the workshop reported incursions on clients’ autonomy and quality of life. One workshop participant gave the example of an adult client requesting and successfully managing scotch thickened to accommodate his dysphagia, only to have this decision overturned by a risk-averse management. A “one-size-fits-all” approach to services is not working to ensure access and equity for all actual and potential speech pathology clients. Concluding comments Our workplaces will continue to experience significant societal, systemic and technological change, and in turn influence our practice. We will not be able to anticipate, prepare for, shield or pre-empt the impact of all these changes on ethical provision of our services. Consequently we need to stay vigilant, scanning the environment for trends and changes that may influence our practice, discussing their potential impacts on our services and engaging in CPD about ethics. As McAllister (2006) has previously discussed, we need to be ethically aware and think about ethics as a part of our daily planning, delivery and evaluation of services, not just as something that is called on when confronted with “dilemmas” pertinent to Australian Government Productivity Commission. (2005). Australia’s health workforce. Productivity Commission Research Report . Canberra: Commonwealth of Australia. Beauchamp, T., & Childress, J. (2009). Principles of biomedical ethics (6th ed.). Oxford: Oxford University Press. Body, R., & McAllister, L. (in press). Ethics in speech language therapy . London: Wiley & Sons. Chetney, R. (2002). Interactive home telehealth: moving from cost savings to reimbursement. Creative, proactive individual clients. References

strategies help agencies turn telehealth into a revenue generator. Telemed Today , 9 (3), 19–20. Cornford, T., & Klecun-Dabrowska, E. (2001). Ethical perspectives in evaluation of telehealth. Cambridge Quarterly of Healthcare Ethics , 10 , 161–169. Cross, R., Leitão, S., & McAllister, L. (2008). Think big, act locally: Responding to ethical dilemmas. ACQ 10(2) 39–41. Eadie, P. & Atherton, M. (2008). Ethical conversations. ACQ 10 (3), 92–94. McAllister, L. (2006). Ethics in the workplace: More than just using ethical decision making protocols. ACQuiring Knowledge in Speech, Language and Hearing , 8 (2), 76–80. Reed, G., McLaughlin, C., & Milholland, K. (2000). Ten interdisciplinary principles for professional practice in telehealth: Implications for psychology. Professional Psychology: Research and Practice , 31 (2) 170–178. Sim, J. (1997). Ethical decision making in therapy practice . Oxford: Butterworth Heinemann. Speech Pathology Australia. (2000). Code of ethics . Mel­ bourne: Author. Speech Pathology Australia. (2003). Scope of practice . Melbourne: Author. Speech Pathology Australia. (2005a). Dysphagia: Modified barium swallow . Melbourne: Author. Speech Pathology Australia. (2005b). Tracheostomy management . Melbourne: Author. Speech Pathology Australia. (2007a). Fibreoptic endoscopic evaluation of swallowing . Melbourne: Author. Speech Pathology Australia. (2007b). Parameters of practice: Guidelines for delegation, collaboration and teamwork in speech pathology practice . Melbourne: Author. Stanberry, B. (2000). Telemedicine: barriers and op­ portunities in the 21st century. Journal of Internal Medicine , 247, 615–628. Theodoros, D. (2008). Telerehabilitation for service delivery in speech-language pathology. Journal of telemedicine and Telecare , 14 , 221–224. United Nations. (1989). Convention on the rights of the child . Geneva: Office of the United Nations Commissioner for Human Rights. United Nations. (2006). Convention on the rights of persons with disabilities . Geneva: Office of the United Nations Commissioner for Human Rights. Marie Atherton is the Senior Advisor Professional Issues at Speech Pathology Australia National Office in Melbourne. In her current role Marie supports the management of ethical complaints to the Association and provides professional and clinical knowledge input to a variety of project and policy activities. Lindy McAllister is a Senior Council Appointed Member of the Ethics Board of Speech Pathology Australia. She is currently Deputy Head (Teaching and Learning) of the Mayne Medical School at the University of Queensland. Lindy has a long history in teaching and writing about ethics in speech pathology.

Correspondence to: Marie Atherton Senior Advisor Professional Issues

Speech Pathology Australia Level 2, 11–19 Bank Place, Melbourne VIC 3000 email: matherton@speechpathologyaustralia.org.au

This article was originally published as: Atherton, M., & McAllister, L. (2009). Emerging trends impacting on ethical practice in speech pathology. ACQuiring Knowledge in Speech, Language, and Hearing , 11 (1), 31–35.

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

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