JCPSLP Vol 20 No 2 July 2018

Ethical considerations Using the scenario 1 case study as an example, a number of ethical issues can be identified relating to the development of this innovative and entrepreneurial method of practice. In this scenario, several breaches of key principles and standards contained within the SPA Code of Ethics, which The principles of beneficence and non-maleficence scaffold the nature of speech pathology professional practice, i.e., we seek to benefit our clients through the application of our knowledge and skill, and we also seek to prevent harm. When we consider the scenario described above, we can identify that the lack of evidence to show that the app does provide benefit to clients (and does not cause harm) is an ethical issue that must be managed or resolved before the app can be used in the delivery of a professional service. Tom’s false claim of being able to provide diagnosis of speech problems through a social media platform and the lack of trials around effectiveness of his product may unknowingly cause harm to consumers. Truth Effective therapeutic relationships are based on trust. Tom is not telling the truth about the effectiveness of his app or his conflict of interest in owning the app. This is inappropriate in professional practice. Professional integrity Advertising the app at work without permission and claiming effectiveness without evidence does not demonstrate integrity. Alignment of the app with Tom’s SPA membership may be seen as coercive and may denigrate the reputation of the profession. Accurate and timely information A speech pathologist has an obligation to provide evidence- based information and interventions to clients. However, the information Tom is providing about his app is neither accurate nor validated. Client relationships Asking clients to promote his app for him is inappropriate, and would be considered unethical due to Tom’s financial gain from such promotion. This clearly demonstrates a conflict of interest. Tom should be aware of, can be easily identified. Beneficence and non-maleficence Entrepreneurship can be achieved with due consideration of all inherent ethical issues and can provide benefit to clients while at the same time achieving innovation in service provision. Scenario 2 sets out an alternative version of the case study in which Tom develops a mobile app. Application of mobile technology: Scenario 2. Tom develops a mobile app to assist people who stutter to manage their dysfluencies. Prior to marketing his app, Tom spends time collecting evidence to demonstrate the usability, usefulness and benefits of the app to consumers. He approaches a lecturer he had at university to assist him to determine an appropriate method for data collection on the use of the app and the Embracing ethical entrepreneurship

benefit to clients. He collects and analyses data from a range of people and with this information is able to identify which clients would benefit from using the app for practice, the dosage and the contexts for use. Tom then develops accurate messages for clients grounded in data and evidence. Tom maintains his currency of knowledge in the area of stuttering by attending professional development events, joining a special interest group and keeping up to date with journal articles describing research in stuttering. With this knowledge he is able to determine which clients may be appropriate for other interventions in addition to the use of the app, and he maintains competency in the provision of these treatment programs. Tom discusses the use of the app and the evidence he has collected with his manager prior to introducing it into the clinic. The manager is able to assist Tom to ensure he has appropriate consent from clients to participate in the trials and suggests a way to expand the data collection, which has in turn increases the applicability of the data collected. With evidence on the benefits of the app now available, the clinic agrees to advertise the app to clients on appropriate platforms. A contract that clearly establishes the parameters regarding intellectual property and financial benefit from sale of the app is developed and signed by all relevant parties. The conflict of interest that potentially existed in the earlier scenario has now been disclosed and managed appropriately. Guidance and governance Developing entrepreneurial ideas and new ways of professional practice requires strong guidance and governance including consideration of ethical issues and in some cases compliance with legal processes. This is particularly the case if there is a commercial interest. Good governance is essential for good business and ensuring strong foundations when planning for innovation and can prevent issues arising in the future. Speech Pathology Australia has a range of resources free for members that may assist them when developing innovative and entrepreneurial ideas. These can be found in the public and members sections of the Speech Pathology Australia website, including: • Speech Pathology Australia Code of Ethics (2010) • The new Online Ethics Learning packages, an interactive self-guided learning tools • Ethics Education Package, hardcopy available for download, which provides detailed information, references, reflective and learning activities for four decision-making frameworks • SPA ethical reasoning worksheets covering four decision-making frameworks. Each worksheet assists ethical decision-making from a different approach: a) Principles-Based Reasoning Decision Making Protocol draws on values, principles and standards of practice, b) Casuistry draws upon precedent or test cases, c) The Ethics of Care Approach focuses on the willingness of health care professionals to advocate for their clients, d) The Narrative Approach focuses on individual life stories. National Office staff are also available to discuss questions members may have when considering innovation

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JCPSLP Volume 20, Number 2 2018

Journal of Clinical Practice in Speech-Language Pathology