Speak Out August 2019 Digital Edition

Ethics

Bethany provides a copy of the parenting order which states that parenting is shared between her and Doug. You keep that copy in Marella’s file. Concern Narrative ethics consideration Possible action How much information

If the parenting order states that one parent has control over medical treatment exclusively, which includes speech pathology as an allied health profession, that must be followed. If the parenting order states that both parents have equal parenting rights, then both parents can be involved in any aspect of care, receive notification of and attend appointments, be provided with feedback on progress in therapy, copies of reports or letters. If a parent advises you that there is no formal document, it can be assumed that equal parenting rights are in place.

The parents may have personal preferences or instructions that they want you to adhere to, however, the parenting order provides the information regarding who has parenting rights for medical treatment

can Doug have access to, particularly if Bethany (who is paying for therapy) doesn’t want him to have anything

You explain to Bethany that you are obliged to act according to the parenting order. Now that Doug has contacted you, you must provide him with the same information that you give to Bethany. It is obvious that Bethany does not like the situation, however, she understands that it is your ethical and legal obligation to act according to the order.

It can be a useful strategy to initiate consistent and equal communication channels with both parents from the beginning of contact with the practice. This could mean that the practice policy is always to have a group email to both parents with any information about the child, and copies of all letters and reports are sent to both parents.

Communication is key for both Bethany and Doug to support Marella’s therapy. It is important that they both know what is happening in sessions and have regular updates about her progress

The parents never attend sessions together, how do you make sure they both are informed of Marella’s progress?

It is important that both parents are aware that any information they provide to the speech pathologist can be seen by the other parent. Bethany asks that Doug does not receive any written reports about Marella, as she paid for them. You inform Bethany that you are obliged to provide information relating to Marella’s speech therapy to both parents, as per the parenting order. During the conversation Bethany threatens to change therapists, but after further discussion she realises that any speech pathologist has the same ethical and legal obligations relating to provision of information to separated parents.

A speech pathologists’ skills and knowledge relate to communication and swallowing, or mealtime assistance needs. Within the context of working closely with a parent to develop communication with their child, a speech pathologist may observe parenting skills. However, professional statements regarding parenting skills or competence sit outside our scope of practice and should not be included in a speech pathology letter or report. A letter or report can be provided containing objective information such as who brought the child to therapy sessions (if recorded in the progress notes), and what speech pathology goals and therapy techniques or strategies have been used but should not contain subjective statements relating to a parenting for use in a court case to determine custody.

You have developed a trusting relationship with Bethany. However, as a result of talking with Doug, you are now aware that Marella spends time with both parents: she lives with Bethany during the week, which is why Bethany brings her to appointments on a Tuesday. Marella spends time with Doug on the weekends.

Bethany asks for a letter from you for the custody hearing in court stating that she is providing all the parenting for Marella and speech therapy is one example of that.

You discuss your professional obligations with Bethany. She tries to argue the point, but you stand firm on what your ethical and professional actions must be. Bethany accepts that and agrees for you to provide a report with objective information about Marella’s progress in speech therapy without any comment on parenting. Alongside the importance of understanding the client’s “story”, there are ethical and legal obligations relevant to this situation that guide a speech pathologists’ actions. A range of information is available for SPA members: the article by Nichola Harris in the February 2019 edition of Speakout is a good place to start, as well as the resources available on the SPA website under the Resources for Speech Pathologists > Professional Resources > Legal Information tab.

Trish Johnson Manager Ethics and Professional Issues

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August 2019 www.speechpathologyaustralia.org.au

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