Speak Out December 2020

ethical obligation in that regard is to identify if the request sits outside your area of experience and competency and if it does, refer them on to another speech pathologist. Mary: Yes, there may well be times when you decide you are just not the right person for the job and it is so important to recognise and assert that. But if you do decide to take on the case, you then need to be rigorous in only giving objective facts and only truly justifiable opinions (based on solid evidence from either your own assessments of the individual’s strengths/weaknesses and/ or the published literature). Amy: So, what happens if you’re asked a question, either in your report or in court, that you’re unsure about? Mary: I think this can be tricky for speech pathologists who may be used to hypothesising or making an ‘educated guess’ in a clinical situation, but it is vital that doesn’t happen a legal setting. It is essential you can defend the opinion you are offering, as objectively and rigorously as possible, and so you may well have to say "I can't comment on that”, “I don’t have enough information to make that judgement”, or “I don't know" if you are asked about something you aren't 100% confident about, and maintain that position even if you feel pushed to give an answer one way or another. Amy: That must be difficult if you’ve been hired by one party to give an opinion to back up their argument? Mary: Yes, but ultimately as a health professional you have to remain impartial, regardless of who made the referral. You have to be able to defend your opinion, and it has to be what you truly believe from the information available, and if that is not what the party who made the referral was hoping would be concluded, then so be it. I’ve certainly felt guilty about that in the past, but I had to remember I was being called to provide an expert opinion to the court, not to back up whatever one party wanted me to say. Amy: What happens if you are asked to comment on the opinion or practice of another professional?

truly believe and can defend, rather than being led by what you think the referrer wants you to say. Trish: I agree that the key in this type of situation is to remain focused on the objective information presented. The Code of Ethics obliges us to be honest and also respectful of our colleagues. You can present an objective reason as to why you disagree with a colleague’s action, but you must remain professional and focus on the interventions provided and not make personal statements. Providing second opinions in a formal or legal setting can be fraught with ethical dilemmas, and speech pathologists should be very careful if asked to comment on the actions of a service provider who is not a speech pathologist, as that is outside our professional area of expertise. Amy: It sounds like there is a lot for people to consider, and I’m sure we’re only scratching the surface here. Does SPA have any other resources people could access on this topic? Mary: Members might be interested in reading the Speech Pathology in Justice Clinical Guidelines and Position Statement, and also referring to information sheets such as Medico-legal Report Writing FAQ , and Appearing as a Court Witness Trish: Yes, there’s also information that may be relevant in the Second Opinions an Independent Reviews FAQ. A final consideration for members looking to work in this area is to discuss the activities you will be undertaking with your professional indemnity insurance provider, to ensure your work is covered under your policy. Amy: Thank you Mary and Trish for your insights into this interesting but challenging area of speech pathology practice. Members who wish to discuss aspects of this type of work can contact the advisors at SPA, email addresses can be found on the staff page on the SPA website.

Mary: This always feels uncomfortable. You may well have to provide a different opinion or judgement if that is what the assessment and the evidence base has led to. I think it is important to distinguish between explaining a difference in opinion or approach, and criticising another professional. Of course, as I mentioned before, you should only be disagreeing/ giving a different opinion if that is what you

Amy Fitzpatrick SPA Senior Advisor, Disability, Mary Woodward, SPA Senior Advisor, Justice and Mental Health and Trish Johnson, SPA Manager, Ethics and Professional Issues.

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December 2020 | Speak Out