Ethics Today

1. Ethics Today Beat the Heat Conference June 26, 2013 Paula Chance,MS CCC/SLP

2. Pretest

3. Moral principals that govern a person’s or group’s behavior

4. How easy is it for you to feel responsible for maintaining the rules that govern an organization of which you are a member? 0______________________________10

5. Do you always follow every rule? If not can you be ethical?

6. Value Differences • What shapes our values? • __________________ • __________________ • __________________ • __________________

7. Value Differences What shapes our values(basic principals)? • Religious beliefs • Cultural sensitivity • Life experiences • Family beliefs

8. What Are Our Guiding principals Values Ethics

9. We are governed by several entities ?

10. HIPPA/IDEA/FERPA Medicare/Medicaid State Commissioner Rules Employer/Campus Facility ASHA Tx State Board of Examiners

11. ASHA CODE OF ETHICS • First written in 1930 • Revised 14 times • Revised 5 times in 1990’s • Revised in 2001 • Revised in 2003

12. WHY REVISE? TABLE FEUD Top 4 Reasons

13. TOP FOUR • Expanded scopes of professional practice • Expansion of client populations & practice settings • Technology • Past ethical misconduct

14. Principle of Ethics -1 Welfare of persons served • Professionally • Research • Humane treatment of animals

15. Principle of Ethics - 2 Highest level of professional competence Proper use and maintenance of equipment

16. Principle of Ethics - 3 Promoting public understanding about the profession

17. Principle of Ethics - 4 Relationships professional often encounter Acceptance of the self-imposed standards

18. State of Texas State Board of Examiners for Speech-Language Pathology And Audiology

19. General Ethical Issues • Time constraints making it difficult to perform administrative duties and provide services • Delivering less service than specified in the plan • Plans developed without input from the appropriate people • Disagreement about eligibility for services

20. General Ethical Issues • Pressure to go along with a team recommendation • Inappropriate use of assistants and paraprofessionals • Asked to provide services outside of scope of competence • Failing to confirm approval of supervisor

21. School Ethical Issues • Pressure to diagnose a disability • Use of Medicaid leads to conflict between medical and educational models • Torn between advocating for the child and advocating for the district • Evaluating second language learners without theoretical or practical knowledge

22. School Ethical Issues • Told by administrator not to make a recommendation because of cost (e.g., outside assessment, technology) • Asked to perform other school duties, resulting in cancellation of services • Conflict between “educational needs” and providing services and products we believe a child needs

23. Recognize An Ethical Decision? Step 1 Identify and gather relevant information (try to get feelings for parent or supervisor out of the picture)

24. A supervisor is concerned about the accuracy of a graduate student’s phonetic transcription, which could result in inaccurate information being used and possibly resulting in an incorrect diagnosis. WHAT ARE THE FACTS?

25. FACTS • Accuracy of the student’s phonetic transcription may or may not be adequate. • The supervisor is concerned about transcription adequacy. • Transcription errors could compromise quality of services. • Transcription adequacy can be evaluated objectively.

26. STEP 2 Possible courses of action Step 3 Is there a need for consultation?

27. Step 4 Plan of Action

28. Fundamental Consideration Welfare of persons I am serving

29. Fundamental Question Who Am I Serving?

30. Clients • Research participants • Colleagues • Students/SLP-Assistants • Supervisors • Other professionals

31. Three scenarios 10 minutes

32. What a Code of Ethics is NOT • The same as feelings • Religion • Following the Law • Following culturally accepted norms • Science marva mount, EBS

33. Challenges and Realities • Expected ethical behavior is consistent across all employment settings and with all clients • Employers often make demands in conflict with ethical behavior • Professional sometimes develop bad habit or use of bad judgment or make mistakes

34. A Code of Ethics is the road map to avoid such pitfalls. Miller, T (2007). Professional Ethics. In R.Lubinski L. Golper, &C. Frattali (Eds.) Professional Issues in Speech-Language Pathology and Audiology. Clifton Park, N.Y: Thomas Delmar.

35. Three Scenarios 10 minutes

36. When we have a problem or dilemma the ethical principals addressed today will not solve the problem BUT They will provide guidelines for looking at each case or problem closely.

37. We will always need to also include: Good judgment Sound reasoning Virtues of good character

38. “Sometimes ethical behavior is not the difference in right and wrong. It is the difference in right and more right.” Stuart Finder Vanderbilt University

40. Your Two Cents • Do you consider this an ethical dilemma? • Do you think the code of ethics has been or may be violated? • What would you advise a colleague in this situation?

41. Auditory Verbal Therapy • At an IEP meeting, a parent requests auditory verbal therapy for her child. No one in the school district is trained in AVT. What are your ethical obligations?

42. Doctor’s Orders • Nea is a 6-year-old with severe cerebral palsy and cognitive impairment, who is fed with a PEG. Nea’s mom really wants her to be able to eat and her teacher presents you with a prescription from Nea’s doctor ordering oral feeding at school.

43. Delegating Dilemma • An SLP has worked with an assistant for several years and decides that the assistant is now qualified to administer diagnostic tests, interpret them, and determine eligibility for services.

44. Licensees shall not: • delegate any service requiring professional competence of a licensee to anyone not licensed to perform that service;

45. David’s Device • David’s team believes that he would benefit from AAC, but there is a difference of opinion about what to purchase. Since there currently is money available, one team member wants to buy a high tech costly device with “room to grow.” You think David could use a light tech solution.

46. Sharing the Load • You have a large caseload. Your principal suggests that your assistant assume responsibility for half your caseload.

47. Ken Dahl • Fall semester begins with 6 new referrals! Thankfully, Ken has an assistant whom he asks to start testing the 3 “easiest” referrals while he sees the children with autism, cochlear implant, or cleft palate.

48. 741.64 (g) Initial contacts directly with the client shall be conducted by the supervising speech-language pathologist. • Following the initial contact, the supervising speech-language pathologist shall determine whether the licensed assistant has the competence to perform specific duties before delegating tasks.

49. Not Enough Time • You plan to supervise your assistant with each individual she sees. However, your schedule becomes increasingly hectic, so you are only able to supervise from 1:00-3:00 every Thursday.

50. Lunch Date • You have several individuals with feeding and swallowing problems on your caseload. You ask your assistant to help at lunchtime, which she does. When you aren’t available, she also advises other staff and answers family members’ questions about feeding techniques.