JCPSLP
Volume 16, Number 1 2014
37
Ethical conversations
KEYWORDS
ETHICAL
PRACTICE
KNOWLEDGE
TRANSLATION
Belinda Kenny
(top) and Susan
Block
Responsible and ethical
clinical practice
A framework for knowledge translation
Belinda Kenny and Susan Block
treatment approaches, changes in treatment focus or
timing and, changes in outcome measurement. New
knowledge can be disseminated through publications, case
presentations, conferences, professional development
seminars or a range of discussions and meetings. Whatever
the means, translation of knowledge is the significant
process that underpins the flow of research knowledge to
practice. In recognition of the importance of these events
and their impacts upon professional development and client
care, Speech Pathology Australia (SPA) has incorporated a
range of such learning opportunities into the calculation of
Professional Self Regulation (PSR) points for members
(SPA, 2013).
The link between ethics and research has been clearly
established, with human research ethics committees
adopting a major gatekeeping role in monitoring benefits
and risks of new research programs (Emanuel, Wendler
& Grady, 2000). However, ethical considerations extend
beyond the research studies themselves. Knowledge
translation (KT) may be defined as:
the exchange, synthesis and
ethically sound
application of knowledge – within a complex system
of interactions among researchers and users for
the purposes of accelerating and capturing benefits
of research through better health outcomes, more
effective health services and resources, and a
strengthened health care system. (Canadian Institutes
of Health Research, 2009, emphasis added by
authors)
This definition is consistent with applying an ethics lens
through which key KT decisions should be considered by
researchers and clinicians.
Some of the ethical challenges
of KT
The goals of KT, to create and implement new health care
knowledge, may provide significant benefits for our clients,
the profession and employers. However, ethically sound
application of such knowledge requires critical reflection of
both the research processes and their outcomes. Trevor-
Deutsch, Allen and Ravitsky (2009) posed five questions to
support such a reflective process:
1. What are the key ethical principles and values that
should guide KT?
2. What are the responsibilities of different stakeholders
in the KT process (e.g., researchers, research funders,
In this paper Belinda Kenny and Susan Block,
members of the Speech Pathology Australia
Ethics Board, reflect upon the challenges and
opportunities facing speech pathologists as
they make decisions about client interactions
and intervention. Such challenges can be
particularly stressful when clinicians attempt
to evaluate, interpret and maintain best
practice and emerging evidence, and balance
the demands of everyday clinical practice.
Professional perspectives
Many speech pathologists work in an environment where
specialisation is neither possible nor appropriate. As a
consequence, most of our colleagues work with a diverse
caseload, with people of different ages, backgrounds,
diagnoses, needs and demands. This means that clinicians
have a wide scope of practice within which they need to
continuously develop knowledge (SPA, 2003). Furthermore,
pressures imposed by expanding waiting lists and
managers who are often not speech pathologists, may
create tensions between optimal treatment and service
delivery policies (Kenny & Lincoln, 2012). Speech
pathologists may then perceive a need to reduce the
amount of treatment a client receives (McAllister, 2006).
When such tension exists, it becomes imperative that the
best possible treatment is delivered to maximise client
outcomes. This goal requires us to carefully consider our
knowledge base and how we translate evidence into our
everyday practice. Indeed, the revised Code of Ethics (SPA,
2010) espouses speech pathologists’ responsibility for
knowledge and application of evidence as a fundamental
professional value and requires that: “We maintain our
currency of professional knowledge and practice and
acknowledge the limits of these” (p. 1). Nonetheless, the
process of developing, accessing and translating
knowledge may be a difficult and confronting task for many
of us (Cartwright, 2012).
Theoretical perspectives
One of the main methods of acquiring knowledge is
through access to the publication of research findings.
Dissemination of research findings aims to present new
information that constructively impact upon the status quo.
The nature of such impacts may involve changes to current
