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JCPSLP
Volume 19, Number 1 2017
Journal of Clinical Practice in Speech-Language Pathology
Ethical conversations
Helen Smith
(top) and
Felicity Burke
KEYWORDS
ETHICS
INDIGENOUS
AUSTRALIANS
SLP SERVICE
PROVISION
Aspiring to build culturally
responsive, collaborative speech-
language pathology services
Some ethical reflections for SLPs working with Aboriginal
and Torres Strait Islander peoples
Helen Smith and Felicity Burke
Australians with expertise and knowledge, working
in collaboration with SLPs can hope to create ethical
practises, culturally competent services and programs
which are relevant and sustainable (Lowell, 2013).
Therefore, we welcome comments and responses to this
discussion from Aboriginal and Torres Strait Islander people
and communities to progress, deepen and further inform
our conversation in future issues.
Culture is central
“Culture is central to Aboriginal and Torres Strait Islander
health and well-being” (IAHA, 2015, p. 7). For services to
be culturally responsive the values, beliefs and philosophies
must be learned and appreciated for each person, group,
family, and community (IAHA, 2015). It takes time to build
trust, safety, knowledge, and to develop relationships which
integrate respect and a collaborative approach to make
services culturally responsive to needs. Taking the time
required moves us toward services which fundamentally
create environments, processes and practices which are
explicitly and consciously culturally inclusive (IAHA, 2014).
Indigenous Allied Health Australia (IAHA) has developed a
cultural responsiveness framework with six key capabilities:
respect for centrality of culture; self-awareness; proactivity;
inclusive engagement; leadership and responsibility and
accountability (IAHA, 2015, p. 13). These capabilities can
be used as the basis for beginning to build a culturally
responsive workforce.
Speech Pathology Australia’s Code of Ethics states
“we do not discriminate on the basis of race” (Speech
Pathology Australia, 2010, p. 1). As a profession, if we
aspire to building culturally responsive collaborative services
with Australia’s First People, exploration of the implications
of this seemingly simple statement is required. Culturally
responsive service provision requires SLPs to recognise,
understand and acknowledge the history of Aboriginal and
Torres Strait Islander peoples. It requires SLPs to accept
this history and the impact on Indigenous Australians for
reconciliation and healing to be fostered. It requires deep
reflection by SLPs on the ongoing impact of historical and
current events, systemic policies and attitudes on the health
and well- being of Aboriginal and Torres Strait Islander
peoples.
Cultural education and cultural
interpreters
Currently variable cultural education opportunities for
practising clinicians, inadequate use of and potential lack of
Speech-language pathologists (SLPs) face
ethical challenges when providing equitable
services to Aboriginal and Torres Strait
Islander peoples. We are conscious of the
multitude of wise, expert and often silenced
Australian Indigenous voices. Voices that
should be sought, listened to, and used to
inform policies. Indigenous Australians, with
expertise and knowledge, working in
collaboration with SLPs, can hope to create
ethical practices, services and programs
which are relevant, equitable and sustainable
for Indigenous Australians.
I
n this edition of Ethical conversations, we hope to
raise the awareness of speech-language pathologists
(SLPs) about some current ethical challenges facing the
profession when aspiring to provide culturally responsive
speech-language pathology services for people who
identify as Indigenous Australians.
Background reflections
As authors who culturally identify as European Australians,
we fully acknowledge our perceptions and understandings
are informed by our own culture and history. We have
worked in remote regions of central Australia. This has
afforded us an opportunity to gain some small knowledge
and insights into the positive effects of health and education
services based on equality and inclusiveness as well as true
collaboration with local expert Aboriginal people. We have
been enriched and grown, both personally and
professionally, through opportunities to participate in
transcultural relationships with people from Aboriginal
cultural backgrounds. We are very aware that our own
cultural heritage impacts any learnings, interpretations and
insights we have gained through these experiences.
We recognise one of the major challenges faced when
considering this topic was our difficulty collaborating
directly with SLPs who identify as Indigenous Australians.
According to the Australian Bureau of Statistics 2011
census, only 0.26% of audiologists and speech-language
pathologists identified as being Aboriginal or Torres Strait
Islander (Mason, 2013). We are conscious of the multitude
of wise, expert and often silenced Australian Indigenous
voices, indigenous voices which should be found, and
listened to, and used to inform our policies. Indigenous