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JCPSLP
Volume 19, Number 2 2017
Journal of Clinical Practice in Speech-Language Pathology
pathologist; when to treat or not treat, when to stop
treatment; whether to treat someone if they cannot pay;
what fees to charge; what to do when you feel a colleague
is not providing best practice. While this balancing of ethical
principles around beneficence, non-maleficence, justice and
autonomy are stated here in reference to private practice,
they also relate to every area of practice.
I think the most important ethical issue facing those in
clinical practice concerns evidence-based practice. There
are some private practitioners who see children for whom
they admit they feel poorly equipped. In some cases the
practitioners have not attended professional development
in the area, and are providing therapy that is therefore
not current best practice. The recent large increase in
new graduates entering private practice also means a
speech pathologist may be less likely to refuse to treat, or
turn away clients for whom they may not be adequately
experienced. And of course yet another issue is that it
appears there are not adequate services for preschool
therapy for children who stutter and so parents who may
not be able to afford private treatment end up needing
to pay for treatment. This can be another conflict for the
practitioner – trying to achieve change with as little cost to
the parents as possible, while still following best practice
treatment guides.
Acknowledgements
With thanks to Christina Wilson, who was the Senior
Advisor Professional Issues at Speech Pathology Australia
at the time of this interview.
relationship in a private practice means they are free to
come and go, especially if they are paying. Clearly, it is
easier to retain people in trials if there is no financial cost to
them. Another example of a conflict of interest is the conflict
of providing an alternative treatment or testing an alternative
treatment if there is a current best practice treatment.
What advantages have you found
to combining private practice and
research?
Many! Having completed a PhD, carrying on with research
is a way of continuing to maximise and develop the skills I
acquired through that process in my day-to-day work. I find
it makes my private practice more stimulating, particularly
as I have already developed my expertise in an area. It
continues to add variety and diversity to my role as a
speech pathologist. Importantly, it has also helped me travel
and have the opportunity to present work at international
and national conferences, and meet and network with other
people who are passionate about the same area. This
allows me to have a close and ongoing relationship and
collaboration with people who have mentored me and
whose work I find really fascinating. Hearing about their
ideas, being a part of that community of people who are
interested in the same areas as I am is something I would
not get from clinical practice alone.
I think it is really important for us as professionals
to continue to learn. If you are not involved in what is
happening in your field, even from the literature, it means
you are only learning from your own experience and that, in
my opinion, is very limiting. It is vital to stay abreast of new
treatments and changes to treatment delivery in an area,
and then apply these to clinical practice. This to me is what
is intended by evidence-based practice.
What do you think are the biggest
ethical issues facing those in
clinical practice?
I think there are ethical issues whenever and where ever
you are working with people and as a practising speech
Susan Block
is a speech pathologist within the Department of
Community & Clinical Allied Health at La Trobe University and is a
Senior Member of the Speech Pathology Australia Ethics Board.
Correspondence to:
Dr Susan Block
La Trobe University
phone: (03) 9479 1801
email:
S.block@latrobe.edu.au