44 / 80
42
JCPSLP
Volume 17, Supplement 1, 2015 – Ethical practice in speech pathology
Journal of Clinical Practice in Speech-Language Pathology
Ethics and technology
KEYWORDS
ACCESS
ETHICS
INFORMATION
PRIVACY
STUTTERING
TELEHEALTH
associated with the emergent virtual world platforms, with
regard to the provision of speech-language pathology (SLP)
services. The second aim of this paper is to outline for SLPs
some major ethical concerns associated with embracing
these emergent and evolving technologies; that is, serving a
digital community while abiding by the profession’s Code of
Ethics. We commence our discussion of these applications
of the web in regards to people with communication
disorders (PWCD) through a short review of the more
established area of telehealth.
Telehealth
Telehealth is not a new digital phenomenon. Modern telehealth
started in the 1960s largely driven by the needs of the military
and of space exploration. Early technologies included the use
of television and the telephone (World Health Organisation
[WHO], 2010). Contemporary telehealth includes:
The delivery of health care services, where distance is
a critical factor, by all health care professionals using
information and communication technologies for the
exchange of valid information for diagnosis, treatment
and prevention of disease and injuries, research and
evaluation, and for the continuing education of health
care providers, all in the interests of advancing the health
of individuals and their communities. (WHO, 2010, p. 38)
The provision of health services to remote sites is
supported by a wide range of technologies (see Table 1 for
a list of resources commonly used by SLPs to support their
service delivery). Technologies such as videoconferencing
suites, email, tele-imaging, and more recently, rich
multimedia approaches such as video-streaming are
commonly used (WHO, 2010). The use of fixed, high-tech
videoconferencing suites to provide telehealth services
through public health departments is well established. One
example of the use of this technology occurs within the
Southern Inland Health Initiative which delivers telehealth
services including videoconferencing and remote diagnosis
to outpatients in rural and remote areas in Western
Australian (Department of Health, 2011). A second tool is
the portable
e-hab
system, developed by Theodoros and
colleagues, for telehealth service delivery to people with a
range of communication and swallowing impairments (see
for example, Sharma, Ward, Burns, Theodoros & Russell,
2011). Another technology being investigated for service
provision is desktop videoconferencing applications such
as Skype, which is envisaged to play an important role in
future delivery of low-risk clinical functions (Armfield, Gray &
Smith, 2012; Carey et al., 2010).
The world wide web offers the promise and
means of continual development and
improved access to speech-language
pathology services for people with communi
cation disorders. In this paper we describe
practices and possibilities for service provision
for this population, using telehealth and
emergent virtual worlds. We illustrate these
technologies with a particular focus on
research and developments for people with
communication disorders. We then highlight
some of the ethical risks associated with the
web in terms of the promotion of non-
evidence based practices, client–patient
relationships and the storage and access of
client data. These concerns are discussed
with reference to Speech Pathology
Australia’s Code of Ethics, and provide
guidance to speech-language pathologists
regarding the potential dangers associated
with service provision over digital platforms.
L
ast year the world wide web (the web) turned 21,
and now over 72% of Australian households are
connected to it (Australian Bureau of Statistics,
2011). The web is a collection of web pages which function
as a resource of the Internet (the world’s largest network
consisting of millions of linked computers) (Morley, 2011).
Today, the Internet and the web enable people around the
world to communicate, interact, and share information
on a large scale for activities such as commerce, health
care, education, socialising, and gaming. However,
global inequality of access and knowledge of information
and communication technologies (ICT), known as the
digital divide
(Wei, Teo, Chan, & Tan, 2011) does exist.
Consequently, the Australian federal government has
recently begun rolling out its highly publicised National
Broadband Network (NBN) which aims to connect all
Australians to a high-speed web by 2020, enabling a
digitally supported economy (Department of Broadband,
Communications & the Digital Economy, 2011).
As an ICT infrastructure develops, it is the role of all
public sectors, including health, to utilise and plan for its
inclusion into a digital future. The first purpose of this paper
is to outline developments within telehealth, and work
Digital possibilities and
ethical considerations
Speech-language pathologists and the web
Grant Meredith, Sally Firmin and Lindy McAllister
Grant Meredith
(top), Sally Firmin
(centre) and
Lindy McAllister