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JCPSLP Volume 17, Supplement 1, 2015 – Ethical practice in speech pathology 7
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Staying on top of the growing evidence base for our
practice and maintaining fitness for practice are concerns
for the whole profession, not just private practice. Earlier
in this paper we raised the issue of responsibility for
CPD, which becomes particularly important as consumer
expectations and knowledge of our evidence base increase
with rising Internet access and information literacy of the
community. In this context, and also that of changing
scope of practice, ensuring fitness for practice of new
graduates, clinicians changing work sectors (e.g., from
health to disability, from education to health), and rural and
remote practitioners becomes a major ethical obligation
for employers, individuals and the professional association.
Ensuring the competence and standards of practice for
allied health assistants and other support workers will also
become a major ethical issue as reshaping of the workforce
occurs and delegation of some speech pathology tasks
becomes more common.
The ethical issues involved in delegation should not be
allowed to mask what Threats, writing in Body and McAllister
(in press), refers to as “protectionism”, however. In the absence
of evidence that speech pathologists deliver superior treatment
to that provided by assistants under their supervision,
Threats argues that there are ethical considerations (as well
as economic considerations) in allowing the extension of
speech pathology services using assistants and volunteers
to reach a greater number of people than the speech
pathology workforce alone could deliver.
While fiscal constraints, workforce concerns, population
trends and consumer preferences are driving shifts in
resource allocations and modes of service delivery,
increasing litigation is also driving management policies.
As organisations seek to limit risk and litigation, some
practitioners in the workshop reported incursions on clients’
autonomy and quality of life. One workshop participant
gave the example of an adult client requesting and
successfully managing scotch thickened to accommodate
his dysphagia, only to have this decision overturned by a
risk-averse management. A “one-size-fits-all” approach to
services is not working to ensure access and equity for all
actual and potential speech pathology clients.
Concluding comments
Our workplaces will continue to experience significant
societal, systemic and technological change, and in turn
influence our practice. We will not be able to anticipate,
prepare for, shield or pre-empt the impact of all these
changes on ethical provision of our services. Consequently
we need to stay vigilant, scanning the environment for
trends and changes that may influence our practice,
discussing their potential impacts on our services and
engaging in CPD about ethics. As McAllister (2006) has
previously discussed, we need to be ethically aware and
think about ethics as a part of our daily planning, delivery
and evaluation of services, not just as something that is
called on when confronted with “dilemmas” pertinent to
individual clients.
References
Australian Government Productivity Commission. (2005).
Australia’s health workforce. Productivity Commission
Research Report. Canberra: Commonwealth of Australia.
Beauchamp, T., & Childress, J. (2009). Principles of
biomedical ethics (6th ed.). Oxford: Oxford University Press.
Body, R., & McAllister, L. (in press). Ethics in speech
language therapy. London: Wiley & Sons.
Chetney, R. (2002). Interactive home telehealth: moving
from cost savings to reimbursement. Creative, proactive
Marie Atherton is the Senior Advisor Professional Issues at
Speech Pathology Australia National Office in Melbourne. In her
current role Marie supports the management of ethical complaints
to the Association and provides professional and clinical
knowledge input to a variety of project and policy activities. Lindy
McAllister is a Senior Council Appointed Member of the Ethics
Board of Speech Pathology Australia. She is currently Deputy Head
(Teaching and Learning) of the Mayne Medical School at the
University of Queensland. Lindy has a long history in teaching and
writing about ethics in speech pathology.
Correspondence to:
Marie Atherton
Senior Advisor Professional Issues
Speech Pathology Australia
Level 2, 11–19 Bank Place,
Melbourne VIC 3000
email:
This article was originally published as: Atherton, M., &
McAllister, L. (2009). Emerging trends impacting on ethical
practice in speech pathology. ACQuiring Knowledge in
Speech, Language, and Hearing, 11(1), 31–35.