JCPSLP Vol 18 No 3 2016

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JCPSLP Volume 18, Number 3 2016 145
Ethical conversations
Helen Smith
KEYWORDS
CULTURAL AND
LINGUISTIC
DIVERSITY
MAJORITY-
WORLD
VOLUNTEERING
NARRATIVE
ETHICS
“I can’t believe you want
to leave at lunch time”
A reflection on how narrative ethics may inform ethical
practice in cross-cultural and majority-world contexts
Helen Smith
constantly complaining at their frustration that they couldn’t
fit in all the content they had planned.
Over lunch one day Sarah asked one of the facilitators
why everything was being covered so quickly. While English
was the official language for education and business,
English was a second (or third language) for most of the
attendees. The majority of the participants had a TAFE-level
qualification and were finding it challenging to keep up. The
facilitator responded to Sarah’s question by saying:
You all had to travel on Tuesday. We had expected
you to travel on Monday as it was a public holiday but
none of you could be bothered to do that. And none
of you will stay all day on Friday. You all want to leave
at lunch time. So our carefully planned 4-day course is
being squashed into 2½ days.
Sarah commented she felt like the facilitator was saying
she and her fellow participants didn’t value the educational
opportunity to improve the specialist services they would
provide to their patients. Nothing could have been further
from the truth. On reflection, Sarah wondered how she
could have helped the facilitators change their perception of
the participants. She was concerned about the facilitator’s
misperception that the participants were not motivated
or were lazy. She wondered how this valued and valuable
training could have been less than optimal because of such
a lack of understanding. She did not feel empowered to
continue the conversation as the facilitator rushed off to
prepare for the next session. Sarah certainly did not feel
valued or respected by the facilitator.
The background story
A narrative approach to ethical reasoning considers an
individual’s or cultural group’s life story (Speech Pathology
Australia, 2014). The values and experiences each
participant brings to the story are considered. This allows
both sets of voices in the story to be heard. Each person in
the story arrives at the situation described from their own
perspective. It is only through the consideration of these
multifaceted perspectives that a new and deeper shared
understanding can be reached.
The volunteer presenters had dedicated valuable
vacation time to come to Africa to deliver training. They
had spent many hours preparing the training program prior
to their departure from home. They came with slides and
handouts and workbooks. The timing of the trip had been
made to accommodate the volunteers’ usual summer
holiday period to have the least impact on their own local
In the mid 1990s for 2½ years I was a volunteer speech
pathologist with Australian Volunteers International in
a sub-Saharan African country. This story is based on
my time working in country. This piece will use a narrative
ethics framework (Speech Pathology Australia, 2014)
to consider the story; the current story as I experienced
it, a reflection on the background story from multiple
perspectives and a reimagined future story. Finally,
some considerations for ethical volunteering as speech
pathologists in culturally and linguistically diverse majority-
world contexts will be provided.
The current story
Sarah,1 a hard- working and dedicated rehabilitation
technician2 returned one Monday from a rare funded
professional development opportunity. She was the mother
of two and the adoptive mother of three (her sister’s
children, adopted after her sister’s death from HIV the year
before), and it had taken a huge amount of organisation
and personal commitment for Sarah to attend the course.
(The course was based in a central location requiring 3–4
hours travel and several nights away from home.)
The course was funded and run by a service organisation
from North America which had recruited volunteer
specialists from their own country, provided them with travel
and living expenses but no salary, so they could provide
a week-long specialist training program to local health
workers. The service organisation had also funded the
travel and living expenses for the local health workers to
attend. A rare and generous gift with the goal of improving
the provision of specialist services to people in the country.
Sarah, a keen learner, was always motivated to improve
her knowledge and skills. Therefore, I was surprised on the
Monday morning following the course when my question
asking how her course had been was met with a huge sigh
and a look of despondency. Concerned, I asked Sarah
what had happened.
Sarah started by expressing her delight in the amazing
opportunity to develop her understanding of the specialist
area. She was delighted that what she was required to do
for patients at our hospital made more sense as the course
rolled out.
Sarah, however, then expressed her frustrations. First,
the “whole” course as outlined in the brochure had not
been provided. Second, each day, regardless of the
presenter, the content appeared very rushed, with no time
to consolidate learning or to ask questions. Despite the
speed of delivery, she commented the presenters were