Speak Out June 2018

Casuistry approach worksheet

What were the outcomes in other cases? When Kasey has researched the evidence for interventions in other cases, her confidence that she can support client choice and autonomy and offer appropriate interventions has increased. She has a wide network of professional colleagues who she is comfortable contacting for peer support, and in the past this has also helped her to identify options to explore. If I haven’t managed a case like this before, are there any similar professional cases or resources I should investigate? Kasey is familiar with resources she can use to explore the evidence, such as SPA evidence alerts, speechBITE, her peer support network, and members of special interest groups. Professional development activities she can access quickly, such as the recorded seminars on the SPA website: • Working with people at the end of life: Do speech pathologists have a greater role to play?; • What do I do now? Augmentative and Alternative Communication is NOT a last resort; • Understanding person-centred and enablement models of care to build opportunity for speech pathology services for older people; • SPA clinical guidelines, including the Dysphagia Clinical Guideline. How similar are the cases? How closely do the features of my current case match previous cases? Are there new or distinguishing features about this case? Kasey has worked with clients with severe dysphagia before but not any with this particular progressive neurological disease. When reflecting on the session, Kasey realises that the main reasons she is feeling uncomfortable and unsure of a plan are that she was not fully aware of the evidence to support interventions to offer, nor able to communicate effectively with Mr Study about his choices. That impacted on discussing: the reasons for his decision to not modify any foods or fluids; provision of information to be confident both Mr and Mrs Study can make informed choices; the alternative options available to him; the reassurance that his autonomy and choices will be respected. She recognises that she needs to investigate appropriate interventions for this progressive neurological disease. This knowledge will help her to decide if she is the right person to continue to work with Mr Study, or if she should quickly refer him to another speech pathologist. What are the reasons for maintaining or changing my response to this dilemma? Kasey identifies that her responsibility is to provide Mr and Mrs Study with accurate and timely information, to enable them to make an informed choice about interventions and strategies that may reduce the risk of aspiration pneumonia. Mr Study requires the introduction of appropriate AAC so that he can participate in the discussion on the options available to him. Kasey investigates the current evidence for interventions for this progressive neurological disease and contacts a colleague who has significant experience with clients living with this disease, for advice and support. She fits this in between other work over the next two days and her confidence that she has the knowledge and skills to appropriately support Mr Study increases. She makes another appointment to visit Mr Study the next day, to continue to provide ongoing speech pathology intervention and support for him.

New Ethics Board

Chair Associate Professor Suze Leitao

Elected Members Dr Alison Holm David Kinnane Tristan Nickless Dr Tanya Serry Community Representatives

The results of the recent election for the Speech Pathology Australia Ethics Board were announced at the National Conference. The Chair of the Ethics Board thanks all members who nominated for the Elected Member positions, for their interest and commitment to promoting proactive ethical practice within the speech pathology profession.

Senior Members Dr Sue Block Trish Bradd Dr Nerina Scarinci Helen Smith

Donna Dancer Grant Meredith Dr Richard Saker

Trish Johnson Senior Advisor, Ethics and Professional Issues

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June 2018 www.speechpathologyaustralia.org.au

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