2023 Student Ethics Essay Award Second-Place Co-Winner #2

Full Disclosure: The Importance of Transparency

by Madison Paxton, University of Georgia

The American Speech-Language-Hearing Association (ASHA) has a Code of Ethics (2016) that drives the practice of audiology and speech-language pathology. It is a written framework that acts as a guide to ensure that moral and justifiable decisions are made by clinicians. Continuous education, truthful self-representation, and displaying values of“accountability, fairness, and responsibility” (ASHA, 2016, p.2) are concepts to work towards when achieving the highest standard of professional integrity (ASHA, 2016). While the code contains common standards that will direct my “day-to-day decision-making” (ASHA, 2016, p.2), it is a living and progressing document. As changes occur, I must re-frame my practice in away that coincides, meaning that I must adapt as the Code of Ethics (2016) does. Following a living document allows me to not become complacent and to stay up to date on its most current form. When I realize that a change is integral, I act on it, and I must do the same when following this framework. Because our practice “affects the health, well-being, and quality of life of individuals served (Kummer & Turner, 2011), this living document exists to remind me of the commitment to my scope of practice.

The ASHA Code of Ethics (2016) needs to be my first point of reference as both a student and a practicing clinician. When faced with a “what-if” question, I should look to the code in determining my next step. This framework should guide my professional choices and can be enforced in daily practice when looked upon as a reflection of the values my “scientific and clinical practice” should be based on (ASHA, 2016, p.2). My ability to display traits of responsibility and accountability are those that help reinforce the integrity of our field. When working to embody these values, it becomes easier to carry them over into my scope of practice. Displaying moral values related to self-respect and truthfulness will help me become a more well-rounded and proficient clinician. However, this concept furthers the importance of knowing that holding the Certificate of Clinical Competence does not imply mastery in all the multifaceted areas of the field. While continuing education and a versatile mentality can help provide additional clinical insight, these concepts do not guarantee my “professional competence and expertise” (ASHA, 2016, p.2). Nevertheless, these are still vital skills to exemplify when applying Principle II, Rule A of the ASHA Code of Ethics (2016) into practice.

Sarah Hines had just begun a new job at a local hospital. She graduated top of her class, and her overly confident mentality gave her little concern about going into the workforce. Because her first few years of employment were in a school, she spent much of her time focusing on speech and language. While she had the most knowledge about articulation, she felt that she had virtually all the knowledge she needed to be a competent clinician. A few days into her new hospital job, a fellow SLP asked her if she had ever helped administer a Modified Barium Swallow. This had always been one of her areas of interest but when in graduate school, she had never been hands-on in performing one. She thought back on her 4.0 GPA and believed if she could administer it successfully, then she might be able to impress her colleagues. When asked, she answered “yes” with no hesitation. When beginning the MBSS, instead of speaking with the physician first, she started by feeding the patient too thick of a liquid and they began to choke. At that moment, Sarah realized that not only did she violate Principle II, Rule A of the ASHA Code of Ethics (2016), but she put her patient’s well-being at risk. When asked, she could have been honest about her experience and used the opportunity as a chance to express interest in continuing education. Instead, she fabricated a lie and violated the ASHA Code of Ethics (2016).

Rather than displaying the trait of honesty, Sarah chose to be deceptive. In achieving Principle II, Rule A, it is my responsibility as a clinician to exemplify upstanding character. The ASHA Code of Ethics (2016) states that “individuals who hold the Certificate of Clinical Competence shall engage in only those aspects of the professions that are within the scope of their professional practice” (ASHA, 2016, p.8). While earning a degree is a fundamental first step, it is my obligation to hold myself to a high standard while being both honest and transparent. No one is expected to know everything, and it is more of a flaw to lie than to admit what I do not know. In a clinical setting, it is important to truthfully profess what degree, certification, training, and overall experiences I have, and in doing so, I can ensure that there is little room for question. In Sarah’s case, honesty could have saved her from violating Principle II. If she had been initially transparent when expressing both her strengths and weaknesses, she could have avoided the violation and exemplified her professionalism in being forthright. This could have been her chance to express interest in continuing education. Instead, she disregarded these opportunities by not establishing clear boundaries about the services she was qualified to administer. She did not have the up-to-date knowledge or additional training needed for the MBSS to be within her scope of professional practice. Being frank and honoring my responsibility to follow Principle II, Rule A of the ASHA Code of Ethics (2016) can help me become a more intentional and value-driven clinician.

Transparency: Being direct and speaking honorably can allow my application of Principle II, Rule A into practice. Overall, by truthfully expressing my areas of competence versus struggle and displaying honorable traits, I am best working to apply the living Code of Ethics (2016) into practice. If I am explicit straight from the beginning, there is less room for questions regarding my professionalism and more room for continual learning opportunities. Staying true to myself and my experiences instead of trying to deceitfully impress can help minimize ethical violations. While embodying these traits can better me as a professional, they are also those that moral people should strive to accomplish. Not only is this crucial in mitigating ethical violations, but it can help protect the profession’s overall integrity.

Citations

American Speech-Language-Hearing Association. (2016). Code of ethics [Ethics]. Available from https://www.asha.org/policy/. 

Kummer, A., & Turner, J. (2011a). Ethics in the Practice of Speech-Language Pathology in Health Care Settings. Seminars in Speech and Language, 32(04), 330–337. https://doi.org/10.1055/s-0031-1292758