Issues in Ethics: Public Announcements and Public Statements

• About This Document
• Issues in Ethics Statements: Definition
• General Principle
• General Guidelines
• Definitions

About This Document

Published 2018. This Issues in Ethics statement is a revision of Public Announcements and Public Statements (originally published in 2008, and revised in 2010 and 2015). It has been updated to make any references to the Code of Ethics consistent with the Code of Ethics (2016). The Board of Ethics reviews Issues in Ethics statements periodically to ensure that they meet the needs of the professions and are consistent with ASHA policies.

Issues in Ethics Statements: Definition

From time to time, the Board of Ethics (hereinafter, the "Board") determines that members and certificate holders can benefit from additional analysis and instruction concerning a specific issue of ethical conduct. Issues in Ethics statements are intended to heighten sensitivity and increase awareness. They are illustrative of the Code of Ethics (2016) and are intended to promote thoughtful consideration of ethical issues. They may assist members and certificate holders in engaging in self-guided ethical decision making. These statements do not absolutely prohibit or require specified activity. The facts and circumstances surrounding a matter of concern will determine whether the activity is ethical.

General Principle

In the Code, Principle of Ethics III concerns the responsibility that professionals have to the public. It states that "individuals shall honor their responsibility to the public when advocating for the unmet communication and swallowing needs of the public and shall provide accurate information involving any aspect of the professions." Under this Principle, Rule E specifies that "Individuals' statements to the public shall provide accurate and complete information about the nature and management of communication disorders, about the professions, about professional services, about products for sale, and about research and scholarly activities."

Principle III, Rule F specifically addresses ethical concerns relating to advertising: "Individuals' statements to the public shall adhere to prevailing professional norms and shall not contain misrepresentations when advertising, announcing, and promoting their professional services and products and when reporting research results." Public communications, statements or announcements of services, products, or publications attributable to individuals should therefore serve to provide accurate and adequate information to aid the public in making informed choices in matters concerning the professions and the services rendered by their practitioners. This general principle and these specific rules must be observed as an affirmative ethical obligation of all individuals, whether they act independently or represent an institution, agency, or organization.

The Board has adjudicated ethics complaints against members who erroneously believed that they were allowed to use their practice setting or telepractice as a vehicle to communicate information about their professional services, which would otherwise not be ethically permitted. In those matters, the Board found members in violation of Principle III Rules in addition to Principle IV, Rule D, which states, "Individuals shall not engage in any form of conduct that adversely reflects on the professions or on the individual's fitness to service persons professionally."

General Guidelines

Announcement of Services in Print or Electronically

Generally, individuals may use as a guide the type of announcement customarily used by other professionals in their local communities. Professional announcements normally include the following: 

• Identification, using appropriate titles. "Speech-language pathologist" and "audiologist" are the official titles of professionals in the field of communication disorders.
• Fees, listing fixed prices or a stated range of prices for specified professional services. When additional charges may be incurred for an integral part of the overall service, these additional fees should be stated.
• Qualifications, including certification, licensure, education, experience, and biographical data.
• Services, including specialties or restrictions.
• Location, hours, and contact information such as telephone number, e-mail address, or URL for websites.
• Staff or associates' names and qualifications.

In making information available to the public in print or electronically, to include social media and blogs, individuals are responsible for fairly and accurately representing their services and the professions; the public must be adequately informed and not misled about the practitioner's areas of competence or the services they provide. It is thus appropriate to list items such as certification, licensure, honorary awards, and accreditation of a graduate academic program by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA), but not to describe any particular expertise that supposedly results from any of those matters.

Additionally, individuals should

• describe services, credentials, qualifications, clinical specialty certification, facilities, staff, and products dispensed in a factual, nonevaluative manner; and
• use appropriate and accurate terminology.

Individuals should not

• misrepresent the nature or extent of services provided or products dispensed;
• guarantee the results of any treatment or procedure, directly or by implication (Principle I, Rule L);
• list fees in a misleading manner—for example, one level of service (diagnostic) may not be offered at a specified fee when, in fact, a lower level of service (screening) is provided;
• state or imply claims of unusual professional skills;
• compare their abilities with those of other individuals; or
• place "blind" listings (e.g., announcements that say, "Call this number for speech therapy services," omitting the name of the individual, agency, or corporate entity offering services) in the classified section of newspapers or other periodicals.

The question of whether it is ethical to use laudatory comments or testimonials from clients is a contested one. Consistent with prevailing HIPAA and other regulations protecting client confidentiality, the comments of a client should never be used without the client's explicit permission. There is no question that it is thoroughly unethical to coerce clients into offering laudatory comments, and in the practitioner–client relationship, forms of coercion can be subtle. Consequently, special care must be taken to ensure that clients understand their rights with respect to providing information concerning their treatment and their evaluation of that treatment.

Another ethical problem that arises in the use of laudatory comments is that the practitioner culls them from a mass of comments, many of which may be neutral and some of which may be quite negative. For that reason, the Board cautions professionals regarding the use of laudatory comments, as they are potentially misleading to the public. The Board recommends an approach that involves collecting evaluations from a representative sample of all clients and providing a statistical picture from the aggregated evaluations.

Promotional Activities

• In representing their services or professional products to the general public, individuals accept the obligation to present information as objectively and accurately as possible and to avoid misleading the public by misrepresentation through implication or deception. Individuals offering free speech or hearing screening should give those who need further services a choice of referral sources.
• Individuals should avoid participation in any activities recommending to the general public the use of any single-source product or service.
• Individuals shall not use their affiliation with ASHA or the ASHA logo to endorse the marketing and promotion of their products or their employer's products, whether related or unrelated to the professions. ASHA members may use the approved ASHA logo to promote their ASHA certification credential.

Other Constraints on Advertising

The rules set out in this statement are offered only as general guidelines for application of the Code of Ethics with regard to public statements and announcements. In addition, individuals may be subject to various state laws such as licensure laws and codes of ethics or conduct. Individuals may be subject also to the regulations of the Federal Trade Commission governing the use of endorsements and testimonials in advertising. Individuals must be aware, therefore, that there are other restraints in the area of professional advertising, which, indeed, may be greater than those set forth in this statement. If ASHA guidelines should prove less restrictive in any respect, individuals must adhere to any higher standards that might be applicable. This statement does not purport to give legal advice in this regard.

Definitions

Individuals: Members and/or certificate holders, including applicants for certification.

Misrepresentation: Any statement by words or other conduct that, under the circumstances, amounts to an assertion that is false or erroneous (i.e., not in accordance with the facts); any statement made with conscious ignorance or a reckless disregard for the truth.

Public statement: Any direct or indirect statement, suggestion, or implication, including but not limited to one that is made orally, in writing, pictorially, electronically, or by any other audio or visual means, or by any combination thereof.

Announcement of services: Any written or oral communication, illustration, sign, notice, or depiction, in print or in an electronic medium, that is designed to inform the public about professional services or products related to the field.