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Outline for Today
• Why study ethics?
• The origins of ethics
• Research on ethical behavior
• Principles of Ethics for TS...
Learner objectives
• Participants will:
▫ Review laws and codes of ethics pertaining to speech
language pathologists
▫ Hig...
Ethics defined
• The code of good conduct for an individual or
a group. (Merriam-Webster’s, 2010)
• A discipline dealing w...
How are ethics codes different from laws?
Rules of Ethics are specific statements of
minimally acceptable professional con...
Do you need Continuing Education or want 
to listen to this course live?
Click here to visit 
the online courses.
Click for Audio‐over‐Powerpoint Presentation
Why study ethics?
“With great power comes great responsibility.”
Responsible practice means adherence to a standard of eth...
International Environment
2002
Finland
Denmark
New Zealand
United States
(20th)
Haiti
Iran
20012000
Finland
Denmark
New Ze...
Economic Incentive for being Ethical
• For honest companies, moving from a low
corruption climate to one where corporate a...
Most Ethical Countries Least Ethical Countries
1. DENMARK
2. NEW ZEALAND
3. SINGAPORE
4. FINLAND
5. SWEDEN
1. SOMALIA
2. M...
Most Ethical Professions Least Ethical Professions
1. NURSES
2. PHARMACISTS
3. TEACHERS (HIGHSCHOOL)
4. DOCTORS
5. POLICEM...
Probing the Field of Law
• “Two-thirds of respondents in a survey of California lawyers said
they “compromise their profes...
Trying to correct the downward trend.
• “At present, several state bars and professional
organizations are scrambling to s...
Can we change behavior?
A study by MIT
So what can we do? How do we
change a profession’s ethical
behavior?
Ethical Studies by MIT
Study 1
50 math 
questions
Study 2
15 math 
questions + 
Book Lists
Study 3
20 math 
questions
+ Et...
All of the documents and charts in this presentation 
can be downloaded from our Free Resource Library.
Click here to visi...
Principles of Ethics
ASHA’s and TSHA’s Codes
Personal Responsibility
Professional Competence
Responsibility to the Public
...
The origins of ethics
Influence of Greek Philosophers TSHA/ASHA Code of Ethics
• Personal Happiness (Aristotle)
• Professi...
Origins of Ethics
• Actions that Allow Social
Interaction
Socrates
• “The truly wise man will know
what is right, do what ...
Origins of Ethics
• Actions that Promote Personal
Happiness
Aristotle
• In Aristotle's view, when a
person acts in accorda...
Origins of Ethics
• Actions that Promote Peace of Mind
Epictetus
• “the greatest good was
contentment and serenity”
• We g...
Origins of Ethics
Epicurus
• Hedonism, responding to one’s
own desire without consideration
for the greater of society
Joe...
Principles of Ethics I
• Personal Responsibility
“Individuals shall honor their responsibility to hold
paramount the welfa...
Principles of Ethics II
• Professional Competence
“Individuals shall honor their responsibility to
achieve and maintain th...
Principles of Ethics III
• Responsibility to the Public
“Individuals shall honor their responsibility to the
public by pro...
Principles of Ethics IV
• Responsibility to the Profession
“Individuals shall honor their responsibilities to
professional...
Our discussion today
• The original intent of Ethics, it was meant as a way of creating
dialogue.
• This dialogue is creat...
Five Ethical Philosophies
• The Categorical Imperative
• Utilitarianism
• The Golden Mean
• The Veil of Ignorance
• The Go...
Ethics through Case Study
Which Principles are violated?
Which Ethic Rule is in Violation?
How you will respond to the sit...
Case Study
To whom it may concern,
I am looking for guidance toward best practice on an inpatient
rehabilitation unit. The...
3
2
Selecting Personnel to Conduct the
Evaluation
• Level 1: trained (in CLD issues) bilingual speech-
language pathologis...
• You do a Child Find evaluation. The mother brings a
copy of a report from a private practice that was done a
few months ...
The Relativity of Ethics
• Ethical standards evolve over time.
• Consider the practices of Lionel Logue in the
King’s spee...
Case Study
• Bilingual SLP goes to daycare to serve student.
Next to her is an English-speaking SLP serving a
Spanish-spea...
Case Study
• A monolingual SLP is pushed to evaluate and
provide therapy for children who don’t speak
English. When he tol...
Case Study
• A graduate student’s supervisor tells her to
implement speech/articulation exercises for
students with only a...
Case Study
• You do an initial school evaluation for a 6-year-old
student, Maria, who is predominantly Spanish speaking.
T...
Case Study
• A parent denies bilingual services. You believe that the
student will benefit from speech services in Spanish...
Case Study
• A teacher reports to you that she has a bilingual student
in her class who she is concerned about. She went t...
• Your supervisor asks you to complete 45-minute sessions
with your students in a 40-minute period, stating that
they are ...
• You are one of the few bilingual SLPs in the Grande ISD
and your caseload reaches 60 students across 6
campuses. You do ...
Case Study
• You do an initial school evaluation for a 4-year-old
student, Jose, whose family uses only Spanish in the
hom...
Case Study
• A parent of one of your students goes to a local
clinic to get additional services. The clinic tells
the pare...
Case Study
• You work in the Po-Dunk ISD. You took 4 semesters of
Spanish in high school and are able to greet people in
S...
• Your supervisor lays out a schedule for you, the bilingual
SLP, that looks like this:
▫ 8-8:30 Billy at Stromville Eleme...
Case Study
• You are a bilingual student completing a clinical
rotation. You observe an evaluation in which an
English-dom...
• Near the end of the school year you run out of CELF-4
protocols but still have many more evaluations to
complete. You te...
Bilingual vs. CLD Caseloads
• Distinction
▫ Bilingual – one with native or near-native
proficiency in two languages
▫ CLD-...
Click to visit www.bilinguistics.com
Even More Ethical Considerations
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Even More Ethical Considerations

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Gain insight into how to successfully navigate the difficult conversations and interactions that our field presents us with.

Have you ever had an ethical question or dilemma arise? Or do you work with clients who speak a language other than English and have concerns about how ethical the services are that they receive? Back by popular demand, our original ethics presentation drew a huge crowd and resulted in many invigorating, compassionate discussions. Following that event we were contacted by even more speech pathologists with ethical dilemmas and share their case studies with you here in this course.

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Transcript of "Even More Ethical Considerations "

  1. 1. Outline for Today • Why study ethics? • The origins of ethics • Research on ethical behavior • Principles of Ethics for TSHA and ASHA • Case studies
  2. 2. Learner objectives • Participants will: ▫ Review laws and codes of ethics pertaining to speech language pathologists ▫ Highlight legal issues in serving a bilingual population ▫ Consider case studies of ethical issues related to working with culturally and linguistically diverse populations. ▫ Identify sections of the Codes of Ethics that assist in decision-making for case studies.
  3. 3. Ethics defined • The code of good conduct for an individual or a group. (Merriam-Webster’s, 2010) • A discipline dealing with right conduct and morality. (Webster’s, 2001) • “moral principles or values that address whether actions, intentions, and goals are right or wrong” (Herer, 1989) • The main ethical category for ancient Greeks was arete or virtue • List of Rules
  4. 4. How are ethics codes different from laws? Rules of Ethics are specific statements of minimally acceptable professional conduct or of prohibitions and are applicable to all individuals. Laws are legal documents setting forth rules governing a particular kind of activity. Rules of Ethics Law
  5. 5. Do you need Continuing Education or want  to listen to this course live? Click here to visit  the online courses.
  6. 6. Click for Audio‐over‐Powerpoint Presentation
  7. 7. Why study ethics? “With great power comes great responsibility.” Responsible practice means adherence to a standard of ethics. It makes us better people? Because we have to? State Board of Examiners Requirement Why have the requirements changed? What happened?
  8. 8. International Environment 2002 Finland Denmark New Zealand United States (20th) Haiti Iran 20012000 Finland Denmark New Zealand United States (14th) Haiti Iran 20112003-2010 United States (22th)
  9. 9. Economic Incentive for being Ethical • For honest companies, moving from a low corruption climate to one where corporate and government misdeeds are more prevalent can represent as much as a 20% additional tax on top of the normal costs of doing business. • For our field, this equates to: • Retention of staff • Reduction in errors
  10. 10. Most Ethical Countries Least Ethical Countries 1. DENMARK 2. NEW ZEALAND 3. SINGAPORE 4. FINLAND 5. SWEDEN 1. SOMALIA 2. MYANMAR 3. AFGHANISTAN 4. IRAQ 5. UZBEKISTAN Countries
  11. 11. Most Ethical Professions Least Ethical Professions 1. NURSES 2. PHARMACISTS 3. TEACHERS (HIGHSCHOOL) 4. DOCTORS 5. POLICEMEN 1. LOBBYISTS 2. TELEMARKETER 3. CAR SALESMEN 4. CONGRESSMEN 5. STOCK BROKER Professions
  12. 12. Probing the Field of Law • “Two-thirds of respondents in a survey of California lawyers said they “compromise their professionalism as a result of economic pressure.” • Lawyers in Maryland reported their profession had degenerated so badly that “they were often irritable, short-tempered, argumentative, and verbally abusive.” • Lawyers in Virginia were asked whether the increasing problems in professionalism were attributable to “a few bad apples” or a widespread trend. They overwhelmingly said, “a widespread trend.” • Lawyers in Florida reported that a “substantial minority [were] money grabbing, too clever, tricky, sneaky, and not trustworthy.”
  13. 13. Trying to correct the downward trend. • “At present, several state bars and professional organizations are scrambling to shore up their professional ethics. Some are increasing courses in college and graduate schools, and others are requiring brush-up ethics classes.”
  14. 14. Can we change behavior? A study by MIT So what can we do? How do we change a profession’s ethical behavior?
  15. 15. Ethical Studies by MIT Study 1 50 math  questions Study 2 15 math  questions +  Book Lists Study 3 20 math  questions + Ethics Code Group 1 Control  32.1/50 Group 2 Test Group 3 Test 36.2/50 36.2/50 3.1/15 4.1/15 3.0/15 3.0/20 5.5/20 3.o/20
  16. 16. All of the documents and charts in this presentation  can be downloaded from our Free Resource Library. Click here to visit the Resource Library
  17. 17. Principles of Ethics ASHA’s and TSHA’s Codes Personal Responsibility Professional Competence Responsibility to the Public Responsibility to the Profession
  18. 18. The origins of ethics Influence of Greek Philosophers TSHA/ASHA Code of Ethics • Personal Happiness (Aristotle) • Professional Influence (Epicurus) • Social Interaction (Socrates) • Promoting Peace of Mind (Epectetus) • Personal Responsibility • Professional Competence • Responsibility to the Public • Responsibility to the Profession
  19. 19. Origins of Ethics • Actions that Allow Social Interaction Socrates • “The truly wise man will know what is right, do what is good, and therefore be happy.” • Ethics is a conversation that enables people to interact communally within a society
  20. 20. Origins of Ethics • Actions that Promote Personal Happiness Aristotle • In Aristotle's view, when a person acts in accordance with his nature and realizes his full potential, he will do good and be content.
  21. 21. Origins of Ethics • Actions that Promote Peace of Mind Epictetus • “the greatest good was contentment and serenity” • We get to go to work each day knowing we will be respected and valued
  22. 22. Origins of Ethics Epicurus • Hedonism, responding to one’s own desire without consideration for the greater of society Joe Wilson Serena Williams Shoe guy • Guidance of actions that do not reflect poorly on society (a professional’s field)
  23. 23. Principles of Ethics I • Personal Responsibility “Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or participants in research and scholarly activities and shall treat animals involved in research in a humane manner.”
  24. 24. Principles of Ethics II • Professional Competence “Individuals shall honor their responsibility to achieve and maintain the highest level of professional competence.”
  25. 25. Principles of Ethics III • Responsibility to the Public “Individuals shall honor their responsibility to the public by promoting public understanding of the professions, by supporting the development of services designed to fulfill the unmet needs to the public.”
  26. 26. Principles of Ethics IV • Responsibility to the Profession “Individuals shall honor their responsibilities to professionals and colleagues, and students. Individuals shall uphold and accept the professions’ self-imposed standards.”
  27. 27. Our discussion today • The original intent of Ethics, it was meant as a way of creating dialogue. • This dialogue is created by: 1) naming or bringing to attention a goal or value 2) putting it to the test with rigorous discussion about real life circumstances.
  28. 28. Five Ethical Philosophies • The Categorical Imperative • Utilitarianism • The Golden Mean • The Veil of Ignorance • The Golden Rule
  29. 29. Ethics through Case Study Which Principles are violated? Which Ethic Rule is in Violation? How you will respond to the situation?
  30. 30. Case Study To whom it may concern, I am looking for guidance toward best practice on an inpatient rehabilitation unit. The details about the case are as follows: The SLP only speaks English and does not understand Spanish. There is a Spanish speaking patient who suffered a CHI while at work. This individual spoke several languages prior to the accident and as of this time, only his primary language of Spanish has returned. The company will provide a translator during OT, PT, and ST treatments. The SLP does not feel competent to treat this individual due to the language barrier. She stated it is “unethical” for her to provide ST services because she cannot verify the validity of the translation. I am looking for guidance on how to provide the best skilled ST services for this individual. The other resources available at our hospital include certified translators as well as a “blue phone” translator service. (I have searched the ASHA website and have contacted the only bilingual SLP in our area and she is not available for hospital coverage.)
  31. 31. 3 2 Selecting Personnel to Conduct the Evaluation • Level 1: trained (in CLD issues) bilingual speech- language pathologist fluent in the native language • Level 2: trained (in CLD issues) monolingual speech- language pathologist assisted by trained bilingual ancillary examiner. • Level 3: trained (in CLD issues) monolingual speech- language pathologist assisted by trained interpreter Source: ASHA
  32. 32. • You do a Child Find evaluation. The mother brings a copy of a report from a private practice that was done a few months earlier. The SLP used the PLS-3-English with an interpreter and reported the norms from the English version. The results indicated a severe expressive and receptive language delay.
  33. 33. The Relativity of Ethics • Ethical standards evolve over time. • Consider the practices of Lionel Logue in the King’s speech
  34. 34. Case Study • Bilingual SLP goes to daycare to serve student. Next to her is an English-speaking SLP serving a Spanish-speaking child and intervening on the unvoiced “th” sound that does not exist in Spanish.
  35. 35. Case Study • A monolingual SLP is pushed to evaluate and provide therapy for children who don’t speak English. When he told his employer that this was an ethically uncomfortable situation, the response was, “Any service is better than no service. What is unethical is not serving the clients.”
  36. 36. Case Study • A graduate student’s supervisor tells her to implement speech/articulation exercises for students with only a diagnosis of language impairment.
  37. 37. Case Study • You do an initial school evaluation for a 6-year-old student, Maria, who is predominantly Spanish speaking. There is an evaluation report in her folder from a private practice two months prior. The only information provided is a list of the items the child got correct and those that the child missed on a standardized test. Receptive and expressive language skills are reported as severely disordered. • Your evaluation indicates typical receptive language skills and moderately delayed expressive language skills.
  38. 38. Case Study • A parent denies bilingual services. You believe that the student will benefit from speech services in Spanish and that if services are done in English you will be teaching English rather than addressing underlying language deficits. Your supervisor tells you that you need to do services in English.
  39. 39. Case Study • A teacher reports to you that she has a bilingual student in her class who she is concerned about. She went to her principal to find out how to refer her for speech- language testing and the principal told her they already had too many Hispanic students in special education so she should not make the referral.
  40. 40. • Your supervisor asks you to complete 45-minute sessions with your students in a 40-minute period, stating that they are students receiving Medicaid and the Medicaid regulations state that if you complete at least 7 minutes of your last 15-minute unit, you can report it as a complete 15-minute unit.
  41. 41. • You are one of the few bilingual SLPs in the Grande ISD and your caseload reaches 60 students across 6 campuses. You do not feel you are able to provide effective services to that many children. • What do you do?
  42. 42. Case Study • You do an initial school evaluation for a 4-year-old student, Jose, whose family uses only Spanish in the home. He has very limited English exposure. He was diagnosed 9 months prior with severe expressive and receptive language disorder at a private practice. They provided speech therapy in English for 6 months until the mother decided she was wasting her money because services were in English. The mother asks you your opinion.
  43. 43. Case Study • A parent of one of your students goes to a local clinic to get additional services. The clinic tells the parent that they will put the family on their waiting list of 150 people and that they can expect to wait 8-10 months before they will receive services. When the family asks the clinic where else they might go, the clinic provides no suggestions.
  44. 44. Case Study • You work in the Po-Dunk ISD. You took 4 semesters of Spanish in high school and are able to greet people in Spanish and understand some frequent vocabulary. Your boss asks you to evaluate a child whose predominant language is Spanish.
  45. 45. • Your supervisor lays out a schedule for you, the bilingual SLP, that looks like this: ▫ 8-8:30 Billy at Stromville Elementary ▫ 8:30-8:45 travel 12 miles to to Batesville Elementary ▫ 8:45-9:45 therapy with a group of 4 students ▫ 9:45-10:00 travel 15 miles to Brook Elementary ▫ 10:00-11:00 Group of 5 students ▫ 11:00-12:00 Group of 5 students ▫ 12:00-1:00 Lunch and travel 45 miles to Cramville ▫ 1:00-3:00 Two groups of 4 students each.
  46. 46. Case Study • You are a bilingual student completing a clinical rotation. You observe an evaluation in which an English-dominant SLP administers a receptive vocabulary task in Spanish. She mispronounces the words. You know what she is saying but the student does not appear to understand so you say the word correctly and the student get the item correct. The supervising SLP asks you not to interrupt her testing session again. She diagnoses the student with a moderate receptive language impairment.
  47. 47. • Near the end of the school year you run out of CELF-4 protocols but still have many more evaluations to complete. You tell your supervisor you need more protocols and she informs you that there is no budget for that and you will have to make photocopies of the protocols for the rest of the school year. Case Study
  48. 48. Bilingual vs. CLD Caseloads • Distinction ▫ Bilingual – one with native or near-native proficiency in two languages ▫ CLD-Competent – one with knowledge of cultural and linguistic differences, including language influences in bilingual development • No one can be bilingual enough ▫ Proficiency ▫ Languages • In Texas, multicultural caseloads are the norm.
  49. 49. Click to visit www.bilinguistics.com
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