2013 Student Ethics Essay Award — 3rd Place
Ethical Dilemmas in the Workplace: Can We Determine What is Most Ethical?
by Margaret Searcy
Western Carolina University
Chapter Advisors: Traci Rice and Kristopher Cleary
A public school-based clinician begins the year with a daunting caseload. As she begins to prepare for upcoming evaluations she learns that a new student at the school who has failed his language screening comes from a Spanish-speaking household and that English is not his primary language. The clinician, although she knows a smattering of Spanish from classes in high school and college, knows that she is not culturally competent to adequately assess this student in a way that is non-discriminatory. With this in mind, she approaches her supervisor, in the hopes that perhaps another professional who is proficient in Spanish language and culture is available to perform the assessment for this child. Her supervisor reminds her that the district is small and resources are limited, so there is not anyone available for this purpose. The supervisor reassures her, "You took Spanish classes in high school and college. You'll be fine," and also reminds her that the time and resources it would take to organize an alternative assessment would be very problematic and urges the clinician to press on with a standardized assessment as usual. The clinician is faced with a dilemma: Disregard her supervisor's advice and find an individual who can competently complete the assessment or press on and assess anyway as her supervisor recommended? She faces other concerns for the student as well, will the time it takes to organize the culturally appropriate assessment deny the student valuable intervention time, causing him to fall further behind his peers? Or, will assessing the student with her own limited Spanish skills indicate a need for unnecessary intervention?
Recent data indicates that the number of children who speak a language other than English at home rose 155% between 1980 and 2009, and approximately 24% of those children speak English with difficulty (U.S. Department of Education, 2012). With a limited number of certified professionals available, only 2% of ASHA professionals as of 2003, to serve this population many practitioners will face ethical issues similar to the one described above (ASHA Leader, 2003).
How is the ethically responsible clinician to address this matter? The simplest way might be to say, "No, this clinician should not assess the student. The Code of Ethics clearly states that individuals must not discriminate in the delivery of services based on national origin, and must not provide services outside of one's scope of competence" (ASHA, Principle of Ethics I; Principle of Ethics II). However, ethical issues are rarely so simply answered. Is refusing assessment to the student, however incompetent the clinician may feel, discriminatory? Is refusing assessment of this student holding his welfare paramount (ASHA, Principle of Ethics I)? Should this clinician treat the student if she is not competent to do so? Regardless of these questions, as an agent of a public school receiving public funding she is obligated to provide services (ASHA Leader, 2003). In addition, this clinician is legally obligated to administer assessments in the client's most proficient language using materials in that language (Chabon, Brown, Gildersleeve-Neumann, 2010). Given this information, another question arises: Can the clinician be legal and ethical simultaneously in this situation?
In an ideal world, this clinician would have a culturally competent, certified professional available for referral, but just as ethical issues are rarely resolved simply, rarely are professionals in ideal situations. In a far from ideal situation, this clinician might simply throw her hands up in frustration and assess this student as she would any other. However, a review of literature offers some alternative models for assessment of individuals who speak English as a second language, such as dynamic approaches and curriculum-based approaches, among others, including collaborating with an interpreter. While these options may still not be ideal, they offer better alternatives than purely standardized assessment in English only. Ethically, clinicians are obligated to engage in lifelong learning to maintain professional competence and performance (ASHA, Principle of Ethics II). This principle compels clinicians to reach out to the available evidence base in order to make the best clinical decisions. In this case, reviewing the literature gives the clinician a better solution than standardized testing only.
In this light, the Code of Ethics can be viewed not as a list of things we cannot do, but as a guide to what else we can do. This clinician could have stopped short at "do not discriminate" and "do not provide services outside the scope of practice," but upon further examination of the Code of Ethics she can find a better solution. The Code of Ethics should not be viewed as a list of restrictions, but rather as a guide for we can do for our clients. When viewed this way, more possibilities may become apparent and we can ensure that we have truly held the welfare of the individuals we serve paramount.
American Speech-Language-Hearing Association. (2010). Cultural competence [Issues in Ethics]. Available from www.asha.org/policy.
American Speech-Language-Hearing Association. (2010). Code of ethics [Ethics]. Available from www.asha.org/policy.
Assessing speakers with limited English proficiency. (2003, February 4). ASHA Leader. Retrieved from http://www.asha.org/Publications/leader/2003/030204/030204e/.
Chabon, S. , Brown , J. E. & Gildersleeve-Neumann, C. (2010, August 3). Ethics, equity, and english-language learners: A decision-making framework. ASHA Leader.
U.S. Department of Education, National Center for Education Statistics. (2012). The Condition of Education 2011 (NCES 2011-045), Indicator 6.