Ask many ASHA members about the work of our Board of Ethics (BOE) —and its value to them and their own work—and their response might be "I really don't know" or "I truly haven't thought about the BOE in relation to me." In the hope of demystifying this important group and, by so doing, allowing you to take full advantage of what it offers, you're invited to read on.
You'll discover that the BOE has three charges: to formulate and propose amendments to the Code of Ethics, to develop education programs and materials on ethics, and to adjudicate cases of alleged violation of the Code of Ethics. You'll read about the newly revised Code of Ethics, as well as the BOE's exploration into strengthening th e code's application to research. Ethics education activities and a plan for future activities are covered, and education resources are identified. The adjudication function of the BOE is ongoing, and you'll learn about the importance of conflict resolutio n.
A future series of articles in The ASHA Leader will cover how to prepare and how to respond to a complaint, multicultural issues in ethics, confidentiality, and research issues.
The Board of Ethics
The BOE has 12 members, including one public member. It is a board of peers and is representative of researchers, audiologists, speech-language pathologists, clinicians, administrators, teachers, and scientists. Currently serving are Allan Diefendorf, Mary Bolton-Koppenhaver, Melanie Frazek, Judson P. Garrett (public member), Harvey Gilbert, Nancy P. Huffman (chair), Kevin P. Kearns, Deborah A. King, Charissa R. Lansing, James McCartney, William Mustain, and Polly Pooser. Ann H.B. Brockenborough and Roy Shinn rotated off the Board in December 2001. ASHA's director of ethics, David R. Denton, serves as the ex officio to the board and is the ASHA National Office point-person in the administration of the ethics program. Linda D'Aloisio, director of administration and communications for ASHA's academic, accreditation, certification, and ethical issues unit, is the manager of information pertaining to ethics activities.
Code of Ethics Is Revised
In November 2001, the Legislative Council (LC) approved revisions to the Code of Ethics. Rules of Ethics have been added and/or modified pertaining to the representation of credentials of assistants, delegation of tasks to assistants, provision of clinical services by correspondence and telecommunication, referrals based on personal financial interest, sexual harassment, sexual activities with persons over whom one exercises professional authority, and plagiarism. The revised Code of Ethics can be downloaded from ASHA's Web site and is also available by calling the Action Center at 800-498-2071 or requesting it via Fax-on-Demand at 877-541-5035.
Most ASHA certificate holders, members, clinical fellows, and applicants for ASHA membership or certification (all of whom must abide by the ASHA Code of Ethics) are unaware of the lengthy process a code revision entails. It is and should be a careful, considered process. After all, it is a profession's code of ethics that forms standards of professional conduct, demonstrates a profession's and a professional's willingness to police themselves and enforce standards of conduct, gives guidance and support to the professional, informs consumers and professionals about the kind of cooperation they have a right to expect, and serves as a guide to ethics committees (see History of Health-Care Ethics. . Seminars in Hearing, 21, 3–20).
The ASHA BOE can only propose revisions to the LC. The board studies the code in light of professional practices and trends in violations to determine if changes are warranted. It deliberates ideas for changes; drafts revisions; and conducts select and widespread peer review by ASHA members, ASHA committees and boards, directors of academic programs, allied and related professional organizations, state associations, and state licensure boards. The BOE analyzes feedback, makes further revisions based on comments received, and then prepares the resolution with the final proposed revisions to go to the LC for deliberation. This last step is, in a sense, the final peer review because Legislative Councilors seek and receive input from their constituents and hear opinions expressed in the membership forum before they vote.
The contributions of the current BOE members, and those members from 1999 and 2000—Charles Anderson, Lynne C. Brady Wagner, Dean Garstecki, Sandy Friel-Patti, Leonard LaPointe, Jean Lovrinic, and Elaine Sands—who developed earlier drafts of the revisions, were invaluable in bringing the code revisions to fruition.
Research and Ethics
The BOE has embarked on another code revision study addressing research-related issues. The present code contains five specific references to ethics in research. One concerns the protection of rights and the welfare of human subjects. There are two references relating to the ethics of public statement about research results. Two other references pertain to publications and presentations and the assigning of credit to contributors and referencing sources when using other people's ideas.
To date, the BOE has received communications from the former and current ASHA vice presidents for research and technology; heard a presentation from Herbert Baum, ASHA's former chief of staff for science and research; had some of its members attend the May 2001 ASHA-sponsored conference, "Promoting Research Integrity in Communication Sciences and Disorders and Related Disciplines"; and has a subcommittee chaired by Charissa Lansing reviewing identified research ethics issues and drafting code revisions that will more potently address ethics in research. It is anticipated that these proposed revisions will be sent out this year for select and widespread peer review and member input.
Ethics Education—A Critical Role
The BOE is charged with developing educational programs and materials on ethics for distribution to members and certificate holders, to academic programs, and to other agencies and associations. To that end, the board is engaging in strategic planning to explore and create new initiatives. The Ethics Education Subcommittee spearheaded this process by conducting an extensive review of our current education activities and making recommendations for changes. Some changes are already underway, some you will see in the near future, and some, especially those requiring significant financial resources, will be longer in coming to fruition. The board is already working as a resource to the Council for Clinical Certification (CFCC) and the Council on Academic Accreditation (CAA) in Audiology and Speech-Language Pathology on the implementation of the new Standard III-F, which requires applicants for the CCC in speech-language pathology to demonstrate knowledge of standards of ethical conduct.
Also, in conjunction with the CFCC as it works on the implementation of registration of speech-language pathology assistants (SLPAs), a subcommittee of the board is exploring means of guiding ethical behavior of SLPAs. Supervisors have ultimate responsibility for the ethical conduct of ASHA-registered SLPAs. Another subcommittee of the BOE is working with the CAA to identify indicators of ethics education in curricula that will be used by academic accreditation site visitors.
The Ethics Roundtable, which appears on ASHA's Web site, is a discussion forum for current issues in ethics. It is an excellent teaching tool, as well as a resource for clinicians who may be faced with an ethical dilemma. The roundtable encourages debate and commentary and serves to point out that there may be more than one answer to an ethical problem.
ASHA's Issues in Ethics Statements are statements of instruction and guidance that are prepared by the BOE. They analyze a specific issue of ethical conduct, discuss how the board addresses the issue, and offer guidance for members and certificate holders in ethical decision making. Issues in Ethics Statements are published in the ASHA Desk Reference as well as on ASHA's Web site. There are 15 Issues in Ethics Statements. (Nine have been recently revised; the others are currently under revision.) Examples of issues covered are conflicts of interest, reimbursement for clinical services, ethics in research, and jurisdiction of the ASHA BOE. Finally, there is a new statement that focuses on confidentiality of client/student/patient information and relationships with colleagues.
Future education activities the BOE is planning include:
- making greater use of the ASHA Web site by creating links to other ethics sites
- expanding the current annotated bibliography
- using the Web site to survey members' and certificate holders' needs in ethics education
- revising and updating the Ethics Kit that is used as an instructional resource in academic preparation programs as well as other venues
- offering more continuing education activities of varying formats
- exploring expansion of the PRAXIS to include an ethics section
- exploring adding documentation of continuing education in ethics as a requirement for maintenance of certification
The BOE processes and adjudicates alleged violations of the Code of Ethics. As part of its education function, the board has emphasized in its Convention presentations and roundtables the importance of using conflict resolution and problem-solving strategies, including proactive advocacy, as first steps to solving ethical issues. Fortunately, for professions of our size, the number of complaints adjudicated is relatively few. If a situation is such that a complaint must be prepared, an understanding of the process and the procedures followed by the BOE is necessary. A future ethics column will deal with how to prepare a complaint and how to prepare a response to a complaint.
The Ethics Column
A new ethics column will appear in The ASHA Leader five times per year and will be a resource for information sharing on ethics issues. The BOE welcomes ideas for topics of interest. If you have suggestions, please forward them to David R. Denton at firstname.lastname@example.org .