The founding, in 1925, of the "organization of speech correctionists," which ultimately became the American Speech-Language-Hearing Association, was based in part on the need "to establish scientific standards and a code of ethics" (Paden, 1970). This early conceptualization and reference to ethics and its inclusion in our Association's original bylaws demonstrates its pivotal place in our history. It also acknowledges our awareness of the need to provide professional standards.
By 1952, with increased public recognition of the importance of the Code of Ethics, the Code became formalized as a separate document. It has continued to be modified and strengthened with the most recent revision adopted in 2003. The present Code is an affirmation of our professional obligations and privileges, as well as a reflection of the evolution and expansion of the professions of speech-language pathology and audiology. Each revision reflects the experiences and concerns of the membership. For example, the most recent Code incorporates issues related to the appropriate use of support personnel and the delegation of responsibilities, telemedicine, the referral process, sexual harassment, plagiarism, and the role of ethics in research and scholarship.
The ASHA Code of Ethics is a framework within which our professions present their values in the form of standards and practices as reflected in both requirements and prohibitions. All ASHA members, student affiliates, certified non-members, applicants for membership and/or certification, and clinical fellows are guided by and obligated to comply with the principles and rules expressed in the Code of Ethics. It is a dynamic record of principles that comprise its core values and that are described in the Preamble as both "aspirational and inspirational in nature," and rules that articulate enforceable standards, expectations, and proscriptions.
Parsons (2001) asserts that a code of ethics is "that profession's contract with the society it serves rather than, as some people may like to believe, a cookbook to thumb through when you're looking for the answer to a dilemma." (para. 3). A code of ethics serves a number of significant and varied functions. Fisher (2003), in "decoding" the ethics code of the American Psychological Association, listed four purposes of the document:
1. Establishing the integrity of a profession by embracing common, core values reflecting consensus among members
2. Offering education and professional socialization by supporting and guiding individuals about what to expect of themselves and one another, deterring participation in unethical conduct and communicating the values of the profession to students and new professionals for the protection of the public
3. Gaining public trust by explicating the standards of the profession which exist in part to safeguard consumers' welfare and by which the public can assess the conduct of the individuals with whom they interact
4. Enforcing ethical behavior through clear statements of expectations which guide professionals to act ethically and avoid unethical behaviors
Thus, a code of ethics is a shared statement of the values specific to a particular group. It defines, and makes public, common fundamental principles and standards for practice, research, and education; supports self-reflection and public accountability; and recognizes individuals as a community of professionals with unique privileges and obligations. In this sense it has been referred to as at the "heart of an ethics program within a profession" (Murray & Aitken, 2000). As can be seen from our own history, a code is integral, not incidental, to a profession's purpose, its membership, and those it serves.
Uses and Abuses
Considering the powerful nature of a code of ethics it is not surprising that it has the potential to be both used and/or abused by the members it represents. The code is not something to be feared, but rather to be embraced. It is not designed to serve as a bludgeon or weapon to use against others. On the contrary, it provides the means by which we can work together toward an "ultimate good."
To assist SLPs and audiologists in effectively using the ethical principles and rules in their varied roles and work contexts, we outline several factors below for consideration.
- Timing: SLPs and audiologists may turn to the Code to guide their own decision-making and action. If, however, the code is not consulted until after an action has occurred, its educational value is diminished. Huffman (2003) asserts that to maximize the Code's utility, individuals should use it proactively. "Knowing our Code of Ethics, anticipating ethical predicaments and being able to document and provide a rationale for our actions are keys to successful ethical practice" (p. 23).
- Motivation: When ethical conduct is questioned and a complaint filed there can be serious consequences for all involved. Sometimes, accusations are the result of employment disputes. Other complaints may stem from personality disagreements, or on a more serious level, personal vendettas. The Code of Ethics cannot and should not be used to resolve these conflicts.
- Accuracy and validity: False or inappropriate accusations may lead to further abuse of the Code, in the form of retaliation against or ostracism of the complainant. However, even when the facts related to an action are accurate, if the accuser has insufficient evidence to support a complaint, validation cannot be found in the Code. "If it is not right it is not necessarily unethical" (author unknown). On the other hand, failure to charge an individual with a possible violation of the Code because of fear of reprisal or lack of interest is also problematic.
- Nature of the complaint: Different theoretical perspectives about the best treatment approaches or research methodologies to employ in a specific situation often represent the state of the art and science in the profession. Theoretical debates, however, in and of themselves, do not constitute ethical dilemmas and cannot be decided on the basis of the principles and rules in the Code of Ethics.
- Personal values and the Code of Ethics: Parsons (2001) comments about "the inappropriateness of interpreting any code of ethics so literally as to think that this is all that is needed to make a moral decision" (p.1). On the other hand, it has been argued that the rights and duties of moral persons do not vary with their professional affiliations and thus the existence of separate professional codes may be self-serving. (IIT, 2005). Although our moral principles and professional obligations are not independent, one does not compromise the other. It is because of our responsibility to ensure the confidence and respect of our clients that we as professionals are guided by a code of ethics and maintain personal standards of conduct befitting SLPs and audiologists. Professional practice relies on an understanding of the standards and conduct of our own community of professionals regardless of how strong an individual member's moral character may be. The Code of Ethics provides us with guidelines about what other SLPs and audiologists know, think, and do. This presents a unique context for decision-making and one that may be different from public opinion, legal doctrines, or personal views. (Davis, p. 5).
The Code of Ethics assists members through the explication and examination of certain ideals. In this way, adherence to the ASHA Code of Ethics offers benefits and protections for our patients, our colleagues, and ourselves.
The Code of Ethics itself does not make a person ethical nor is it the mechanism by which we solve ethical problems (English, 2001). Ethical questions are complex and imprecise and it may not be easy to apply general rules to concrete and specific ethical conflicts. Ethical decision-making involves a commitment to applying the ethics code to construct rather than simply to discover solutions to ethical quandaries. In this way, the Code of Ethics is both empowering and proscriptive in nature.