From time to time, the Board of Ethics 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 and 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.
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For a variety of reasons, such as leaving a practice to pursue other career opportunities or relocating for family reasons, clinicians may decide to end their relationships with clients. There is nothing unethical about such departures. (Although, given the shortage of professionals in this field, it may be necessary to caution managers of care-giving facilities that it is unethical to try to exert moral pressure on clinicians to continue once they have indicated their plans to leave.) However, professionals must be mindful of the fact that such departures may result in former clients being left without appropriate care. It is therefore imperative that speech-language pathologists and audiologists in such transitional situations maintain their focus on the welfare of the client. They should be careful to uphold the ASHA Code of Ethics so that clients are not harmed by the clinician's departure.
When clinicians leave a caseload without coverage by an appropriately qualified professional, it is called client abandonment. A professional who abandons her or his clients without making effective efforts to provide for their continuing care violates the first principle of the ASHA Code of Ethics: “Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally….”
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Speech-language pathologists and audiologists should hold paramount their obligations to clients whom they have been serving. Every effort should be made to ensure continuity of care and, in the event that vigorous good-faith efforts are not sufficient to guarantee continuity, to accommodate the needs of clients who will be left, even for a short period, without an appropriately qualified clinician. Such needs might be accommodated by developing home programs that could be used during an interim period without professional services, referring clients to appropriately qualified professionals in the surrounding area, and providing clients and their families with troubleshooting techniques and maintenance exercises and activities.
A professional who is leaving a facility should, if requested, assist the organization with recruitment of a replacement and should offer to participate in the orientation of replacement personnel as necessary.
Speech-language pathologists and audiologists who leave an organization or facility should attempt to sever ties with the employer amicably. Employers should cooperate in every way with departing clinicians in order to safeguard the well-being of clients. When the speech-language pathologist's or audiologist's departure has been precipitated by difficulties in workplace relationships or what the clinician regards as deficiencies in working conditions, there may be increased potential for behavior that violates the principles and rules of the Code of Ethics. Professionals in such situations should avoid engaging in behaviors that might be viewed as retaliatory or slanderous. Employers who are ASHA members likewise are expected to behave in ways that place the highest priority on the needs of the clients. Angry and spiteful words, obstructive actions, and uncooperative or aggressive behavior are potentially very harmful to clients and reflect badly on the profession. If a practitioner believes that a facility is not meeting professional standards, the practitioner should report the facility to the appropriate oversight organization. If an employer believes that a clinician is unqualified or has behaved unethically, that problem should be reported to the appropriate oversight body. It is a violation of the ASHA Code of Ethics for such problems or suspicions to become matters of slander, public disputes or personal attacks, or gossip.
Some disruptions of clinician-client relationships are involuntary. If a clinician is dismissed for cause, the employee's responsibility to clients terminates with the dismissal, and the facility assumes all responsibility for seeing that no clients suffer harm as a result of the departure. Clinical relationships may also be interrupted if an organization decides to close a program for financial reasons or when natural disasters occur. It would be expected that even in these types of situations, speech-language pathologists and audiologists would hold paramount the welfare of the clients they have served, but no clinician is ever morally required to work without pay or to place herself or himself in physical danger in order to offer client care.