by Erika Rose Baldwin, University of Wisconsin–Milwaukee
Ava Kit is a speech-language pathologist with over twenty-five years of experience serving special education populations in the public schools. Ava’s extensive experience and strong perceptibility, empathy, and drive enable her to provide exceptional services, but also make it challenging for her to avoid over-investment in her clients’ diverse and pressing needs. Social media’s constant access to news and commentary related to the populations she works with, combined with the demands of her job, can cause Ava to become overwhelmed. To reduce this overload, Ava has found solace in taking action. Writing her representatives, sharing information on social media platforms, volunteering for her state association, voting—all these forms of advocacy, and more, enable Ava to channel the negative news into positive action, easing her overload while effecting broader change for the populations that she is so passionate about.
As the beginning of the new fiscal year approaches, Ava learns that her state government is considering a significant reduction in funding for special education services in the public schools. Reading through the proposal, Ava is astonished to discover how such budget cuts will reduce the access to assistive technology and bilingual services that are making such a positive difference in the lives of so many of her clients. Without hesitation, Ava shares the budget proposal on her social media platforms, accompanied by a message urging her network to join her in contacting representatives regarding this issue.
A few minutes later, Ava receives a notification. A high school classmate who Ava has not talked to in years has commented on her Facebook post: “We have a deficit. I’m sure difficult decisions had to be made with this budget. That amount of money can’t really make that much of a difference.”
Ava is stunned. Heart pounding, mind racing, she instantly conjures up several scenarios of specific clients, the precise expense of their services, and the necessity of these services for them to reach their full potential in the educational setting. This classmate has no background working with special education students, nor experience with the daily challenges that they face.
If he only knew their stories, surely, he would understand.
In today’s digital world, more people are online than ever before. Facebook users spend over seven hundred billion minutes logged in every month (McGary, 2010) and, since 2005, the percentage of adults on social media has increased from 8% to 72% (Ventola, 2014). Advocacy, then, becomes an even more critical component of the speech-language pathologist and audiologist scope of practice in this arena—we must aim to ensure the voices of our clients are not drowned in such digital noise. However, despite our positive intents, it is imperative that we “ensure the welfare of the consumer” and “protect the reputation and integrity of the professions” (American Speech-Language-Hearing Association, 2016) by remaining vigilant of the information we are sharing online. Therefore, while well-intentioned, Ava’s impulse to respond to her classmate’s comment with stories about her clients poses serious risk to violating the American Speech-Language-Hearing Association (ASHA)’s Code of Ethics.
Principle I, Article P of ASHA’s Code of Ethics (2016) states that, “Individuals shall protect the confidentiality of any professional or personal information about persons served professionally or participants involved in research and scholarly activities and may disclose confidential information only when doing so is necessary to protect the welfare of the person or of the community, is legally authorized, or is otherwise required by law.” In this scenario, Ava intends to use her client’s needs as evidence to justify state funding. While she is engaging in advocacy, Ava’s social media platform does not qualify as appropriate context to disclose such private client information. Therefore, by intending to share with her classmate this anecdotal evidence, regardless of her intent, Ava seriously threatens to violate ASHA’s Code of Ethics. Doing so may also expose Ava to “liability under federal HIPAA and state privacy laws” (Ventola, 2014).
So, what is Ava to do? How can we all engage in these forms of online advocacy while ensuring that we keep client information secured? Such is a pertinent question as we practice in an unprecedented digital age: so much so that, in the 2018 ASHA Schools Survey, one of the posed ethics challenges was “reading confidential or inappropriate information about a student posted by an audiologist or SLP on social media” (American Speech-Language-Hearing Association, 2018).
An answer to this question lies in considering the foundations of effective argumentation. Ethos, pathos, and logos—these are the three rhetorical devices that can be used in persuasive communication. By considering responding with her anecdotal experience, Ava is relying on pathos: she is attempting to invoke an emotional response and, thus, support from her classmate. However, in Ethos, Pathos, Logos: A Script for Clinical Communication, Alderman (2018) argues that “pathos is traditionally regarded as more central to personal communications than in a clinical setting” (p. 301). As clinicians, we, like Ava, must remember that we have an obligation to both the profession and our clients to maintain our sense of professionalism in advocacy communication, rather than dissolve into pathos. While pathos can be used to “strengthen the messages” (Alderman, 2018, p. 301), it need not form the central argument, especially when it poses the risk of disclosing private information.
In contrast, consider Ava’s ethos. “Ethos addresses the character of the communicator: to be effective, the conveyor must be credible, empathetic to the needs of the recipient and the subject matter, and they must communicate with good intention” (Alderman, 2018, p. 301). As speech-language pathologists and audiologists that are well-versed in the diversity of client needs, we can remember that our credibility is well-established. Therefore, situations such as this can be approached with an ethos angle: acknowledging the position of the speaker, but also remaining confident in our education and experiences and the purpose this gives us to speak up for client needs.
Finally, logos can be combined with ethos to appropriately advocate in this situation. “Logos is a concept dear to the heart of the modern clinician. Dealing in the clear articulation of facts and figures . . . logos appears to stand in unchallenged primacy” (Alderman, 2018, p. 301). Rather than provide anecdotal evidence that risks violating ASHA’s Code of Ethics, Ava can refer her classmate to evidence-based resources that communicate the cost, purpose, and need for the services that her clients receive under the current budget. Doing so still communicates the necessity of services without violating her client’s privacy.
Principle III, Article E of the ASHA Code of Ethics (2016) states: “Individuals' statements to the public shall provide accurate and complete information about the nature and management of communication disorders, about the professions, [and] about professional services.” When clinicians engage in important conversations regarding client care on social media, by reducing pathos and centering arguments around ethos and logos, advocacy can be achieved without disclosing personal client information. As the next generation of Ava Kits facing an unprecedented digital age, client privacy must be held paramount throughout our ever-increasing engagement in social media.
Alderman, C. (2018). Ethos, pathos, logos: a script for clinical communication. Journal of Pharmacy Practice and Research, 48(4), 301–302. doi: 10.1002/jppr.146
American Speech-Language-Hearing Association (2016). Code of Ethics [Ethics]. Retrieved from /Code-of-Ethics/.
American Speech-Language-Hearing Association (2018). 2018 Schools Survey. Retrieved from /siteassets/uploadedfiles/2018-Schools-Survey-Summary-Report.pdf [PDF].
McGary, M. (2010). The Social Media Mix: How SLPs and Audiologists Are Using Social Media in Their Professional Lives. The ASHA Leader, 15(15). https://doi.org/10.1044/leader.GS.15152010.n.
Ventola, C. L. (2014). Social Media and Health Care Professionals: Benefits, Risks, and Best Practices. Pharmacy and Therapeutics, 39(7), 491–499, 520.