Employers, Employees, and Ethics

by Nancy P. Huffman

(This article originally appeared in the October 7, 2003 issue of The ASHA Leader.)

A recurring theme in inquiries to the ASHA Ethics division is "employer demands." That is, employers requesting that our members and certificate holders engage in conduct that places them at risk for violating their ethical responsibilities. Ethically compromising requests might be to:

  • use culturally insensitive tests in order to "qualify" a child for service
  • request additional increments of treatment in order to cover travel expenses
  • sign for Medicaid services in schools for children whom they have never seen and whose care they have not supervised
  • provide treatment with which they disagree as a result of family/parent insistence
  • provide treatment for which they havehad no training or experience

With employers under the jurisdiction of ASHA's Code of Ethics, an employee may have recourse through filing an ethics complaint. There is little recourse for such action when the employer is outside of ASHA's jurisdiction—but read on for some ideas. Demands are often made by employers who have no awareness of their employee's need to adhere to a code of ethics.

As employers, how do we acknowledge our employees' ethical obligations? How do we foster ethical decision-making practices among our employees? Or handle issues raised when employees must satisfy multiple codes of ethics/conduct by virtue of licensing, profession, or employment setting obligations?

As employers we need to familiarize ourselves with the codes of ethics of our employees' professions. We can review workplace practices and regulatory requirements in relation to the ethical responsibilities our employees must fulfill. We can create an ethics-friendly environment bypromoting ethics discussion and analysis of ethical issues that emerge. We can implement conflict resolution practices to avoid situations that rise to the leel where an ethics complaint is filed.We can encourage ethics education by conducting case reviews to improve skills for anticipating potential ethical predicaments and handling them responsibly. We can encourage discussions of the code of ethics of each of the professions represented in our workplace in a compare-and-contrast fashion. We can expect our employees to be knowledgeable about professional ethics and serious about fulfilling their affirmative ethical obligations.

As employees we can use every opportunity available in our workplace to inform and educate co-workers, administrators, and union leaders about professional ethics, especially if our employer (or administrator) is not a member of the profession. At the time of interview, ask if the employer's business entity or school district has a code of conduct or code of ethics. Ask employers how they foster ethically responsible professional practice. Work to establish conflict resolution strategies to seek solutions to ethically compromising issues. Union members should recognize their membership as a valuable resource, especially when they are reluctant to complain about employer demands because of fear of retaliation.

As employees, we can use the Code of Ethics proactively. For example, how do we evaluate and document the effectiveness of our services (Principle of Ethics I, Rule G)? Documentation is an important tool for accumulating the data to use as a rationale for continuation or termination of service, or increasing our decreasing the frequency and intensity of service. Our reports, representing our independent judgment, may be submitted to a team and to the client/caregiver. How do we ensure and document our own clinical competence in evaluating and treating clients, including our acquisition of new knowledge and skills that might be necessary for client care (Principle of Ethics II, Rules B and C)?  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.

Nancy P. Huffman previously served as a member of the ASHA Board of Ethics.

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