Issues in Ethics: Conflicts of Professional Interest
About This Document
Published 2025. This Issues in Ethics statement was originally published in 2004 and was last revised in 2018. It has been updated to make any references to the Code of Ethics consistent with the Code of Ethics (2023) (hereinafter, "Code of Ethics"). The Board of Ethics (hereinafter, the "BOE") reviews Issues in Ethics statements periodically to ensure that they reflect current practices and the current Code of Ethics.
Issues in Ethics Statements: Definition
From time to time, the BOE 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 are 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
Introduction
This Issues in Ethics statement is presented for the guidance of ASHA members and certificate holders in matters relating to conflicts of professional interest.
Because of the power of external factors to influence interpretation and reasoning—and the possibility that these external factors may undermine objectivity—all professionals must pay close attention to, and seek to avoid, conflicts of interest. It is not necessary for such influence or compromise to have occurred before a situation can be identified as a conflict of interest. It is sufficient for the situation to appear to provide the potential for professional judgment to be compromised.
The following information is provided in an attempt to heighten sensitivity, increase awareness, and enhance judgments in those circumstances when conflicts of interest influence, or appear to influence, professional conduct.
Guidance
If conflicts of interest cannot be avoided, then proper disclosure and management is the responsibility of (a) ASHA-certified audiologists and speech-language pathologists (SLPs); (b) speech, language, and hearing scientists who are ASHA members; and (c) applicants for the ASHA Certificate of Clinical Competence (CCC) and/or membership.
The importance of avoiding a potential conflict of interest is reflected in the following Code of Ethics Principles and Rules:
Principle I: "Individuals shall honor their responsibility to hold paramount the welfare of persons they serve professionally or who are participants in research and scholarly activities."
In other words, professional practice decisions must first and foremost promote the best interests of those who are being served. Typically, there is no conflict between the professional's interest and the interests of those they serve. This is because both the professional and the client typically share the same interests (e.g., the clinician and the client/patient both want improvement to occur as much and as quickly as possible). Moreover, professionals are usually quite skilled in keeping their own personal interests and preferences separate from their professional responsibilities.
Principle III: "In their professional role, individuals shall act with honesty and integrity when engaging with the public and shall provide accurate information involving any aspect of the professions."
Simply put, all ASHA members and certificate holders have a duty to conduct themselves in such a way as to preserve and protect the public's trust and confidence in the professions.
Principle III, Rule B related specifically to conflicts of interest and states as follows: "Individuals shall avoid engaging in conflicts of interest whereby a personal, professional, financial, or other interest or relationship could influence their objectivity, competence, or effectiveness in performing or professional responsibilities. If such conflicts of interest cannot be avoided, proper disclosure and management is required."
Under certain circumstances, it may be difficult for a professional to maintain the separation of personal interest from professional service. These situations often involve professionally related commercial enterprises or financial arrangements in which the individual is involved and personally benefits. Conflict of interest can also arise when clients/patients, relatives of clients/patients, or contractors offer gifts or incentives that may predispose the professional to favor them. Involvement in the professional assessment (clinical, academic, or administrative) of someone who is a friend can constitute a conflict of interest. Becoming involved in a situation that can potentially compromise independent judgement or objectivity diminishes the public's trust and confidence in the professions. Even the appearance of a conflict of interest can be damaging to the public perception of the professions.
Discussion
Conflicts of interest can occur in teaching, research, and clinical practice, and they may be obvious or subtle. No Principle or Rule of the Code or this Issues in Ethics statement can address all of the forms that such conflicts can take. This Issues in Ethics statement gives guidance in identifying conflicts of interest and suggests what should be done when a conflict is identified.
Identifying Conflicts of Interest
Many conflicts of interest involve commercial interests or financial arrangements. Policies and procedures in workplace settings should be evaluated to safeguard against biases or preferences being introduced into professional judgments. If a professional is offered, or receives, gifts or incentives—even something as minor as a free lunch—it can create a conflict of interest.
Individuals must carefully consider all circumstances surrounding the offer of a gift or an incentive, including the purpose of the donor, how the transaction may be viewed by impartial observers, and the potential impact on the practice of the professions. Individuals must also be aware of ways in which their personal and family relationships, and other close personal associations, may potentially bias their judgments.
An individual’s belief that their professional judgment or objectivity is unaffected by gifts, other economic incentives, or personal ties does not mean there is no conflict of interest. This is partly because the influence introduced by personal interests may be subtle, such that the person may be unaware of the way in which their judgment has been biased. For this reason, it is important for workplaces to establish policies regarding employee conduct in order to minimize professional conflicts of interest.
Personal and family relationships complicate the ability to recognize potential conflicts of interest. Avoid preferential treatment in referrals, in the evaluation of employees, or in the assessments of students and fellow faculty members.
What to Do About Conflicts of Interest
When faced with a potential conflict of interest, there are three appropriate steps to take: avoid, disclose, and manage.
Avoid
It is best to avoid situations that could result in conflicts of interest whenever possible. In commercial and financial matters, avoidance does not mean that benefits may not be accepted. It means that some benefits are prohibited and that all benefits should be carefully scrutinized. Audiologists, SLPs, and speech, language, and hearing scientists should not accept gifts or benefits unless they can clearly demonstrate that such gifts or benefits primarily contribute to the welfare of persons served professionally and do not dimish the dignity or autonomy of the professions.
If a conflict of interest cannot be avoided, it must be properly disclosed and managed.
Disclose
Disclosure is a self-initiated action that provides personal and professional information to interested parties, such as the client and/or employer, with the intent of being honest, forthcoming, and complete. Transparency is a crucial part of addressing any conflict of interest.
Disclosure of both financial and nonfinancial relationships is inherent in assumed ethical conduct. Many clinical, research, and teaching scenarios can potentially foster a natural tension between professional obligation and personal preference/gain. Misrepresentation by errors of both omission and commission can create ethical violations.
Manage
Management is the action taken to minimize or mitigate the conflict of interest—or the appearance thereof.
In some cases, management may involve the recusal of one of more individuals. Recusal is the action of withdrawing from situations when one's participation creates, or could potentially create, bias that could adversely influence the decision.
As an example, when a professional sits on a committee that makes decisions about the advancement of others or about the distribution of resources and benefits to others, a conflict of interest may require that the professional recuse themselves from the discussion and vote on this topic. Similarly, recusal may be warranted if a professional is asked to provide services to a family member or a close friend. Recusal may occur because of the professional's financial interests in or personal ties to one or more of the parties. By disclosing the nature of the relationship and by stepping out of the decision-making process, the professional ensures that any personal preferences or biases that they may have will not unfairly influence the deliberations or services provided.
In some cases, after a professional has properly disclosed a conflict of interest, it is beneficial to create a formal management plan. This document sets forth how a conflict will be managed or eliminated. By creating a management plan, the professional ensures that all attempts are being made to protect the integrity of the individual or the institution and to preserve public trust.
Management plans can vary greatly, depending on the type of conflict being addressed. A plan may create limitations on a professional’s ability to work with or provide services to individuals with whom they have personal or familial relationships. It may also create oversight and ongoing reporting requirements where a conflict of interest cannot be avoided. Management plans are usually in effect until the conflict of interest no longer exists or changes. Such plans should be reviewed periodically and altered or amended based on the changing circumstances. It is recommended that such plans be in writing and be signed or acknowledged by all parties involved with the conflict.
Summary
Conflicts of interest erode the public's trust and must be avoided whenever possible. When they cannot be avoided, they must be properly disclosed and managed. Preservation of the highest ethical standards is vital to the conduct of independent judgment an professional practice by audiologists, SLPs, and speech, language, and hearing scientists.
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