Chapter 21 - Professional Ethics

Question 1

What ethical dilemma is presented regarding the placement of a PEG tube for a patient after a stroke?

Answer 1

The family member with durable power of attorney denies the feeding tube placement, claiming the patient would not want such treatment.

This raises questions about the patient’s autonomy and the family’s interpretation of their wishes.

Question 2

In the outpatient clinic scenario, what diagnosis may be used for insurance reimbursement?

Answer 2

Developmental apraxia.

Using this diagnosis allows the child to receive necessary services that would otherwise not be covered.

Question 3

What productivity standards are SLPs in an outpatient medical setting subject to?

Answer 3

High productivity standards to support the departmental budget and avoid personnel cutbacks.

These standards can pressure SLPs to recommend more sessions than necessary for financial reasons.

Question 4

What ethical implications arise from hiring a retired SLP with no training in adult disorders?

Answer 4

The new SLP’s lack of skills in dysphagia, aphasia, or cognitive disorders raises concerns about patient care quality and professional responsibility.

This scenario highlights the need for proper training and competence in specialized areas.

Question 5

What is the overarching theme of the chapter on ethics in the medical setting?

Answer 5

The use of ethical principles to guide workplace decisions and behaviors.

Ethical behavior is essential in all situations, especially in patient care.

Question 6

What does the chapter assume about professionals providing care?

Answer 6

That they are providing evidence-based care and utilizing the most current information available.

Ethical practice is intertwined with competent assessment and intervention.

Question 7

What are the four guiding principles of ASHA’s Code of Ethics?

Answer 7

• Welfare of persons served
• Professional competence and performance
• Public understanding of the profession
• Honesty and fairness in professional relationships.

Each principle is elaborated by supporting and explanatory rules.

Question 8

What is the focus of the Principle of Ethics I?

Answer 8

To hold paramount the welfare of persons served and treat research animals humanely.

This principle emphasizes responsible service delivery and patient welfare.

Question 9

What is emphasized in the Principle of Ethics II?

Answer 9

The highest level of professional competence and performance.

Practitioners must operate within their scope of practice and seek training when necessary.

Question 10

What does the Principle of Ethics III promote?

Answer 10

Public understanding of the professions and the development of services for unmet public needs.

It emphasizes accurate communication in all aspects of the profession.

Question 11

True or False: A profession’s code of ethics holds members to lower standards than laws regulating the practice.

Answer 11

False.

A code of ethics holds professionals to higher standards than legal regulations.

Question 12

What should professionals do when they lack the appropriate skills to treat a patient?

Answer 12

Seek assistance from others and gain formal training in necessary areas.

This ensures competent service delivery and patient safety.

Question 13

Fill in the blank: Ethical decisions in medical settings may have a _______ impact on the quality of life of the persons served.

Answer 13

more immediate.

This highlights the urgency and importance of ethical considerations in healthcare.

Question 14

What is a key responsibility of SLPs according to the ethical framework?

Answer 14

To provide competent and responsible services.

This includes ongoing evaluation of service effectiveness and patient outcomes.

Question 15

What is the responsibility of professionals according to Principle of Ethics III?

Answer 15

To promote public understanding of the professions and provide accurate information in all communications

This includes dissemination of research findings and marketing of products and services.

Question 16

What are the requirements for public communication as per Principle of Ethics III?

Answer 16

Members must ensure integrity, accuracy in credentials, and honest representation of clinical information

This includes information about products and treatments.

Question 17

What must SLPs be aware of regarding public statements?

Answer 17

Potential conflicts of interest

They should refrain from activities that may mislead the public.

Question 18

True or False: SLPs can mislead the public if it leads to obtaining payment for services.

Answer 18

False

Misleading the public is unethical and relates to defrauding for payment.

Question 19

What is emphasized in Principle of Ethics IV?

Answer 19

Honoring responsibilities to the professions and maintaining relationships with colleagues

This includes respect for other service providers.

Question 20

Who do SLPs interact with in the healthcare arena?

Answer 20

Physicians, nurses, pharmacists, nutritionists, physical and occupational therapists, nurse practitioners, and social workers

These interactions can significantly affect patient outcomes.

Question 21

What does the ASHA Code of Ethics require regarding interactions with other professionals?

Answer 21

Competence, adherence to principles, and respect for patients and service providers

Dignified interactions are expected.

Question 22

What are the high standards of conduct outlined in Principle IV?

Answer 22

Avoiding misrepresentation, harassment, abuse of power, and discrimination

This includes guidelines for reporting and complying with investigations.

Question 23

What should SLPs do when faced with ethical dilemmas?

Answer 23

Consult the ASHA Code of Ethics regularly

They are required to affirm adherence to the code when renewing licensure.

Question 24

What ethical principles does the AMA emphasize?

Answer 24

• Competence
• Compassion
• Professionalism
• Honesty
• Respect for the law and rights of others
• Pursuit of learning

These principles serve as models for other professions.

Question 25

List the tenets included in the APA Code of Ethics.

Answer 25

* Beneficence * Nonmaleficence * Fidelity * Responsibility * Integrity * Justice * Respect for rights and dignity ## Footnote These tenets guide ethical behavior in psychology.

Question 26

What is a key component of ethical decision-making frameworks?

Answer 26

Differentiating ethical issues from conflicts of another type ## Footnote This helps in identifying the potential damage to people or communities.

Question 27

What does the Markkula Center suggest for ethical decision making?

Answer 27

Identify stakeholders, relevant facts, and options for acting ## Footnote Questions about fairness and respect for dignity are addressed.

Question 28

What is the potential conflict in ethical principles mentioned?

Answer 28

Patient autonomy may conflict with beneficence or nonmaleficence ## Footnote For example, a patient refusing necessary medical interventions.

Question 29

Fill in the blank: Ethical dilemmas in medical settings can have immediate effects on _______.

Answer 29

[quality of life for the patient]

Question 30

What should professionals do to ensure ethical decisions are made?

Answer 30

Engage in discussions with colleagues about relevant facts and ethical principles ## Footnote This can lead to optimal decisions regarding clinical ethics.

Question 31

What is the role of Speech-Language Pathologists (SLPs) in medical settings?

Answer 31

SLPs evaluate and treat individuals with reduced capacity to participate in their own care. ## Footnote This includes patients with cognitive, language, or swallowing challenges.

Question 32

What is a Durable Power of Attorney for Health Care (DPAHC)?

Answer 32

An advance directive that establishes a health care proxy to make decisions when the patient cannot. ## Footnote The proxy ideally knows the patient's values and can participate in the health care process.

Question 33

What responsibilities does a health care proxy typically have?

Answer 33

Responsibilities may include: * Selecting or discharging clinicians and facilities * Consenting to or refusing treatment * Viewing medical records * Withdrawing or withholding life-sustaining treatments * Agreeing to organ donations.

Question 34

What is a living will?

Answer 34

A legal document that specifies types of life-sustaining and medical treatments a patient wants or does not want. ## Footnote It is generated when the patient can make independent decisions.

Question 35

What topics are typically addressed in a living will?

Answer 35

Topics may include: * Resuscitation * Mechanical ventilation * Nutritional support * Hydration assistance * Dialysis.

Question 36

How do ethical dilemmas in medical settings benefit from collaboration?

Answer 36

Collaboration allows for open dialogues and relies on decision-making frameworks to define dilemmas and reach consensus. ## Footnote This approach can lead to more positive outcomes.

Question 37

What is the purpose of Biomedical Ethics or Medical and Research Ethics centers?

Answer 37

These centers promote communication among medical staff and address ethical dilemmas by clarifying questions and recommending next steps.

Question 38

What ethical challenges do SLPs commonly face in medical settings?

Answer 38

Common challenges include: * Documentation lapses * Employer demands regarding productivity * Ethical issues related to reimbursement.

Question 39

What is the significance of documentation in the medical setting?

Answer 39

Documentation is crucial as it validates care provided; the saying 'If it is not documented, it did not happen' underscores this importance.

Question 40

What are the implications of misrepresentation in clinical documentation?

Answer 40

Misrepresentation can endanger professional reputations and may lead to issues of fraud. ## Footnote Clinicians should avoid altering records to secure reimbursement.

Question 41

What is 'doubled agency' in patient care?

Answer 41

Doubled agency recognizes shared responsibility between patient and clinician for the course of treatment. ## Footnote This concept emphasizes both parties' roles in achieving effective care.

Question 42

What is the role of the SLP in relation to patient autonomy?

Answer 42

The SLP must ensure that patients receive individualized, evidence-based, and respectful services, recognizing their vulnerability.

Question 43

Why is understanding a code of ethics important for professionals?

Answer 43

It helps professionals understand how their field evolves and develops standards of conduct. ## Footnote This understanding is crucial for ethical decision-making in practice.

Question 44

What are some sources of support for ethical decision-making in medical settings?

Answer 44

Sources include: * Biomedical Ethics centers * Professional organizations like ASHA * Ethical guidelines and resources available online.

Question 45

True or False: Ethical challenges in medical practice only arise in clinician-patient relationships.

Answer 45

False. Ethical dilemmas can also occur within workplace dynamics and expectations.

Question 46

What should practitioners do if they suspect unethical practices by colleagues?

Answer 46

They should report suspected unethical practices to employers, state licensing boards, or the Board of Ethics.