Ethical Decision-Making In The Current Practice .
Ethical Decision-Making inthe Current PracticeEnvironment: Applying theRevised Code of EthicsNew Mexico Speech-Language and HearingAssociationAnnual ConventionOctober 22, 2016Albuquerque, NMTheresa H. Rodgers, MA, CCC-SLP, ASHA Fellow,Licensed SLP, EdS (Learning Disabilities)
Disclosure StatementFinancial Relationships Honorarium provided by NMSHA Travel expenses to New Mexico reimbursed perstate policy by Louisiana licensure board (forattendance at National Conference of StateBoards of Examiners’ 29th Annual Conference inSanta Fe)Non-Financial Relationships 2016 Vice Chair of ASHA’s Board of Ethics Member of the Louisiana licensure board
No portion of this presentation maybe reproduced without permission.The handout may be downloadedfor use by conference participants.
Acknowledgements!Special thanks to the followingindividuals who contributed significantlyin the development of this presentation: Heather Bupp, Esq. Shelly Chabon, Ph.D., CCC-SLP Glenn M. Waguespack, M.S., CCC-A Ellen Fagan, Ed.D., CCC-SLP
The Current Practice Environment:Considerations and Constraints? Productivity Demands (e.g., SLPs in SNFrequired to clock out to complete documentation) Expectation that clients will be maintained oncaseload [and/or at same level of service] evenwhen no longer warranted Pressure to bill on-going assessment providedwithin therapy sessions as “evaluation” Provision of services without adequate training
The Current Practice Environment:Considerations and Constraints? Paperwork burden and its effect on serviceprovision to patients/clients/students, as well asquality of record-keeping (potential billing errors,inadequate documentation of services, etc.) Pressure to sign-off on “Medicaid” billing whenproper supervision has not been delivered (lackof caseload relief to allow for adequatesupervision time) Lack of currency in practice techniques (lack ofrelease time for quality continuing education;practitioner burn-out and work-life balanceissues)
The Current Practice Environment:Considerations and Constraints? Inadequate/improper supervision of graduatestudents, assistants and/or Clinical Fellows Inappropriate delegation of tasks to graduatestudents and/or assistants Inadequate/improper documentation of supervision Conflict of interest (e.g., solicitation of cases for parttime private practice from practitioner’s full-timeemployment entity)
The Current Practice Environment:Considerations and Constraints? Questions concerning cultural competence in theadministration and interpretation of diagnosticmaterials Cultural competence issues in interacting withfamilies and those whom we serve Patient/client abandonment
LawMoralsEthics
Moral Principles (Kitchener)Underpinnings of many ethicalguidelines1. Autonomy (freedom of action & choice)2. Justice (fairness)3. Beneficence (doing good for others)4. Nonmaleficence (preventing or avoiding harm)5. Fidelity (loyalty)
Ethical Principles (Kitchener) Autonomy: Having the right of self-determination Beneficence: Doing good for others Nonmaleficence: Preventing or doing no harm Justice: Treating individuals fairly Professional Competence: Knowing theboundaries
Ethics and the LawLegalMoralllegalImmoralSlocum, J.M. Ethics, law and regulatory affairs: Comparisons andcontrasts. Retrieved May 4, 2016 ds/2014/02/T71-Ethics-v-Law.pdf
“Ethics is NOT primarilyconcerned with getting peopleto do what they believe to beright, but rather with helpingthem to decide what is right.”Jones, Sontag, Beckner, Morton and Fogelin in Seymour, 2001
Codes of EthicsDifferences/Similarities Professional Organizations Regulatory Agencies ASHA Summary of State of-Ethics/
New Mexico Rules and RegsRetrieved August 5, 2016 fromhttp://www.rld.state.nm.us/boards/Speech Language Pathology Audiology and Hearing Aid Dispensing Practices.aspx
Charge to the ASHA Board of Ethics(BOE)Bylaws of the Association – Article VIII 0.pdf Formulate, publish, and, from time to time, amenda Code of Ethics Develop educational programs and materials formembers (Ethics Education Subcommittee) Adjudicate complaints alleging violations of theCode of Ethics
Ethics Education Ethics Education Subcommittee (Board of Ethics membersin 4th year of their term) Issues in Ethics Statements Convention Presentations Student Ethics Essay Award Program Live online Web chats – The schedule can be found athttp://www.asha.org/events/live/ Articles for The ASHA Leader, ASHAWire, ASHA AudiologyConnections, and other publications Guest speakers
Process for Filing ComplaintsIf you have reason to believe the Code has beenviolated, you shall inform the ASHA Board of Ethicspursuant to Principle IV, Rule M.Code of Ethics (2010r)Code of Ethics (2016)Code of Ethics(2010r) is theapplicable code forsuspected violationsoccurring prior toMarch 1, 2016.The newest revision ofthe ASHA Code ofEthics (2016) is theapplicable code forsuspected violationsoccurring March 1,2016, and thereafter.
No Anonymous Complaints Lessens filing of frivolous or maliciouscomplaints Difficult for the Board of Ethics to assess veracityof the complainant, credibility of facts, andevidence on which complaint is based
Ethics Complaints & BOEPowers ASHA BOE has no “investigative”resources/authority. ASHA BOE has no subpoena power. Cases are heard and decided based oninformation provided by complainants,respondents, and, in limited cases, licensingboards, courts, public records, or the media.Retrieved August 5, 2016, fromhttp://www.asha.org/practice/ethicsPage 1 of 2
SANCTIONS(PRIVATE) ReprimandBetweenComplainant andRespondentPUBLICPUBLICPublished in The ASHA Leader andon ASHAwireCensureWithholding – for Applicants orDropped Members*Suspension– For months or years*Revocation – For months, years, orlife** Interrupts Certification/ MembershipCease & desist orders, which can be public or private,can also be issued.
Sanctions – Regulatory Boards Reprimand (Public) Probationary status (e.g., limit practice toareas prescribed by the board; completion ofprofessional education approved by the boarduntil satisfactory skill level achieved, etc.); NMRules 16.26.8.7 I. – “License restrictedsubject to conditions” Fine (for each violation) Require restitution to a consumer whosuffered damages as a result of theconduct
Sanctions – Regulatory Boards Suspension (NM Rules 16.26.8.7 H.) Revocation (NM Rules 16.26.8.7 G.)(Note: Revocation may or may not be permanentdepending on enabling statute.) Other discipline (e.g., Open Book Examination inLa.)(Restitution of costs and expensesassociated with disciplinary proceedings mayalso be allowed, depending on statute.)
Considerations inImposing Sanctions –Regulatory Boards Self-report vs. consumer complaint Severity of offense Extenuating circumstances First or repeated offense for same violation Repeat offender for various violations Consistency with previous board actions precedents Degree of harm to the consumer
Public Disciplinary Action – Regulatory BoardRetrieved October 4, 2016, fromhttp://www.rld.state.nm.us/boards/Speech Language Pathology Audiology and Hearing AidDispensing Practices Disciplinary Actions.aspx
Public Sanction – ASHA BOERetrieved October 4, 2016, leid 2531183
ASHA BOE Decision – Public SanctionRetrieved October 4, 2016, leid 2541714
Retrieved August 4, 2016, from included in handouts)
ASHA Code of Ethics (2016) Updated Preamble New Terminology SectionREVISIONS Edited Principles (III, IV) 15 New RulesBupp, H. (2016). What’s New in the 2016 Ethics Code? The ASHALeader, 21(7), 58-59. doi:10.1044/leader.AN1.21072016.58
ASHA CODE PreambleThe preservation of the highest standards of integrity andethical principles is vital to the responsible discharge ofobligations by audiologists, speech-language pathologists, andspeech, language, and hearing scientists who serve asclinicians, educators, mentors, researchers, supervisors, andadministrators. This Code of Ethics sets forth the fundamentalprinciples and rules considered essential to this purpose and isapplicable to the following .By holding ASHA certification or membership, or throughapplication for such, all individuals are automatically subject tothe jurisdiction of the Board of Ethics for ethics complaintadjudication. Individuals who provide clinical services and whoalso desire membership in the Association must hold the CCC.
ASHA CODE PreambleThe Code is designed to provide guidance tomembers, applicants, and certified individuals asthey make professional decisions. Because theCode is not intended to address specific situationsand is not inclusive of all possible ethicaldilemmas, professionals are expected to followthe written provisions and to uphold the spirit andpurpose of the Code.
BOE Jurisdiction (Preamble)ASHA Board of Ethics only has jurisdiction over:Members of ASHA – Certified andNoncertifiedNonmembers holding the CCCApplicants for membership and/orcertificationBOEJurisdiction
Terminology – New SectionExamples include: Publicly sanctioned Self-report Shall vs. may Diminished decision-makingabilityRetrieved August 4, 2016, .pdf
How Is the Code Organized? The fundamentals of ethical conduct aredescribed by Principles of Ethics and by Rules ofEthics. Principles of Ethics form the underlyingphilosophical basis for the Code of Ethics. Rules of Ethics are specific statements ofminimally acceptable as well as unacceptableprofessional conduct.Bupp, H. & Rodgers, T. (2016, July). It’s hot, hot, hot! Applying the 2016 ASHACode of Ethics in speech-language pathology practice. Seminar presented at theASHA Connect conference, Minneapolis, Minnesota.
Principles within Code of EthicsPrinciple I Responsibility to persons served professionallyand to research participantsPrinciple II Responsibility for one’s professionalcompetencePrinciple III Responsibility to the publicPrinciple IV Responsibility for professional relationships
Intra- and InterprofessionalCollaborationPrinciple I, Rule BPrinciple IV, Rule A – New RuleIndividuals shall work collaboratively, whenappropriate, with members of one’s ownprofession and/or members of other professionsto deliver the highest quality of care.
Supervision Principle I, Rule D Principle I, Rule E Principle I, Rule F Principle I, Rule G Principle IV, Rule IRevised language clarifies and strengthens theseRules. The responsibility for the welfare of thosebeing served remains with the certified individual.
Issues in Ethics StatementsRelating to Supervision Audiology Assistants (2014) Clinical Services Provided by Audiology and Speech-LanguagePathology Students (2013) Responsibilities of Individuals Who Mentor Clinical Fellows inSpeech-Language Pathology (2013) Speech-Language Pathology Assistants (2014) Supervision of Student Clinicians (2010)http://www.asha.org/practice/ethics/ethics issues index/
Informed ConsentPrinciple I, Rule HIndividuals shall obtain informed consent of servicesprovided, technology employed, and products dispensed.This obligation also includes informing persons servedabout possible effects of not engaging in treatment or notfollowing clinical recommendations. If diminished decisionmaking ability of persons served is suspected, individualsshould seek appropriate authorization from a spouse, otherfamily member, or legally authorized/appointedrepresentative.Principle I, Rule I
Use of Technology Principle I, Rule K Principle I, Rule N – Updated Rule Principle II, Rule H Principle II, Rule G – New RuleThis new Rule was created to address theincreased use of technology and telepractice,emphasizing best practice and treating within scopeof practice and/or competency.
Impaired Practitioner Principle of Ethics I, Rule R Principle of Ethics I, Rule S – New RuleIndividuals who have knowledge that a colleague isunable to provide professional services with reasonableskill and safety shall report this information to theappropriate authority, internally if a mechanism existsand, otherwise, externally.This new Rule recognizes that impaired practitionersmay not always be able or willing to seek professionalassistance and/or withdraw from practice.
Patient/Client AbandonmentPrinciple I, Rule TIndividuals shall provide reasonable notice andinformation about alternatives for obtaining care inthe event that they can no longer provideprofessional services.Issues in Ethics Statement:Client Abandonment bandonment/Updated IES Coming Soon!
Research Conduct44Principle II, Rule C – New RuleIndividuals who engage in research shall comply with allinstitutional, state, and federal regulations that address anyaspects of research, including those that involve humanparticipants and animals.Principle IV, Rule RIndividuals shall comply with local, state, and federal laws andregulations applicable to professional practice, researchethics, and the responsible conduct of research.Principle II, Rule C was created to clarify basic regulatorycompliance for both professional practice and researchendeavors.
Administrative/SupervisoryRolesPrinciple II, Rule FIndividuals in administrative or supervisory roles shall notrequire or permit their professional staff to provide servicesor conduct clinical activities that compromise the staffmember’s independent and objective professional judgment.This new Rule addresses issues in practice environmentsincluding unrealistic productivity demands, billing pressureswith conflicts, and being asked to provide services outside ofone’s scope of practice and/or competency.
Issues in Ethics Statement:Prescription (2015)“In all circumstances, it is incumbent on thespeech-language pathologist or audiologistto determine when to accept limitations onprofessional responsibility maintain[]independence of judgment and preserve[] theprofessional prerogatives to plan and provide speechlanguage pathology or audiology services that are inthe best interest of the individual client and accept[]responsibility n/
Conflict of InterestPrinciple III, Rule BIndividuals shall avoid engaging in conflicts ofinterest whereby personal, financial, or otherconsiderations have the potential to influenceor compromise professional judgment andobjectivity.
DisclosuresPrinciple III, Rule GIndividuals shall not knowingly make false financialor nonfinancial statements and shall complete allmaterials honestly and without omission.This new Rule strengthens the disclosurerequirements that are already required forprocesses related to research, presentation, orwriting.
DisclosuresPrinciple IV, Rule FPrinciple IV, Rule QThese new Rules were created to be specific about therequired behavior of individuals who are: Applying for ASHA certification and/or membership orreinstatement thereof, as well as individuals who arerequired to make disclosures for other similar purposes –Principle IV, Rule F; Making or responding to ethics complaints or offeringevidence and/or testimony for a complaint – Principle IV,Rule Q.
Reporting Members of OtherProfessionsPrinciple IV, Rule NIndividuals shall report members of other professions who theyknow have violated standards of care to the appropriateprofessional licensing authority or board, other professionalregulatory body, or professional association when suchviolation compromises the welfare of persons served and/orresearch participants.Because ASHA members and/or certificate holders work withmany related professionals, this new Rule was created toencourage the reporting of conduct that compromises the careof those we serve.
Self-ReportingPrinciple IV, Rule SIndividuals who have been convicted; been found guilty; orentered a plea of guilty or nolo contendere to (1) anymisdemeanor involving dishonesty, physical harm – or thethreat of physical harm – to the person or property ofanother, or (2) any felony, shall self-report by notifying ASHAStandards and Ethics (see Terminology for mailing address)in writing within 30 days of the conviction, plea, or finding ofguilt. Individuals shall also provide a certified copy of theconviction, plea, nolo contendere record, or docket entry toASHA Standards and Ethics within 30 days of self-reporting.
Self-Reporting – Principle IV, Rule S(5) Disclosure InformationThis new Rule mirrors and1.Have you ever been convicted; been foundsupports the first disclosureguilty; or entered a plea of guilty or nolocontendere toquestion on the audiology andmisdemeanor involving dishonesty,SLP applications for certification A. Anyphysical harm to the person or propertyor reinstatement thereof,of another, or a threat of physical harmto the person or property of another orrequiring an individual to “selfB. Any felony?report” any convictions,Check one: [ ] Yes [ ] No2.Are you presently indicted on or chargedmisdemeanors, felonies, etc.,withwhen applying for ASHAA. One or more misdemeanors involvingdishonesty, physical harm to the personcertification or when becomingor property of another, or threat ofASHA certified. The new themephysical harm to the person or propertyof another orof self-disclosure is fortified byB. One or more felonies?this Rule.Check one: [ ] Yes [ ] No
Self-ReportingPrinciple IV, Rule TIndividuals who have been publicly sanctioned ordenied a license or a professional credential by anyprofessional association, professional licensingauthority or board, or other professional regulatorybody shall self-report by notifying ASHA Standards andEthics (see Terminology for mailing address) in writingwithin 30 days of the final action or disposition.Individuals shall also provide a certified copy of thefinal action, sanction, or disposition to ASHAStandards and Ethics within 30 days of self-reporting.
Self-Reporting – Principle IV, Rule TThis new Rule mirrors andsupports the third disclosurequestion on the audiology andSLP applications for certificationor reinstatement thereof,requiring an individual to “selfreport” any public sanctions,professional discipline, or denialsof a credential/license, etc., whenapplying for ASHA certification orbecoming ASHA-certified. Thenew theme of self-disclosure isfortified by this Rule.Disclosure Information (continued)3.Have you ever beenA. Disciplined or sanctioned, otherthan for insufficient professional orcontinuing education, by anyprofessional association,professional licensing authority orboard, or other professionalregulatory body?B. Denied a license or a professionalcredential by any professionalassociation, professional licensingauthority or board, or otherprofessional regulatory body?Check one: [ ] Yes [ ] No
National Practitioner Data Bank(NPDB)Healthcare Integrity Practitioner DataBank (HIPDB)Nowhere to Run, Nowhere to HideMartha and the Vandellas
National Practitioner Data Bank (NPDB) and theHealthcare Integrity and Protection Data Bank(HIPDB) NPDB - Title IV of Public Law 99-660, the HealthCare Quality Improvement Act of 1986, asamended; National Practitioner Data Bank openedin September 1990 (45 CFR Part 60) HIPDB - Established under Section 1128E of theSocial Security Act as Added by Section 221(a) ofthe Health Insurance Portability and AccountabilityAct (HIPAA) of 1996; HIPDB Opened 1999(implementing regulations (45 CFR Part 61)Campbell, S (2008). Healthcare Integrity & Protection Databank updates.Presentation at the annual convention of the National Council of State Boardsof Examiners for Speech-Language Pathology and Audiology, Vienna, VA.
Laws Governing the Data Banks Third Law Governing the NPDB and HIPDB – Section 5(b)of the Medicare and Medicaid Patient and ProgramProtection Act of 1987, Public Law 100-93 (Section 1921 ofthe Social Security Act, as amended)Illich, D., Erlandson, D., and Hua, J. (2012). What Speech-LanguagePathologists and Audiologists Need to Know about the Data Banks.Licensure, Summer 2012.
NPDB-HIPDB PurposeThe intent is to protect the public,improve the quality of health care anddeter fraud and abuse in the healthcare system by providing informationabout past adverse actions ofpractitioners, providers, or suppliers toauthorized health care entities andagencies.
Who reports to the NPDB-HIPDB?NPDB (under Section 1921)HIPDB Medical Malpractice Insurers State Licensing & Certification Agencies Hospitals and Other Health CareOrganizations Health Plans Peer Review Organizations Private Accreditation Organizations Professional Societies* Federal Agencies Drug Enforcement AgencyHHS Office of Inspector GeneralHealth Resources and Services Admin.Indian Health ServicesDOD Health Care EntitiesVeterans HospitalsFederal and StateGovernmentAgenciesHealth Plans* With formal peer review
What is reportable to the NPDB-HIPDB?NPDBHIPDB Medical Malpractice Licensure ActionsPayments Medicare & Medicaid All practitionersExclusions Adverse Actions Federal and State Health(physicians and dentists)Care Programs Licensure Criminal Convictions orCivil Judgments Clinical Privileges Must be health care related Professional SocietyMembership* Other Adjudicated Actions Medicare and Medicaid Formal or official final actionExclusions Availability of a due process All practitionersmechanism DEA Actions Acts or omissions that affector could affect the payment, All practitionersprovision, or delivery of a*other practitioners may be reported health care service or item
Letters of ConcernAny negative action or finding that is publiclyavailable information and is rendered by a licensingor certification authority is reportable. Some states consider a Letter of Concern to bea publicly available negative action or finding,thereby making it available. States that do not consider a Letter of Concernto be a publicly available negative action orfinding are not required to report the action tothe Data Bank.Illich, D., Erlandson, D., and Hua, J. (2012). What Speech-Language Pathologists andAudiologists Need to Know about the Data Banks. Licensure, Summer 2012.
NPDB and HIPDB Merger HRSA published the NPRM on February 15, 2012 toimplement Section 6403 of the Affordable Care Actof 2010. Purpose - to eliminate duplicative data reporting andaccess requirements between the NPDB andHIPDB and to streamline Data Bank operations. The statute’s intent was to transition HIPDBoperations to the NPDB while maintaining reportingand querying requirements.Illich, D., Erlandson, D., and Hua, J. (2012). What Speech-LanguagePathologists and Audiologists Need to Know about the Data Banks.Licensure, Summer 2012.
The Data Bank Merger The Final Rule was published in the April 5, 2013Federal Register and became effective May 6,2013. The NPDB and the HIPDB merged into one databank: the NPDB. The website: http://www.npdb.hrsa.govRetrieved October 1, rge.jsp
NPDB Reporting Basis for Action Codes (e.g., Breach ofConfidentiality, Improper or InadequateSupervision or Delegation) Action Codes (e.g., Probation, Suspension,Fines) Revisions to Actions (e.g., License Restored,Extension of Previous Action)
HIPDB - As of December 31, 2011Total of 1216 Reports for Audiologists and SLPso 265 reports for audiologistso 951 reports for speech-language pathologistsIllich, D., Erlandson, D., and Hua, J. (2012). What speech-languagepathologists and audiologists need to know about the data banks.Licensure, Summer 2012.
HIPDB – “Repeat Offenders”Audiology Practitioners - Reports in HIPDB One Report – 140 Two Reports – 40 Three Reports – 4 Four Reports –3 Five Reports –3 Total 190As of December 31, 2011
HIPDB – “Repeat Offenders”SLP Practitioners with Reports in HIPDB One Report – 554 Two Reports – 142 Three Reports – 23 Four Reports –5 Five Reports –5 Total 729As of December 31, 2011
HIPDB – “Top 15 Reasons for AARs”AUDIOLOGISTS Other, not classified 32 Unprofessional conduct -28 Violation of Federal/State statutes,regulations, or rules 24 License action by Federal, State, or locallicensing authority 22 Criminal Convictions - 20 Practicing without a valid license - 19 Failure to comply with CE requirements - 18As of 12-31-11 (Cumulative Data)
HIPDB – “Top 15 Reasons for AARs”AUDIOLOGISTS (Continued) Negligence 11Program-related conviction 11Incompetence –10Practicing with an expired license - 6Misrepresentation of credentials - 6Improper or inadequate supervision ordelegation 5 Improper or abusive billing practices –5 Failure to meet licensure board reportingrequirements 3As of 12-31-11 (Cumulative Data)
HIPDB – “Top 15 Reasons for AARs”SPEECH-LANGUAGE PATHOLOGISTS Failure to comply with continuing educationrequirements 112 Violation of Federal/State statutes, regulations,or rules 105 Practicing without a valid license 98 Practicing with an expired license – 69 Other, not classified 63 Unprofessional conduct 50 Failure to meet licensing board reportingrequirements 44As of 12-31-11 (Cumulative Data)
HIPDB – “Top 15 Reasons for AARs”SPEECH-LANGUAGE PATHOLOGISTS(Continued) Improper or inadequate supervision ordelegation 35 Criminal convictions 35 License action by federal, state or local licensingauthority –23 Improper or abusive billing practices - 35 Negligence 17 Program-related conviction 16 Misrepresentation of credentials - 14 Incompetence 10As of 12-31-11 (Cumulative Data)
Number of NPDB Reports byPractitioner Type09/01/1990-12/31/2014Report TypeAudiologistsSLPsTotalClinical Privileges/PanelMembership Action123Exclusion Action5171122Government AdministrativeAction426Judgment or Conviction156883Malpractice Payment471966State Licensure Actions25812271485Total NPDB Reports38413891773Illich, D., and Hua, J. (2015). Update on the Data Bank for SpeechLanguage Pathologists, Audiologists and their State Boards.Licensure, Summer 2015.
Ethical Decision-Making ModelAm Ifacing anethicaldilemmahere?What are therelevant facts,values & beliefs?Who are the keypeople involved?(Chabon, S. and Dunham, Chapter 7, in Chabon, S., Denton, D.R., Lansing, C.R.,Scudder, R.R. and Shinn, R. (2007) Ethics education. ASHA Publication.
Ethical Decision-Making ModelState thedilemma clearlyAnalysisChabon, S. & Morris, J. (2005). Raising ethical awareness in the practice of speechlanguage pathology and audiology: A 24/7 endeavor. California Speech-LanguageHearing Association Magazine, 35 (1) 6-8.
Ethical Decision-Making ModelWhat are thepossible coursesof actionone could take?What are theconflictsthat arise fromeach action?PROPOSEDCOURSE OFACTIONChabon, S. & Morris, J. (2005). Raising ethical awareness in the practice of speechlanguage pathology and audiology: A 24/7 endeavor. California Speech-LanguageHearing Association Magazine, 35 (1) 6-8.
Ethical Decision-Making ModelEvaluate:1)2)3)4)5)6)Ethical PrinciplesCode of EthicsCultural Heritage/ValuesSocial RolesSelf-InterestsLawsDoes your proposedcourse of actionlead toCONSENSUS?If YES –then proceed Chabon, S. & Morris, J. (2005). Raising ethical awareness in the practice of speechlanguage pathology and audiology: A 24/7 endeavor. California Speech-LanguageHearing Association Magazine, 35 (1) 6-8.
Ethical Decision-Making ModelAm Ifacing anEthicaldilemmahere?What are therelevant facts,values & beliefs?State thedilemma clearlyWho are the keypeople involved?Evaluate:1) Ethical Principles2) Code of Ethics3) CulturalHeritage/Values4) Social Roles5) Self-Interests6) LawsPROPOSEDCOURSE OFACTIONDoes your proposedcourse of actionlead toCONSENSUS?If YES –then proceed What are theconflictsthat arise fromeach action?If NOAnalysisWhat are thepossible coursesof actionone could take?(Morris & Chabon, 2005)
Ethical ScenariosEach of the scenarios represents a potentialviolation of the ASHA Code of Ethics or adilemma with which you may be confronted.Determine if any violation has occurred and, ifso, which principle(s) and/or rule(s) has beenviolated. Analyze the situations relative topotential ethical violations and resolution of theproblems.
Scenarios applicable to various audiologyand speech-language pathology practicesettings will be presented for participantdiscussion at the conference session. Audioclips will be utilized to enhance the scenariothemes.
Discussion Questions1. What is the major ethical issue in thiscase?2. Is this a violation of the ASHA Code ofEthics?3. If so, which principle(s) and/or rule(s)does it violate?4. Is time of the essence and what arethe consequences?
IPEInterprofessional Education“ Two or more professions learn about,from, and with each other to enableeffective collaboration and improve healthoutcomes.”World Health Organization Definition
Interprofessional Practice (IPP)“ Multiple health workers from different professionalbackgrounds provide comprehensive health servicesby working with patients, their families, caregivers,and communities to deliver the highest quality ofcare across settings.”Framework for Action on Interprofessional EducationWorld Health Organization Definition
Interprofessional Education Collaborative Expert Panel. (2011). Core competencies forinterprofessional collaborative practice: Report of an expert panel. Washington, D.C.:Interprofessional Education Collaborative.
Core Competency Statements for IPP:Values/EthicsGeneral Competency Statement-VE. Work with individuals of otherprofessions to maintain a climate of mutual respect and sharedvalues.Specific Val
violated, you shall inform the ASHA Board of Ethics pursuant to Principle IV, Rule M. Code of Ethics (2010r) Code of Ethics (2010r) is the applicable code for suspected violations occurring prior to March 1, 2016. Code of Ethics (2016) The newest revision of the ASHA Code of Ethics (2016) is the applicable code for suspected violations .
May 02, 2018 · D. Program Evaluation ͟The organization has provided a description of the framework for how each program will be evaluated. The framework should include all the elements below: ͟The evaluation methods are cost-effective for the organization ͟Quantitative and qualitative data is being collected (at Basics tier, data collection must have begun)
Silat is a combative art of self-defense and survival rooted from Matay archipelago. It was traced at thé early of Langkasuka Kingdom (2nd century CE) till thé reign of Melaka (Malaysia) Sultanate era (13th century). Silat has now evolved to become part of social culture and tradition with thé appearance of a fine physical and spiritual .
On an exceptional basis, Member States may request UNESCO to provide thé candidates with access to thé platform so they can complète thé form by themselves. Thèse requests must be addressed to esd rize unesco. or by 15 A ril 2021 UNESCO will provide thé nomineewith accessto thé platform via their émail address.
̶The leading indicator of employee engagement is based on the quality of the relationship between employee and supervisor Empower your managers! ̶Help them understand the impact on the organization ̶Share important changes, plan options, tasks, and deadlines ̶Provide key messages and talking points ̶Prepare them to answer employee questions
Dr. Sunita Bharatwal** Dr. Pawan Garga*** Abstract Customer satisfaction is derived from thè functionalities and values, a product or Service can provide. The current study aims to segregate thè dimensions of ordine Service quality and gather insights on its impact on web shopping. The trends of purchases have
Chính Văn.- Còn đức Thế tôn thì tuệ giác cực kỳ trong sạch 8: hiện hành bất nhị 9, đạt đến vô tướng 10, đứng vào chỗ đứng của các đức Thế tôn 11, thể hiện tính bình đẳng của các Ngài, đến chỗ không còn chướng ngại 12, giáo pháp không thể khuynh đảo, tâm thức không bị cản trở, cái được
A Framework for Ethical Decision Making in Business In business, people make decisions differently than at home Organizational pressures have a strong influence The ethical decision making process includes Ethical issue intensity Individual factors Organizational factors The framework for ethical decision making does not describe how to make ethical decisions
Thinking, the Framework for Ethical Decision Making offers you a four step process for effective ethical decision making. If you use this framework to solve every ethical problem you encounter, you will become a powerful ethical decision-maker, which in turn will allow you to be an influential and effective professional. How is the Framework Used?
