In the complex, complicated world in which we live, we are faced with moral dilemmas from time to time. The world of speech therapy is no different. Perhaps one could argue that the issues are quite acute in this field. We are dealing with our clients’ daily quality of life. If you are a parent looking for a therapist, it is helpful to be aware of these potential issues. With this in mind, we have detailed some of our “ethical experiences”. They have helped us form our code of speech therapy ethics.

• After seeing a client for a number of sessions, our therapist felt that this child would gain from group therapy with peers. We don’t currently offer such a program. Should the therapist refer this client to another clinic which does offer this program?

We have a straight forward creed, which we call our “relative rule”. Simply put: If this client were our relative, what would we advise them? If we feel that they would be best served by attending a program that we don’t offer-we will refer out. Speech therapy covers many issues. It is almost impossible for a speech therapist to “specialize” in all of them! Although we can assist clients for most speech related issues, we have also developed a relationship with other speech therapists to whom we refer, based on the specific needs of our clients. This is what being ethical means to us.

• After seeing a client for several months, our therapist feels that the client has made sufficient progress to be discharged. The client is content to continue. Should we bring up the option of discharge or wait until the client says something?

As per the “relative rule” above, we would most certainly inform the parent that in our opinion, the child no longer needs speech therapy. If the parent still wished to continue with therapy (which has happened!), we would be comfortable to oblige, knowing that the parent  had all the factors in mind when choosing to do so.

• Most, if not all, 3^rd party funding sources (government, charity, etc.), will not pay for a missed session. As per our policy, if a client doesn’t show up for their appointment, they are responsible for the session fees. Would we invoice the 3^rd party funding as if the session had taken place, since the parent wishes us to do so?

We must follow the guidelines of the funding source. If they will not pay for missed sessions, we cannot invoice them for such an occasion. Doing so would e illegal at worst and not ethical at best. It is important for clients with funding to be aware of this beforehand. This helps avoid such situations in the first place. Therefore, we clearly spell this out in our office policy form, which we give to our clients at or before the first session.

It is important to note that ASHA licensed SLP’s are bound by the ASHA Code of Ethics.