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Professional Ethics: Walk the Line: 

Professional Ethics: Walk the Line C. Robin Morehouse, AuD, L-AUD, CCC-A Theresa H. Rodgers, MA, L-SLP, CCC-SLP Glenn M. Waguespack, MS, L-AUD, CCC-A November 16, 2006 ASHA Convention Miami

Slide2: 

Audiologist #1 evaluates a patient for hearing aids and informs the patient that he is recommending the aids from XYZ Manufacturer because he is only four aids away from qualifying for a free cruise. Audiologist #2 sees a different patient and bases his recommendation for aids on the quantity discount he receives from ABC Manufacturer. However, he does not pass the information or the discount on to the patient. Is either audiologist unethical? Are there ethical issues? Which audiologist is more ethical? Walking the Line???

DIFFERENCES/SIMILARITIES CODES OF ETHICS: 

DIFFERENCES/SIMILARITIES CODES OF ETHICS PROFESSIONAL ORGANIZATIONS REGULATORY AGENCIES

DIFFERENCES IN SANCTIONS: 

DIFFERENCES IN SANCTIONS PROFESSIONAL ASSOCIATION REGULATORY BOARD

Review of Complaints: 

Review of Complaints

Considerations inImposing Sanctions: 

Considerations in Imposing Sanctions 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

SANCTIONS : 

SANCTIONS Issue a private letter of reprimand or concern Issue a public letter of reprimand or concern Require restitution of costs and expenses Impose probationary conditions Impose a fine for each violation Suspend the license Revoke the license Restrict the license by limiting or reducing scope of practice Other discipline (e.g., Open Book Examination)

Healthcare Integrity and Protection Data Bank (HIPDB): 

Healthcare Integrity and Protection Data Bank (HIPDB) Established under Section 1128E of the Social Security Act as Added by Section 221(a) of the Health Insurance Portability and Accountability Act (HIPAA) of 1996

Healthcare Integrity and Protection Data Bank (HIPDB): 

Healthcare Integrity and Protection Data Bank (HIPDB) The HIP Data Bank is a national health care data collection program for the reporting and disclosure of certain final adverse actions taken against health care providers, suppliers, or practitioners. Its principal goal is to prevent health care fraud and abuse and to improve the quality of patient care.

Slide10: 

Healthcare Integrity and Protection Data Bank (HIPDB) Who is reported? Health Care Practitioners and Providers Who must report? Federal and State Government Agencies, Health Plans What is reported to HIPDB? (Practitioners, Providers, Suppliers) Licensing and Certification Actions; Criminal Convictions; Civil Judgments; Exclusions from Federal or State health care programs; Other adjudicated actions or decisions

HIPDB – Basis for Action Codes Confidentiality, Consent or Disclosure Violations: 

HIPDB – Basis for Action Codes Confidentiality, Consent or Disclosure Violations Example: C3 Breach of Confidentiality Misconduct or Abuse Examples: 71 Conflict of Interest D3 Exploiting a Patient for Financial Gain

HIPDB - Action Codes Licensure - Actions: 

HIPDB - Action Codes Licensure - Actions Revocation of License Probation of License Suspension of License Reprimand or Censure Voluntary Surrender of License Limitation or Restriction on License Denial of License (Renewal Only)

Ethical Situations: 

Ethical Situations The following scenarios represent potential violations of a professional association and/or state regulatory board Code of Ethics. Read each carefully and determine whether a violation has occurred. If so, indicate which of the principle(s) has been violated and the appropriate sanction.

Livin’ La Vida Loca: 

Livin’ La Vida Loca Ricky Martin

ETHICAL SITUATION SPEECH-LANGUAGE PATHOLOGY: 

ETHICAL SITUATION SPEECH-LANGUAGE PATHOLOGY Ima Essellpea, a local salsa instructor and speech-language pathologist, paid for the following ad to be published in the local yellow pages: 'Specializing in the latest technology-based treatment for stuttering. Guaranteed to show improvement within 30 days.' A complaint is filed by one of Ms. Essellpea’s patients who maintains that his fluency problem did not improve within the first 30 days.

Slide16: 

Is this a violation of the ASHA Code of Ethics? If so, which principle(s) does it violate? Is this a violation of a state regulatory board’s Code of Ethics? If so, which principle(s) does it violate? Assuming that a disciplinary hearing is held, what might be the appropriate sanction(s)? How would you report the actions to the HIPDB?

Slide17: 

Bridge over Troubled Water Simon and Garfunkel

Ethical Situation: 

Ethical Situation You and another supervisor have been assigned to supervise graduate student clinical practicum activities in a rehabilitation center off-campus. You file a complaint stating that the other supervisor often lets his/her supervisees dismiss therapy early and go home, but still lets the students claim the full amount of clinical practicum hours.

Slide19: 

Is this a violation of the ASHA Code of Ethics? If so, which principle(s) does it violate? Is this a violation of a state regulatory board’s Code of Ethics? If so, which principle(s) does it violate? Assuming that a disciplinary hearing is held, what might be the appropriate sanction(s)? How would you report the actions to the HIPDB?

Crying in the Chapel: 

Crying in the Chapel Elvis

Ethical SituationSpeech/Language Pathology: 

A Fort Lauderdale SLP who is planning to get married over the weekend and go on her honeymoon the following week, is intent on having all paperwork completed before she leaves work on Friday. On Thursday, she completes the Medicaid billing for the month and includes therapy sessions for two children who are usually seen on Friday mornings. The therapy logs indicate that both children are absent on Friday, but she submits the billing as it was completed with the intention to omit one of the Medicaid billings for the next session with the children. After an audit, a complaint is filed by Medicaid officials. Ethical Situation Speech/Language Pathology

Slide22: 

Is this a violation of the ASHA Code of Ethics? If so, which principle(s) does it violate? Is this a violation of a state regulatory board’s Code of Ethics? If so, which principle(s) does it violate? Assuming that a disciplinary hearing is held, what might be the appropriate sanction(s)? How would you report the actions to the HIPDB?

Slide23: 

I Shot the Sheriff Eric Clapton

ETHICAL SITUATION AUDIOLOGY: 

ETHICAL SITUATION AUDIOLOGY Sheriff Boudreaux has noise-induced hearing loss because Thibodaux’s gun accidentally went off close to Boudreaux’s ear while they were in the duck blind. Sheriff Boudreaux’s audiologist works part-time at two different sites. Equally priced hearing aids are dispensed at both sites, but his audiologist only receives commissions at one site. The audiologist sends the Sheriff to the site which provides the commission. After being fitted with the aids, the Sheriff finds out the audiologist has an office closer to the Sheriff’s house that would have been more convenient for him.

Slide25: 

Is this a violation of the ASHA Code of Ethics? If so, which principle(s) does it violate? Is this a violation of a state regulatory board’s Code of Ethics? If so, which principle(s) does it violate? Assuming that a disciplinary hearing is held, what might be the appropriate sanction(s)? How would you report the actions to the HIPDB?

Slide26: 

Take It Easy The Eagles

ETHICAL SITUATION AUDIOLOGY: 

ETHICAL SITUATION AUDIOLOGY While an experienced audiologist is making an earmold impression for a patient in the office, the material inadvertently goes beyond the cotton block, resulting in a small perforation of the tympanic membrane. The patient files a complaint.

Slide28: 

Is this a violation of the ASHA Code of Ethics? If so, which principle(s) does it violate? Is this a violation of a state regulatory board’s Code of Ethics? If so, which principle(s) does it violate? Assuming that a disciplinary hearing is held, what might be the appropriate sanction(s)? How would you report the actions to the HIPDB?

Margaritaville: 

Margaritaville Jimmy Buffet

ETHICAL SITUATION AUDIOLOGY: 

ETHICAL SITUATION AUDIOLOGY A parent with concerns about his/her child’s hearing sees audiologist #1 who determines that the child’s hearing is within normal limits. Unconvinced, the next day the parent seeks a second opinion from audiologist #2 who diagnoses the child as having a moderate hearing loss. The parent files a complaint. During the investigation the secretary reported that audiologist #1 conducted the hearing evaluation on a Friday afternoon after the audiologist returned from lunch in Little Havana with the smell of alcohol (mojitos) on his breath.

Slide31: 

Is this a violation of the ASHA Code of Ethics? If so, which principle(s) does it violate? Is this a violation of a state regulatory board’s Code of Ethics? If so, which principle(s) does it violate? Assuming that a disciplinary hearing is held, what might be the appropriate sanction(s)? How would you report the actions to the HIPDB?

Witchy Woman: 

Witchy Woman The Eagles

ETHICAL SITUATION SPEECH-LANGUAGE PATHOLOGY: 

ETHICAL SITUATION SPEECH-LANGUAGE PATHOLOGY An SLP assistant working with a client with ADHD and a language impairment complains to her supervisor because she feels she needs help in dealing with the student’s significant behavioral problems as well as the language disorder. She feels she is not getting enough supervision but the supervisor states that she’s too busy to give more time to the assistant. The supervisor tells her she should have already learned in her coursework what to do with clients like this. The assistant voices her concerns to the department head who then files a formal complaint.

Slide34: 

Is this a violation of the ASHA Code of Ethics? If so, which principle(s) does it violate? Is this a violation of a state regulatory board’s Code of Ethics? If so, which principle(s) does it violate? Assuming that a disciplinary hearing is held, what might be the appropriate sanction(s)? How would you report the actions to the HIPDB?

Slide35: 

Money (That’s What I Want) Barrett Strong

ETHICAL SITUATION AUDIOLOGY: 

ETHICAL SITUATION AUDIOLOGY The State Commission for the Deaf implements a hearing aid program for individuals who meet age, audiological, and income requirements. An audiologist, who is a participating vendor in the state’s program, fits an elderly lady from Broward County who meets the eligibility requirements but does not inform the lady of his participation in the program and charges full price for the aids. Upon learning of the program through her neighbor, the lady asks the audiologist for a refund. The audiologist refuses because it has been ninety days since the aids were fitted. The lady files a complaint.

Slide37: 

Is this a violation of the ASHA Code of Ethics? If so, which principle(s) does it violate? Is this a violation of a state regulatory board’s Code of Ethics? If so, which principle(s) does it violate? Assuming that a disciplinary hearing is held, what might be the appropriate sanction(s)? How would you report the actions to the HIPDB?

Sherry: 

Sherry The Four Seasons

ETHICAL SITUATION SPEECH-LANGUAGE PATHOLOGY: 

ETHICAL SITUATION SPEECH-LANGUAGE PATHOLOGY Sherry Carpenter, the wife of a prominent attorney is an SLP for the school system. She has a known alcohol abuse problem and has been issued numerous DUI citations for which she’s never been prosecuted. One morning as she drove into the school parking lot, she lost control of her vehicle and plowed into the side of the school cafeteria. The principal of the school notified authorities who found her to have a blood alcohol level of 1.2. Subsequently, the Special Education Supervisor filed a complaint.

Slide40: 

Is this a violation of the ASHA Code of Ethics? If so, which principle(s) does it violate? Is this a violation of a state regulatory board’s Code of Ethics? If so, which principle(s) does it violate? Assuming that a disciplinary hearing is held, what might be the appropriate sanction(s)? How would you report the actions to the HIPDB?

The Devil in Disguise: 

The Devil in Disguise Elvis

Ethical Situation Speech-Language Pathology: 

Ethical Situation Speech-Language Pathology An SLP dismisses a client from therapy after repeatedly discouraging his sexual advances. She provides him with a referral list of three SLPs. The client reviews the list and tells her which SLP he has selected but refuses to sign a release of information. Concerned that a colleague may be subjected to the same sexual advances, she calls her colleague to warn her of this client’s behavior.

Slide43: 

Is this a violation of the ASHA Code of Ethics? If so, which principle(s) does it violate? Is this a violation of a state regulatory board’s Code of Ethics? If so, which principle(s) does it violate? Assuming that a disciplinary hearing is held, what might be the appropriate sanction(s)? How would you report the actions to the HIPDB?

Burning Love: 

Burning Love Elvis

ETHICAL DILEMMA AUDIOLOGY: 

ETHICAL DILEMMA AUDIOLOGY An audiologist evaluates a wealthy patient from the Keys and determines that he would benefit from hearing aids. During a subsequent appointment to fit the hearing aids, the patient asks the audiologist for a date (both are divorced). She has dinner with him that evening and continues to see him socially and professionally.

Slide46: 

I keep my eyes open all the time…… I Walk the Line

WHAT IS YOUR ETHICAL DILEMMA?: 

WHAT IS YOUR ETHICAL DILEMMA?

Slide48: 

E-MAIL ADDRESSES Robin Morehouse [email protected] Theresa Rodgers [email protected] Glenn Waguespack [email protected]

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