Experienced speech-language pathologists' responses to ethical dilemmas: an integrated approach to ethical reasoning.
OBJECTIVE
To investigate the approaches of experienced speech-language pathologists (SLPs) to ethical reasoning and the processes they use to resolve ethical dilemmas.


METHODS
Ten experienced SLPs participated in in-depth interviews. A narrative approach was used to guide participants' descriptions of how they resolved ethical dilemmas. Individual narrative transcriptions were analyzed by using the participant's words to develop an ethical story that described and interpreted their responses to dilemmas. Key concepts from individual stories were then coded into group themes to reflect participants' reasoning processes.


RESULTS
Five major themes reflected participants' approaches to ethical reasoning: (a) focusing on the well-being of the client, (b) fulfilling professional roles and responsibilities, (c) attending to professional relationships, (d) managing resources, and (e) integrating personal and professional values. SLPs demonstrated a range of ethical reasoning processes: applying bioethical principles, casuistry, and narrative reasoning when managing ethical dilemmas in the workplace.


CONCLUSIONS
The results indicate that experienced SLPs adopted an integrated approach to ethical reasoning. They supported clients' rights to make health care choices. Bioethical principles, casuistry, and narrative reasoning provided useful frameworks for facilitating health professionals' application of codes of ethics to complex professional practice issues.
Kenny
Belinda
B
University of Sydney-Speech Pathology, Faculty of Health Sciences, Cumberland Campus, Lidcombe, New South Wales 1825, Australia. b.kenny@usyd.edu.au
Lincoln
Michelle
M
Balandin
Susan
S
D000328:Adult; D004989:Ethics; D005260:Female; D006801:Humans; D008875:Middle Aged; D011340:Problem Solving; D011361:Professional Competence; D013066:Speech-Language Pathology; D013663:Teaching; D000078329:Workforce