The audiologist in this scenario faces an ethical dilemma regarding his decision not continue holding ASHA certification due to the cost implications. A decision to maintain the credential will come at an additional cost for the audiologist, which he views as a negative outcome on his part. However, the decision not to hold the credential also negatively affects his students’ career progression. Consequently, the ethical dilemma in this case is whether to continue incurring the cost to facilitate the students’ attainment of future credentialing or to stop the practice and complicate the matter for students who wish to attain ASHA certification.
Before making a value judgment of the decision by the audiologist, it is important to understand the fact surrounding the current scenario. Firstly, ASHA does not require a receptor or supervisors as commonly referred to undergo any additional formal training or hold a special certificate apart from the CCC-A which is the main certificate required of receptors in programs with ASHA accreditation (Hamill, 2012).
Consequently, the issue arising from the decision by the audiologist not to maintain credential is whether the student requires it for future practice and the impact on professional development if the student does not get the certification. Ultimately, the decision whether maintaining ASHA certification is important lies on the graduate students. By the time a student has initial practical exposure in audiology, they must have made the decision on whether they need ASHA certification or plan to take a different professional route.
Since not all preceptors are ASHA certified (Hamill, 2012), students can demand such credentials based on their professional decision. In this case, it is approached for students wishing to attain ASHA certification to request that all their placements be with ASHA certified preceptors. When this is the case, it is only ethical that the receptor maintains the credentials to assist the students in their professional growth.
The ethical dilemma in this situation surrounds whether the student should enter a dating relationship with the patient or not. Further, how does the student enter such a relationship? Should she first stop providing the diagnostic services to the patient or continue offering the services and then wait for the prescribed time to elapse before they begin dating?
Although the current case relates to a student on externship, her case can still be generalized to reflect the practice of the profession. The issue of dating or entering a romantic relationship is clearly highlighted in the medical profession. The ethical guidelines assert that a medical practitioner cannot enter a romantic relationship with a patient while the patient is still under her care (Alghrani, Bennett and Ost, 2012). The two can only enter a romantic relationship with the medical practitioner has formally discharged the patient. Further, the ethical requirement also provides that even after discharging the patient, the two cannot enter a romantic relationship with a prescribed number of months usually six months to one year.
The possibilities of the outcome of dating relationship between a physician and patient means the student must weigh the matter and make a decision that will not jeopardize her professional development (Alghrani, Bennett and Ost, 2012). However, she must also consider acceptable ways of getting into a dating relationship with the current patient to ensure she does not neglect her emotional growth.
The student must decide what is best for her profession and emotional growth. She should first make a decision on whether she is keen on entering a dating relationship with the patient. If the answer is yes, will then have to terminate the physician-patient relationship formally before commencing the dating relationship for her to ensure the relationship is ethical.
As the supervisor, Dr. Brown faces an ethical dilemma when making the decision on how to handle the request for a letter of recommendation from the student. The doctor can choose to report that the student had successfully met the university requirement for placement. The other option is to provide an accurate assessment of the level of performance demonstrated by the student during the period of placement.
Professional practice requires members to demonstrate they are adequately furnished with relevant knowledge and practical skills in their area of specialization. One of the areas that students demonstrate their readiness practice is by meeting all their responsibilities during internship and externship programs. Consequently, the performance of these programs might be an indicator of how effective the student can be relied upon to offer quality services (Lubinski and Hudson, 2012).
In this case, the marginal performance by the student can be used as an indicator that she is not ready to practice although her performance at the university might be exemplary. Based on the performance demonstrated during the rotation, it can be argued that the student is not ready to practice.
Dr. Brown must provide a letter of recommendation that clearly reflect the level of professional development attained by the student since the provision of a letter of recommendation that misleads future employer might put future patients at risk. When arriving at the decision, Dr. Brown should be guided by the ethical principle of honesty (Lubinski and Hudson, 2012). If the receptor is not sure of the best action to take under this circumstance, consultation with the university liaison might be beneficial. The consultation might lead to an assessment of the overall performance of the student so that the final decision reflects her development both from the academic perspective and from the evaluation of her practice skills during the rotation.
Ethical practice requires that the receptor provide accurate information on the performance of the student during the rotation. The doctor should, therefore choose not to write the letter of recommendation or write facts on the performance of the student to minimize risk to future patients and help the student improve in areas of weakness.
Reference
Alghrani, A., Bennett, R., & Ost, S. (Eds.). (2012). Bioethics, Medicine and the Criminal Law: The Criminal Law and Bioethical Conflict: Walking the Tightrope (Vol. 1). Cambridge: Cambridge University Press.
Hamill, T. (Eds.). (2012). Ethics in audiology (2nd ed.). Reston, VA: American Academy of Audiology.
Lubinski, R., & Hudson, M. (2012). Professional issues in speech-language pathology and audiology. Boston, MA: Cengage Learning.
