Aconflict of interest arises when a relationship or circumstance places an individual in a situation in which they have competing interests.
A speech pathologist will be most concerned about avoiding a conflict of interest in relation to the provision of care to their clients or patients. A conflict of interest may occur in speech pathology where a personal or private interest or relationship compromises or improperly influences the performance of a speech pathologist’s professional duty or causes them to make a decision that conflicts with their professional duty to a client or patient.
The mere existence of a conflict of interest does not necessarily indicate any wrongdoing or breach of professional standards. However, it presents a situation that needs to be identified and appropriately managed in accordance with any relevant legal requirements, applicable professional and ethical standards, and the expectations of the community.
These 10 tips and tricks might assist you to avoid and manage a conflict of interest in your practice of speech pathology.
1. Recognise the broad range of potential personal or private interests
A personal or private interest that competes with a professional duty can arise in various ways, some of which are not always readily apparent. The interest may be financial or nonfinancial. Examples of financial interests include holding a board or management position or ownership interest in a health service in which you provide clinical services, undertaking a paid teaching role in addition to clinical duties, and working for more than one employer. Examples of nonfinancial interests include being a member of an organisation that expresses or promotes certain religious, political, health related, or social views and having a personal or social relationship with a patient or a member of a patient’s family.
2. Consider whether your private or personal interest could lead to a conflict of interest
As your career evolves, the nature of your interactions, relationships, and interests will likely change. In the early phase of your career, you might work in a single practice or for a single employer. Later, you may work across multiple employers, establish your own practice, undertake other professional duties such as teaching or research, or even become involved in activities outside speech pathology. These are all potential sources of conflicts of interest. It is worthwhile to regularly review your activities and relationships throughout your career to identify whether your changing professional and personal roles may give rise to a potential conflict.
3. Be aware of the activities that might place you in a conflict-of-interest situation
Certain activities or situations heighten the risk of a conflict-of-interest situation arising. You should be extremely cautious about having any interactions or relationships with patients that are not clinical. As a general rule, you should not engage in any business or financial dealings with a patient. You should maintain professional boundaries with patients and their family and avoid inappropriate social relationships or interactions. Other situations that may heighten the risk of a conflict of interest occurring include accepting a gift or benefit from a patient or their family, promoting any product or service (other than your professional practice), having a financial interest in another business whose products or services you promote or recommend, and undertaking research that involves your clients/patients as participants.
4. Questions to ask
To identify conflict-of-interest risk factors, it is valuable to ask the following questions:
Do you have a personal or private interest (other than the fees or salary you receive for providing speech pathology services) or a relationship that might improperly influence your professional judgement or responsibilities to your patient?
Will you or a family member receive any gift or benefit (other than the fees or salary you receive for providing speech pathology services) in connection with your actions or recommendations regarding a patient?
Could your professional judgement be affected, or perceived to be affected, by your personal interest?
Could your actions compromise your clinical relationship with your patient, or your relationship with your employer, your colleagues, or others, or erode their trust in you?
Would your patient continue the clinical relationship if they were aware of your interest?
5. Recognise who might be affected by a conflict of interest
A conflict of interest has the potential to affect various stakeholders. Most obviously, it might affect your patient. This is a serious issue because a speech pathologist’s foremost consideration as a health professional is the health and wellbeing of their patient. However, a conflict of interest may also potentially affect others, such as your employer, a colleague, or funders of speech pathology services. By considering and recognising who could be affected by a conflict of interest, it will assist you to identify how the conflict might be resolved.
6. Weigh the issue against ethical and professional standards
You should evaluate your potential or actual conflict of interest in light of your legal and ethical obligations as a speech pathologist. Community expectations are also a useful measure to consider. Members of Speech Pathology Australia have an obligation to act in accordance with the professional standards and ethical principles established by Speech Pathology Australia. It may also be necessary to have regard to the legal, professional, and ethical requirements imposed upon all health professionals by state and territory regulatory bodies and agencies.
7. If in doubt about the existence of a conflict of interest, or how to manage it, seek advice
If you are concerned about whether you may have a conflict of interest, or are unsure about how it should be managed, it may be helpful to discuss the matter with another person. In some cases, this might be a colleague or a friend. In other cases, you might seek advice from a professional advisor such as a lawyer, your professional indemnity insurer, or your professional association. Speech Pathology Australia provides guidance on the management of conflicts of interest in professional practice, including through its Code of Ethics and its Conflict of Interest guidelines. It also provides an advisory service to its members and may be able to assist with queries regarding potential conflicts of interest.
8. Be open and disclose the interest
If conflict of interest circumstances arise, you should disclose the relevant interest to the parties that may be affected by it. In particular, you should disclose the interest to those of your clients or patients whose care may potentially be affected—this would be an integral component of a patient’s informed decision-making. Disclosure will allow the patient to consider whether your interest might influence your actions, to assess whether they require you to take some other action, and to decide whether to begin or to cease the clinical relationship with you. Disclosure on its own does not resolve a conflict of interest; however, it will identify relevant concerns and create a framework for the implementation of measures for its management. An outcome may be that you withdraw from the activity or relationship that creates the conflict of interest or that you refer the patient to another speech pathologist. It may also be necessary to disclose the interest to other affected parties such as employers and colleagues.
9. Seek the assistance of a third party
If you cannot avoid or manage a conflict of interest through any of the ways outlined above, it may be appropriate to request an independent third party to assist in advising on or resolving the matter. If appropriate, you might request the third party to make a determination in relation to the matter by applying applicable legal, professional, and ethical principles. The decision of an independent, credible third party may mitigate the likelihood that the outcome would be impugned. Of course, any recommendations of the third party would need to be actioned.
10. Learn more about conflicts of interest
The relationships between speech pathologists, other health providers, patients, funders, educational institutions, researchers, and other stakeholders can be complex, and these interactions increasingly raise the possibility of the occurrence of conflicts of interest. Learning more about conflicts of interest in health and in other professions and industries will assist you to understand how to avoid and manage conflicts of interest in your speech pathology practice. Avoiding and managing conflicts of interest is an important element of practising professionally and ethically.
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Arthur Rallis
Dr. Arthur Rallis is a commercial and health lawyer with a medical background who has 25 years’ experience working with the health industry. He regularly advises health professional associations and health professionals on their legal and ethical obligations.