Ethics in stuttering treatment in the schools: issues and intersections

Area of Science:

• Speech-Language Pathology
• Bioethics
• Educational Psychology

Background:

• Providing speech-language pathology services in schools presents unique ethical challenges, particularly for students who stutter.
• The intersection of school-based practice and the specific needs of children who stutter raises complex ethical considerations for clinicians.
• Existing literature often lacks a focused ethical analysis of stuttering intervention within educational settings.

Purpose of the Study:

• To explore and analyze the ethical challenges encountered by speech-language pathologists providing services to students who stutter in school settings.
• To provide a structured ethical framework for evaluating clinical decisions in school-based stuttering treatment.
• To examine the multifaceted impact of ethical considerations on various stakeholders involved in stuttering intervention.

Main Methods:

• The study employs a qualitative approach, analyzing three distinct clinical scenarios involving school-based stuttering treatment.
• Seedhouse's Ethics Grid is utilized as a theoretical scaffold for critical ethical analysis.
• Key ethical principles such as autonomy, beneficence, non-maleficence, and veracity are examined within the context of these scenarios.

Main Results:

• Ethical dilemmas arise concerning respecting student autonomy, prioritizing student needs, and balancing beneficence with risk minimization.
• The study highlights the impact of clinical outcomes on students, families, clinicians, and school personnel.
• Practical concerns including legal mandates, professional codes, stakeholder wishes, and treatment efficacy/efficiency are identified as significant ethical factors.

Conclusions:

• Ethical decision-making in school-based stuttering services requires careful consideration of student-centered principles and practical constraints.
• The application of a structured ethical framework like Seedhouse's Ethics Grid can enhance the analysis and resolution of complex clinical issues.
• Addressing these ethical challenges is crucial for ensuring effective and equitable speech-language pathology services for students who stutter.