BOUNDARY ISSUES (1)

Jois Stansfield and Frances McAleer consider the following scenario:

Brought to (Face)book
BOUNDARY ISSUES EXPLAINED The Health Professions Council Standards of Conduct, Performance and Ethics require us to behave with honesty and integrity at all times (p.14). We are reminded that poor conduct outside of your professional life may still affect someones confidence in you and your profession (p.9). Arguably, our clinical conversations and research literature do not focus sufficiently on moral principles, but they at least touch on the ethics around issues such as prioritisation and evidence-based practice. In this new series we think through the sort of everyday events which although they receive much less attention - also need to be on our ethical radar screen. (HPC, 2008). The Royal College of Speech & Language Therapists code of ethics and professional behaviour (RCSLT, 2006) is also helpful in reminding us of our duties. Ethical reasoning can be supported by tools such as the Seedhouse grid and Values Exchange (Seedhouse, 2009). Ethical principles and guidelines may not have been designed to deal with current forms of communication, but they can be used to guide professional and personal behaviour. Nevertheless, ultimately it is up to each of us to judge what is correct behaviour. Our duty towards our clients includes ensuring that the well-being of the clients is not compromised by any action or omission on the part of the SLT (RCSLT, 2006, p.12) and that we should have effective and proper communication with them. This might suggest that if we see a criticism of the speech and language therapy service we are offering on a social networking site, we should respond, either directly through the site, or later once we meet the client in clinic. But we are also required to avoid inappropriate or disruptive personal relationships with clients (RCSLT, 2006, p.11), so this would need to be considered carefully. The fact that we have read such a comment, even though it is in the public domain, might be considered by the client to be inappropriate, disruptive or improper communication. With regard to professional conduct, reading clients status updates may be seen as a conflict of interest: we know the client in our professional rather than personal capacity.

You are a member of Facebook. It is obviously open to you to search for clients or their parents on this social networking site, and to look at any information they have chosen to make publicly available. But are there implications about what you do with this if, for example, it makes it clear they are unhappy with the service they are receiving?

lectronic communication in general and social networking sites in particular have changed the way we communicate in profound ways. The social networking sites that are best known in the UK include Twitter, Bebo, Mumsnet, LinkedIn, Friends Reunited, WAYN and MySpace, with the highest profile currently enjoyed by Facebook. These media have a powerful capacity to speed up communication and many of us use them in the same way as having face to face conversations. One difference is that a spoken conversation is not recorded in any written form as it takes place, while social networking site conversations are. Social networking sites have their own vocabulary and etiquette. In terms of confidentiality, by signing up to something like Facebook you agree for them to have access to the information that you have provided and you choose how much of that information is available to the public. In principle, what you can see about people should be what they want you to be able to see. It is possible to keep your profile 'private' if you select the right options, however not everyone does. Depending on your privacy settings, anyone whom you choose to be your friend, or friends of friends or everyone can see most of your information. This can be anything from your photos to your status updates, for example, if you were to sound off about something or someone. It can mean that something written in the heat of the moment can be there for all to see, long after the moment has passed. Comments can, of course, be deleted by whichever party has written them (so long as they are quick enough to do so before anyone important notices them!) so, if you do realise a few hours later that what you wrote was not perhaps your best idea, it is possible to retract a statement before everyone has seen it. With the nature of Facebook, though, you can be fairly certain that at least one or two people will have and so there will be some form of consequence, even if it is just from your real friends. Clients, students and professionals are all likely to use social networking sites and to have electronic conversations which they do not keep private. So what are the ethical issues? The particular focus is the boundary between private and public behaviour. The Health Professions Council states we must be professional and ethical, act with integrity and honesty and behave appropriately

Jois

Frances

Has the client already identified themselves as a client and us as their therapist? Should we respond at all, with or without making it explicit how we know the person concerned? Probably not. If responding in a public arena, we need to be very clear about the limits of confidentiality as we must not compromise these. So far as personal conduct is concerned, it is worth remembering that our own use of social networking sites must be sufficiently prudent that it does not bring us or the profession into disrepute, so discretion in posting photographs, opinions and even in vocabulary usage is called for. Would you really want your client, boss, clinical educator (or mother) seeing the content of your public pages? Clients are at liberty to hold forth, comment, and even praise online. Most do not have the same professional restrictions on their personal lives as speech and language therapists. As speech and language therapists, we have a duty to act with integrity in public but also in our personal lives. This does not mean that we can all be paragons of virtue, but that we consider the effects of our actions, including those when using social networking sites, and reflect on if or how these may influence peoples views of our profession. Jois Stansfield is Professor of Speech Pathology at Manchester Metropolian University. Frances McAleer graduated from Manchester Metropolian University in 2007 with an honours degree in International Fashion Marketing. She is Joiss daughter, and definitely does not let her mother read her Facebook pages.
References Health Professions Council (2008) Standards of conduct, performance and ethics. London: HPC. Royal College of Speech and Language Therapists (2006) Communicating Quality 3. London: RCSLT. Seedhouse, D. (2009) Values Exchange. Available at: http://www.values-exchange.com (Accessed: 17 August 2009).

SPEECH & LANGUAGE THERAPY IN PRACTICE SPRING 2010

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