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Professional ethics: the four principles, autonomy, informed consent and professional integrity
A speech and hearing clinician's ethical decisions rest on four principles — beneficence, non-maleficence, autonomy and justice — so you explain the pros and cons to the patient and respect his decision, obtain informed consent from every patient (and from parents or a guardian when needed), do not promise outcomes, and act only within your competence.
Why it matters in the exam
Most questions present a dilemma and ask for the right step: a patient who asks for one hearing aid against a recommendation for two — explain the pros and cons and accept his decision; a lucid patient who refuses thickened liquids — explain the risk and respect the choice; parents who ask to intensify treatment — find out what they understand and align expectations; and a clinician who tells parents their daughter "will reach perfect functioning" — outcomes must not be promised. Under the Patient's Rights Law (1996), when proposing treatment the patient is given all the relevant information: what the treatment is, its chances and risks, and the alternatives.
Another part concerns consent and limits: informed consent is always required, even for an 18-month-old (from the parents); in a divorce both parents' consent is needed, and if they disagree you turn to the competent authority; for a person under guardianship you balance his wishes with the guardian's decision. On integrity: a clinic name such as "Perfect Speech" misleads the public; a clinician with no knowledge of stuttering does not treat it just because the employer presses; when the workplace standard differs from the reasonable professional standard — follow the higher of the two; a clinician who does not keep up to date breaches competence and beneficence; and giving a child more sessions because of his mother's connections is discrimination.
Key points
- Four principles: beneficence, non-maleficence, autonomy, justice.
- Explain pros and cons and respect the patient's choice.
- Informed consent always; a child — parents; divorce — both parents.
- No promised outcomes; no misleading advertising.
- Act within your competence and by the higher standard.
Summary table
| Principle | What it requires | Exam example |
|---|---|---|
| Autonomy | Respect the patient's decision after he has full information | One hearing aid instead of two; a lucid patient refusing thickened liquids |
| Informed consent | Information on the treatment, chances, risks and alternatives; consent from every patient | A toddler — from the parents; divorce — both parents; a guardian — balance with the patient's wishes |
| Beneficence | Act for the patient's good, in line with current knowledge | A clinician who does not follow research breaches the principle |
| Non-maleficence and limits of competence | Do not treat beyond your knowledge and experience | Employer pressure to treat stuttering without training — decline or get training and supervision |
| Justice and non-discrimination | Fair allocation of resources and equal treatment | More sessions for a child because of his mother's status — discrimination |
| Integrity and truthfulness | Do not promise outcomes, do not advertise misleadingly, present alternatives fairly | "Perfect Speech" — a misleading name; conflict of interest — present both options |
| Professional standard | When the workplace standard differs from the reasonable one | Follow the higher of the two; disagreeing with a senior — speak to him directly |
In the full version for subscribers
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Sources
- Beauchamp & Childress, Principles of Biomedical Ethics, 8th edition (2019) — The four principles
- Israeli Patient's Rights Law, 1996 — Informed consent and the right to information
- Israeli Speech and Hearing Clinicians Association, code of ethics (current version) — Professional conduct
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-02. The text may contain errors; when in doubt, check the source.