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Not knowing the language: An ethical dilemma

A major part of working as a Speech-language Pathologist (SLP) is not just treating a

persons communication disorders and/or swallowing disorders, but also being culturally

competent about ones clients. According to the American Speech-Language Hearing

Association [ASHA] (2017) being culturally competent is defined as the following

Cultural competence involves understanding and appropriately responding to the unique

combination of cultural variablesincluding ability, age, beliefs, ethnicity, experience,

gender, gender identity, linguistic background, national origin, race, religion, sexual

orientation, and socioeconomic status (Cultural Competence, Overview).

This definition mandates that SLPs not only need to be aware of the previously mentioned parts

that make up a persons culture, but also the primary language that he/she speaks. By being

aware of ones language background an SLP can distinguish a language disorder from a language

difference, which is a very important thing to differentiate. One does not want to diagnose

someone with a disorder if it is considered a normalcy in their culture. Additionally, with

language diversity, it can lead to some communication breakdowns when one is not familiar with

the language that a client is speaking to them. One major dilemma that can occur from this is that

should a SLP treat a person that speaks a language he/she is not familiar with and/or does not


If a SLP treats a client and does not speak the language and/or does not do extensive

research about the language and its norms, that clinician could be breaking several codes

outlined in the ASHA Code of Ethics. The first principle that could be violated is Principle of

Ethics I. It states, Individuals shall honor their responsibility to hold paramount the welfare of

persons they serve professionally or who are participants in research and scholarly activities

(Code of Ethics, 2016). Meaning that when treating a client one must take the clients best

interest and well-being in to account. Under this principle there are two main rules that could

additionally be violated by treating a client and not having background knowledge. These rules

of ethics are Rules A and B, which state, Individuals shall provide all clinical services and

scientific activities competently and Individuals shall use every resource, including referral

and/or interprofessional collaboration when appropriate, to ensure that quality service is

provided (Code of Ethics, 2017). The main principle and rules mentioned above are all being

violated for the same reason of not taking the clients well-being into account and doing/treating

them in the most effective way. Also, because the SLP is not an expert or lacks adequate

knowledge on the culture/language, the client would not be getting the best care that they need

and deserve to receive.

Another main principle that could be violated by treating a client when the clinician

doesnt speak the language is the Principle of Ethics II. This principle states, Individuals shall

honor their responsibility to achieve and maintain the highest level of professional competence

and performance (Code of Ethics, 2016). This principle is saying that SLPs must be able to

provide the best care that they are capable of achieving to their clients. Without a working

knowledge of the language, one cannot provide the highest level of care to his or her clients.

While one can do research to learn about the language and what is typical and atypical, it does

not account for actually speaking the language. For this reason, this principle of ethics would be

violated when the clinician is not familiar with the language.

While the ASHA Code of Ethics gives SLPs an outline and rules to follow when treating

it can also give them answers to dilemmas, such as what to do when one does not speak the

clients language. A principle that helps in this situation would be Principle of Ethics IV. It

mandates that Individuals shall uphold the dignity and autonomy of the professions, maintain

collaborative and harmonious interprofessional and intraprofessional relationships, and accept

the professions' self-imposed standards (Code of Ethics, 2016). In simplistic terms, this

principle is saying that when one does not know the language and is not well equipped to treat

that client they should use their interprofessional relations and refer to another clinician that is

well versed in that language and culture. However, sometimes another SLP is not available to

treat a client. When this situation occurs one could utilize translators. While translators can be

very helpful, SLPS must always verify that that the person translating is a reliable and honest

source to avoid violating Principle of Ethics II. Also, an SLP should never have someone who is

directly involved in the case translate to a client. For example, children translating for their

parents are not always the best option because the child could be changing what the clinician is

saying if it directly affects them. Meaning children should be used as a last resort for a translator

option. Translators, however, are not the easiest to come by and for some languages do not exist

because of their rarity. In these cases, one would have to do extensive research on the language

to learn about the background and culture. After doing their research they would have to apply

the knowledge they learned to their treatment and make sure that when treating they are being

mindful of the cultures beliefs and practices. Furthermore, with advances in technology an SLP

has a vast amount of tools that they could use to help with the language barrier. There are many

applications that help translate languages that are not commonly spoken. By using an application

that translates, an SLP will hopefully be able to breakdown that language barrier a little bit.

Overall, different languages can cause a breakdown in communication, but if the correct

steps are taken one can treat someone that speaks another language effectively. First, a clinician

must be culturally competent of the culture. Another way to make sure that a client is being

treated effectively would be to refer out to peers that speak that language or get assistance from

translators. Technology can also be a great source of information for clinicians in treating clients.

SLPs can use applications to translate information to their clients. By making sure one is aware

of cultural differences and ways to treat a client in a way that would best suit them, the clinician

would be following the AHSA Code of Ethics.

Work Cited

Cultural competence. (2017). Retrieved March 5, 2017, from

American Speech-Language-Hearing Association. (2016). Code of ethics [Ethics]. Available