Code of Ethics: Our Core Values in Action Megan Whelan, Ph.D., R.D.N., C.D.N. D'Youville College
Program Objectives At the end of the session, audience members will be able to: Locate the Academy/CDR Code of Ethics from the Academy website State the function and purpose of the Academy/CDR Code of Ethics Describe the ways in which the Academy/CDR Code of Ethics guide values and ethics in nutrition and dietetic practice Identify the ethical obligations dietetics practitioners hold to the public, clients, colleagues, and the profession Discuss the steps to approach ethical-decision making using the Academy/CDR Code of Ethics
Definitions Morals Substrate to distinguish between right and wrong Moral values Beliefs and behaviors that we judge others by Ethics Analyzing our moral values in seeking a decision on how to act Professional Ethics Moral principles of a profession (Boyce, 2017; Macrina, 2011)
Positionality We best serve ourselves and society by holding ourselves to the highest ethical standards and using science-based decisions to guide our practice Our practice is human in nature and is affected by our culture, experiences, and opinions A culture of nutrition and dietetics practice exists and influences our opinions and insights View of ethical behavior vary Gut feelings influence interpretation of events "No formal code can fully guide...[our] personal judgment for all situations" (Sauer, 2016, p. 148).
Code of Ethics for the Nutrition and Dietetics Profession Effective June 1, 2018 Code applies to: All nutrition and dietetics practitioners Members of the Academy (credentialed or not) Accept or maintain CDR credentials
Four Key Principles of Ethical Theory 1. Autonomy Individuals have capacity to engage in decision-making 2. Beneficence Benefit others 3. Non-maleficence Intent not to inflict harm 4. Justice Fair, equitable, appropriate treatment for all individuals
Nutrition and Dietetics Practitioners: Key Principles 1. Competence and professional development in practice (Non-maleficence) 2. Integrity in personal and organizational behaviors and practices (Autonomy) 3. Professionalism (Beneficence) 4. Social responsibility for local, regional, national, global nutrition and well-being (Justice)
Purpose of the Code of Ethics Establish the principles and ethical standards of professional practice and conduct Reflect the core values: customer focus, integrity, innovation, social responsibility, and diversity Primary Goal: Protect individuals, groups, organizations, communities or populations Obligated to report perceived violations Meet the guidelines for the accrediting agency for the CDR
Accessing the Code Academy Website - https://www.eatrightpro.org/practice/code-ofethics/what-is-the-code-of-ethics CDR Ethics Requirement - https://www.cdrnet.org/news/ethicsrequirements-for-recertification
Steps to Approach Ethical Decision-Making Fornari, A. (2015). Approaches to ethical decision-making, Journal of the Academy of Nutrition and Dietetics, 115(1), 119-121.
Step 1: State ethical dilemma Is it an ethical issue? Specific to one of the Principles and Standards Is it a business issue? A business dispute, breach of a contractual obligation, billing/contract dispute Is it a legal issue? State or federal law violation Is it an employment issue? Addressed by employer's policies and resolved in workplace Is it a personal issue?
Step 2: Apply the Code of Ethics 1. Competence and professional development in practice (Nonmaleficence) 8 principles 2. Integrity in personal and organizational behaviors and practices (Autonomy) 9 principles 3. Professionalism (Beneficence) 9 principles 4. Social responsibility for local, regional, national, global nutrition and well-being (Justice) 6 principles
Step 3: Select the Best Alternative to Resolve the Dilemma Reflect upon: What influence may impact your decision? How do alternative solutions align with your values and the values of your institution? Are you able to confidently defend your decision using the Academy's Code, the Standards of Professional Practice, to other nutrition and dietetics professionals? How will your decision affect others?
Step 4: Develop Strategies to Implement Resolution Use the Standards of Professional Performance as a guide Action to address the dilemma: Education, training, development of professional guidelines, policies and procedures
Step 5: Evaluate and Minimize Future Occurrence Monitor outcome to determine if your resolution worked Do you have specific strategies to prevent a similar issue for occurring?
Ethics Complaints and Violations Academy/CDR Disciplinary and Ethics Complaints Policy A fair system to deal with complaints about practitioners from peers or from the public Alleged violation of the Code of Ethics for the Profession of Dietetics reported via complaint form https://www.eatrightpro.org/practice/code-ofethics/what-is-the-code-of-ethics/ethics-complaints-andviolations
Application to Practice Scenario 1: Professional Boundaries in Practice (Adapted from Nelkin, 2015) A client visits his RDN to follow a healthful diet. He knows he could "lose some weight" but his current stated goal is to "start eating better foods." The RDN interrupts the client while he is sharing his personal goal and suggests he should also consider a weight loss goal. The RDN then shares a list of foods that "most people like," describes her personal view of how "all people should eat like me." She then sets a goal of weight loss of 5 pounds by the next visit.
Application to Practice Scenario 2: Management Practice (Sauer, 2016, p. 148) A newly hired and overwhelmed clinical nutrition manager is forecasting enteral nutrition formulary costs for the next budget cycle. While informally contacting product suppliers, the manager learns that the representative from a specific supplier is also a wellrespected personal acquaintance. New to her role, she assumes that the annual formulary costs represent a small percentage of the operating budget; thus, she makes a hasty decision to purchase products from her personal acquaintance without further evaluation.
Application to Practice Scenario 3: Business Practice (Academy, 2009, p. 13) A RDN is reading blogs posted by colleagues in dietetics. He finds nutrition misinformation written by an RDN; her posting is not in agreement with a non-government organization's recommendations and current scientific evidence. He is familiar with the topic because he consults for a food company that relies on the current scientific information to support their brand messages. He knows that the RDN is incorrect and perpetuating myths, but he worries that it could also be a conflict of interest for him to correct the RDN on the blog.
Application to Practice Scenario 4: Social Media (Nelkin, 2015, p. 977) A patient sees her RDN on Facebook and "friends" him. The RDN accepts the invitation since he gets along well with his patient during counseling sessions.
New York State: Certified Dietitian Nutritionist Unprofessional conduct for health professions defined Examples: not accurately representing self; not using evidence-based therapy; harming a patient Complaint Hot Line More information can be found at http://www.op.nysed.gov/title8/part29.htm#waived
Conclusion Ethics issues are complicated and are connected to legal, personal, and political issues Code of Ethics used as a framework Focus is on education and remediation and self-monitoring Every member and credentialed practitioner is responsible to uphold the Code of Ethics Be familiar with the Code and the value it brings to protecting the public and the profession
References Academy of Nutrition and Dietetics (2018). What is the Code of Ethics. Retrieved from https://www.eatrightpro.org/practice/code-of-ethics/what-is-the-code-ofethics Boyce, B. (2017). The balance of professional ethics. Journal of the Academy of Nutrition and Dietetics, 117(7), 1120-1123. Fornari, A. (2015). Approaches to ethical decision-making. Journal of the Academy of Nutrition and Dietetics, 115(1), 119-121. Macrina, F.L. (2014). Scientific integrity: Text and cases in responsible conduct of research. Washington, D.C. Nelkin, M.B. (2015). Professional boundary issues in practice. Journal of the Academy of Nutrition and Dietetics, 115(6), 975-977. Sauer, K. (2016). Ethics in action: Ethical considerations in management practice. Journal of the Academy of Nutrition and Dietetics, 116(1), 148-149.