Code of Ethics for the Profession of Dietetics

Patricia M. Guenther, PhD, RDResearch ProfessorDivision of NutritionUniversity of Utah

ACADEMY/CDR

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• Questionnaire• Overview of ethics• Code of Ethics for the Profession of Dietetics• Complaint process and resolutions• First steps you can take• Case scenarios• Key points

Outline

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“Right and Wrong”

“Moral and Immoral”

“Just and Unjust”

Ethics is the Struggle Between…

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1. The study of standards of conduct and moral judgment.

2. The study of the general nature of morals and of the specific moral choices to be made by a person.

3. The rules or standards governing the conduct of a person or the members of a profession.

Definitions of Ethics

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• Aspirational

• Educational

• Regulatory

Types of Codes

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1. Fundamental Principles

2. Responsibilities to the Public

3. Responsibilities to Clients

4. Responsibilities to the Profession

5. Responsibilities to Colleagues and Other Professionals

Code consists of Five Categories

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• Protects the profession and the credentials

• Influences public and private policy

• Improves professional practice

• Educates dietetics practitioners about ethical decisions

• Meets the guidelines of the accrediting agency for the Commission on Dietetic Registration (CDR)

Functions of the Code of Ethics

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The Code is not intended to

• Identify and reprimand all unqualified dietitians and dietetic technicians

• Be a punitive force to take away credentials

Misconceptions about the Code of Ethics

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Academy/CDR Initiatives

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• Code of Ethics

• Standards of Professional Practice

• Professional Development Portfolio

History of the Academy/CDR Code

1934 – 1st Report presented to members.

1982 – 1st Code adopted. Enforced 1985.

1987 – 2nd Code adopted. Enforced 1987.

1998 – 3rd revised Code adopted by HOD in fall.

1999 – Revised Code published January.

2007 – New Task Force formed to review and revise the 1999 Code.

2009 – Revised Code approved by HOD, BOD and CDR.

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• Journal of the Academy of Nutrition and Dietetics, August 2009, pages 1461-1467.

• Academy Web site – www.eatright.org/codeofethics

Accessing the Code of Ethics

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• Ethics Committee• Ethics Team at Headquarters• Ethics For Further Reading List• FNCE sessions• Ethics Opinions• Ethics in Action columns• Case Studies (24): Application of the Code of Ethics• Case Studies (9): Impact of Social Media

Tools and Resources

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• “Code of Ethics--Video Version”• “Ethical Dilemmas in Dietetics Practice”

• Series of five videos• Case studies and discussion questions

Tools and Resources (cont.)

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Ethics Committee was established in 1982

Composed of three members who each serve 3 year terms

• One appointed by the Academy President

• One appointed by the Speaker, HOD

• One appointed by chair of CDR

• One new member is added each year

Academy Ethics Committee

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• Attends all meetings of Ethics Committee

• Reviews files and correspondence

• Provides counsel as to legal implications of decisions and actions

Academy’s Legal Counsel

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• Any member or non-member can make a complaint.

• Complaints are not anonymous but are confidential.

• If a complaint is made, it is forwarded to the member for a response.

• The Ethics Committee then reviews the complaint and discusses the response in executive session.

Access to the Ethics Committee

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• The enforcement procedures are intended to permit a fair resolution of disputes on ethical practices in a manner that protects the rights of individuals while promoting understanding of ethical practice.

• The Ethics Committee has the authority and the flexibility to determine the best way to resolve a complaint, including educational means where appropriate.

Ethics Case Management Procedure

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• Case may be dismissed

• Further information may be requested

• Person may be contacted with specific actions for educational intervention

• Censorship, probation, suspension, or expulsion

• RD or DTR credential or specialist credential may be suspended or revoked

Ethics Committee uses a defined policy and procedure handbook to guide its decisions.

What happens next…

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Types of Complaints

Inquiries Complaints Complaint Types

8 1 Personal dispute

15 5 Inappropriate advice (3); Practicing without a license; Copyright violation

16 6 Inappropriate advice; Personal dispute; Poor business practice (4)

24 11 Poor business practice (5); Licensure violation (4); Lack of scientific support; Legal violation

18 5 Personal dispute; Lack of scientific support (2); Misuse of credential; Poor business practice

• Legal issue?

• Employer policy issue?

• Personal issue?

• Business dispute?

• Academy/CDR member involved?

• If Code is violated, cite specific principle violated

Ethical Issue or Not?

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• Three ethics case studies will be reviewed.

• Work in small groups to discuss one of them.

• Choose a reporter to answer the questions posed.

Ethics Case Studies

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•Is the situation described an ethical issue or not?

•Is the situation described a business dispute?

•What category and principle(s) of the Code of Ethics does it relate to and how/why?

•What are the key issues?

•How might you handle as a colleague?

Questions to Discuss for Each Case Study

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A new RD has been employed by a naturopathic medical clinic to provide diet education and therapy to patients. One of the naturopaths has requested that she recommend a new diet regimen advocating the use of pomegranates to improve patient’s circulation and an herbal tea for controlling diabetes. In addition, she has been asked to promote the raw food diet to all patients.

Case Study #1: Practicing on the Edge of Science

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• Is the situation described an ethical issue or not?

• Is the situation described a business dispute?

• What category and principle(s) of the Code of Ethics does it relate to and how/why?

• What are the key issues?

• How might you handle as a colleague?

Small Group Discussion

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• What Was the Ethics Committee’s Reaction to the Case?

• Key Issues

• How to Handle

Results

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An RD has been attending CPEU programs for 4 years, but has not recorded the information for her 5-year portfolio. She has documentation and paperwork for many of the hours but is not sure she has documentation to satisfy the full 75-hour requirement. She finds information from two wellness programs she attended but does not have the dates, nor the number of credit units. Rationalizing that she did attend the presentations and that CDR will not check, she picks dates within her 5-year period and a number of units, and she records the information on her activity log.

Case Study #2: Falsifying Continuing Professional Education

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• Is the situation described an ethical issue?

• Is the situation described a business dispute?

• What category and principle(s) of the Code of Ethics does it relate to and how/why?

• What are the key issues?

• How might you handle as a colleague?

Small Group Discussion

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• What Was the Ethics Committee’s Reaction to the Case?

• Key Discussion Points

• How to Handle

Results

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An RD is on Facebook and comes across a posting from an intern who is currently working in a clinical setting. The intern includes information about a patient and what the physician had said to her at the facility without using any names.

Case Study #3: Social Media

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•Is the situation described an ethical issue or not?

•Is the situation described a business dispute?

•What category and principle(s) of the Code of Ethics does it relate to and how/why?

•What are the key issues?

•How might you handle as a colleague?

Small Group Discussion

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• What Was the Ethics Committee’s Reaction to the Case?

• Key Discussion Points

• How to Handle

Results

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Summary

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