Applying ethical reasoning approaches to complex cases in professional practice

Background: This study explored speech pathologists’ experiences with dysphagia management—an ethically complex area of professional practice. It aimed to describe speech pathologists’ responses to ethical dilemmas and to interpret their responses using four different approaches to ethical reasoning. Research approach: Four cases were drawn from a multisite qualitative study of ethics in the speech pathology profession. Cases were based upon findings from individual interviews with experienced speech pathologists. Participants’ narratives were analysed by mapping responses against features of bioethical principles, casuistry, narrative and ethics of care approaches. Findings: Speech pathologists’ ethical reasoning stories demonstrate how experienced professionals may apply elements of principle-based, casuistry, ethics of care and narrative approaches to resolve ethical conflict. Conclusions: Contributions of each approach are discussed with examples of how theoretical approaches may guide healthcare professionals and students to manage ethically troubling scenarios.