Ethics under pressure in audiology and speech therapy: ethical challenges in South African practice management

ABSTRACT:

Summary / Objective:

Ethical practice is central to audiology and speech therapy (STA), yet ethical decision-making in South African practice management occurs within complex structural constraints. Conceptualising ethics as a situated and relational practice, this study explored ethical challenges encountered by practitioners and how these are negotiated across public and private contexts.

Details / Method:  

A qualitative design was used, drawing on semi-structured interviews conducted in 2025 with 92 practitioners. Data were thematically analysed, with descriptive and exploratory statistical analyses used to examine sectoral patterns for analytical insight.

Results: 

Four interrelated themes emerged: resource-driven ethical dilemmas in the public sector; tensions between business ethics and financial sustainability in private practice; challenges related to culturally sensitive and ethical care; and ethical tensions associated with advocacy and systemic reform.

Conclusion: 

Findings highlight ethics as everyday moral work that is structurally and relationally produced rather than solely individual. Addressing these challenges requires strengthened ethics education, mentorship, institutional support, and contextually grounded ethical guidance.

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