At the Intersection of Ethics and Evidence

Published in the May 2024 ISHA Voice.

By Michelle Zemsky Dineen, chair of the Ethics Education Committee

Early Friday morning and ISHA Convention Day 1, it’s a tough slot. There we were, at 8AM, with a room full of participants. Admittedly, my heart was racing a bit as I kicked off things for our group of presenters. Perhaps it was the coffee. More likely, it was excitement. I was fortunate to have been invited to collaborate on this session by someone I admire, a lot. Together we crafted a team and a session we were excited to share with our colleagues.

I’ll start by saying ethics gets a bum rap in many conversations. It is one more requirement, another box to check, and it lacks pizzazz. I get it, there is nothing sexy about ethics and we often have that visceral response when it forces us to think about those times we have been uncomfortable, often really uncomfortable, at work.

We talked about various clinical topics and viewed them using two separate mindsets, ethics and evidence-based practice (EBP). Our discussions included end-of-life feeding and advanced dementia, timing of swallow assessments post-intubation, pediatric voice disorders, and Gestalt Language Processing. Mostly, I found myself appreciating that the intersection of ethics and evidence is larger than I realized. I am not alone.

Malec (2012) highlighted individual needs and preferences (autonomy) and awareness of best practices (clinical competency), among other skills related to ethical awareness in practice. Notably, these terms are relevant both within the ASHA Code of Ethics (2023) and integration of EBP via clinical expertise, evidence, and client (or proxy) perspectives (ASHA, n.d.).

Ultimately, I am not sure that EBP has more appeal than ethics. Perhaps it feels more relevant. Maybe it avoids negative associations. Staying curious and learning feels good, particularly when we are driven to finding information to treat our clients.

The scope of ethical content has grown so much since the early days of the “requirement”. Are there ethical topics you are excited to explore? Please reach out to the ISHA Ethics Education Committee. We are excited to hear from you!

My thanks to Mary Bacon, Victoria Reynolds, and Carol Szymanski for the collaboration and exploring ethics and evidence.


American Speech-Language-Hearing Association. (n.d.) Evidence-based practice (EBP). Retrieved February 28, 2024 from

Malec, J. F. (2012, November 1). Evidence-based and ethical practice in rehabilitation for TBI and polytrauma.

Michelle serves as the Chair of ISHA's Ethics Education Committee and Task Force Chair of ISHA's new Interprofessional Education and Collaborative Practice (IPECP) Task Force. She is passionate about teaching and learning with her students and colleagues through interprofessional collaboration, and honoring what we all bring to the table to serve patients/clients and their families.