Frontline Initiative Ethics

Ethics on the Frontline


Rick Rader, MD is the director of the Morton J. Kent Habilitation Center and the Orange Grove Center in Chattanooga, Tennessee

One of the distinguishing criteria of a profession, as opposed to a “job”, is that professionals subscribe to a code of ethics. Direct Support Professionals (DSPs) have been around for generations, but only in the last few years has there been a formal national movement to acknowledge direct support as a “profession.” That’s not to say that DSPs have not conducted themselves in a professional or ethical manner; in fact, the best ethics are those formulated individually based on good judgment, responsibility, and commitment. DSPs have been making daily ethical decisions on their own for generations, and for the most part, making the right choices.

Codes of ethics are formal guidelines for professional action that are shared by persons within the profession and should be compatible with individual’s professional personal values. These “values” exist in two forms: “self-value” and “equal worth.” Self-value is one’s belief that one is of worth to others, while “equal worth” is the belief that other people are equal in worth to oneself.

The process of becoming a professional is complete only when the values of the profession are integrated into the values of the person. A professional can’t hang up their “code of ethics” when they leave work at the end of the day. They must feel that their ethical conduct is part of they way they conduct every facet of their lives. Thus, “ethical” DSPs conduct themselves ethically at home, at school, in relationships, at other jobs, and in every activity in their community they participate in.

The purposes of “ethics” are threefold. First, they serve to educate members of the profession about sound and appropriate behavior. Second, they provide a mechanism for sound professional accountability. Lastly, they serve as a catalyst for improving the practice of the profession overall.

Most codes of ethics have five underlying principles that govern the development of ethical standards. These underlying principles are —

  1. Autonomy — the belief that all people have the right to self-determination.
  2. Nonmaleficence — the belief that DSPs should strive to do no harm.
  3. Beneficence — the belief that DSPs must promote something positive, namely the growth, development, and welfare of people receiving supports.
  4. Justice — the belief that “fairness” must apply to everyone.
  5. Fidelity — the belief that all promises made must be honest and attainable; we must honor our commitments to the people we serve and their families, supervisors, and colleagues.

While the above principles may seem like a gaggle of hard-to-remember words, if you concentrate on the beliefs they represent and apply them to any situation you encounter (for instance, in a group home setting, on a job site, in the community or on a recreational outing) you will soon see that they are simple and readily applicable.

A draft Code of Ethics was created by the National Alliance of Direct Support Professionals (NADSP) and was presented to DSPs across the country last year. DSPs had the opportunity to offer feedback and suggestions for modification to the code. The process to create the code was lengthy and complex involving professionals from many disciplines, DSPs, self-advocates, families, and policymakers from a variety of settings across the country. The National Code of Ethics for Direct Support Professionals was finalized and approved at a recent meeting of NADSP. (Editor’s note: The code is included as a pullout of this newsletter.)

The true test of the effectiveness of a code of ethics is the tried and true “reality check.” In order for ethics to have merit and relevance (and ultimately adoption), they must be able to be translated into everyday life…at home, in classrooms, on the job. The Code of Ethics can help fulfill the need of DPSs to conduct themselves in appropriate, legitimate and honorable ways — meeting the five above mentioned underlying principles of ethical behavior (autonomy, nonmaleficence, beneficence, justice, fidelity).

Your next step is to look over the Code of Ethics, familiarize yourself with it and then take it for a road test.…Take it to work with you tomorrow.