Code of Ethics: Our Core

Values in Action

Megan Whelan, Ph.D., R.D.N., C.D.N.

D'Youville College

Program Objectives

At the end of the session, audience members will be able to:

Locate the Academy/CDR Code of Ethics from the Academy

website

State the function and purpose of the Academy/CDR Code of

Ethics

Describe the ways in which the Academy/CDR Code of Ethics

guide values and ethics in nutrition and dietetic practice

Identify the ethical obligations dietetics practitioners hold to the

public, clients, colleagues, and the profession

Discuss the steps to approach ethical-decision making using the Academy/CDR Code of Ethics

Definitions

Morals

Substrate to distinguish between right and wrong

Moral values

Beliefs and behaviors that we judge others by

Ethics

Analyzing our moral values in seeking a decision on how to act

Professional Ethics

Moral principles of a profession

(Boyce, 2017; Macrina, 2011)

Positionality

We best serve ourselves and society by holding ourselves to the highest ethical standards and using science-based decisions to guide our practice

Our practice is human in nature and is affected by our culture, experiences, and opinions

A culture of nutrition and dietetics practice exists and influences our opinions and insights

View of ethical behavior vary

Gut feelings influence interpretation of events

"No formal code can fully guide...[our] personal judgment for all situations" (Sauer, 2016, p. 148).

Code of Ethics for the Nutrition and

Dietetics Profession

Effective June 1, 2018

Code applies to:

All nutrition and dietetics practitioners

Members of the Academy (credentialed or

not)

Accept or maintain CDR credentials

Four Key Principles of Ethical Theory

1. Autonomy

Individuals have capacity to engage in decision-making

2. Beneficence

Benefit others

3. Non-maleficence

Intent not to inflict harm

4. Justice

Fair, equitable, appropriate treatment for all individuals

Nutrition and Dietetics Practitioners:

Key Principles

1. Competence and professional development in practice

(Non-maleficence)

2. Integrity in personal and organizational behaviors and

practices (Autonomy)

3. Professionalism (Beneficence)

4. Social responsibility for local, regional, national, global

nutrition and well-being (Justice)

Purpose of the Code of Ethics

Establish the principles and ethical standards of professional

practice and conduct

Reflect the core values: customer focus, integrity, innovation, social responsibility, and diversity

Primary Goal:

Protect individuals, groups, organizations, communities or

populations

Obligated to report perceived violations

Meet the guidelines for the accrediting agency for the CDR

Accessing the Code

Academy Website - https://www.eatrightpro.org/practice/code-of-

ethics/what-is-the-code-of-ethics

CDR Ethics Requirement - https://www.cdrnet.org/news/ethics-

requirements-for-recertification

Steps to Approach Ethical

Decision-MakingFornari, A. (2015). Approaches to ethical decision-making, Journal of

the Academy of Nutrition and Dietetics, 115(1), 119-121.

Step 1: State ethical dilemma

Is it an ethical issue?

Specific to one of the Principles and Standards

Is it a business issue?

A business dispute, breach of a contractual obligation,

billing/contract dispute

Is it a legal issue?

State or federal law violation

Is it an employment issue?

Addressed by employer's policies and resolved in workplace

Is it a personal issue?

Step 2: Apply the Code of Ethics

1. Competence and professional development in practice (Non-

maleficence)

8 principles

2. Integrity in personal and organizational behaviors and practices

(Autonomy)

9 principles

3. Professionalism (Beneficence)

9 principles

4. Social responsibility for local, regional, national, global nutrition and

well-being (Justice)

6 principles

Step 3: Select the Best Alternative to

Resolve the Dilemma

Reflect upon:

What influence may impact your decision?

How do alternative solutions align with your values and the values of

your institution?

Are you able to confidently defend your decision using the Academy's

Code, the Standards of Professional Practice, to other nutrition and

dietetics professionals?

How will your decision affect others?

Step 4: Develop Strategies to

Implement Resolution

Use the Standards of Professional Performance as a

guide

Action to address the dilemma:

Education, training, development of professional

guidelines, policies and procedures

Step 5: Evaluate and Minimize Future

Occurrence

Monitor outcome to determine if your resolution worked

Do you have specific strategies to prevent a similar issue

for occurring?

Ethics Complaints and Violations

Academy/CDR Disciplinary and Ethics Complaints Policy

A fair system to deal with complaints about practitioners

from peers or from the public

Alleged violation of the Code of Ethics for the Profession

of Dietetics reported via complaint form

https://www.eatrightpro.org/practice/code-of-

ethics/what-is-the-code-of-ethics/ethics-complaints-and-

violations

Application to Practice

Scenario 1: Professional Boundaries in Practice (Adapted

from Nelkin, 2015)

A client visits his RDN to follow a healthful diet. He knows he could "lose some weight" but his current stated goal is to "start eating

better foods." The RDN interrupts the client while he is sharing his

personal goal and suggests he should also consider a weight loss

goal. The RDN then shares a list of foods that "most people like,"

describes her personal view of how "all people should eat like me."

She then sets a goal of weight loss of 5 pounds by the next visit.

Application to Practice

Scenario 2: Management Practice (Sauer, 2016, p. 148)

A newly hired and overwhelmed clinical nutrition manager is

forecasting enteral nutrition formulary costs for the next budget cycle. While informally contacting product suppliers, the manager

learns that the representative from a specific supplier is also a well-

respected personal acquaintance. New to her role, she assumes

that the annual formulary costs represent a small percentage of the

operating budget; thus, she makes a hasty decision to purchase

products from her personal acquaintance without further

evaluation.

Application to Practice

Scenario 3: Business Practice (Academy, 2009, p. 13)

A RDN is reading blogs posted by colleagues in dietetics. He finds

nutrition misinformation written by an RDN; her posting is not in agreement with a non-government organization's

recommendations and current scientific evidence. He is familiar

with the topic because he consults for a food company that relies

on the current scientific information to support their brand

messages. He knows that the RDN is incorrect and perpetuating

myths, but he worries that it could also be a conflict of interest for

him to correct the RDN on the blog.

Application to Practice

Scenario 4: Social Media (Nelkin, 2015, p. 977)

A patient sees her RDN on Facebook and "friends" him. The RDN

accepts the invitation since he gets along well with his patient during counseling sessions.

New York State:

Certified Dietitian Nutritionist

Unprofessional conduct for health professions defined

Examples: not accurately representing self; not using

evidence-based therapy; harming a patient

Complaint Hot Line

More information can be found

at http://www.op.nysed.gov/title8/part29.htm#waived

Conclusion

Ethics issues are complicated and are connected to legal, personal,

and political issues

Code of Ethics used as a framework

Focus is on education and remediation and self-monitoring

Every member and credentialed practitioner is responsible to

uphold the Code of Ethics

Be familiar with the Code and the value it brings to protecting the

public and the profession

References

Academy of Nutrition and Dietetics (2018). What is the Code of Ethics. Retrieved from https://www.eatrightpro.org/practice/code-of-ethics/what-is-the-code-of-ethics

Boyce, B. (2017). The balance of professional ethics. Journal of the Academy of Nutrition and Dietetics, 117(7), 1120-1123.

Fornari, A. (2015). Approaches to ethical decision-making. Journal of the Academy of Nutrition and Dietetics, 115(1), 119-121.

Macrina, F.L. (2014). Scientific integrity: Text and cases in responsible conduct of research. Washington, D.C.

Nelkin, M.B. (2015). Professional boundary issues in practice. Journal of the Academy of Nutrition and Dietetics, 115(6), 975-977.

Sauer, K. (2016). Ethics in action: Ethical considerations in management practice. Journal of the Academy of Nutrition and Dietetics, 116(1), 148-149.