August 2006

Robert M. Gippin, Esq.
AFA Director
Goldman & Rosen, Ltd.
11 S. Forge St.
Akron, OH

The Audiology Foundation of America ("AFA") has for many years presented otoscopes to incoming students at special ceremonies. Grants to fund the purchase of the otoscopes have come from manufacturers, who are identified to the students. Does this violate ethical prohibitions? A review of professional ethics standards suggests that it does not. There are also no issues of state or federal law, since they are inapplicable to students at this stage of their careers, and would, in any event, not be violated.

The essence of the ethical restriction against gifts from manufacturers is to avoid any actual or perceived conflict of interest (AAA Ethics Rule 4c; AAA/ADA Ethical Practice Guideline on Financial Incentives from Hearing Instrument Manufacturers; ASHA Principle of Ethics III.B; ASHA Conflicts of Professional Interest Statement). There is no absolute prohibition against the receipt of things of value from manufacturers, and such value is routinely given to practicing audiologists in many ways within the scope of the ethical guidelines. The test is whether the value and nature of the item given, and the context in which it is given, would reasonably cause the public to believe that the recipient would be influenced to recommend the manufacturer's products without regard to objective professional judgment.While the value of an otoscope is not negligible, it is at more or less the threshold ($100) set by the AAA/ADA Guideline, which is itself a generally understood threshold in the healthcare professions. Further, the gift is given in an educational context, in which it is recognized that audiologists may accept things of incidental value. Though that is more often expenses collateral to seminars for practicing audiologists, the distinction is without significance. The AFA is moreover acting as the direct provider of the otoscope; the role of the manufacturer is thus diluted. As a matter of common sense, it is unlikely that the public would find any likelihood of influence on a practicing audiologist's product recommendations, based on the gift of an otoscope through the AFA four years or more before the audiologist became licensed to practice. The connection is simply too remote, even if the student keeps and uses the otoscope and is thereby reminded of warm feelings felt at the ceremony.  The ancient motto of the Order of the Garter applies here, "Honi soit qui mal y pense," "Shame on him who thinks evil of this." The gift of the otoscope is an appropriate and entirely ethical enhancement of the professional welcoming ceremony.