IHS - International Hearing Society Professional and Ethical Standards Questions and Answers — Questions and Answers
Question 1: A client with a history of chronic ear infections mentions that their ear feels full and asks the hearing instrument specialist to 'flush it out' with water. What is the most ethically and professionally appropriate action for the specialist to take?
- Use an otoscope to confirm it is just cerumen before attempting a gentle lavage.
- Refer the client to a physician for a medical evaluation of the ear. (Correct answer)
- Advise the client to purchase an over-the-counter earwax removal kit and return in one week.
- Explain that while it might be wax, you can only perform a dry removal with a curette.
Correct answer: Refer the client to a physician for a medical evaluation of the ear.
The client's history of chronic ear infections is a contraindication for water-based cerumen removal (lavage). Furthermore, a feeling of fullness could indicate a medical issue beyond simple cerumen impaction. The most appropriate and safest course of action is to refer the client to a physician for diagnosis and treatment, staying within the professional scope of practice.
Question 2: Which of the following actions constitutes an unethical conflict of interest according to the IHS Code of Ethics?
- Attending a free training seminar hosted by a manufacturer to learn about new technology.
- Recommending a specific brand of hearing aid because the specialist has the most experience and success fitting that product.
- Offering a discount on hearing aids to a family member.
- Accepting a commission structure that pays a higher percentage for the sale of premium-level devices over basic-level devices. (Correct answer)
Correct answer: Accepting a commission structure that pays a higher percentage for the sale of premium-level devices over basic-level devices.
A commission structure that incentivizes selling more expensive products creates a conflict of interest. It may influence the specialist to recommend a device based on personal financial gain rather than the client's specific hearing needs, lifestyle, and budget. The client's welfare must always be the primary consideration, free from such conflicts.
Question 3: To comply with the principle of informed consent, a hearing instrument specialist must ensure the client understands all of the following BEFORE they sign a purchase agreement, EXCEPT:
- The total cost of the hearing aids and any non-refundable fees.
- The specific warranty details and the trial period/return policy.
- The technical specifications of the digital signal processor in the hearing aid. (Correct answer)
- The potential benefits, limitations, and realistic expectations of the recommended hearing aids.
Correct answer: The technical specifications of the digital signal processor in the hearing aid.
Informed consent requires the client to have all the necessary information to make an autonomous decision. This includes understanding costs, policies, benefits, and limitations. However, detailing the highly technical specifications of the internal processor is not necessary for informed consent and is typically beyond the scope of what a client needs to know to make a sound decision.
Question 4: A hearing professional posts a photo on their personal, private social media account. The photo shows them celebrating a successful fitting with a client, whose back is to the camera but whose distinctive tattoo is visible. The post text says, 'So happy for my client who can hear his grandkids clearly now!' This action is:
- Acceptable, because the client's face is not visible and the account is private.
- Acceptable, as it is considered positive marketing for the practice.
- Unethical, because it shares a client's story without express written consent, which is a breach of confidentiality. (Correct answer)
- Unethical only if another user recognizes the client from the tattoo and comments on the post.
Correct answer: Unethical, because it shares a client's story without express written consent, which is a breach of confidentiality.
Under HIPAA and professional ethics codes, any information that can potentially identify a patient is considered Protected Health Information (PHI). A distinctive tattoo, combined with the context of the post, could lead to identification. Sharing any client information or images on social media without explicit, written authorization is a serious breach of confidentiality, regardless of privacy settings or whether a name is used.
Question 5: According to federal regulations enforced by the Federal Trade Commission (FTC), what is required regarding the trial or adjustment period for hearing aids?
- A mandatory 30-day trial period must be offered for all dispensed hearing aids.
- Any non-refundable fees can be no more than 10% of the total purchase price.
- The full terms of the trial period, including any non-refundable fees, must be clearly disclosed in writing before the sale. (Correct answer)
- Sellers are prohibited from charging any fees if the hearing aid is returned during the trial period.
Correct answer: The full terms of the trial period, including any non-refundable fees, must be clearly disclosed in writing before the sale.
While many states mandate a trial period of a specific length, there is no single federal law that sets a mandatory trial period for all sales. However, the FTC's role in consumer protection requires that if a seller offers a trial or return period, all terms and conditions—especially any non-refundable costs like dispensing or fitting fees—must be provided in writing to the consumer before the purchase is finalized to prevent deceptive sales practices.
Question 6: The primary purpose of maintaining accurate and comprehensive client records, as required by professional standards and regulations like HIPAA, is to:
- Justify billing codes to insurance companies.
- Ensure continuity of care and provide a legal document of the services rendered. (Correct answer)
- Create a database for marketing and sending promotional materials.
- Track sales statistics for business management.
Correct answer: Ensure continuity of care and provide a legal document of the services rendered.
While records are used for billing and business analysis, their foremost purpose is clinical and ethical. Complete records ensure that any practitioner can understand the client's history, the rationale for treatment, and the outcomes, thus ensuring high-quality continuity of care. They also serve as the official legal record of the client-practitioner relationship and the services provided.
IHS - International Hearing Society Professional and Ethical Standards Questions and Answers
A client with a history of chronic ear infections mentions that their ear feels full and asks the hearing instrument specialist to 'flush it out' with water.
What is the most ethically and professionally appropriate action for the specialist to take?