Section One

Module 3: Civil Rights and Professional Ethics

  • What requirements must my choices satisfy?

  • After working with the material in this module, readers will be able to

    • explain the relevance of federal civil rights law to client-centered culturally and individually appropriate speech-language pathology

    • recite from memory several key phrases from ASHA’s (2023) Code of Ethics and ASHA’s (2017) Issues in Ethics statement about cultural and linguistic competence

    • use the legal and professional requirements described in this chapter to evaluate professional behaviors related to culture and identity in speech-language pathology

Here in Module 3, we will build on the three models presented in Module 2 by addressing two sets of requirements that affect our work in all settings: federal civil rights law and the ASHA Code of Ethics. Module 4 will then address additional requirements that apply to healthcare and education settings specifically.

Federal Civil Rights and Anti-Discrimination Law

Federal civil rights law is comprehensive, complex, and always changing, but in many ways the requirements can be summarized in simple terms that link directly to the models we discussed in Module 2. Let’s start with the larger notion of civil rights, and then we can consider how specific current civil rights laws and questions will affect your clinical and professional practice.

At its largest level, the construct of civil rights refers to an awareness that everyone who is viewed as a “full member” of a society should have the same fair and equitable opportunities to access the publicly available goods, services, and other benefits of that society. Different opportunities, goods, services, and benefits have been treated as civil rights in different societies at different times, and every society throughout all of human history has developed and used its own definitions of fairness, equity, acceptable inequities, who is considered to belong “in” a society, and even who “everyone” is. In this worldwide and historic context, we also need to recognize that the U.S., as a whole, has an undeniable history of having defined some people from some cultural backgrounds or with some individual identities, at different points in time, as somehow falling outside of the boundaries that defined the civil rights held by other people.

In part because of our country’s history, civil rights laws and regulations in the U.S. have increasingly prohibited most divisions or discrimination among adults on the basis of culture, background, or identity, as those characteristics relate to everyone’s rights to access publicly available goods and services and other public benefits of society. (Children have some civil rights but not others, as a result of our generally shared recognition that young children need assistance and cannot be expected to manage either the responsibilities or the benefits that full adult members of society receive.) Phrased positively, current federal civil rights law specifies that everyone in the U.S. who satisfies any necessary objective requirements has an equal right to engage in and benefit from public interactions such as employment, commerce, travel, education, healthcare, and others, and also has an equal right to have equitable access to the publicly available goods, services, and other benefits of society itself.

Civil rights law does not require, of course, that any single person or any group must be given unlimited access to any materials, space, or assistance. Civil rights law requires only that the limitations to access imposed on some full members of the society must be the same as the limitations to access imposed on all people. One relatively uncontroversial example might be that most grocery stores impose the same limitations on all shoppers: They give food only to persons who wear shoes in the store and pay for the food. Similarly, if a hospital needs to hire a new nurse, the hiring committee is not required to hire everyone who applies, but they must select the one person they do hire by evaluating every candidate’s relevant skills, not by selecting or eliminating people from any racial, ethnic, or gender groups. And states are allowed to require all drivers to pass certain tests and to obey certain safety laws, but states cannot declare that the members of some cultural or identity-based group are prohibited from driving on their highways.

The law is also clear that “equitable access” must mean reasonably equitable access to the full benefit, an important idea that relates to a difference between discriminatory actions and discriminatory outcomes. Discrimination can refer to an overt action (or to a failure to act), and it can also refer to differential outcomes that occur as the combined effect of individual or systemic actions, some of which might appear neutral in isolation (as we will discuss in greater detail in several places throughout these modules).

The simplest summary, again, is that all adults who qualify as full adult members of current U.S. society are required by law to have equitable access to the publicly available goods, services, and other benefits of society. Current basic civil rights law in the U.S. will therefore have several direct impacts on your practice, in many ways, starting with your own rights as an employee and extending, most importantly, to the rights of all people who could benefit from your clinical and professional expertise.

Civil Rights as Employees

With respect to rights and discrimination as employers and employees, most speech-language pathologists are bound by multiple federal laws that prohibit discrimination in the workplace on the basis of “race, color, religion, sex (including pregnancy, childbirth, and related medical conditions, transgender status, and sexual orientation), national origin, age (40 or older), disability, or genetic information” (as of February 12, 2025; Equal Employment Opportunity Commission, EEOC: https://www.eeoc.gov/laws-guidance ; see the website for up-to-date details). The laws are comprehensive and apply to all stages of employment: job application procedures, hiring, training, pay, review, advancement, and removal or firing. Because these federal laws apply to all federal employers, state employers, local government employers, and private employers and businesses with 15 or more employees, their protections about employment-related discrimination will apply to most speech-language pathologists who work for any organization or company other than a small private practice.

In most work settings, therefore, your practice of client-centered, culturally and individually appropriate speech-language pathology will begin with the requirement that no employer or potential employer is allowed to discriminate against you on the basis of your personal characteristics. As a matter of federal law, you cannot be treated more positively or more negatively by your managers than other people are treated if the difference in your treatment is because of your race, ethnicity, age, disability, or any other protected category. You cannot be denied a job, reviewed poorly, given a promotion, or denied a promotion on the basis of your cultural or personal background. In addition, you cannot be expected to work under negative conditions created by your fellow employees based on these types of variables after your managers are aware of the situation (such as harassment, taunting, or even anything presented as “merely teasing” about your looks, background, accent, religion, or physical abilities).

This legal prohibition against discrimination also includes the legal concept of making “reasonable accommodations” for your background, your identity, and your needs. If you need to be home before sunset on Fridays because of your religious beliefs, background, and practices, for example, part of not discriminating against you on the basis of your religion will be that your employer will make reasonable changes to your work schedule to allow you to be home before sunset on Fridays. Similarly, if you have limitations in your physical ability to stand or to lift, or if you are pregnant, among many other examples, your employer will probably be required to recognize, respect, respond to, and make reasonable accommodations for your needs.

In practice, these issues can be complex, as you are probably aware from your own past experiences and from reading these few simple examples. There are exceptions and complications, and you will need to explore the federal Equal Employment Opportunity Commission’s website, explore your organization’s human resources materials, or talk to an employment attorney, if you have specific questions. As we build our general context for culturally and individually appropriate speech-language pathology, however, many of the issues are also relatively straightforward. Current civil rights employment law in the U.S. requires that, within reasonable bounds, you must be given the same opportunity to succeed (or fail) at work that any other person with your same professional skills would be given, regardless of your cultural or personal background and with reasonable supports that fit your own cultural and personal needs.

Civil Rights as Clinicians and Professionals

The work that we do as speech-language pathologists is also controlled by a combination of federal and state laws, including the Civil Rights Act of 1964, the Rehabilitation Act of 1973, the Americans with Disabilities Act (1990), and many related laws and regulations. In different combinations for different work settings, these laws work together to prohibit educational, healthcare, and other public-facing organizations or businesses from discriminating against their students, clients, or customers on the basis of race, color, sex (which has been interpreted by the courts to include pregnancy, sexual orientation, and, at different times, gender identity or “transgender status”), disability, religion, familial status, national origin, or citizenship status. As speech-language pathologists, therefore, as a matter of current federal law in the U.S., we are not allowed to refuse to serve any client, to limit any client’s access to our services, or to provide higher- or lower-quality services to any client if our decisions or actions are based in any way on the client’s or the family’s race, sex, religion, or the other personal variables listed in the law. Because access to the full benefit of educational and healthcare services, including speech-language pathology, is protected as a civil right for all people under current federal law, we as service providers must ensure that our actions do not infringe on any person’s civil right to have equitable access to our services.

To be clear, as we addressed above for grocery stores and driving tests, civil rights law does not mean that we are somehow required to give away our speech-language pathology services to any person or to all people. We are allowed to determine who needs our services, to decide that some people do not need our services, to establish fees and expect to be paid, and to make rules that we will not schedule another appointment for someone who has failed to pay us or failed to show up for some number of previous appointments, among many other possible limitations that we might set on the availability of our services. As we set those limitations, however, we must set them for everyone; the simple fact of federal law is that we are not allowed to declare that we do not serve any subset of “people like that” when the variable in question relates to a person’s culture, background, language, or personal identity.

It is also important to note, as a final point, that civil rights law not only prohibits overt discrimination but also requires us to take multiple proactive steps to ensure as best we reasonably can that our services are available in equitable ways to all persons. The requirement not to discriminate against clients on the basis of their national origin, for example, is interpreted in federal law as requiring schools and healthcare organizations to make reasonable efforts to offer information in the languages that most clients and families in their geographic area know and use (because language is generally tied to country of origin; see Module 6). Similarly, the requirement that we must not discriminate against clients or families on the basis of their physical abilities goes well beyond our stated willingness to work with a person who uses a wheelchair; the ADA requires most businesses to actively ensure that our spaces are equally physically accessible for people who use wheelchairs and for people who walk. Again, the law recognizes complexities and provides reasonable protections for everyone involved, but, overall, as we will continue to explore throughout this website, civil rights law requires us to be proactive about ensuring that all people from all cultures and backgrounds, and with all personal identities and a wide range of physical and neurocognitive abilities, have equitable opportunities to access the full benefits of our services.

Your Turn

While I am writing in early 2025, U.S. society, and many prominent political and other persons involved in our federal government, seem to be actively re-evaluating our civil rights and anti-discrimination laws. Find an example in the current news as you are reading that is related to any of the issues discussed in this section. Evaluate it using the 16 Questions matrix from Module 2. How will you structure your workplace, with respect to that issue? Why?

Explore the civil rights information available at the websites of the U.S. Equal Employment Opportunity Commission, the Civil Rights Division of the U.S. Department of Justice, the U.S. Department of Health and Human Services’ Office for Civil Rights, or the U.S. Department of Education. Compare what you find to the information on your own school’s, clinic’s, facility’s, or organization’s website, and compare it to the descriptions provided in this section. As of late 2024, for example, the Department of Health and Human Services required healthcare providers to publicly state their commitment to non-discrimination and provided a sample statement that stated

This organization/provider complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, religion, or sex (including pregnancy, sexual orientation, and gender identity). We do not exclude people or treat them differently because of race, color, national origin, age, disability, religion, or sex (including pregnancy, sexual orientation, and gender identity).

Has this guidance changed? Does your clinic have this statement or something similar in a prominent place on your website?

Does your hospital offer information in the several languages that are most common in your geographic area? Does your school send home printed information to families in the few most common languages in your area? (If so, does English always appear first, or are the languages rotated in a way that reflects a genuine attempt to ensure that every patient and every family of every national origin is not discriminated against by your facility in any way?)

Discuss the civil rights laws and requirements from this section in the context of the material we discussed in Modules 1 and 2. We are each individuals, with our own important identities and beliefs, and we also each belong to multiple groups. Civil rights laws prescribe or impose some requirements for all of us. Do civil rights laws therefore unreasonably limit your ability to be you? Who is allowed to impose requirements upon a whole group, when, and why?

The ASHA Code of Ethics

ASHA’s Code of Ethics (ASHA, 2023) complements the universal requirements provided in such sources as federal and state law by outlining specific responsibilities for speech-language pathologists (and related professionals). Organized as four main principles, each with associated rules, the Code describes nonnegotiable requirements for all speech-language pathologists who hold or who are seeking ASHA membership or certification. It also provides an elegant framework for high-quality clinical and professional work for all speech-language pathologists and speaks directly to several aspects of high-quality, client-centered, culturally and individually appropriate work.

Hold Paramount the Welfare of Persons Served

The first principle of the ASHA Code of Ethics establishes that clients’ needs come first, using words that most ASHA-certified speech-language pathologists have memorized: the first principle requires us to “hold paramount the welfare of” (ASHA, 2023, p. 5) the people we serve. What do those words mean?

Holding clients’ welfare paramount means that the foremost issues in our minds, as we make clinical decisions, should always be our clients’ abilities, needs, and overall well-being in the context of their lives.

Consider the following scenarios. Are these clinicians’ actions legal, to the best of your current understanding of current civil rights law? Are the clinicians holding paramount their clients’ abilities, needs, and overall welfare in the context of the clients’ lives, or is something else driving these clinicians’ clinical decisions?

 Margaret speaks English and provides services in English. When clients ask if she could provide materials in another language or use an interpreter, she tells them that she does not have the time to find translated materials, that interpreters are expensive, and that English is the dominant language in their area.

 Mikayla uses reading materials from her religion as the basis for her therapy. When clients comment on this choice, she says that she has multiple copies of the materials easily available, which helps her to keep costs down, and that she finds the topics comforting.

 Mel uses foods and mealtime routines from her own culture as the basis for the recommendations she provides to patients with dysphagia. When patients ask for examples of diet textures that refer to foods they would recognize, or ask for recommendations that fit their social and emotional assumptions around meals, Mel doesn’t understand the problem and suggests that they can experiment at home.

You probably noticed many ways that, in ASHA’s terms, these clinicians were holding paramount many issues other than their clients’ needs. They might not have thought of their work as illegal or unethical, but their choices did not originate from their clients’ needs or hold their clients’ welfare paramount. Instead, these clinicians allowed their own linguistic and cultural preferences to guide their clinical decisions. Basic ethical practice, in other words, overlaps with legal practice and with our description of client-centered, culturally and individually appropriate practice. Holding clients’ welfare paramount means recognizing, respecting, and responding to clients’ needs, which are shaped by their cultural and linguistic backgrounds.

ASHA’s (2017) statement on cultural and linguistic ethics also explained the importance of this principle by requiring that care “should not vary in quality” on the basis of a client’s cultural, linguistic, group-based, or individual identities. Again, notice that this statement is essentially repeating the essence of federal civil rights law. Imagine that Margaret, from the examples above, is a highly skilled clinician who uses well-supported research-based treatments. Her clients who speak English tend to improve as they work with her. What would happen to her clients who do not speak English, even if she is using the same well-supported treatment techniques? If she is using a language they do not understand, they will not improve, or at least will not improve nearly as much as her English-speaking clients improve. She will have allowed the effectiveness of the care she provides to vary on the basis of her clients’ linguistic backgrounds.

Another way to describe Margaret, Mikayla, and Mel’s decisions and actions would therefore be that they were discriminating against some clients, as civil rights law addresses. “Discriminating” is a strong word (to which we will return in Module 9, among other parts of this website), and many clinicians acting in ways that turn out to be discriminatory might resist this description of their work, even as they are aware that the law prohibits discrimination. Regardless of the clinicians’ intent, however, notice that the result in our three example cases would be that clients who shared Margaret’s language, Mikayla’s religion, and Mel’s cultural food preferences would receive care that matched their abilities, their needs, and their lives, which we know will be more effective than care that does not match a client’s abilities, address their needs, or fit their lives. If clients similar to the clinician receive effective care, while clients who differ from the clinician on any cultural dimension such as language, religion, or foods receive less effective care, then a discriminatory difference has emerged. The care these clinicians are providing is inequitable (as defined in Module 1 and as defined in civil rights law), meaning that some clients did not receive what they needed, or meaning that the clients’ clinical outcomes were unequal, because of the clinician’s failure to address each client’s cultural and linguistic characteristics appropriately.

ASHA emphasizes that cultural and linguistic abilities are part of basic ethical practice to prevent the possibility that we might, even unintentionally, provide poorer services to clients who differ from us. We cannot hold our clients’ welfare paramount, the first and primary principle of ASHA’s Code of Ethics, unless we hold their cultural, linguistic, and personal backgrounds paramount. ASHA has also specified, in an important document known as an “Issues in Ethics” statement on cultural and linguistic competence, that

“cultural and linguistic competence is as important to the successful provision of services as are scientific, technical, and clinical knowledge and skills. The Code requires the provision of competent services to all populations and the recognition of the cultural and linguistic experiences, or life experiences, of both the professional and those they serve.”

This website was shaped, in many ways, by these two basic ethical requirements from ASHA: that we must hold our clients’ welfare paramount (from the Code of Ethics; ASHA, 2023), and that we must provide “competent services to all populations” (from the 2017 Issues in Ethics statement). The Code of Ethics also prohibits discrimination, but the combination of these two affirmatively phrased requirements makes a stronger point than merely prohibiting specific types of discrimination. It is not enough to have another explanation (“I was not discriminating against them, it’s just that interpreters are expensive”). Equally, it is not enough to select only clients like ourselves, clients whose backgrounds we are comfortable with, or clients whose identities we approve of, and then proceed to hold only those clients’ welfare paramount. ASHA requires us to serve persons from all populations competently, in a way that holds paramount their backgrounds and their needs.

To be clear, let’s also remember that we are required to provide speech-language pathology services, not required to agree with every client’s opinions about everything or required to somehow take on our clients’ cultures or identities as our own. ASHA’s use of “all populations” here also must be interpreted reasonably, as we mentioned for the reasonable limitations on any organization’s or business’s responsibilities under federal civil rights law; the phrase requires us to serve all our clients correctly, not literally to provide services to every human being on the planet. Nevertheless, in short, as a matter of federal law and basic professional ethics, speech-language pathologists

  • do not “deny[…] services on the basis of an individual's cultural and linguistic background” (ASHA, 2017);

  • do “not discriminate in the delivery of professional services or in the conduct of research and scholarly activities on the basis of race, ethnicity, sex, gender identity/gender expression, sexual orientation, age, religion, national origin, disability, culture, language, or dialect” (ASHA, 2023; Principle I, Rule C, of the Code of Ethics), a list that is interpreted in the 2017 Issues on Ethics statement as “prohibit[ing] discrimination across the full range of dimensions of diversity”; and

  • use “lifelong learning to develop the knowledge and skills required to provide culturally and linguistically appropriate services” to “all populations” (from the 2017 Issues on Ethics statement).

Your Turn

If you are not ASHA certified and not seeking ASHA certification, you are not bound by ASHA’s Code of Ethics, and civil rights laws and interpretations in the U.S. change routinely. Will you do your best to consistently “hold paramount the welfare of” all persons you serve and “provide competent services to all populations” anyway? Why or why not?

Discuss ASHA’s requirements, as described in this section, in the context of the material from Modules 1 and 2. We are each individuals, with our own important identities and beliefs, and we also each belong to multiple cultures or groups. ASHA imposes some requirements on all certified speech-language pathologists. Who is allowed to impose requirements upon a whole group, when, and why?

I tend not to emphasize rote memorization as a learning tool, but this material is an exception. You might want to memorize all of the following phrases:

  • to “hold paramount the welfare of” the people we serve (the first principle of ASHA’s 2023 Code of Ethics)

  • to provide “competent services to all populations” (from ASHA’s 2017 Issues in Ethics Statement)

  • “care should not vary in quality” on the basis of a client’s cultural, linguistic, group-based, or individual identities (from ASHA’s 2017 Issues in Ethics Statement)

Responsibilities to Ourselves, to the Public, and to our Profession

The three remaining principles of the ASHA Code of Ethics provide additional necessary context and requirements, for service delivery and also for the domains of professional practice. As we hold paramount our clients’ needs, professionals must also “achieve and maintain the highest levels” of professional expertise and performance; provide “accurate information” to the public; and “uphold the dignity…of the professions,” including in how we interact with each other and with other professionals (ASHA, 2023).

These principles help us guard against unintended inequities in clinical service delivery, such as those that Margaret, Mikayla, and Mel were allowing to happen. They also help us guard against any unintended inequities that might arise because of how we approach our many other responsibilities across the domains of professional practice.

Consider how the following three additional speech-language pathologists are approaching the domains of professional practice. Which elements of federal civil rights law do you recognize? What professional ethics issues do you see?

 NeeDee works for a large practice that provides speech-language, occupational, and physical therapy. She schedules her sessions without conferring with her colleagues or asking the clients when they have appointments with her colleagues. The advertising flyers she developed to take to the community parent-and-baby resource fair are in English, even though her town includes a large Korean community, and they describe only the benefits of speech-language services, without mentioning occupational or physical therapy.

 On the first Friday of every month, Noelle’s hospital offers free, optional Lunch-and-Learn sessions for employees about basic greetings, politeness routines, and medical terms in one of the languages that are common in their community. The 20-minute sessions rotate among addressing Spanish, Tagalog, English, Cantonese, and American Sign Language. Noelle has never attended.

 Nuuvi serves as the Director of Special Education for their school district. The school board has proposed new requirements that teachers and other professionals must have cars rather than depending on the city bus to get to school, must speak English at all times while they are at school, and must not wear any headcovering of any kind while they are at school. Nuuvi does not understand why the speech-language pathologists in their department are upset about these proposals and advises them to stay out of educational politics.

Take a moment to think about these situations and about NeeDee, Noelle, and Nuuvi’s individual actions. Were the organizations attempting to follow or potentially violating civil rights law? If the scenarios had been described slightly differently, would the individuals’ actions or the organizations’ actions have struck you as more or less legal or ethical? As you think about their actions or some changes they might consider, remember that ASHA’s Code of Ethics is purely consistent with current civil rights law and requires all of the actions summarized in Box 3.1.

Box 3.1. Culture- and identity-related requirements based on the ASHA Code of Ethics, including as interpreted in ASHA’s (2017) Issues in Ethics statement, for clinical service delivery and for the domains of professional practice

> to hold paramount the welfare of any person we are trying to serve clinically or professionally

> to provide competent services to all populations

> to achieve and maintain the highest levels of professional expertise and performance, including through lifelong and continuing attempts to improve in the area of culturally and linguistically appropriate services

> to provide complete and accurate information to the public

> to uphold the dignity of the professions, including in how we interact with other speech-language pathologists and with other professionals

> to recognize, respect, and respond to the values, preferences, language, cultural background, and individual identities of all people we encounter in clinical service delivery and in the domains of professional practice

> to ensure that the outcomes of our efforts in clinical service delivery and across the domains of professional practice do not vary in quality on the basis of the cultural, linguistic, or other group or identity-based characteristics of the people involved.

Among the key points here, for the professional practice domains, is that “discrimination in any professional arena and against any individual for any reason, whether subtle or overt, ultimately dishonors the professions and harms all those within the practice” (ASHA, 2017). And, again, as we mentioned for clinical service delivery, discrimination need not include overt refusal to serve a group of people. Discrimination also occurs when inequities arise in the outcomes of our actions, in either service delivery or professional practice domains, if those actions were guided by our inaccurate cultural, linguistic, or identity-based assumptions instead of by the needs of the client, the public, the other professionals, or our profession as a whole.

Your Turn

Read (or re-read) ASHA’s (2023) Code of Ethics and ASHA’s (2017) Issues on Ethics statement about cultural and linguistic competence. Find any one idea that you do not understand, or love and want to explore in more depth, or otherwise have any question about. Commit to learning something about that idea. (Put a reminder to revisit the idea on your calendar for a month from now.)

As we mentioned in the previous Your Turn questions, you might not be bound by ASHA’s Code of Ethics; civil rights laws, interpretations, and emphases change through time; and we are each individuals, with our own identities, beliefs, and journeys through our own personal and professional lives. Will you do your best to follow ASHA’s four main principles of ethics even if you are not formally bound by them?

What cultural or linguistic knowledge, skills, and abilities are required by your state’s code of ethics, statement of practice standards, or similar documents for professionals who hold the license or certification you hold or are seeking?

Who is allowed to impose requirements upon a whole group, when, and why?

Discuss Margaret, Mikayla, Mel, NeeDee, Noelle, and Nuuvi with some friends or colleagues. Brainstorm several different ways each of them could pursue additional training or lifelong learning to improve their clinical and professional practices (skip up to Module 18 if you’d like to!).

I tend not to emphasize rote memorization as a learning tool, but this material is an exception. You might want to memorize the following phrase:

  • “whether subtle or overt,” discrimination “ultimately dishonors the professions” (from ASHA’s 2017 Issues in Ethics statement).

Highlight Questions for Module 3

This module emphasized memorizing some specific wording. Can you complete and recite from memory all of the following phrases? Why does it matter in some situations to know the precise wording of any rule? Why does it matter in some situations to understand the underlying spirit of any rule?

> from the first principle of ASHA’s (2023) Code of Ethics: that we are to “hold…”

> from ASHA’s (2017) Issues in Ethics statement: that we are to provide “competent services to…”

> from ASHA (2017) Issues in Ethics Statement: that “care should not…” on the basis of a client’s cultural, linguistic, group-based, or individual identities

> from ASHA (2017) Issues in Ethics Statement: that “whether subtle or overt,” discrimination “ultimately…”

Modules 1 and 2 had emphasized our own journeys, the importance of a wide range of characteristics within cultures, and the importance of recognizing and respecting a wide range of individual identities. Did you perceive any tension between those emphases and the requirements described here in Module 3? As we have asked several times, who is allowed to impose which rules upon whom, when, and why? Are civil rights laws and the ASHA Code of Ethics consistent with, or inconsistent with, an emphasis that each person is entitled to respect, recognition, and their own journey through their own life?

What was your reaction, overall, to the organizational structure in this module that positioned the ASHA Code of Ethics and ASHA’s (2017) Issues in Ethics statement on cultural and linguistic competence as in the same territory as civil rights law? (The link was not my idea! See ASHA’s cultural responsiveness materials.)