NS106 Unit 4 Ethics Analysis Example

A Sales Bonus for Every Scoop: A Unit 4 Professional Ethics Analysis of a Technician Told to Feature the Gym's Protein Powder

[Student Name]

Purdue University Global

NS106: Nutrition Profession and Career Planning

Unit 4 Professional Ethics Analysis

[Instructor Name]

[Date]

The fitness center, the technician and the policy are composite; the code of ethics and the professional literature cited are real.

The Situation

Tomás, a composite 27-year-old nutrition and dietetics technician, registered, works at Summit Strength, a regional chain of fitness centers. He meets with members to discuss general nutrition and, under the supervision of a contracted registered dietitian nutritionist, helps with plans for members referred for weight management. Last month the chain launched its own protein powder, Summit Whey, sold at the front desk for $54 a tub. A new policy requires staff to include Summit Whey in every member's nutrition plan, and staff receive a $6 bonus for each tub sold to a member they advise.

Tomás has two concerns. Many of his members already get enough protein from food, and some, including an older member with early kidney disease referred by her physician, should not be adding protein without medical advice. He also wonders whether he must tell members about the bonus.

The Standard

The Code of Ethics for the Nutrition and Dietetics Profession, adopted by the Academy of Nutrition and Dietetics and the Commission on Dietetic Registration in 2018, applies to all credentialed practitioners, including technicians. Among its principles of integrity in personal and organizational behavior, it requires practitioners to disclose any conflicts of interest, including any financial interests in products or services that are recommended, and to refrain from accepting gifts or services that may influence, or appear to influence, professional judgment (Academy of Nutrition and Dietetics & Commission on Dietetic Registration, 2018). The code's revision in 2018 was designed in part to make these duties clearer for practitioners working in commercial settings (Peregrin, 2018).

The code also requires practitioners to practice within their scope and to base practice on evidence and the client's needs, which bears on the second concern.

Analysis

The policy creates two distinct ethical problems.

Financial interest. A $6 bonus for every tub sold gives Tomás a personal financial interest in recommending the product. Under the code, that interest must be disclosed to members when he recommends the powder. Disclosure alone does not resolve the problem, because the code also asks practitioners to avoid inducements that may influence or appear to influence their judgment. A bonus tied to every sale is exactly that kind of inducement.

Recommendation without need. The policy requires the powder in every plan, regardless of whether a member needs it. Most of Tomás's members eat protein well above the adult allowance, which is set per kilogram of body weight (Institute of Medicine, 2005), from ordinary food. Recommending a supplement they do not need serves the chain's sales, not the member's interests, and for the member with kidney disease it could be harmful. The code's requirement that recommendations rest on evidence and the client's needs means a blanket policy cannot be followed without violating it for some members.

Disclosing the bonus would satisfy the letter of one standard, but it would not cure the deeper problem, which is a policy requiring Tomás to recommend a product to every member whether or not that member needs it, and no disclosure can make an unneeded recommendation an honest one.

The Member With Kidney Disease

The member referred by her physician deserves separate attention. Protein restriction is often part of care for chronic kidney disease, and decisions about protein intake for her belong to her physician and a dietitian working with her medical team. A technician recommending a protein supplement to her, even with disclosure, would be acting outside the supervising dietitian's plan and potentially against her medical care. The code's requirement to practice within one's scope and to refer when needs exceed it applies directly here. Whatever happens with the policy, Tomás should not include the powder in her plan.

Whose Interests Are at Stake

Several parties have legitimate interests. The members want sound advice. The chain wants revenue from a product it has invested in. Tomás wants to keep his job and his credential. The supervising dietitian shares responsibility for the plans Tomás helps write. A good resolution should respect as many of these interests as possible without sacrificing the members' welfare, which the code places first.

Options

1. Comply fully, recommending the powder to everyone and disclosing the bonus. This meets the disclosure requirement but violates the requirement to base recommendations on need and risks harm to some members.

2. Refuse the policy entirely. This protects members but may cost Tomás his job, and it does not address the chain's legitimate interest in selling a product that some members could use.

3. Recommend the powder only to members who need additional protein and cannot meet their needs from food, disclose the bonus in writing every time and decline the bonus for members referred for medical reasons. Raise the policy with his manager and the supervising dietitian.

Recommended Course

Option 3 best fits the code. Tomás should speak first with the supervising registered dietitian nutritionist, since he works under her supervision and she shares responsibility for plans. Together they should ask the manager to change the policy from "every plan" to "plans where appropriate" and to separate staff advice from sales bonuses. Until the policy changes, Tomás should recommend the powder only when a member's needs justify it, disclose the bonus each time and refer the member with kidney disease back to her physician for any protein decisions.

What If the Chain Refuses

If the chain insists on the original policy, Tomás faces a conflict between his employer and his professional obligations. The code places obligations to clients and the public above obligations to an employer, and it expects practitioners to speak up when an employer's policy conflicts with those obligations rather than simply follow it. Before taking that step, he should put his concerns in writing to his manager, citing the specific members for whom the powder would be inappropriate, since a concrete case is harder to dismiss than a general objection. He could document his concerns, seek advice from the Commission on Dietetic Registration's ethics resources and, if necessary, look for a position where he can practice within the code.

Why Summaries Fall Short

A summary of the code would list the duty to disclose conflicts of interest and stop there. Applied to Tomás's situation, the code turns out to require more than disclosure, and the most important question, whether a recommendation serves the client, is not answered by disclosing anything.

References

Academy of Nutrition and Dietetics & Commission on Dietetic Registration. (2018). Code of ethics for the nutrition and dietetics profession. https://www.eatrightpro.org/career/code-of-ethics

Institute of Medicine. (2005). Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. National Academies Press. https://doi.org/10.17226/10490

Peregrin, T. (2018). Revisions to the code of ethics for the nutrition and dietetics profession. Journal of the Academy of Nutrition and Dietetics, 118(9), 1764-1767. https://doi.org/10.1016/j.jand.2018.05.028