BACKGROUND: As dietitians actively engage in sectors beyond healthcare, practitioners are expected to uphold ethical standards that reflect both individual conduct and the profession's social identity. The growing influence of digital technologies, sustainability challenges, and interdisciplinary collaboration further underscores the need to understand current standards of ethical practice. However, global dialog on dietetic ethics remains limited and fragmented. OBJECTIVE: To analyze how professional ethics are governed and enforced, and how ethical content domains are structured and expressed in dietetic codes worldwide. METHODS: A qualitative document analysis was conducted on national or regional codes of ethics and conduct from 25 dietetic associations spanning North America, Europe, Asia-Pacific, and Africa. Documents were obtained from public repositories or through direct association outreach. Codes written in English or Chinese were analyzed directly; others were translated using artificial intelligence (AI) and verified by issuing organizations. Using a reflexive content analysis approach, we examined revision history, government and enforcement, and ethical content domains. RESULTS: Enactment of ethical guidelines ranged from 1982 to 2024, and only five documents reported revision practices, with update cycles varying from scheduled to ad hoc. Regional variation was observed across three dimensions of ethical guidelines: intended audience scope, aspirational enforcement approaches, and references to legal compliance in relation to local laws or legislation. All documents referenced bioethical principles, but only eight incorporated environmental ethics; ethical guidance addressed professional interactions outside patient-practitioner relationships. Conflicts of interest in these contexts included non-financial domains (e.g., media engagement), with advertising and marketing explicitly discussed in several recently updated guidelines. CONCLUSIONS: Findings highlight key opportunities to strengthen ethical guidance in dietetics, particularly in relation to environmental ethics, collaborative practice contexts, and conflicts of interest in digital settings.
Zheng et al. (Tue,) studied this question.