ch 16-18

Question 1

Introduction to Balancing Client Rights and Practitioner Values

Answer 1

Balancing client-centered care with personal beliefs and ensuring practitioner safety.

Question 2

Understanding Moral Injury

Answer 2

 Definition:
- A situation where actions violate deeply held personal beliefs.
- May result in symptoms similar to depression or PTSD.
 Impact:
- Moral injury can disrupt practitioners’ mental health and professional abilities.
 Ethical Obligation:
-Practitioners are not required to endanger themselves physically or morally

Question 3

Ethical Responses to Safety Concerns

Answer 3

Practitioners can remove themselves from situations posing physical danger

Question 4

Steps to Address Safety Risks

Answer 4

 Move to a safe location.
 Attempt collaboration with clients or others to resolve risks.
 Follow organizational guidelines for relationship termination, if necessary

Question 5

Addressing Implicit Bias

Answer 5

 Discuss biases with mentors.
 Review professional standards.
 Participate in cultural humility and inclusion training.

Question 6

Reflection and Cultural Humility

Answer 6

 Identify and acknowledge implicit biases.
 Practice cultural humility during stress or conflict

Question 7

Moral Distress vs. Moral Injury

Answer 7

 Moral Distress:
 Temporary discomfort during ethical uncertainty.
 Requires intensive self-reflection.
 Moral Injury:
 Long-term mental health harm.
 Includes symptoms like depression, anxiety, and burnout.
 Key Goal: Avoid moral injury while managing moral distress

Question 8

Navigating Ethical Limitations

Answer 8

Moral objection to identity, roles, or routines is not a valid reason to terminate
therapeutic relationships.
 Steps for Transition:
-Reflect on limitations.
- Prioritize client, student, or colleague well-being.
- Follow organizational guidelines for transition.

Question 9

Tips for Ethical Practice

Answer 9

 Proactive Self-Reflection:
 Organizational Guidelines:
 Collaboration:

Question 10

Introduction to Productivity in
Occupational Therapy

Answer 10

 Definition of Productivity:
- Measurement of workload and service delivery in occupational therapy.
 Contemporary Practice:
-Focus on functional outcomes and units of service for reimbursement.
 Challenge:
- Balancing quality care with productivity expectations

Question 11

Patient-Driven Payment Model (PDPM)

Answer 11

 Introduced in 2019.
 Emphasis on medical diagnosis rather than billable therapy units

Question 12

Impacts PDPM

Answer 12

 Reduced therapy staff numbers.
 Increased workload for remaining practitioners

Question 13

Challenges in Productivity Standards

Answer 13

 Key Challenges:
-Managing higher caseloads.
- Balancing direct and indirect client care.
- Ensuring quality amidst tight schedules.
 Ethical Concerns:
- Balancing organizational directives with client best interests

Question 14

Common Ethical Challenges

Answer 14

 Charging for unprovided services.
 Coercing participation against client objections.
 Documenting off-clock to meet standards.
 Overrating impairments or providing unnecessary services.
 Reporting colleagues or employers for suspected violations

Question 15

Professional Duty

Answer 15

 Follow legal and ethical standards.
 Use independent clinical judgment for client care

Question 16

Consequences of Non-Compliance

Answer 16

 Legal penalties, loss of license, and professional reputation damage.

Question 17

Strategies for Practitioners

Answer 17

 Work within organizational structures.
 Report fraud or unethical practices.
 Seek whistle-blower protections if necessary.

Question 18

Whistleblowing

Answer 18

 Protected under the False Claims Act (2015).
 Provides legal recourse and potential financial rewards

Question 19

Resources for Practitioners

Answer 19

AOTA Practice Essentials
 Office of Inspector General (OIG): Reporting fraud and violations.
 Medicare and Medicaid Services: Guidance on compliance and reimbursement policies.
 State Licensure Resources Regulations governing OT practice.

Question 20

Tips for Ethical Practice

Answer 20

Be Informed
Proactive Communication
Moral Courage
Seek Guidance

Question 21

Introduction to Ethical Challenges in
Occupational Therapy

Answer 21

 Key Challenges:
 Organizational trends and societal inequities.
 Business orientation and resource allocation.
 Cultural diversity and social determinants of health.
 Focus of Discussion:
 Primarily health care organizations such as hospitals, clinics, skilled nursing
facilities, and home health agencies

Question 22

Evolution of Organizational Ethics

Answer 22

 Gained momentum in the 1990s with the Joint Commission mandate.
 Focus on hospital codes of conduct addressing admissions, billing, staff relations, and more

Question 23

focus and purpose

Answer 23

Shift from individual ethics to group and organizational behavior.
Align decisions with organizational values transparently and fairly.

Question 24

Common Ethical Problems

Answer 24

 Productivity and billing pressures.
 Compromised care due to cost containment.
 Moral distress in therapeutic relationships.

Question 25

Practitioner Dilemma

Answer 25

 Balancing client rights with organizational policies.
 Navigating market-based pressures to “do more with less.”

Question 26

Core Responsibilities

Answer 26

 Uphold professional core values: altruism, equality, freedom, justice, dignity,
truth, prudence.
 Prioritize client rights and well-being

Question 27

Key Ethical Principles ch 18

Answer 27

 Beneficence: Promote client well-being.
 Nonmaleficence: Prevent harm.
 Autonomy: Respect client choices

Question 28

Systemic and Global Issues

Answer 28

Barriers to Access:
 Sociopolitical and socioeconomic inequities.
 Financial and social service limitations.
Practitioner Responses:
 Advocating for clients beyond typical role expectations.
 Magnifying clinical reports for funding.
 Addressing systemic barriers collaboratively

Question 29

Managing Organizational Ethics

Answer 29

 Challenges and Solutions:
 Moral Distress: Arises from conflicting ethical responsibilities.
 Organizational Ethics Programs
Preventive Approach:
 Focus on precursors rather than consequences of moral distress

Question 30

Organizational Strategies
ch 18

Answer 30

 Employ shared decision-making processes.
 Foster interdisciplinary ethics teams.
 Provide psychological support and moral leadership

Question 31

Practitioner Actions ch 18

Answer 31

Collaborate with leadership to align quality benchmarks.
 Advocate for policy changes that mitigate ethical distress.
 Use objective data to justify ethical concerns

Question 32

Aligning Organizational and
Practitioner Values

Answer 32

Key Indicators for Change:
 Disconnect between mission/values and daily actions.
 Lack of leadership support for ethical behavior.
Occupational Therapy Managers’ Role:
 Set policies reflecting professional standards.
 Facilitate ongoing ethical education and open dialogue

Question 33

Tips for Navigating Ethical Challenges

Answer 33

 Reflect on and uphold personal and professional values.
 Work collaboratively to resolve ethical issues.
 Advocate for systemic policy changes.
 Facilitate open conversations about barriers and risks