Ethics

Question 1

What common themes are found in the values of physical therapy and other medical professions?

Answer 1

Accountability, integrity, social responsibility, and excellence.

Question 2

How is ethics defined?

Answer 2

A system of beliefs and behaviors that guide conduct based on what people value

Question 3

What is descriptive ethics?

Answer 3

A form of ethics that describes how people behave in ethical situations without judging their choices, acknowledging cultural and historical differences.

Question 4

What is normative ethics?

Answer 4

A form of ethics that prescribes what people should or should not do in ethical situations, judging behavior based on societal standards.

Question 5

What does moral psychology study?

Answer 5

The development of moral reasoning through intellectual growth, self-awareness, and understanding one’s place in society.

Question 6

What is applied ethics?

Answer 6

Professional or practical ethics that utilizes general ethical theories, moral reasoning, and professional codes of conduct to make decisions and solve problems.

Question 7

Why is moral courage important in applied ethics?

Answer 7

It represents the ability to stand up and do the right thing, even when it’s difficult.

Question 8

What does it mean for applied ethics to be care-based?

Answer 8

It keeps the relationship with the patient central while balancing emotional commitment and fiduciary responsibility.

Question 9

What progression does moral reasoning follow as one develops professionally?

Answer 9

From doing what one is told, to focusing on self-interest, to obeying the law, to understanding and balancing the needs of others with one’s own.

Question 10

How does moral reasoning evolve as one gains experience in the profession?

Answer 10

It progresses from self-centered reasoning to a more rational and impartial consideration of all actors’ needs in ethical situations.

Question 11

What does the sliding continuum in moral reasoning illustrate?

Answer 11

It illustrates the shift from simplistic compliance to complex decision-making that considers the needs of both oneself and others.

Question 12

What resources does the APTA provide to guide ethical decision-making for physical therapists?

Answer 12

The APTA provides a code of ethics, core values, a normative model of expected behavior, CAPTE criteria for professional ethics, and ethical guidelines within the clinical performance instrument.

Question 13

What are the core values of the physical therapy profession according to the APTA?

Answer 13

Accountability, altruism, compassion, excellence, integrity, professional duty, and social responsibility.

Question 14

When was the code of ethics for physical therapists adopted by the APTA House of Delegates?

Answer 14

In 2009.

Question 15

What is the role of the code of ethics in physical therapy?

Answer 15

It defines ethical principles, sets standards of behavior and performance, and provides accountability for the profession, guiding therapists in ethical challenges.

Question 16

How does the APTA code of ethics inform the public?

Answer 16

It describes what can be expected from physical therapists, helping to establish accountability and trust.

Question 17

How does the APTA code of ethics differ from state laws regarding physical therapy?

Answer 17

The code of ethics serves as ethical guidance but is not specifically referenced in state laws, which govern the legal obligations of physical therapists.

Question 18

What is the significance of the word “shall” in the APTA code of ethics?

Answer 18

“Shall” indicates an expectation that all physical therapists will adhere to the principles stated in the code, making compliance mandatory.

Question 19

What does Principle 1 of the APTA code of ethics state?

Answer 19

Physical therapists shall respect the inherent dignity and rights of all individuals, regardless of their background or life choices.

Question 20

What does Principle 2 of the APTA code of ethics emphasize?

Answer 20

Physical therapists shall be trustworthy and compassionate, addressing the rights and needs of patients and clients.

Question 21

According to Principle 3, what is expected of physical therapists regarding professional judgment?

Answer 21

Physical therapists shall be accountable for making sound professional judgments.

Question 22

What does Principle 4 of the APTA code of ethics address?

Answer 22

Physical therapists shall demonstrate integrity in their relationships with patients, clients, and colleagues.

Question 23

What obligation does Principle 5 impose on physical therapists?

Answer 23

Physical therapists shall fulfill their legal and professional obligations.

Question 24

What does Principle 6 state about the professional development of physical therapists?

Answer 24

Physical therapists shall enhance their expertise through lifelong learning and refinement of skills.

Question 25

What is the focus of Principle 7 in the APTA code of ethics?

Answer 25

Physical therapists shall promote organizational behaviors and business practices that benefit patients, clients, and society.

Question 26

What does Principle 8 encourage physical therapists to do?

Answer 26

Physical therapists shall participate in efforts to meet the health needs of people locally, nationally, and globally.

Question 27

How are the APTA core values integrated into the code of ethics?

Answer 27

The core values of accountability, altruism, compassion, excellence, integrity, professional duty, and social responsibility are reflected throughout the principles of the code of ethics.

Question 28

What laws govern the practice of physical therapy?

Answer 28

Physical therapy practice is governed by both federal laws (like the False Claims Act and Anti-Kickback Statute) and state laws, including each state’s Practice Act.

Question 29

What is the False Claims Act?

Answer 29

The False Claims Act allows private citizens to sue individuals or entities that defraud the government, with provisions for whistleblower protection and does not require proof of intent to defraud.

Question 30

What does the Anti-Kickback Statute prohibit?

Answer 30

The Anti-Kickback Statute prohibits the payment of kickbacks, bribes, or rebates for the referral of Medicare or Medicaid patients.

Question 31

What are the Stark laws?

Answer 31

The Stark laws prohibit physicians from self-referring Medicare and Medicaid patients to entities in which they have a financial interest, including specific health services like physical therapy.

Question 32

Why is it important to know your state’s Practice Act?

Answer 32

Each state’s Practice Act defines legal obligations and the limits of practice for physical therapists, which can vary from state to state.

Question 33

What are some examples of fraud, waste, and abuse in physical therapy?

Answer 33

Examples include fraudulent diagnoses to increase visits, falsifying medical records, billing for unrendered services, and waiving patient co-pays or deductibles.

Question 34

How can waiving a patient’s deductible be considered fraud?

Answer 34

Waiving a deductible breaches the contract with the insurance company regarding the agreed payment for services, thus constituting fraud.

Question 35

What does “unbundling” mean in the context of insurance billing?

Answer 35

Unbundling refers to itemizing charges that should be billed as a bundled amount, in order to receive a higher reimbursement than what is contractually agreed upon.

Question 36

What are the potential consequences of engaging in fraud, waste, and abuse?

Answer 36

Consequences can include criminal and civil penalties, exclusion from seeing Medicare patients, and insurance companies withholding payments or conducting audits.

Question 37

How does the profession self-police against fraud?

Answer 37

The profession encourages self-regulation, adherence to professional values and ethics, and education of consumers about acceptable practices and charges.

Question 38

What protections exist for whistleblowers in the context of fraud in healthcare?

Answer 38

Federal acts provide protection and easier access for whistleblowers to report wrongdoing without fear of retaliation.

Question 39

What is the purpose of educating consumers about fraud, waste, and abuse?

Answer 39

Educating consumers helps them understand what to expect regarding charges and services, thus promoting transparency and accountability within the healthcare system.

Question 40

What is the purpose of the ethical decision-making model discussed?

Answer 40

It helps analyze ethical dilemmas or decisions by categorizing them into a continuum from unethical to ethical and legal to illegal.

Question 41

What are the four quadrants of the ethical continuum?

Answer 41

1. Unethical and illegal
2. Unethical but legal
3. Ethical and legal
4. Ethical but illegal

Question 42

What does RIPS stand for in the ethical decision-making model?

Answer 42

Realm, Individual process, and Ethical situation.

Question 43

How do we define the ‘realm’ in RIPS?

Answer 43

The realm can be individual (relationship between two people), organizational (impact on the institution), or societal (larger societal impact).

Question 44

What does the ‘individual process’ involve?

Answer 44

It involves assessing what the situation requires of the individual, including moral sensitivity, moral judgment, moral motivation, and moral courage.

Question 45

What is the difference between an ethical issue and an ethical dilemma?

Answer 45

An ethical issue involves challenged values, while an ethical dilemma involves two right answers or two courses of action that fulfill an important duty.

Question 46

Define ethical distress.

Answer 46

Ethical distress occurs when an individual knows the right course of action but is unable to take it due to barriers.

Question 47

What is ethical temptation?

Answer 47

Ethical temptation refers to a choice between right and wrong where choosing the wrong option might offer a personal benefit.

Question 48

Describe ethical silence.

Answer 48

Ethical silence occurs when ethical values are challenged but no one speaks up to address the issue.

Question 49

What questions should be asked when gathering information about an ethical situation?

Answer 49

Consider relevant facts, stakeholders, possible consequences, relevant laws, professional resources, and if any of the five tests for right versus wrong apply.

Question 50

What are the five tests for determining right versus wrong?

Answer 50

1. Legal Test - Is it illegal?
2. PU Test - Does it feel wrong?
3. Front Page Test - Would I be embarrassed if my decision was public?
4. Mom/Dad Test - How would my parents react?
5. Professional Ethics Test - Does it align with professional ethics?

Question 51

What is the final step in the RIPS decision-making process?

Answer 51

Reflect on and evaluate the outcome of the action taken, reassess if it was effective, and learn from the experience.

Question 52

Why is it important to check with the state licensing board regarding ethical concerns?

Answer 52

Each state has specific procedures for reporting ethical concerns within the profession.

Question 53

What should physical therapists know to execute their roles effectively?

Answer 53

Knowledge of the APTA code of ethics, state practice act, CMS conditions of participation, and the RIPS framework is essential for ethical practice.