Introduction to Ethics Flashcards
1
Q
What are a few ways to define ethics = ?
Introduction to Ethics
A
- A branch of philosophy that focuses on justice, morality, right vs wrong, honesty, and free will.
- A set of rules that govern the behavior of a person (What is “right”, or “ideal”).
- Sometimes called a rational reflection or analysis.
- Are usually a higher standard than the law.
2
Q
What influences our own ethical identity ?
Introduction to Ethics
A
(a) Ethical identify influenced by many factors, including:
- Family
- Peers
- Religion
- Experiences
- Situations
(a) Based on the word “ethos”: character;
- ”the distinguishing character, sentiment, moral nature, or guiding beliefs of a person, group or institution.”
(a) Are culturally based;
- Specific to each individual based on personal, religious, cultural and environmental values.
3
Q
What is Physical Therapy Ethics ?
Introduction to Ethics
A
- Ethics guides our decisions about what is right/wrong, and extends beyond our personal lives into our professional conduct.
- Physical Therapy Ethics = a set of beliefs, attitudes, principles, justified conduct and ideals in physical therapy.
- The conduct and beliefs of physical therapists as individuals or as groups.
4
Q
Why do we study PT ethics = ?
Introduction to Ethics
A
(a) Increases our cognitive skills and reasoning
- Helps us identify moral issues and reasons
- Helps increase our awareness of an alternative viewpoint
(b) Improves moral responsibility as a clinician
(c) Helps to increase moral tolerance
- Strengthen our ability to have disagreements in a more open-minded way
- Helps to strengthen our ability to deal reasonably with moral vagueness, ambiguity and disagreements
- This helps to guide our ways of thinking and our actions, and enhancesthe care we give
5
Q
Ethical “Compass” = ?
Introduction to Ethics
A
Ethical “Compass”:
- This is different than a GPS!
- Set of ideas, concepts, values that keep us heading in the right direction.
- Provides a tool when there are various pathways/behaviors.
- Is a guide we can fall back on when unsure.
- Is a useful resource for advocating for those impacted by unethical actions.
6
Q
APTA Code of Ethics:
- Principle #1: Physical therapists shall respect the = ?
Introduction to Ethics
A
Principle #1:
- Physical therapists shall respect the inherent dignity and rights of all individuals.
- Core Values: Compassion, Integrity
- 1A. Physical therapists shall act in a respectful manner toward each person regardless of age, gender, race, nationality, religion, ethnicity, social or economic status, sexual orientation, healthcondition, or disability.
- 1B. Physical therapists shall recognize their personal biases and shall not discriminate against others in physical therapist practice, consultation, education, research, and administration.
7
Q
APTA Code of Ethics:
- Principle #2: Physical therapists shall be____ and ____ compassionatein addressing the rights and needs of patients/clients.= ?
Introduction to Ethics
A
Principle #2:
- Physical therapists shall betrustworthy and compassionatein addressing the rights and needs of patients/clients.
- Core Values: Altruism, Collaboration, Compassion and Caring, Duty.
- 2A. Physical therapists shall adhere to the core values of the profession and shall act in the best interestsof patients/clients over the interests of the physical therapist.
- 2B. Physical therapists shall provide physical therapy services with compassionate and caring behaviorsthat incorporate the individual and cultural differences of patients/clients.
- 2C. Physical therapists shall provide the information necessary to allow patients or their surrogates tomake informed decisions about physical therapy care or participation in clinical research.
- 2D. Physical therapists shall collaborate with patients/clients to empower them in decisions about theirhealth care.
- 2E. Physical therapists shall protect confidential patient/client information and may disclose confidentialinformation to appropriate authorities only when allowed or as required by law.
8
Q
APTA Code of Ethics:
- Principle #3: Physical therapists shall be accountable for = ?
Introduction to Ethics
A
Principle #3:
- Physical therapists shall be accountable for making sound professional judgments.
- Core Values: Collaboration, Duty, Excellence, Integrity
- 3A. Physical therapists shall demonstrate independent and objective professional judgment in the patient’s/client’sbest interest in all practice settings.
- 3B. Physical therapists shall demonstrate professional judgment informed by professional standards, evidence(including current literature and established best practice), practitioner experience, and patient/client values.
- 3C. Physical therapists shall make judgments within their scope of practice and level of expertise and shallcommunicate with, collaborate with, or refer to peers or other health care professionals when necessary.
- 3D. Physical therapists shall not engage in conflicts of interest that interfere with professional judgment.
- 3E. Physical therapists shall provide appropriate direction of and communication with physical therapist assistantsand support personnel.
9
Q
APTA Code of Ethics:
- Principle #4: Physical therapists shall demonstrate integrity in their relationships with = ?
Introduction to Ethics
A
Principle #4:
- Physical therapists shall demonstrate integrity in their relationships with patients, clients, families, colleagues, students, research participants, other health care providers, employers, payers, and the public.
- Core Value: Integrity
- 4A. Physical therapists shall provide truthful, accurate, and relevant information and shall not make misleading representations.
- 4B. Physical therapists shall not exploit persons over whom they have supervisory, evaluative or other authority (eg,patients/clients, students, supervisees, research participants, or employees).
- 4C. Physical therapists shall not engage in any sexual relationship with any of their patients/clients, supervisees, or students.
- 4D. Physical therapists shall not harass anyone verbally, physically, emotionally, or sexually.
- 4E. Physical therapists shall discourage misconduct by health care professionals and, when appropriate, report illegal or unethical acts, including verbal, physical, emotional, or sexual harassment toan appropriate authority with jurisdiction over the conduct.
- 4F. Physical therapists shall report suspected cases of abuse involving children or vulnerable adults to theappropriate authority, subject to law.
10
Q
APTA Code of Ethics:
- Principle #5:Physical therapists shall fulfill theirlegal and professional _ = ?
Introduction to Ethics
A
Principle #5:
- Physical therapists shall fulfill theirlegal and professional obligations.
- Core Values: Duty, Accountability, Social Responsibility
- 5A. Physical therapists shall comply with applicable local, state, and federal laws and regulations.
- 5B. Physical therapists shall have primary responsibility for supervision of physical therapist assistants and supportpersonnel.
- 5C. Physical therapists involved in research shall abide by accepted standards governing protection of researchparticipants.
- 5D. Physical therapists shall encourage colleagues with physical, psychological, or substance related impairmentsthat may adversely impact their professional responsibilities to seek assistance or counsel.
- 5E. Physical therapists who have knowledge that a colleague is unable to perform their professional responsibilitieswith reasonable skill and safety shall report this information to the appropriate authority.
- 5F. Physical therapists shall provide notice and information about alternatives for obtaining care in the event thephysical therapist terminates the provider relationship while the patient/client continues to need physical therapyservices.
11
Q
Introduction to Ethics
APTA Code of Ethics:
- Principle #6: Physical therapists shall enhance their expertise through thelifelongacquisition andrefinement of = ?
A
Principle #6:
- Physical therapists shall enhance their expertise through thelifelongacquisition andrefinement ofknowledge, skills, abilities, and professional behaviors.
- Core Value: Excellence
- 6A. Physical therapists shall achieve and maintain professional competence.
- 6B. Physical therapists shall take responsibility for their professional development based on criticalself-assessment and reflection on changes in physical therapist practice, education, health caredelivery, and technology.
- 6C. Physical therapists shall evaluate the strength of evidence and applicability of contentpresented during professional development activities before integrating the content or techniquesinto practice.
- 6D. Physical therapists shall cultivate practice environments that support professionaldevelopment, lifelong learning, and excellence.
12
Q
APTA Code of Ethics:
- Principle #7: Physical therapists shall promote organizational behaviors and business practices that benefit = ?
Introduction to Ethics
A
Principle #7:
- Physical therapists shall promote organizational behaviors and business practices that benefit patients, clients, and society.
- Core Values: Integrity, Accountability
- 7A. Physical therapists shall promote practice environments that support autonomous and accountable professionaljudgments.
- 7B. Physical therapists shall seek remuneration as is deserved and reasonable for physical therapist services.
- 7C. Physical therapists shall not accept gifts or other considerations that influence or give an appearance of influencingtheir professional judgment.
- 7D. Physical therapists shall fully disclose any financial interest they have in products or services that they recommend topatients/clients.
- 7E. Physical therapists shall be aware of charges and shall ensure that documentation and coding for physical therapy services accurately reflect the nature and extent of the services provided.
- 7F. Physical therapists shall refrain from employment arrangements, or other arrangements, that prevent physical therapists from fulfilling professional obligations to patients/clients.
13
Q
APTA Code of Ethics:
- Principle #8: Physical therapists shall participate inefforts to meet the health needsof = ?
Introduction to Ethics
A
Principle #8:
- Physical therapists shall participate inefforts to meet the health needsof people locally,nationally, or globally.
- Core Values: Social Responsibility
- 8A. Physical therapists shall providepro bonophysical therapy services or support organizations that meetthe health needs of people who are economically disadvantaged, uninsured, and underinsured.
- 8B. Physical therapists shall advocate to reduce health disparities and health care inequities, improve accessto health care services, and address the health, wellness, and preventive health care needs of people.
- 8C. Physical therapists shall be responsible stewards of health care resources and shall avoid over-utilizationor under-utilization of physical therapy services.
- 8D. Physical therapists shall educate members of the public about the benefits of physical therapy and theunique role of the physical therapist.
14
Q
4 Steps of Resolving Ethical Situations = ?
Introduction to Ethics
A
(1) Recognize and define:
- Using the RIPS (Realm-Individual Process-Situation) decision making model.
(2) Reflect:
- Consider the facts and contexts surrounding the issue, laws, obligations; consequences of choosing one alternative over another.
- Who are the stakeholders involved? Is this a ”right vs right”…or ”right vs wrong”?
- What resources should you use to decide further?
(3) Decide the “right thing to do”:
- Three main paths used when resolving ethical dilemmas:
- (1) Rules-based: follow the rules, duties, obligations, or ethical principles already in place (Eg. Prohibitions against killing/stealing).
- (2) Ends-based: focuses on the consequences of the decision/action and the good orharm that will result forall ofthe stakeholders (Eg. The decision to not tell a terminally ill patient about the prognosis because of the risk of loss of hope).
- (3) Care-based: Resolve dilemmas according to relationships and concern for others (Eg. “the golden rule”– do unto others as you would have them do unto you).
(4) Implement, Evaluate, Reassess:
- Create an implementation plan, overcome barriers, examine if policies/procedures need revising.
15
Q
RIPS = ?
Introduction to Ethics
A
R.IP.S =
- Realm
- Individual Process
- Situation
16
Q
R in RIPS = ?
Introduction to Ethics
A
Realm = Who is Affected?. Is it an individual, organization, or society?
Individual = least complicated usually
- Personal decisions that you make alone or with a patient
- Focuses on rights, duties, behaviors, responsibilities between individuals
- Eg. Patient confidentiality
Organization/institution
- Focuses on the good of the organization (school, hospital…)
- Eg. Financial gain of the organization, hospital policies
Societal
- Most complex and least individual control
- Focuses on the common good
- Eg. Distribution of health care
The difficulty lies when your duty in various realms is competing/conflicting
17
Q
IP in RIPS = ?
Introduction to Ethics
A
Individual Process: What considerations, thoughts, actions occur?
What does the ethical situation most require of me?
Moral/ethical Sensitivity?
- Recognizing and interpreting ethical situations; awareness
Moral/ethical Judgment?
- Deciding between a right vs wrong action; generating options
Moral/ethical Motivation?
- Prioritizing ethical values over other values; eg. over financial gain, status or self interest
Moral/ethical Courage or Character?
- Demonstrating courage
- Persisting and implementing a plan of action, even if it means facing adversity
18
Q
S in RIPS = ?
Introduction to Ethics
A
Situation:
* What is being experienced
* What is the specific nature of the situation?
Classified as a:
- Issue or Problem: Situation in which moral values are being challenged.
- Temptation: A choice must be made between a right and wrong decision.
- Silence: All key parties realize that ethical values are being challenged but no one is talking about it or how to address it.
- Distress: PT knows the right course of action but aren’t empowered or authorized to perform it.
- Dilemma: Right vs right; a decision must be made but both obligations cannot be fulfilled (Eg. My desire to do what is right for my patient, but patient refuses (autonomy)).
23
Q
These six theories have had a big impact on health-care ethics = ?
Introduction to Ethics
A
(1) Rights Ethics: Human rights, human entitlement.
(2) Duty Ethics: Duty to respect autonomy; universalize (if you like/cheat, your ‘duty’ to respect others).
(3) Utilitarianism: ‘The most good for most people’; intrinsic good.
(4) Virtue Ethics: Virtues, character, ideals, emotions, attitude (major role in health care).
(5) Religious Ethics: Sacred, God’s commands
(6) Pragmatism: Context, pluralism
