Standard #6: Physical therapist assistants shall enhance their competence through the lifelong acquisition and refinement of knowledge, skills, and abilities. 6A. Physical therapist assistants shall achieve and maintain clinical competence. 6B. Physical therapist assistants shall engage in lifelong learning consistent with changes in their roles and responsibilities and advances in the practice of physical therapy. 6C. Physical therapist assistants shall support practice environ- ments that support career development and lifelong learn- ing. Interpretation: Clinical Competence (APTA, 2013b). Standard 6A should cause physical therapist assistants to reflect on their current level of clinical competence, to identify and address gaps in clinical competence, and to commit to the maintenance of clini - cal competence throughout their career. The supervising physical therapist can be a valuable partner in identifying areas of knowl- edge and skill that the physical therapist assistant needs for clini- cal competence and to meet the needs of the individual physical therapist, which may vary according to areas of interest and ex- pertise. Further, the physical therapist assistant may request that the physical therapist serve as a mentor to assist him or her in acquiring the needed knowledge and skills. Interpretation: Lifelong Learning (APTA, 2013b). Standard 6C points out the physical therapist assistant’s obligation to support an environment conducive to career development and learning. The essential idea here is that the physical therapist assistant en - courage and contribute to the career development and lifelong learning of himself or herself and others, whether or not the em- ployer provides support. Standard #7: Physical therapist assistants shall support organizational behaviors and business practices that benefit patients/clients and society. 7A. Physical therapist assistants shall promote work environments that support ethical and accountable decision making. 7B. Physical therapist assistants shall not accept gifts or other con- siderations that influence or give an appearance of influenc- ing their decisions. 7C. Physical therapist assistants shall fully disclose any financial interest they have in products or services that they recom - mend to patients/clients. 7D. Physical therapist assistants shall ensure that documentation for their interventions accurately reflects the nature and ex- tent of the services provided. 7E. Physical therapist assistants shall refrain from employment ar- rangements, or other arrangements, that prevent physical therapist assistants from fulfilling ethical obligations to pa- tients/clients. Interpretation: Organizational and Business (APTA, 2013b). Standard 7 reflects a shift in the Standards. One criticism of the former version was that it addressed primarily face-to- face clini- cal practice settings. Accordingly, Standard 7 addresses ethical obligations in organizational and business practices on a patient/ client and societal level. Interpretation: Documenting Interventions (APTA, 2013b). Standard 7D addresses the need for physical therapist assistants to make sure that they thoroughly and accurately document the interventions they provide to patients/clients and document re - lated data collected from the patient/client. The focus of this Standard is on ensuring documentation of the services rendered, including the nature and extent of such services. Standard #8: Physical therapist assistants shall participate in efforts to meet the health needs of people locally, nationally, or globally. 8A. Physical therapist assistants shall support organizations that meet the health needs of people who are economically dis - advantaged, uninsured, and underinsured.
Next, consider this excerpt from the EJC Opinion titled “Topic: Sexual Relationships with Patients/Former Patients” (modified for physical therapist assistants): A physical therapist [assistant] stands in a relationship of trust to each patient and has an ethical obligation to act in the pa- tient’s best interest and to avoid any exploitation or abuse of the patient. Thus if a physical therapist [assistant] has natural feelings of attraction toward a patient, he or she must subli- mate those feelings in order to avoid sexual exploitation of the patient (APTA EJC, 2001). One’s ethical decision-making process should focus on whether the patient/client, supervisee, or student is being exploited. In this context, questions have been asked about whether one can have a sexual relationship once the patient/client relationship ends. To this question, the EJC has opined as follows: ● The Committee does not believe it feasible to establish any bright-line rule for when, if ever, initiation of a romantic/sexual relationship with a former patient would be ethically permis- sible. ● The Committee imagines that in some cases a romantic/sex- ual relationship would not offend if initiated with a former pa - tient soon after the termination of treatment. In others, such a relationship might never be appropriate. Standard #5: Physical therapist assistants shall fulfill their legal and ethical obligations. 5A. Physical therapist assistants shall comply with applicable local, state, and federal laws and regulations. 5B. Physical therapist assistants shall support the supervisory role of the physical therapist to ensure quality care and promote patient/client safety. 5C. Physical therapist assistants involved in research shall abide by accepted standards governing protection of research par- ticipants. 5D. Physical therapist assistants shall encourage colleagues with physical, psychological, or substance-related impairments that may adversely impact their professional responsibilities to seek assistance or counsel. 5E. Physical therapist assistants who have knowledge that a col- league is unable to perform their professional responsibilities with reasonable skill and safety shall report this information to the appropriate authority. Interpretation: Colleague Impairment (APTA, 2013b). The cen- tral tenet of Standards 5D and 5E is that inaction is not an option for a physical therapist assistant when faced with the circumstanc - es described. Standard 5D states that a physical therapist assis- tant shall encourage colleagues to seek assistance or counsel. Standard 5E addresses reporting information to the appropriate authority. 5D and 5E both require a factual determination on the physical therapist assistant’s part. This may be challenging in the sense that the therapist might not know or it might be difficult to deter- mine whether someone, in fact, has a physical, psychological, or substance-related impairment. In addition, it might be difficult to determine whether such impairment may be adversely affecting someone’s work responsibilities. Once a determination is made, the obligation under 5D centers not on reporting, but on encouraging the colleague to seek as- sistance. However, the obligation under 5E does focus on report- ing. But note that 5E discusses reporting when a colleague is un- able to perform, whereas 5D discusses encouraging colleagues to seek assistance when the impairment may adversely affect his or her professional responsibilities. Standard 5D discusses some- thing that may be affecting performance, whereas 5E addresses a situation in which someone is clearly unable to perform. The two situations are distinct. It is important to note that 5E does not mandate to whom the assistant should report; it gives discretion to determine the appropriate authority.
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