Case studies from each category are provided to enhance the learner’s understanding of the ethics involved. They are presented as vignettes to facilitate identification of the problem Social boundaries vignettes Vignette 1 – Job with fringe benefits ● “I don’t see anything wrong with dating my clients. It’s a great way to meet people.” said Peter. ● “I jokingly hit on my coworkers, but it’s all in good fun, and they know I don’t mean it. Isn’t that OK?” Jose asked. The APTA Code of Ethics for the Physical Therapist (2010b) states: “Physical therapists shall not engage in any sexual relationships with any of their patients/clients, supervisees, or students” (Principle 4E). It also states that “Physical therapists shall not harass anyone verbally, physically, emotionally and sexually” (Principle 4F). Dating a client may compromise the client-therapist relationship, transforming it from a “collaborative relationship” (Principle 2D) to one in which the therapist has authoritarian power to control the relationship. Most professional codes of ethics discourage dating clients during the therapeutic relationship. When the therapeutic relationship is terminated, the situation may change. Making sexually oriented comments to coworkers is considered harassment and is covered by federal law and institutional policies for reporting incidents of harassment. Physical therapy personnel are expected to comply with “established policies and procedures … including familiarity with national, state, local, district, and territorial procedures for handling ethics complaints” (Principle 5A). And the answer to Jose’s question is no, it is not OK to make sexually oriented comments to coworkers, and they probably do not think it is all in good fun. Those coworkers should report the harassment according to institutional policies ● “I’m even better at work when I’m high, drunk, juiced, spaced out, whatever. Being high reduces on-the-job stress and helps me be friendlier with clients,” said Courtney. The APTA Code of Ethics for the Physical Therapist (2010b) states that “Physical therapists shall achieve and maintain professional competence” (Principle 6A). Clearly, any situation that may compromise professional competence should be avoided and, if present, should be corrected by the individual. Vignette 2 – Liar, liar, pants on fire ● “If I don’t like a fellow worker, I tell lies about him or her to my friends,” said Jenna. ● “I told my staff therapist to start that new program. Then I complained to my boss that she started the program behind my back. I like to stir things up a bit – reduce the boredom factor,” said Louise. The APTA Code of Ethics for the Physical Therapist (2010b) states that “physical therapists shall promote practice environments that support autonomous and accountable professional judgments” (Principle 7A). The code also states “Physical therapists shall act in a respectful manner toward each person” (Principle 1A). Clearly, Louise’s actions are disrespectful and can result in practice environments that are disruptive and dysfunctional for autonomous and accountable judgments. Vignette 3 – Crazy talk ● “Some patients do crazy things. They make for great funny stories at parties. Sometimes I even elaborate a little,” said Renee. The APTA Code of Ethics for the Physical Therapist (2010b) states that “physical therapists shall protect confidential patient/client information” (Principle 2E). Compliance with the Health Insurance Portability and Accountability Act (HIPAA) is Professional behavior vignettes Vignette 1 – Up, up, and away
and the rationale for its solution. Although the vignettes are based on actual cases, all names and situations have been changed to avoid identifying any person or facility.
and procedures. Implementing and following such policies helps contribute to a moral culture of respect for persons. Vignette 2 – My colleagues are (were) my friends ● “When my colleagues tick me off, I swear at them. They should do a better job,” said Ellie. ● “Sometimes I follow my colleagues to their homes just to see how they will react,” said Carlos. The APTA Code of Ethics for the Physical Therapist (2010b) states that “Physical therapists shall not exploit persons over whom they have supervisory, evaluative or other authority” (Principle 4B) and “shall cultivate practice environments that support professional development” (Principle 6D). Exploitation is a type of harm from one individual or entity to another. In this case, exploitation results in an emotional versus a physical harm. As mentioned previously, harm involves “setbacks to interests, reputations, property, privacy and liberty” of an individual (Beauchamp & Childress, 2013, p. 153). Although such incidents of harm may seem trivial compared to actual physical injury, the person at whom Ellie is swearing may feel humiliated, and the person or persons who Carlos follows home may feel annoyed. Such person or persons may also feel that boundaries of privacy were overstepped. Their colleagues may feel powerless or reluctant to confront Ellie and Carlos if they fear repercussions. The APTA Code of Ethics for the Physical Therapist (2010b) states: “Physical therapists shall not harass anyone verbally, physically, emotionally, or sexually” (Principle 4F). Clearly, any situation that may compromise professional competence should be avoided, and if present, should be corrected by the individual. also applicable in this situation, if the identity of the patient is revealed (U.S. Department of Health. Vignette 4 – Oops and oops again ● “I reported continuing education hours to the state licensure board that I did not actually attend or earn,” said Rafael. The APTA Code of Ethics for the Physical Therapist (2010b) states that “physical therapists shall provide truthful, accurate, and reliable information and shall not make misleading representations” (Principle 4A) and that “physical therapists shall comply with applicable local, state, and federal laws and regulations” (Principle 5A). Reporting false information to a regulatory agency such as a state licensure board is also illegal and may result in the state licensing board taking disciplinary action against Rafael. Vignette 5 – I’m out of here ● “I decided I was not going to treat any more of these folks, and I up and left. No, I did not submit a letter of resignation. They can figure it out when I don’t show up for work tomorrow,” said Jeremy. The APTA Code of Ethics for the Physical Therapist (2010b) states that “physical therapists communicate with, collaborate with, or refer to peers or other healthcare professionals when necessary” (Principle 3C). It further states that “physical therapists shall provide notice and information about alternatives for obtaining care in the event the physical therapist terminates the provider relationship while the patient/client continues to need physical therapy services” (Principle 5F). Leaving a client without access to expected treatment, or withdrawal of treatment without giving reasonable notice or providing a competent replacement, is called patient/client abandonment (Morris, 2011). Abandoning clients without making provision for continued treatment is both unethical and, in many states, illegal. The practitioner is expected to give notice of intent to
EliteLearning.com/Physical-Therapy
Book Code: PTNJ0824
Page 14
Powered by FlippingBook