Scope of practice issues vignettes Vignette 1 – Will the real PT please stand up! ● “Can physical therapists use hypnosis? Does ‘music therapy’ work for autism? Does auditory integration therapy have any evidence?” asked Ruth. The APTA Code of Ethics for the Physical Therapist (2010b) states that “physical therapists shall evaluate the strength of evidence and applicability of content presented during professional development activities before integrating the content or techniques into practice” (Principle 6C). It also states that “physical therapists shall make judgments within their scope of practice and level of expertise” (Principle 3C). Physical therapy personnel do not generally receive education or training in the use of hypnosis, so the answer is no, they cannot use hypnosis as a therapeutic intervention. However, if a physical therapist or physical therapist assistant received specific education and training in the use of hypnosis through another professional or continuing education program and could demonstrate competence, then hypnosis could be used. However, the practitioner would need to inform the client or clients that hypnosis is not regarded as within the scope of physical therapy practice. Additionally, even if this therapist has credentials in hypnosis, the service could not be part of the physical therapy plan of care or billable as physical therapy because it is outside the scope of practice of the physical therapist. Evidence-based practices need to be supported by well- established scientific research that was conducted using Management of continuing education courses vignette Vignette 1 – Knowledge and truth are optional ● “I’m giving a continuing education course on ergonomics, but I really don’t have any experience (or knowledge) in the area,” said Erica. ● “I let class attendees know that I don’t always tell the physician the truth about what techniques I’m using,” said Don. “Physical therapists shall “provide truthful, accurate, and relevant information and shall not make misleading representations” (APTA, 2010b, Principle 4A). In addition, Principle 6A states that “Physical therapists shall achieve and maintain professional Supervision of physical therapy assistants vignette Vignette 1 – The Supervisor needs a supervisor ● “My PTA [physical therapy assistant] did not treat that client the way I would have, so I will not sign her supervision log,” said Stephanie. ● “I’m too busy to check on my PTA. I don’t know what he has been doing. That’s his business,” said Lisa. ● “I know the PTA did not treat that client, but I signed the supervision log anyway,” said Mark. “The PTA signed PT on that note. I let it pass,” said Tracy.
accepted research techniques and concluded that a particular technique is effective for clients with a particular disease, disorder, or injury. Vignette 2 – Details, details! ● “I took a course on hypnotizing animals for medical research, but my licensure board won’t count the course toward my continuing education requirements. As a result, I can’t get my license renewed, and therefore I can’t practice. Animals, people, what’s the difference?” said Polly. The APTA Code of Ethics for the Physical Therapist (2010b) states that “physical therapists shall take responsibility for their professional development based on critical self-assessment and reflection on changes in physical therapy practice, education, health care delivery, and technology” (Principle 6B). Generally, such professional development should be relevant and within the scope of physical therapy practice. State regulatory boards are concerned primarily with the provision of physical therapy services to humans or groups of humans. Some state boards include animal physical therapy within the defined scope of physical therapy practice, whereas others are silent. In this case, if Polly can demonstrate to the state board that her practice was focused on therapy for animals, then, given her scope of practice and expertise, the state board could accept animal hypnotism as appropriate continuing education credits toward renewal for her license. competence.” When a person attends a continuing education course, he or she has a reasonable expectation that the presenter is knowledgeable about the subject matter and is willing to share the information with others. In these vignettes, it is deceitful for Erica to teach a course on a subject about which she knows little because attendees are unlikely to gain any additional knowledge or skill. Likewise, Don is not practicing in an ethical manner. His failure to tell a physician the truth about what techniques are being used in treatment may reduce the benefit to the client and certainly does little to improve interprofessional collaboration and communication. The APTA Code of Ethics for the Physical Therapist (2010b) states that “physical therapists shall promote practice environments that support autonomous and accountable practice” (Principle 7A). Principle 3E states: “Physical therapists shall provide appropriate direction of and communication with physical therapist assistants and support personnel.” Supervisors should also be familiar with the APTA Standards of Practice for Physical Therapy (2013), which state that the “physical therapist communicates, coordinates, and documents all aspects of patient/client management” (Principle H).
ETHICS AND EMERGING TECHNOLOGIES
As the practice of physical therapy moves further into the 21st century, physical therapy personnel will encounter new and emerging technologies that will present their own unique ethical challenges. The mapping of the human genome, for example, has redefined ways in which physical therapists think about disease and disability; genetic testing that has raised questions Robotics In clients with neuromuscular injuries and diseases, robotic technologies aim to promote motor recovery through interactions with highly controlled physical environments. However, the use of such technologies raises ethical questions. For example, how do we address breakthrough technologies that add functional independence through compensation at the expense of recovery? What factors should we consider
of privacy, discrimination, and genetic determinism. As more complicated technologies are integrated into mainstream rehabilitation, physical therapy personnel must be adequately trained in their use for client safety and effectiveness as they are challenged to make decisions about fair allocation of resources.
with emerging technologies that foster a one-sided focus on a person’s problems and not on their existing strengths? The point about ethics and technology is that technology itself is not value neutral. Those who develop technologies make certain assumptions about quality of life and what constitutes a meaningful life (Greenfield & Musolino, 2012).
Page 17
Book Code: PTNJ0824
EliteLearning.com/Physical-Therapy
Powered by FlippingBook