can play a pivotal role in reducing healthcare disparities. Ultimately, confronting implicit bias in healthcare is essential to creating a more just and equitable healthcare system where
everyone receives fair and equal treatment regardless of their background or characteristics.
MORALITY, VALUES, ETHICS, AND THE LAW
The ability of physical therapy practitioners to pursue their clinical practices in an ethical manner can be challenging when they fail to fully understand the subtle conceptual differences that underlie ethical decision making. To consistently and effectively address and resolve ethical and legal questions, physical therapy practitioners must be able to distinguish among Morality and values The root of the word morals, mos (pl. mores ), refers to the customs of the people (Engelhardt, 1996, p. 33). Morality is a relational concept concerned with how people choose to live together to protect a high quality of life for an individual or a community as a whole (Doherty & Purtilo, 2016). Morality includes the values, beliefs, and customs of a person or a group that influences behavior and judgment about what is right or wrong and good or bad. Values, in turn, are beliefs that a person, group, or society cherish (Rokeach, 1973) and are often culturally shaped and instilled through an individual’s family, community, school, or religion. Culture, which involves an integrated pattern of human behavior that includes the customs, beliefs, and values of racial, ethnic, religious, professional, and social groups (Crawley, 2005), has a great influence on morality. The concepts of cross-cultural health care and cultural sensitivity are based on the recognition and significance of cultural differences and the different perspectives on health, illness, and medicine that often arise among healthcare professionals, their clients, and their clients’ families (Prather, 2016). Moral values include compassion, courage, altruism, honesty, fairness, and integrity. Personal or professional moral values influence daily moral actions and behaviors. Most of us do not think about our moral values when we navigate daily life unless we encounter a situation that raises a moral question. In the case scenario depicted earlier, John had to consider what professional moral values are owed to June. Where did his professional duty lie? To whom was he most Ethics and the law Physical therapy practitioners need to be aware of how the legal rules and regulations affect their professional practices. Whereas ethics is defined by an individual, group, or community on the basis of what is considered a right or wrong action or good or bad behavior; in the case of a professional organization, based on the core values and principles underlying its code of ethics, laws are defined by the government, based on concepts of justice and equality. Specifically, the law is a compendium of rules governing power, property, and people that society wishes to enforce, particularly those rules that bear on liberty, harm, and its prevention (Doherty & Purtilo, 2016). For citizens of the United States, sources of legal duties include the U.S. Constitution, state constitutions, and federal and state statutes. State statutes consist of the administrative law that mandates how professionals are eligible and allowed to practice (Federation of State Boards of Physical Therapy [FSBPT], 2014a). In each state, the statutory law establishes the boundaries and requirements for professions to establish their state practice act. Physical therapists and physical therapy assistants are legally and ethically obligated to practice on the basis of their state practice acts. Specifically, state practice acts are enacted primarily for the purpose of safeguarding the public health, safety, and welfare by providing for state administrative control, supervision, and regulation of the practice of physical therapy (FSBPT, 2014a).
morality, values, ethics, and the law. Although some healthcare professionals use terms such as morality, values, and ethics interchangeably, healthcare ethicists such as Doherty and Purtilo (2016) contend that a more nuanced use of these concepts sharpens our approaches to ethical decision making.
accountable and why? What would a compassionate physical therapist do? Professionals like John, when faced with a moral issue, turn to ethics. Ethics provides the tools, language, and methods needed to make decisions when faced with moral dilemmas and moral issues. Specifically, ethics involves the “systematic study of and reflection on morality” (Doherty & Purtilo, 2016). It is a discipline that uses special methods and approaches to examine moral situations that involve reflection about one’s assumptions, beliefs, customs, and habits. Although the basic principles of ethics remain stable, particularly those associated with professional ethical codes, the understanding of morality changes as events and innovations create new situations that cause individuals to reorganize their thinking and alter behavior to address new issues. One example that will be addressed later is the emerging use of telemedicine and telehealth to provide client consultation and care (Greenfield & Musolino, 2012). The use of telehealth challenges healthcare providers to rethink traditional ethical obligations of confidentiality, privacy, and client-centered care in a new context. For example, can physical therapy practitioners implement a beneficial individualized physical therapy plan of care that is delivered to the client via live streaming on the internet, and simultaneously protect the client’s right to privacy and confidentiality? Or can a physical therapist in one state treat a client in a neighboring state using telecommunication when the therapist is not licensed in that client’s state? State practice acts provide the legal basis of the establishment of professional state boards. A state’s board of physical therapy is appointed by that state’s governor and confirmed by its state legislature. The state board of physical therapy establishes the rules and regulations guiding the practice of physical therapy within its geographic boundaries. Physical therapy practitioners must be aware of the practice act within the state or states in which they pursue their professional craft. In recent times, the substance of the formerly distinct obligations of law and ethics has become blended into increasingly unitary standards of professional conduct (Doherty & Purtilo, 2016). Courts now examine healthcare professional codes of ethics as secondary sources of legal obligations – for example, judicial case law labels client abandonment as a form of professional negligence (FSBPT, 2014b). Physical therapists violating their state practice act can be found liable for civil negligence, as well as criminal negligence. Although laws and ethical standards seem to reinforce one another, Doherty and Purtilo (2016) point out that professionals should not always expect to receive the same guidance from laws and policies as they receive from ethical principles and rules. That is to say, laws and ethical standards each have their own special function in governing the practice of physical therapy.
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