The first part of this course will help the therapist understand the importance of ethical behavior in patient care, and will familiarize them with ethical theories and principles and the guidelines of professional conduct. The second part of the course will focus on the laws pertaining to physical therapy practice in the State Ethics by definition What is ethics? The study of ethics is the philosophical study of morality. This discipline concerns the examination of the principles that govern “right” and “wrong” behavior, and outlines the theories or systems of moral conduct for individuals and groups. Medical ethics involves applying guidelines, values, and shared beliefs to decision-making in patient care. To behave ethically is to act in a manner that is morally correct, honorable, and trustworthy. The study of ethics involves looking at the reasoning behind moral practices and actions. To understand ethics, therefore, it is necessary to understand the components of morality. Morality is a societal system of adhering to moral rules, which concerns the goodness and virtuousness of human character. Morality is concerned with conformity to the ideals of right human conduct, and is a guide for shaping human action for the betterment of society. It is influenced by family tradition, social custom, religion, culture, peer group, and profession; and, as such, it is a learned response. Morals are virtues, and morality establishes a framework in which people Case study #1 “Professional Accountability” Sarah has recently graduated and is working as a physical therapist at her first job in a busy outpatient clinic. Sarah has been carefully yet quickly oriented to the clinic and, after being complimented on her common sense and responsible nature, she is turned loose with her own patient list. Her confidence has been strengthened daily by successful patient care, and one afternoon she finds she is the only physical therapist left treating patients in the clinic. Sarah’s returning patient with a partial rotator cuff tear has been shown into a room by the receptionist, where Sarah greets him. As she begins treatment, she finds that he is intoxicated and unable to respond without slurring his words. Sarah worries that he will be unable to tell her when he perceives pain during range of motion or electrical stimulation,
of Georgia, including select Georgia General Provisions, the Georgia Physical Therapy Practice Act, the Physical Therapy Board Rules and Policies, and other important information to help Georgia physical therapy professionals to recognize and navigate important legal information. can positively interact with one another through an agreed-upon set of rules. Integrity is a characteristic that is inherent to the individual. It reflects an honesty, soundness, completeness, and incorruptibility of character. It has been said that a person who has integrity will do the right thing even when no one is looking. Ethics may be divided into two categories: personal ethics and professional ethics. Personal ethics involves the application of a learned moral code and personal integrity in making ethical decisions. Personal ethics is sometimes referred to as taking responsibility for one’s actions. Taking into account the consequences of one’s actions before acting enables a person to participate in analytical decision-making. Professional ethics involves adhering to a set of guidelines determined by a professional group, such as the APTA. Professional ethics requires that the therapist practice legally, respect confidentiality, obtain informed consent, document accurately, and avoid fraudulent activities. but she is afraid he will become belligerent if she refuses to treat him. Discussion Points: Sarah’s professional responsibility to her patient What should Sarah do? She and the clinic may be liable if treatment leads to further damage to his shoulder. If she can safely get him out of the clinic without harm, how will he transport himself home without injuring himself or others? What about the potential danger to Sarah or the receptionist as Sarah tries to defuse the situation? Is it medically ethical to treat this patient? Is it legally ethical to treat this patient, or to allow him to leave the clinic unescorted? Which action is morally right?
THEORETICAL BASIS OF ETHICS
Humans have struggled throughout history to establish guidelines of communication through which to more clearly understand one another. Philosophers have contemplated the interaction of human behaviors and actions since ancient times. The Golden Rule, “Do to others what you would want others to do to you,” is the basis for normative ethics, which is the setting of moral standards that regulate right and wrong conduct. There are three strategies that provide the basis of normative ethics: virtue theories, duty theories,and consequentialist theories. Virtue theories have roots in ancient Greek civilization and are the source of the oldest traditions of Western philosophy. They emphasize the responsibility of adults to morally educate the young in the development of good character habits. Greek philosopher Plato focused on the four cardinal virtues of wisdom, courage, temperance, and justice. Aristotle also considered fortitude,generosity, self-respect, and sincerity to be important (Barnes, 1984). In medieval times, Christians added the theological virtues of faith, hope, and charity to the foundation of virtue theories. The goal is the benevolent practice of virtue in human action, with the avoidance of vice. Vices may include cowardice, injustice, vanity, and insensibility. With virtue theories, individuals inherently make the correct moral decisions based on their own good character and integrity. Duty theories , also known as deontological or nonconsequentialist theories, view morality as based on obligation. (The word “duty”derives from the Greek word
“deonto.”) This group of theories became defined in the 17th and 18th centuries, and emphasizes acting with a sense of duty to God, self, and others. The individual should avoid wronging others, treat people as equals, and promote the good of others. In one of his categorical imperatives, philosopher Immanuel Kant (1797/1985) said that people should be treated as an end to themselves, not as the means to an end. Duty theories view action as a reflection of moral conviction, and include adhering to the principles of fidelity (keeping promises), reparation (compensating those we have harmed), gratitude(thanking those who have helped us), justice (improving the conditions of others), self-improvement (improving our own virtues), and nonmaleficence (not hurting others). With duty theories, individuals make the correct moral decisions based on their perceived moral obligations, regardless of the consequences. Consequentialist theories , also known as teleological theories , determine the making of moral decisions by weighing the consequences of our actions. (The word “teleology” derives from the Greek word “telos,” which means “ends.”) An act is considered morally right if the outcome is more favorable than unfavorable. Subsets of these theories are ethical egoism, ethical altruism, and utilitarianism. These are rival theories in which different outcomes may be found. Ethical egoism, or social contract theory, considers an action to be morally right if the individual performing the action has a favorable outcome. Ethical altruism considers an action morally right if everyone but the individual performing the action is benefited. Utilitarianism
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