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Ethical Issues and Decision Making, 2nd Edition: Summary
COMMON CATEGORIES OF ETHICAL ISSUES
LEARNING TIP! Seven professional core values to guide PT practice (as defined by the APTA): • Accountability • Altruism • Compassion/caring • Excellence • Integrity • Professional duty • Social responsibility
Three categories of ethical issues have been identified to be common in physical therapy practices as described below. • Client rights and welfare: Determining the limits of client confidentiality is most likely to raise ethical issues Case Example Jay is about to be discharged home from the hospital as he recovers from a gunshot wound to the shoulder. He will need PT as well as wound care. Beth is a physical therapist who will be seeing him for PT after his discharge, and she learns that Jay’s sister, Marie, will do most of his wound care. Beth also learns that Jay is HIV positive, and he begs the staff to keep his HIV status confidential—especially from his family. He is afraid his father will evict him. ○ Should Beth maintain confidentiality by keeping Jay’s secret, or does she have an obligation to protect Marie’s welfare? • Professional Responsibilities/Role Case Example Angela and Rod were classmates in school, and both now work as physical therapists at the local hospital. Rod is aware from socializing outside of class that Angela likes to go drinking. Nine months after accepting the job, Rod notices that Angela is consistently late to work, seems sluggish in the morning, and makes numerous documentation errors. Rod walks into the break room at 10 a.m. and sees Angela placing a flask into her locker.
Prototypical Ethical Problems Prototypes are useful in ethics because they help clinicians sharpen the distinction of an ethical issue by clarifying the characteristics and dimensions of a problem or problems that must be navigated to make a successful decision. One of the initial steps in making an ethical decision is to define the type of ethical problem one is dealing with. There are three main prototypes: • Moral distress: A situation presents a barrier that blocks a clinician from doing what they perceive is right • Locus of authority: Arises from the ethical question of who should have the authority to make an important ethical decision. In healthcare, the physician is assumed to be the ultimate authority in decision making • Ethical dilemma: Occurs in the presence of an ethical conflict when one must decide a course of action by balancing two or more values, or ethical principles (obligations), that both equally apply
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