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Ethical Issues and Decision Making, 2nd Edition: Summary
Types of Ethical Issues in Physical Therapy Practice • Social boundaries ○ Examples: Dating clients, sexual harassment in the workplace, exploitation • O rganizational and management issues ○ Examples: Substance abuse at work, being untruthful in the workplace, breaking a contract, overbilling, being pressured to provide unnecessary services • Competency ○ Example: Providing services you are not trained in or not competent • Documentation ○ Examples: Documenting services that were not provided, documenting inaccurate information, deleting documentation • Student education ○ Example: Cheating, not completing clinical rotations • Licensing ○ Example: Not being up to date with your license, flashing reporting thing on license application, updating license when moving • Scope of practice ○ Example: Providing services outside the scope of practice as a physical therapists or physical therapy assistant • Continuing education ○ Example: Falsely reporting CEU credits, teaching a course without appropriate experience • Supervision of physical therapy assistants ○ Example: Inappropriately supervising PTAs or students, not co-signing notes correctly
• Autonomy: The self-determination principle. PTs must respect the right of an individual to hold views, make choices, and take action based on their values ○ Informed consent: Healthcare professionals are obligated to inform a client of the relevant risks, benefits, and uncertainties of a treatment and each alternative procedure; the consequences of nontreatment; goals of treatment; and the prognosis for achieving the goals • Confidentiality: An extension of privacy, in that an individual has voluntarily disclosed, in a relationship of trust, private information about themselves with the expectation that it will not be divulged without permission • Social justice: Promoting organizational behaviors and business practices to benefit patients and society, including access to services, fairness, and equality • Procedural justice: Implementing decisions according to fair processes that ensure “fair treatment” and following the rules (laws, policies, etc.) • Veracity: Based on virtues of truthfulness, candor, and honesty. This refers to speaking truthfully and ensuring the learner understands as a means to establish trust • Fidelity: Being faithful to one’s commitments and placing the interests of clients above self-interests Ethical Decision-Making Process 1. Get the story straight—gather relevant information 2. Identify the type of ethical problem 3. Use ethics theories or approaches to analyze the problem(s) 4. Explore the practical alternatives. 5. Complete the action 6. Evaluate the process and outcome
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