Exam 1 - PT 625 Professional Development I
APTA Documents
- APTA Code of Ethics for the Physical Therapist - APTA Guide for Professional Conduct - APTA Standards of Ethical Conduct for the PTA - APTA Core values for the PT and PTA
Situation - Ethical dilemma
- two alternate courses of actions may be taken, both of which fulfill an important duty and it is not possible to fulfill both obligations - right versus right
Situation - Ethical problem/issue/situation
- important values may be challenged but it is clear what should be done - difficult decision making or problem solving is not required - right versus wrong
Personal Scope of Practice
- within the individual's unique body of knowledge - educated, trained and competent to perform
Four Qualities of Professions
1) Advanced Expertise 2) Independent Judgement 3) Social Organization 4) Commitment to the Public Good
Independent Judgement
1) Independent/autonomous (ex: physician owned therapy clinics) 2) Requires discretion in decision making
3 Scopes of PT Practice
1) Professional 2) Jurisdictional 3) Personal
Social Organization
1) professional organization 2) licensing agencies 3) regulatory boards - (CAPTE) 4) permits engagement in certain tasks 5) professional designation
4) Commitment to the Public Good
1) shared devotion to public good 2) code of ethics 3) professional conduct
Advanced Expertise
1) sophisticated practical skills (know-how) 2) advanced theory based knowledge
Moral Vagueness
A situation in which it is not clear what a specific moral value implies - moral idea is unclear
Ethical Dilemma
A situation in which there are 2 or more equally "right" options. There are two of more competing norms or codes of ethics and it is unclear which way to proceed - acting on one moral conviction typically means breaking another - Ex: gifts, overutilization of services, disclosure
Compliance
A situation where there is a stated right and wrong - unclear how a person will act - requires integrity, self-discipline, and commitment to do the right thing
APTA Core Values
1.Accountability 2.Altruism 3.Collaboration 4.Compassion / Caring 5.Duty 6.Excellence 7.Inclusion 8.Integrity 9.Social Responsibility
Law
A rule formally recognized as binding or enforced by a controlling authority
Levels of Intimacy - Level 1
Considered Professional - cliche convo - no genuine sharing - safe communication
Levels of Intimacy - Level 3
Considered Professional - patient shares personal ideas and judgement - provider shares some info in response to patient - personal opinions and beliefs
Levels of Intimacy - Level 2
Considered Professional - report facts - limited personal information shared - other's opinions and feelings
Steps to Assertive Behavior (DESC)
D - describe the situation E - express your feelings about the situation S - specify the change you want C - consequences (identify the results that will occur)
RIPS Model - Situation
Ethical problem/issue/situation Ethical Temptation Ethical Distress Ethical Silence Ethical Dilemma
Primary Prevention
Identify risk factors and implement services to reduce risk in individuals and populations (intervening before health effects occur by identifying risk factors and reducing them)
Secondary Care
Medical care provided by a specialist or facility upon referral by a primary care physician that requires more specialized knowledge, skill, or equipment than the primary care physician has. - patient referred to PT services ex: dentistry, nurse practitioner, PA, etc
Levels of Intimacy - Level 4
Occasionally professional - share feelings and emotions - true friendship - deep trust - patient does not fear being judged
Tertiary Care
Patient referred to highly specialized, complex, technology based settings for consultation or specialized services
Secondary Prevention
Prevent or slow the progression of functional decline and disability and enhance activity and participation in individuals with an identified condition (efforts to limit the effects of an injury or illness that you cannot completely prevent)
Tertiary Prevention
Reduce the degree of disability by restoring or preventing the deterioration of skills and independence in individuals with chronic health conditions to allow optimal activity and participation (intervention implemented after a disease or injury)
RIPS MODEL - Realm
Individual (priority is the good of the patient/client), Organizational (priority is the good of the organization), Societal (priority is common good and betterment of society)
Situation - Ethical temptation
Involves a choice between a "right" and a "wrong" in which one may stand to benefit from doing the wrong thing; described as a "right" versus "wrong" situation
What constitutes professional dress?
Student shall wear a nametag indicating the student's name, UIC affiliation, and designation at all times in the facility. Student shall comply with the dress code of the program and of the facility
Bioethics or Biomedical ethics
Study of ethical issues related to the provision of healthcare, emerging biomedical technologies and research
Ethics
Study of morality or moral behavior
Situation - Ethical distress
The right course of action is clear, but the individual is not authorized or empowered to perform it
Fidelity
be faithful to patients/clients, colleagues
Nonmaleficence
do not harm
Distributive Justice
equal distribution of limited resources to all members of a group
Descriptive Ethics
ethics that describes the moral beliefs and actions of a group regardless if their beliefs and actions are justified - study of people's views about moral beliefs, standards, and behaviors
Normative Ethics
ethics within an established moral system that stand up to full scrutiny of various perspectives and facts about the world - utilitarianism - analyses how people ought to act
Procedural Justice
first come first served, alpha order or other procedure used to distribute resources
Jurisdictional Scope of Practice
guided by state practice acts
Individual Process - Moral Judgement
deciding between right/best and wrong/worst actions
Individual Process - Moral courage or Moral character
implementing the chosen ethical action even though doing so many cause adversity
Confidentiality
keep info concerning patients private unless avoiding harm
Individual Process - Moral Motivation
prioritizing moral values over personal values, financial gains or self-interest
Individual Process - Moral Sensitivity
recognizing, interpreting, and framing ethical situations
Autonomy
self-determination
Veracity
tell the truth
Professionalism
the skill, good judgment, and polite behavior that is expected from a person who is trained to do a job well
Beneficence
act for the benefit of others
Justice
act in fairness to all - there's 3 types of justice
Compensatory Justice
act to make up for previous injustice
Levels of Intimacy - Level 5
NEVER professional - peak communication - mutual complete openness - sexual relationship
Can a student PT work under general supervision of a PT?
NO! PT must be in the room.
Steps to Applying the RIPS Model to Ethical Decision Making
Step 1) Recognize and define the ethical issues - identify the RIPS Step 2) Reflect on the info gathered in #1 Step 3) Decide how to proceed Step 4) Implement, Evaluate, Reassess
Professional Distance - Over distance
• Absence of caring engagement • Difficulty relating to a person • Listen without sympathy • Use pity: distorted form of caring that involves looking down on someone
Professional Distance - Under distance
• Become emotionally enmeshed in a person's suffering • Leads to compassion fatigue: a pre-occupation with a person's suffering because of excessive emotional involvement
Situation - Ethical silence
- ethical values are challenged, but no one is speaking about this challenge to values - individual practicing ethical silence may be experiencing ethical distress
CAPTE (commission on accreditation in physical therapy education)
- grants accreditation status for PT and PTA programs - serves to protect students and stakeholders
Professional Scope of Practice
- grounded in a unique body of knowledge - educational preparation - supported by evidence - linked to existing and emerging practice frameworks
Primary Care
First contact providers of care ex: direct acress, PCP, PT
Why do we have the model practice act?
It's for the public :)
RIPS MODEL - Individual Process
Moral Sensitivity Moral Judgement Moral Motivation Moral Courage