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