Ethics in PT Practice (10/22b) [Integrative] Flashcards
(25 cards)
Four Basic Ethical Traditions
Rule Based
End Based
Virtue Based
Care Based
Rule Based Ethics (Kant)
Rules
Duties/Responsibilities
Ethical Principles
Code of Ethics
End Based Ethics (Mill)
Teleology
Consequences
Outcomes
Greatest good for greatest number of people
Utilitarianism
Virtue Based (Aristotle)
Virtues and values that are good for society
Golden mean
Core values
Professional identity
Moral agency
Care Based (Gilligan)
Voice of care
Feminist ethics
Relationships are key
Life experience
Duties of Healthcare Providers
Autonomy
Beneficence
Nonmaleficence
Justice
Veracity?
Every clinical decision is an ___ ___
ethical decision
Physical Therapy Core Values
Accountability Altruism Compassion/caring Excellence Integrity Professional duty Social responsibility
Development of Ethical Reasoning - Kohlberg
“What is just?”
From less→more reasoning:
- do what you’re told
- let’s make a deal
- be nice & people will like you
- obey the law
- use due process
- be rational/impartial
Development of Ethical Reasoning - Gilligan
“Ethics of Care”
From less→more reasoning:
- self concern
- concern for the needs of others
- balancing self needs and needs of others
Contemporary Moral Reasoning
Moral courage as a value
Care based
- Relationship with patient/client is central
- Balance of emotional commitment and fiduciary responsibility
APTA Resources for Physical Therapists
Code of Ethics
CORE Values
Normative Model
CAPTE Criteria
Clinical Performance Instrument
Types of Codes of Ethics
Directive Nondirective Protective Specific Enforceable
Directive Code of Ethics
provide guidance for mandatory behavior
may use the term “shall”
EX: APTA is directive code of ethics
Nondirective Code of Ethics
permitted or recommended behavior
may use the term “should”
APTA Code of Ethics - Principles
1) Respect the inherent dignity and rights
2) Trustworthy and compassionate
3) Accountable, sound professional judgements
4) Integrity in relationships
5) Legal and professional obligations
6) Enhance their expertise
7) Business practices that benefit patients/society
8) Meet the health needs of people
APTA Code of Ethics - Summary of Principles
Emphasis on PT as a unique profession
Focus on autonomy, responsibility, and accountability
Federal Law vs State Law
FEDERAL
- Anti Fraud and Abuse
- False Claims Act
- Anti Kickback Statute
STATE
- Practice Act
Fraud, Abuse, and Waste
Fraudulent diagnosis
Services/supplies not rendered
Waiver of deductible or co-pay
Unbundling or exploding charges
Falsification of medical records
Misrepresentation of diagnosis
Soliciting, offering, or accepting any form of kickback
Controlling Fraud
Criminal/civil penalties
Exclusion from Medicare
Withholding payment
Self-policing
Consumer education
Protection for ‘whistleblowers’
Easy access for reporting
Ethical Decision Making - Simple Analysis
Ethical and legal
Ethical but illegal
Unethical but legal
Unethical and illegal
Ethical Decision Making - RIPS Model
Realm
- Individual
- Organizational/Institutional
- Societal
Individual Process
- Moral sensitivity
- Moral judgement
- Moral motivation
- Moral courage
Ethical Situation
- Issue or problem
- Dilemma
- Distress
- Temptation
- Silence
RIPS Model - Realms
Individual - relationship between individuals
Organizational - good of the organization
Societal - common good
RIPS Model - Individual Process
Moral sensitivity - recognize situation
Moral judgement - right vs wrong
Moral motivation - moral values above other values
Moral courage - implement action
