Week 4 - RIPS model

What are the 4 Principles in the Code of Ethics?

What are the 4 Principles in the Code of Ethics?

• Autonomy - respect for pts self-determination

• Beneficence - promote the interests of the pt

• Non-maleficence - cause no harm

• Justice - act fairly

What is considered an ethical dilemma?

When equally compelling principles are in conflict with no obvious resolution

What is an ethical reflection?

• Being aware of personal biases and assumptions (and not imposing them on others)

• Understanding the patient from their lived experience

• Listening to understand

What does RIPS (model) stand for?

• Realm, Individual Process, Situation

• Recognize and define ethical issues, reflect, decide to do the right thing, implement, evaluate, and re-assess

What is the RIPS cycle?

• Recognize and define ethical issues, reflect, decide the right thing to do, implement, evaluate, and re-asses

What does Realm (RIPS model) mean?

Is it in the individual, organizational, or societal realm?

What does individual process (RIPS model) mean?

The use of:

• Moral sensitivity - recognize the situation

• Moral judgement - make a decisions about right or wrong action

• Moral motivation - put moral values above other values

• Moral courage - Should you do it?

What does the situation (RIPS model) include?

• Issue or problem

• Dilemma

• Distress

• Temptation

• Silence

What is moral sensitivity?

The ability to recognize the ethical situation

What is moral judgement?

Making a decision about right or wrong action

What is moral motivation?

Putting moral values above other values

What is moral courage?

Deciding if the moral decision should be implemented

What is distress (type of ethical situation)?

Right course of action is known, but no authority to perform it

What is temptation (types of ethical situations)?

Choice between right and wrong; may stand to benefit from doing wrong

What is silence (type of ethical situation)?

Ethical values are challenged, but no one is speaking about the challenge

What are questions for ethical reflections?

• What are the relevant facts (or factors)?

• Who are the major stakeholders?

• What what are the possible consequences?

• What are the relevant laws, obligations, and ethical principles?

• What professional resources are available?

What is rule-based decision making?

Following rules and duties already in place

What is ends-based decision making?

Resolving moral situations based on consequences and good/harm for all stakeholders

What is care-based decision making

Making moral decisions based on relationships and concern for others

What are the three simple steps for moral decision-making?

1.) Have the courage to take action

2.) Evaluate the outcome

3.) Reflect on the outcome - ask what you did well and what you learned

How would you apply the RIPS model to receiving a gift from a patient?

Realm - This situation affects me (an individual) and potentially my place of work (organization/institution) because of the laws in place about PTAs/PTs accepting gifts.

Individual process - This situation would require a moral judgment. I would have to decide if it is worth risking my job or offending my coworkers to accept the gift. If I declined the gift, I would have to risk offending the patient who offered it to me.

Situation - This would be an ethical dilemma. Both options could fill obligations: accepting the gift shows the patient I care for them and not accepting the gift fulfills my obligation as a physical therapy worker, though I would have to stop doing my job.