Professionalism and Ethics

• Advance expertise and education

• Independent judgement

• Social organization and recognition

• Commitment to the public good

4 criteria of physical therapy.

- “birth to death” health practitioner

- promote fitness initiative and education

- provide prevention services

- reduce or eliminate the need for costlier forms of care

- shorten or even eliminate institutional stays

Ethics

is a philosophical discipline pertaining to notions of good and bad, right and wrong — our moral life in the community.

Bioethics

is the application of ethics to the field of medicine and healthcare.

Autonomy

- respect the right of individuals to make decision on their own behalf

- patients to act as their own agent

- free will with informed consent

Beneficence

- duty to do the best for the individual patient

- act in the best interests of the patient

- basic principle of caring

- act in accordance with a patient’s welfare

Nonmaleficence

- duty to do no harm

- making and determining risk/benefit ration

- balance of benefit and harm = utility

Fidelity

do as you say you will do + respect confidentiality.

Justice

- fairness with the distribution of medical resources

- nondiscriminatory

- transparency, accountability, and consistency

Veracity

- obligation to be truthful of what patients expect doctors to tell them

- truth-telling or full, honest disclosure

Paternalism

- cares for an individual’s interest in place of autonomy
- acts as a patent and makes decisions for the patient based on what the professional believes is in the best interest of the patient

- violation of autonomy and beneficence

• Realm

• Individual process

• Situation

component of the RIPS

Moral Judgement

- requires deciding on right versus wrong actions

- involves generating options, selecting, and applying ethical principles

Moral Motivation

- places a priority on ethical values over other values, such as self-interest, status, or financial gain

- professionalism is a primary motivator for ethical behavior

Moral Courage

involves implementing the chose ethical action, including the development a plan and perseverance in the face of barriers and adversity

Moral Sensitivity

involves recognizing, interpreting, and framing ethical situations.

Issue/Problem

type of ethical situation wherein important values are present or may be challenged.

Dilemma

- type of ethical situation wherein two alternative courses of action may be taken, both of which fulfill an important duty, and it is not possible to fulfill both obligations

- “right vs right” decision

Distress

- type of ethical situation wherein you know the right course of action but are not authorized or empowered to perform it

- may present as a later complication of any of the ethical situation

- is often identified during the implementation phase of decision making

Temptation

- type of ethical situation wherein a choice between a “right” and a “wrong” and in which you may stand to benefit from doing the wrong thing
- “right vs wrong” situation

Silence

- type of ethical situation wherein ethical values are challenged, but no is speaking about this challenge to values

- may actually be the course take by an individual who is experiencing moral distress

• Step 1: Facts

• Step 2: Moral Reasons

• Step 3: Options and Outcomes

• Step 4: Deliberation and Decision

• Step 5: Action

• Step 6: Review

steps for resolving ethical dilemmas.

Rule-Based

follow the rules, duties, obligations, or ethical principles already in place.

Ends-Based

determine the consequences or outcomes of alternative actions and the good or harm that will result for all of the stakeholders.

Care Based

resolve dilemmans according to relationship and concern for others.