Introduction
For over 75 years the profession of physical therapy has required it's members to adhere to a standard of ethical behavior.1 The first Code of Ethics adopted by the American Physiotherapy Association in 1935 focused mainly on the relationship between the physical therapist (PT), referring physician, and the disciplinary actions of violating that relationship.2(p.4) Since then the Code of Ethics has evolved into what the American Physical Therapy Association (APTA) refers to as the Code of Ethics for the Physical Therapist (PT Code), and the Standards of Ethical Conduct for the Physical Therapist Assistant (PTA Standards).2(p.5),3,4 Today the Code and Standards are designed around the association's core set of values to help define the ethical standards and obligations of the PT and physical therapist assistant (PTA), and to act as reference for situations of ethical dilemmas.3,4
The ethical dilemma is defined as "a conflict of values where each value action is seen to be equally bad or good, and to act on one value cancels out the other so that you can't have it both ways."5(p.1333) In the United States a common cause of the ethical dilemma is rationing of health care and forced allocation of resources.6 Health care rationing is often thought of as the denial of necessary care, or the utilization of lower quality health care in place of more costly but superior alternatives. However, health care rationing is better defined as the equitable and mindful disbursement of a scarce supply of necessary resources.7(p.151) It is my opinion that in order to achieve the best outcome in ethical dilemmas involving health care rationing, one must apply a needs based distribution of justice reasoning and consider the bi...
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... K. Understanding Health Policy: A Clinical Approach. 5th ed. New York, NY: McGraw-Hill; 2009
8. Nalette E. Constrained physical therapist practice: an ethical case analysis of recommending discharge placement from the acute care setting. Phys Ther. 2010;90(6):939-952. doi:10.2522/ptj.20050399.
9. Swisher LL, Arslanian LE, Davis CM. The realm-individual process-situation (RIPS) model of ethical decision making. Published by: APTA Section on Health Policy & Administration. Vol. 5 No. 3. October 2005. Available at: http://www.apta.org/uploadedFiles/APTAorg/Practice_and_Patient_Care/Ethics/Tools/RIPS_DecisionMaking.pdf. Accessed on: March 22, 2014.
10. Edwards I, Delany CM, Townsend AF, Swisher LL. New perspectives on the theory of justice: implications for physical therapy ethics and clinical practice. Phys Ther. 2011;91:1642–1652. doi:10.2522/ptj.20100351.10
Sim, J (1997). Ethical Decision Making in Therapy Practice. Oxford: Reed Educational and Professional Publishing Ltd. p.16.
ABSTRACT: In the latest edition of Principles of Biomedical Ethics, Tom Beauchamp and James Childress provide an expanded discussion of the ethical theory underlying their treatment of issues in medical ethics. Balancing judgements remain central to their method, as does the contention that such judgements are more than intuitive. This theory is developed precisely in response to the common skepticism directed at "principlism" in medical ethics. Such skepticism includes the claim that moral reasoning comes to a dead halt when confronted by competing conflicts between moral norms in a given pluralistic situation. In this paper, I use examples from the text to show that despite the authors’s arguments to the contrary, balancing judgements are the product of unreasoned intuitions. Given the necessity of some such judgements in any principle-based system, my argument highlights the degree to which principled ethical reasoning rests upon an arational core.
Slosar, J. P. (2004). Ethical decisions in health care. Health Progress. pp. 38-43. Retrieved from http://www.chausa.org/publications/health-progress/article/january-february-2004/ethical-decisions-in-health-care
Longest Jr., B.B (2009) Health Policy making in the United States (5th Edition). Chicago, IL: HAP/AUPHA.
In conclusion, every patient is worried about their rights to care but not so much are focused on the rights of the physicians providing the care. It is hard to establish a respectable practice if you are required to perform care for instances in which you object or do not want to be a part of. This detracts from the ethical background of practice and procedure every physician should hold to the highest standard.
The Code of Ethics adopted by the American Physical Therapy Association (APTA). It states, in part, “Physical therapists shall … act in the best interests of patients/clients over the interests of the physical therapist.” Once again, with companies putting payment caps on the patients, this is not in the best interests of them to get the proper help they
Today, there are so many legal dilemmas dominating trial for the courts to make a sound legal decision on whose right in a complicated situation. Despite the outcome of the case, the disagreement usually has a profound effect on the healthcare organization, and the industry as a whole. Many cases are arguments centered around if the issue is a legal or moral principle. Regardless what the situation maybe, the final decision is left to the courts to differentiate between the legality issues at hand opposed to justifying a case based on moral rules. According to Pozgar (2012), an ethical dilemma arises in situations where a choice must be made between unpleasant alternative. It can occur whenever a choice involves giving up something good and suffering something bad, no matter what course of action is taken (p. 367). In this paper, I will discuss cases that arose in the healthcare industry that have been tried and brought to justice by the United States court system.
Since ethical dilemmas are not always easily answered through the use of The Code of Ethics, ethical decision-making models are effective tools that can assist nurses in dealing with ethical issues. Ethical decision-making models provide a framework for working through difficult choices. They seek to define the limits of what is morally acceptable and help clarify the guidelines for making those difficult decisions. Ethical decision making models assist nurses in analyzing situations by focusing on understanding the patient needs, need for responsiveness to circumstantial considerations, and recognizing the uniqueness of each situation.
An ethical dilemma is defined as a mental state when the nurse has to make a choice between the options and choices that he or she has at her disposal. The choice is a crucial task as the opting of the step will subsequently determine the health status of the concerned patient, hence it requires a great deal of wisdom along with proper medical and health training before any such step is opted as it is a matter of life and death. Strong emphasis should therefore be on the acquisition of proper knowledge and skills so that nurses do posses the autonomy to interact with patients regarding ethical issues involved in health care affairs and address them efficiently. It is normally argued that nurses are not provided sufficient authority to consult and address their patients on a more communicative or interactive level as a result of which they are often trapped in predicaments where their treatments of action and their personal beliefs create a conflict with the health interests of the patient. (Timby, 2008)
Physical Therapist (PT), are skilled health care practitioners that aim to improve movement, reduce pain and increase patient enjoyment of life. All while providing moral, legal and ethical care to patients. However, each of these requirements of practice are dictated by different entities. Meaning, that the requirements sometimes may or may not correlate with one another. Legally, therapist must abide by both state and national laws that are put in place for all health care professionals, in addition to those specific to the field of Physical Therapy. Whereas, ethical responsibilities may be dictated by the professional organizations and society norms. While morals vary according to different cultures and subcultures, making them specific
According to Morrison and Furlong, normative ethics discovers what is right and wrong and guides decision making for all situations in many areas, including health care. A normative ethical theory that this research will discuss is virtue ethics in the American health care system. The purpose of this research is to develop potential for excellence and to find the best for humans by doing what is right short-term, long-term, and to compete globally (Morrison & Furlong, 2013). Given certain situations, each theory can provide tools to assist in decision-making. But virtue ethics concentrates on excellence and perfection.
Steinbock, Bonnie, Alex J. London, and John D. Arras. "Rule-Utilitarianism versus Act-Utilitarianism." Ethical Issues in Modern Medicine. Contemporary Readings in Bioethics. 8th ed. New York: McGraw-Hill, 2013. 12. Print.
This type of ethical dilemma is common in physical therapy since many of the treatments involve patients to actively participate in the treatment instead of just passively receiving treatments as in surgery or massage therapy. According to a study done by UK National Health service, out of 361 physical and occupational therapists, only around one- third of them reported no ethical dilemma in the past six months (Barnitt, 1998). I...
As with every code of ethics the Physician Assistant profession has revised its code of ethics to keep with the changing times in the medical field. Four main bioethical principles broadly guided the development of these guidelines: autonomy, beneficence, no maleficence, and justice.3This Physician Assistant (PA) should follow the do no harm rule, understand the patient has the right to make decisions about their care, always act in the best interest of the patient, and treat all the patients the same and make sure care is consistent for every
Macklin R. (2003). Applying the Four Principles, Journal of Medical Ethics; 29: p.275-280 doi:10.1136/jme.29.5.275.retrieved from http:// jme.bmj.com/content/29/5/275.full