Ethics in Physical Therapy: A Case Based Approach / Edition 1

by Nancy Kirsch

Overview

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A Case-Based Approach to Learning Ethics in Physical Therapy

Ethics in Physical Therapy utilizes a unique case-based approach to teach students and clinicians how to apply theoretical concepts to real-world situations. The cases were carefully selected to encourage thinking and discussion. The accompanying text provides a framework to answer the "should" questions, such as "What should I do?" and "How should I act?" The format provides the opportunity to move beyond the individual realm, when appropriate, resolving issues within an institutional or societal perspective.

The text is divided into two sections: "Ethics for the Physical Therapist" and "Types of Ethical Decisions: Case Analysis". They are designed to integrate with one another, but, each section can also be used separately. Part I provides more didactic, foundational material, while Part II strives to apply ethical decision-making tools to relevant cases in physical therapy practice, with the second section focusing on case analyses.

The purpose of Ethics in Physical Therapy is to give students and clinicians a lens through which to analyze contemporary ethical challenges. Philosophical theory within the text is limited to that which can be applied practically in the clinical setting. This book is not intended to be a work on ethical behavior, rather, it is designed to provide students and clinicians with a framework in which to approach the uncertainty of ethical decision making with tools to aid their inherent judgment.

Product Details

ISBN-13:	9780071823333
Publisher:	McGraw Hill LLC
Publication date:	04/09/2018
Edition description:	New Edition
Pages:	208
Product dimensions:	6.00(w) x 9.00(h) x 0.46(d)

About the Author

Nancy Kirsch, PT, DPT, PhD is director of the Doctor of Physical Therapy program at Rutgers University. She is currently on the APTA Scope of Practice Task Force and vice president of the Federation of State Boards of Physical Therapy.

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Table of Contents

Foreword ix

Preface xi

How to Use This Book xiii

Part 1 Ethics for the Physical Therapist 1

1 Healthcare Ethics 3

2 Professionalism 17

3 Ethical Guidance: The Code of Ethics for Physical Therapists and Standards of Ethical Conduct for the Physical Therapist Assistant 21

4 Ethical Risk Factors 29

5 Applying Ethical Decision-Making Models in Clinical Practice 33

Case Example 1: Too Much of a Good Thing 37

Case Example 2: Stepping Over the Line? 47

6 The Ethical Challenges of the Future 51

Part 2 Types of Ethical Decisions: Case Analysis 55

7 Introduction to Case Analysis 57

Case Example 3: It's Not in My Job Description! 58

8 Accountability 63

Case 1 Destination Dilemma: Best Interest Determination 63

Case 2 What Happens in PT, Stays in PT: Patient Confidentiality vs. Professional Duty 67

Case 3 Sticks and Stones: Patient-Therapist Relationship Challenges 71

9 Boundary Issues 77

Case 4 A Family Affair: A Dual Relationship 77

Case 5 Who Sent Me a Text?: Social Media Boundary Violation 81

Case 6 Crossing the Professional Chiasm: Power Gradient 85

10 Practice Issues 91

Case 7 Can You "See" Me Now?: Workplace Dictating a Service Delivery Model 92

Case 8 Put Me In, Coach: The Complexities of Answering Patient and Employer Expectations Simultaneously 96

Case 9 Are You the PT for Me?: Self-Assessment to Determine What Is Best for the Patient 99

11 Professional Relationships 105

Case 10 Joint Moves: Respect for Interprofessional Practice 106

Case 11 An Acute Cold Shoulder: Destructive Professional Relationship 110

Case 12 Homesick: Professional Power Gradient Abuse 115

12 Professional Responsibility 121

Case 13 A Passive Protocol: Autonomous Clinical Decision Making 122

Case 14 Artificial Competence: Assessing Competence and Limitations 126

Case 15 Alphabet Soup: Protect Patients by Accurate Reporting of Skills 130

13 Professional Self-Regulation 135

Case 16 Who Are You?: Responsibility to Report 136

Case 17 Where Is the Evidence?: Exceeding Responsibility 139

Case 18 An Education on Staff Behavior: Stopping Poor Practice 143

14 Supervision 147

Case 19 Long-Distance Supervision: Inappropriate Supervision 147

Case 20 Supervision Revision: Supervision Conflict 151

Case 21 PRN PT or PTA: Resisting Supervision 155

15 The Student Physical Therapist 161

Case 22 Student or PT?; Abdication of Supervision 162

Case 23 The Student Advocate: New Professional Responsibility 165

Case 24 Project Professional Skills: Inappropriate Professional Behavior 169

Appendix A The Code of Ethics for Physical Therapists 173

Appendix B Standards of Ethical Conduct for the Physical Therapist Assistant 175

Appendix C Ideas to Consider Answers 177

Appendix D References 179

Index 185

Editorial Reviews

Reviewer: Monique Serpas, PT, DPT, OCS (Southeast Louisiana Veterans Health Care System)
Description: This practical book provides an overall review of ethics throughout healthcare, with specific attention to physical therapy, ethical clinical decision-making models, and cases exploring common ethical dilemmas to demonstrate reasoning in ethics.
Purpose: The book presents a method of ethical decision-making and serves as a framework to understand ethical problems in modern practice. Cases allow for practice using the proposed ethical decision-making model. As technology, responsibilities of physical therapists, and institutional productivity demands evolve, clinicians encounter new ethical challenges, which require careful consideration to determine the ethical path of practice.
Audience: This book is intended for students and practicing clinicians in physical therapy. It can also be a resource for those teaching ethics in physical therapy practice, particularly the cases for group presentation and discussion. The author has experience teaching ethics and is author of an ethics column in the APTA's PT in Motion magazine.
Features: The first of the book's two parts covers ethics in healthcare and how the ethical practice of physical therapy fits into this broader category. Part one also discusses professionalism, risks for ethical misconduct, the code of ethics by the APTA, and ethical decision-making models. Each chapter in part one ends with a section, "Ideas to Consider," which includes multiple choice questions for review. Part two, on types of ethical decisions, reviews the decision-making model through case analysis. Each chapter has a worksheet to help provide structure and consistency in case analysis. In addition, each chapter ends with a section, "Consider and Reflect," which prompts readers to consider the perspectives of all involved parties.
Assessment: The book's format is useful for practicing clinicians as it provides a structure to help them make a decision when there is an ethical question. Students will find the most useful part of the book to be the cases, which apply the ethical decision-making models and the published Code of Ethics by the APTA.

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