1. Introduction to Ethics in Physical Therapy
PTH 511
Introduction to Ethics in Physical Therapy

2. Course Outcomes
Apply ethical decision making consistent with the APTA Code of Ethics.
Discuss the APTA Code of Ethics and Guide for Professional Conduct for Physical Therapists with respect to the profession of physical therapy.
Relate the APTA Code of Ethics to the Benedictine values espoused by the University of Mary.
Apply aspects of the APTA Code of Ethics to clinical situations.

3. Graduate Outcomes
MORAL COURAGE: Grounded in faith and reason, graduates (of the University of Mary graduate-level programs) clarify and defend moral, personal, and social values to uphold the pathway for justice in multiple contexts.

4. Fides et Ratio
Faith and reason are like two wings on which the human spirit rises to the contemplation of truth; and God has placed in the human heart a desire to know the truth—in a word, to know himself—so that, by knowing and loving God, men and women may also come to the fullness of truth about themselves (cf. Ex 33:18; Ps 27:8-9; 63:2-3; Jn 14:8; 1 Jn 3:2).
In presenting principles and moral evaluations regarding biomedical research on human life, the Catholic Church draws upon the light both of reason and of faith and seeks to set forth an integral vision of man and his vocation, capable of incorporating everything that is good in human activity, as well as in various cultural and religious traditions which not infrequently demonstrate a great reverence for life. (Dignitas Personae)

5. What is an ethical decision?

6. Definitions Ethics Bioethics
Ethics is a philosophical discipline pertaining to notions of good and bad, right and wrong—our moral life in community.
Bioethics
Bioethics is the application of ethics to the field of medicine and healthcare. 

7. Bioethical Principles
Beneficence – acting in the patient’s best interest (Hippocratic Oath)
Autonomy – respect for the patient to make own decisions about what is best (patient bill of rights)
Nonmaleficence – doing no harm
Justice – treating everyone fairly
Distributive (equal distribution of goods)
Compensatory (act to make up for past injustice)
Procedural (first come, first serve)

8. Bioethical Rules
Veracity (from autonomy and beneficence) – tell the truth, do not lie
Confidentiality/Privacy (from beneficence) -obligation to keep information concerning patients private except when doing so would bring harm to innocent people or to the client personally
Fidelity (from beneficence) – actions should be faithful to patient

9. The Realm-Individual Process-Situation (RIPS) Model of Ethical Decision Making

10. Components of the RIPS Model
Realm
Individual Process
Situation
Individual
Organizational/Institutional
Societal
Moral Sensitivity
Moral Judgment
Moral Motivation
Moral Courage
Issue/Problem
Dilemma
Temptation
Silence

11. Realm Individual Organizational/Institutional Societal
Good of the pt/client
Focus: rights, duties, relationships, and behaviors between individuals
Least complex problems
Organizational/Institutional
Good of the organization
Focus: structures & systems that facilitate organizational or institutional goals
Societal
Common good
Most complex realm

12. Components of the RIPS Model
Realm
Individual Process
Situation
Individual
Organizational/Institutional
Societal
Moral Sensitivity
Moral Judgment
Moral Motivation
Moral Courage
Issue/Problem
Dilemma
Temptation
Silence

13. Individual Process Moral Sensitivity Moral Judgment Moral Motivation
Moral Courage

14. Components of the RIPS Model
Realm
Individual Process
Situation
Individual
Organizational/Institutional
Societal
Moral Sensitivity
Moral Judgment
Moral Motivation
Moral Courage
Issue/Problem
Dilemma
Temptation
Silence

15. Situation Issue/Problem Dilemma
Moral values are present or may be challenged
Dilemma
Right vs right
Multiple alternative courses of action may be taken, which fulfill an important duty & it is not possible to fulfill each

16. Situation Distress Temptation
Know the right course of action, but are not authorized or empowered to perform it
Often during the implementation phase of decision making
Temptation
Right vs wrong
Choice between wrong & right when you stand to benefit from choosing the wrong

17. Situation
Silence
Ethical values are challenged, but no one is speaking about this challenge to values

18. RIPS Implementation Recognize the ethical challenge
Utilize RIPS to reflect on the ethical situation
Decide on an ethical course of action
Implement your ethical decision
Re-assess
Was the implementation effective?

19. APTA Code of Ethics Principle
Benedictine Value
1. Physical therapists shall respect the inherent dignity and rights of all individuals.
2. Physical therapists shall be trustworthy and compassionate in addressing the rights and needs of patients/clients.
3. Physical therapists shall be accountable for making sound professional judgments.
4. Physical therapist shall demonstrate integrity in their relationships with patients/clients, families, colleagues, students, research participants, other health care providers, employers, payers, and the public.

20. APTA Code of Ethics Principle
Benedictine Value
5. Physical therapists shall fulfill their legal and professional obligations.
6. Physical therapists shall enhance their expertise through the lifelong acquisition and refinement of knowledge, skills abilities and professional behaviors.
7. Physical therapists shall promote organizational behaviors and business practices that benefit patients/clients and society.
8. Physical therapists shall participate in efforts to meet the health needs of people locally, nationally, or globally.

21. HELP!
Where do I go for help to know if a patient is being treated ethically?
Ethical and Religious Directives
National Catholic Bioethics Center
Ethics Committees
Hospital
NDPTA

22. O Mary, bright dawn of the new world, Mother of the living, to you do we entrust the cause of life Look down, O Mother, upon the vast numbers of babies not allowed to be born, of the poor whose lives are made difficult, of men and women who are victims of brutal violence, of the elderly and the sick killed by indifference or out of misguided mercy. Grant that all who believe in your Son may proclaim the Gospel of life with honesty and love to the people of our time. Obtain for them the grace to accept that Gospel as a gift ever new, the joy of celebrating it with gratitude throughout their lives and the courage to bear witness to it resolutely, in order to build, together with all people of good will, the civilization of truth and love, to the praise and glory of God, the Creator and lover of life.