Ethical Decision-Making in Physical Therapy

  By Susan McPhail Wittjen, PT, PhD

Code of Ethics

A code of ethics is an explicit statement of ethical standards developed by a group of professional practitioners. Having a code of ethics is one of the marks of a profession. By developing a code of ethics the professional group states its obligation to establish and enforce standards of ethical behavior. A code of ethics helps to define a profession, and it is a promise to society that the profession will maintain specific ethical standards. A code of ethics should include the central ethical obligation of the group. It should also describe the moral values, duties and virtues that the professional group has identified as necessary for its members to maintain. While a code of ethics cannot make a person ethical, it can help to provide guidance to a person who already has a moral awareness.

One of the criticisms of codes of ethics is that the professional group is responsible for self-policing adherence to the code. If the TPTA and the APTA do not appropriately handle violations of the Code of Ethics, then the code is of little value. Therefore, members of the TPTA Chapter Ethics Committee (CEC) take their responsibilities seriously to see that members of the association follow the code. The Code of Ethics addresses specific issues, but it can also be general and vague at times. Therefore, the CEC and the APTA Judicial Committee must interpret the code as it is applied in specific situations.

The Code of Ethics (the Code) establishes the ethical principles for physical therapists to follow and the Guide for Professional Conduct provides a more thorough interpretation of the principles. Similarly, the Standards of Ethical Conduct for the Physical Therapist Assistant (the Standards) delineates the principles of conduct for the physical therapist assistant and is interpreted by the Guide for Conduct of the Affiliate Member. The Code consists of a preamble and eleven principles while the Standards consist of a preamble and seven standards. The House of Delegates of the APTA, which is the representative voting body of the organization, adopted the Code and the Standards, and only the House of Delegates may amend these documents. The Guides to the Code and the Standards interpret these documents and may be amended by the Judicial Committee of the APTA, an appointed group of members. The Guides are more flexible documents so that they may reflect changes in the health care delivery system. For example, advertising used to be prohibited but is now allowed with certain restrictions. The Judicial Committee determined that in a more competitive health care environment, physical therapists should be allowed to advertise their practices. In 1999 the interpretation of the Code changed to allow physical therapists to determine a diagnosis. While the Code and the Standards cannot be all inclusive to address all possible situations that might arise in practice settings, the Guides can evolve with changes in the profession.

Preamble 

This Code of Ethics sets forth ethical principles for the physical therapy profession. Members of this profession are responsible for maintaining and promoting ethical practice. This Code of Ethics, adopted by the American Physical Therapy Association, shall be binding on physical therapists who are members of the Association.

As stated earlier, codes of ethics usually include a central obligation and the preamble of the Code of Ethics explains that as members of the APTA we are to maintain and promote ethical practice. This is a general statement that sets the overall framework for the content of the Code. It further clarifies that the Code is binding on members of the APTA. There is a statement on the APTA membership application that must be signed indicating that you will abide by the ethical principles established in the Code. There is a similar statement for the Standards indicating that physical therapist assistant members of the APTA "are responsible for maintaining and promoting high standards of conduct." It is important that both physical therapists and assistants recognize that both groups have ethical obligations to patients, each other, to society in general and to the self.

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