Vishram Singh - Textbook of Anatomy Upper Limb and Thorax.. Volume 1 (1).pdf
Ethics in physiotherapy
1.
2. • ETHICS COMES FROM THE GREEK WORD ETHOS MEANS CUSTOM OR MORAL CHARACTER.
• IT IS A BRANCH OF PHILOSOPHY THAT DEALS WITH THE PRINCIPLES OF CONDUCT OF AN INDIVIDUAL OR
GROUP.
• IT WORKS AS A GUIDING PRINCIPLES AS TO DECIDE WHAT IS GOOD OR BAD.
3. Morality
MORALITY SPEAKS OF A SYSTEM OF BEHAVIOR IN REGARDS TO THE STANDARDS OF
RIGHT AND WRONG BEHAVIOR. THE WORD CARRIES CONCEPT OF;
•MORAL STANDARDS, WITH REGARDS TO BEHAVIOR.
•MORAL RESPONSIBILITY, REFERRING TO OUR CONSCIENCE.
•MORAL IDENTITY; ONE WHO IS CAPABLE OF RIGHT OR WRONG ACTION.
4. Morality and our behavior
MORALITY DESCRIBES THE PRINCIPLES THAT GOVERN OUR BEHAVIOR. MORALITY
RELATES TO OUR BEHAVIOR ON THREE LEVELS;
1. TO ENSURE FAIR PLAY AND HARMONY BETWEEN INDIVIDUALS.
2. HELP TO MAKE US GOOD PEOPLE IN ORDER TO HAVE A GOOD SOCIETY.
3. TO KEEP US IN A GOOD RELATIONSHIP WITH THE POWER THAT CREATED US.
5. Morality and our conscience
• MORALITY IMPACTS ON OUR EVERYDAY DECISION.
• CONSCIENCE IS A MATTER OF OUR HEARTS, THAT CONCEPTS OF RIGHT, WRONG AND FAIRNESS ARE
PROGRAMMED IN EACH OF US.
• OUR DECISIONS ARE BASED SOLELY ON OUR NEED TO
SURVIVE. SOMETIMES, IT IS BASED ON LEARNED BEHAVIORS.
6. Examples of Ethical and Unethical behavior
• A MILKMAN WHO ADDS WATER TO MILK IS PRACTICING UNETHICAL BEHAVIOR. HE IS CHEATING HIS
CUSTOMERS WHO HAVE A CERTAIN EXPECTATIONS OF HIM WHICH HE IS NOT LIVING UP TO.
• ON THE CONTRARY, A SHOP KEEPER WHO TAKES EXTRA CARE TO
STORE PROVISIONS IN ORDER TO PROTECT THEM FROM INSECTS ,
IS PRACTICING ETHICAL BEHAVIOR AS HE IS LIVING UP TO THE
EXPECTATIONS OF HIS CUSTOMERS.
8. • THE SET OF MORAL NORMS ADOPTED BY A PROFESSIONAL GROUP TO DIRECT VALUE-LADEN CHOICES IN A WAY CONSISTENT
WITH PROFESSIONAL RESPONSIBILITY IS TERMED AS A CODE OF ETHICS.
• MOST CODES OF ETHICS OF THE PROFESSIONS ARE COMPOSED OF STATEMENTS THAT HAVE AT THEIR CORE ONE OF FOUR VALUE
PRINCIPLES :
1. AUTONOMY
2. BENEFICENCE
3. NONMALEFICENCE
4. JUSTICE
• AND THREE RULES THAT FOLLOW FROM THESE FOUR PRINCIPLES :
1. VERACITY
2. CONFIDENTIALITY AND PRIVACY, AND
3. FIDELITY
9. • ONE MIGHT FOLLOW THEIR CODE WITHOUT INTERNALIZING IT, JUST AS SMALL CHILDREN FOLLOW THE
“RULES OF THE HOUSE.”
• FOR THE CODE OF ETHICS TO FUNCTION AS A SET OF PROFESSIONAL VALUES, ONE MUST REFLECT ON IT
AND DECIDE THAT IT, INDEED, FORMS A VALUES COMPLEX AROUND WHICH ONE IS WILLING TO ORGANIZE
PROFESSIONAL CHOICES.
• THUS, AS WAS PREVIOUSLY STATED, REFLECTION IS NECESSARY TO THE INTERNALIZATION OF VALUES TO
MAKE THEM TRULY ONE’S OWN.
• THE CHOICES THAT THEN FOLLOW THIS INTERNALIZATION ARE LIKELY TO BE CONSISTENT WITH ONE’S
BASIC BELIEFS, SHOW COHERENCE, BE AUTHENTIC OR GENUINE, AND BE ADEQUATE TO THE TASK OF
DECISION MAKING.
10. • THOSE WHO MAKE THE SMOOTHEST TRANSITIONS INTO PROFESSIONAL PRACTICE ARE LIKELY TO BE
THOSE WHOSE PERSONAL VALUES AND PRIORITIES SIGNIFICANTLY OVERLAP WITH THE VALUES
INHERENT IN THEIR CHOSEN PROFESSIONAL PRACTICE.
• GIVEN THAT ONE’S BASIC HUMAN SURVIVAL NEEDS ARE MET, THE MORE ONE REFLECTS ON ONE’S CHOICES
AND ON WHICH CHOICES RESULT IN A GOOD AND MEANINGFUL LIFE, THE MORE ONE IS APT TO
EXPERIENCE CONSISTENT REWARD FROM OPPORTUNITIES.
12. principles
1. AUTONOMY :
THE PATIENT’S RIGHT TO CHOOSE FOR ONE’S LIFE, AND TO VOICE THAT CHOICE FOR AS LONG AS POSSIBLE.
2. BENEFICENCE :
DOING WHAT IS BEST FOR ONE’S PATIENT.
CONTRASTS WITH PATERNALISM OR PATRONIZING.
BENEFICENCE IS A MORAL OBLIGATION OF ALL HEALTH CARE PRACTITIONERS.
WE MUST ACT WITH BENEFICENCE WHEN WE ARE AWARE OF THE FACTS AND THE PATIENT IS AT SIGNIFICANT RISK
OF HARM OR LOSS.
WE MUST ACT WITH BENEFICENCE IF THE BENEFIT TO THE PATIENT OUTWEIGHS THE POTENTIAL HARM TO THE
HEALTH CARE PRACTITIONER.
13. 3. NONMALEFICENCE :
DO NO HARM. DO NOT INJURE, DISABLE, OR KILL A PERSON, OR UNDERMINE A PERSON’S
REPUTATION, PROPERTY, OR PRIVACY.
4. JUSTICE :
FAIRNESS
DISTRIBUTIVE – EQUAL DISTRIBUTION TO ALL MEMBERS OF A GROUP
COMPENSATORY – MAKING UP FOR PAST INJUSTICE (AFFIRMATIVE ACTION)
PROCEDURAL – FIRM COME, FIRST SERVED, ALPHABETICAL ORDER, AND SO FORTH
14. Ethical rules that follow these principles
1. VERACITY –
TELL THE TRUTH, DO NOT LIE.
FROM THE PRINCIPLES OF AUTONOMY AND BENEFICENCE.
KEY ETHICAL ISSUE IS HOW MUCH OF THE TRUTH TO TELL
IN VIEW OF BENEFICENCE.
2. CONFIDENTIALITY AND PRIVACY –
FROM THE PRINCIPLE OF BENEFICENCE.
HEALTH CARE PRACTITIONERS ARE MORALLY OBLIGED TO KEEP CONFIDENT ALL INFORMATION CONCERNING PATIENTS
EVEN IF NOT REQUESTED SPECIFICALLY, EXCEPT WHEN TO DO SO WOULD BRING HAVE THE RIGHT TO KEEP PRIVATE ANY
INFORMATION NOT RELEVANT TO THEIR CARE.
15. 3. FIDELITY –
FROM THE PRINCIPLE OF BENEFICENCE.
HEALTH CARE PRACTITIONERS’ ACTIONS AND TREATMENTS WILL REMAIN FAITHFUL TO THEIR
PATIENT AND TO THEIR COLLEAGUES EVEN WHEN THEY DISAGREE WITH THEIR COLLEAGUES.
16. PROFESSIONAL ETHICS
• MORE COMPLEX THAN SOCIAL ETHICS
• HAS TO CONSIDER HIMSELF AND HIS FELLOW PROFESSIONAL.
17. WHY WE NEED TO FOLLOW ?
• RESPONSIBILITY TO PATIENT
• RESPONSIBILITY TO SOCIETY
• RESPONSIBILITY TO PROFESSION
18. ETHICAL PRINCIPLES - WCPT
THE WORLD CONFEDERATION FOR PHYSICAL THERAPY (WCPT) EXPECTS PHYSICAL THERAPISTS TO:
1. RESPECT THE RIGHTS AND DIGNITY OF ALL INDIVIDUALS
2. COMPLY WITH THE LAWS AND REGULATIONS GOVERNING THE PRACTICE OF PHYSICAL THERAPY IN THE
COUNTRY IN WHICH THEY PRACTICE
3. ACCEPT RESPONSIBILITY FOR THE EXERCISE OF SOUND JUDGMENT
19. 4. PROVIDE HONEST, COMPETENT AND ACCOUNTABLE PROFESSIONAL SERVICES
5. PROVIDE QUALITY SERVICES
6. BE ENTITLED TO A JUST AND FAIR LEVEL OF REMUNERATION FOR THEIR SERVICES
7. PROVIDE ACCURATE INFORMATION TO PATIENTS/CLIENTS, TO OTHER AGENCIES AND THE COMMUNITY
ABOUT PHYSICAL THERAPY AND THE SERVICES PHYSICAL THERAPISTS PROVIDE
8. CONTRIBUTE TO THE PLANNING AND DEVELOPMENT OF SERVICES WHICH ADDRESS THE HEALTH NEEDS OF
THE COMMUNITY