Untitled design (10)

The Subjectivity of Ethics for Physical and Occupational Therapists

Ari Ginsberg. PT, DPT, MSIOP

Defining Ethics

What are ethics? Almost every definition of ethics includes the term morality. Morality explores the idea of what is considered right and wrong. For example, is it wrong to steal, or is it right to give charity to the poor? Although the answer to these questions seems obvious to most, it gets more complicated and unclear when new variables are added to the equation. For instance, is it wrong to steal from the rich to feed the poor? Or should you give charity to people who you feel are lazy and not looking for work? Also, what percentage of your wealth should you give to charity? There is much more complexity and ambiguity to morality in these situations. How do most people answer these questions? (Subjectivity of Ethics)

Subjectivity in Ethics

Due to this moral ambiguity, a lot of subjectivity exists in ethics and morality amongst different cultures and religions.

One example from the book The Righteous Mind: Why Good People Are Divide by Politics and Religion by Jonathan Haidt, is that in India it is unethical to call your parent by their first name, but in America that is not the case.

Jonathan Haidt

One reason for general ethical subjectivity is that ethical systems cannot anticipate all the possible scenarios that may arise. Additionally, as societies advance, new situations are created that could not have been accounted for by ethical systems from the past. It is therefore critical that we acknowledge a certain level of subjectivity and broaden our horizons and tolerance for others.

2 Reasons Why Moral Ambiguity Exists

  1. Ethical systems cannot anticipate all scenarios
  2. Ethical systems need to evolve with society

Ethics for Physical and Occupational Therapists

Just as ethics and morality are necessary in society, a specific branch of ethics relates exclusively to healthcare clinicians, medical ethics. It helps guide ethical decision making amongst medical professionals. Most professional organizations develop ethical systems for clinicians. Specifically, physical and occupational therapy professional organizations have created guidelines for ethics in physical and occupational therapy. They are called the APTA and AOTA Code of Ethics and they provide principles to assist clinicians when ethical scenarios arise.

The APTA and AOTA Core Values

Both Codes of Ethics are premised on core foundational values. The APTA core values include accountability, altruism, collaboration, compassion and caring, duty, excellence, and integrity. The AOTA core values are altruism, equality, freedom, justice, truth, and prudence. Every ethical principle can be traced back to its origin, the APTA and AOTA core values. These values are broad and provided leeway for the APTA and AOTA to fashion ethical principles.

The Evolution of the AOTA Code of Ethics

As mentioned earlier, as society evolves there is often a need to revise and update ethical codes. The AOTA recognized that occupational therapy has changed since its inception of the AOTA and has updated their Code of Ethics in 2020. One example of occupational therapy evolution would be the use of technology and the ethical implications involved. A good example of this would be telehealth. The Covid-19 pandemic created new opportunities for healthcare delivery as in-person visits were somewhat dangerous. Telehealth was a response to the pandemic and has been adopted by the APTA and AOTA as valid for the delivery of physical and occupational therapy services.

A New Ethical Dilemma

An ethical dilemma that has recently emerged for occupational therapists is how to work on dressing skills with clients using telehealth. Is it inappropriate due to the rampant nature of computer hacking, or should it be acceptable if the clinician is using a reasonably secure connection? Another question would be, in what situations should a clinician recommend telehealth? Let’s say the patient would benefit to a greater degree with in-person visits, is it unethical to recommend telehealth? These are some of the numerous questions that have emerged as a result of professional evolution in physical and occupational therapy.

Using Subjectivity in Ethics for Physical and Occupational Therapists

Even though the principles of the APTA and AOTA Codes of Ethics are meant to guide our decisions, there is often a lack of clarity. One of the reasons is based on what was mentioned above, it is impossible for an ethical system to consider every scenario. Also, the reading of these Codes of Ethics is subject to a fundamental debate. Are we supposed to read the principles and analyze them based on the literal wording, or the conceptual underpinnings of the principle?

A Classic Philosophical Debate

The same philosophical debate exists in every religion’s bible as well as the interpretation of the Constitution of the United States of America. How literal do we take the Constitution versus trying to understand the purpose of the amendments? There is no right or wrong answer to this question, it depends on your intuition. So too with ethics for physical and occupational therapists. How literal or non-literal you want to read the APTA Code of Ethics is up to your intuition.

The Benefits of Ethical Understanding

We as clinicians need should recognize this reality and try not to be judgmental in situations that rely on our intuition. Perhaps the other clinician had a different intuition from you, and that is why they made the decision to behave in the way that they did. For more info on this topic, check out Let’s Get Ethical: Ethical Boundaries for PTs/OTs, a 2.5-hour PT/OT CEU course that is designed to explain how we as clinicians rely on our intuition in an ethically ambiguous situation. You can also fulfill your physical therapy ethics requirement in NJ as well as your ethics CEU requirement in many other states. I look forward to hearing from you!

Leave a Comment

Your email address will not be published.

Let's Get Ethical: Ethical Boundaries for PTs/OTs

A 2.5 hour webinar approved for CEUs by the

AOTA – # 02517 

NY Board of Physical Therapy

The Ohio Physical Therapy Association # 21S2571

The NJ Board of PT # 2110-14

Meets Requirements for PTs/PTAs in:

AL, AR, AZ, CO, CT, DE, FL, GA, ID, IA, IL, KS, KY, MA, MD, ME, MI, MN, MO, MS,

MT, NC, ND, NH, OR, PA, RI, SC, SD, UT, VA, VT, WA, WI, WV, WY

due to recognition of approval from another state chapter of the APTA (Ohio PTA)

or another state board of PT (NY, NJ)

Objectives to facilitate clinician ethical practice

 

1. Define ethics and the Code of Ethics of the APTA/AOTA to practice in an ethical manner

2. Analyze the boundaries of ethical priniciples for PTs/OTs to solve ethical dilemmas

3. Apply APTA ethical principles to professional practice through case studies

4. Apply AOTA ethical principles to professional practice through case studies

A posttest/survey will be give after live and on-demand webinars. After purchasing an on-demand webinar you will be redirected to a webpage with the webinar and posttest links. A CE certificate will be emailed following posttest completion

Optimizing the Patient Experience

A 1 hour webinar approved for CEUs by the

AOTA – #02034

NY Board of Physical Therapy

Pending Approval by the NJ Board of PT – 2022 – 2024

Meets Requirements for PTs/PTAs in:

AL, AR, AZ CO, GA, IA, IL, KS, NC, NE, NH, ND, NM, OR, SC, WA, WI

Objectives related to professional development

1) Identify the components of bedside manner/ patient satisfaction and their link to healthcare outcomes

2) Apply strategies using social psychology to optimize the patient experience

3) Implement an organizational approach to improve patient satisfaction scores

A posttest/survey will be given following live and on-demand webinars. After purchasing the on-demand webinar you will be redirected to a webpage with the webinar and posttest links A CE certificate will be emailed following posttest completion

Improving Patient Adherence to Home Exercise Programs

 1 hour webinar approved for CEUs by the

AOTA – #02036

NY Board of Physical Therapy

The NJ Board of PT # 2111-80

Meets Requirements for PTs/PTAs in:

AL, AR, AZ CO, GA, IA, IL, KS, NC, NE, NH, ND, NM, OR, SC, UT, WA, WI

Objectives to facilitate patient/client goal achievement

1. Identify the benefits of home exercise programs

2) Define differing theories of motivation/influence

3) Apply social psychology to HEP prescription/plan

A posttest/survey will be given following live and on-demand webinars. After purchasing an on-demand webinar you will be redirected to a webpage with the webinar and posttest links. A CE certificate will be emailed following posttest completion

The Science of Bedside Manner and Patient Satisfaction

A 2 hour webinar approved for CEUs by the

AOTA – #02037

NY Board of Physical Therapy

Ohio Physical Therapy Association # 21S2565

The NJ Board of PT # 2110-15

Meets Requirements for PTs/PTAs in:

AL, AR, AZ, CO, CT, DE, FL, GA, ID, IA, IL, KS, KY, MA, MD, ME, MI, MN, MO, MS,

MT, NC, ND, NH, OR, PA, RI, SC, SD, UT, VA, VT, WA, WI, WV, WY

due to recognition of approval from another state chapter of the APTA (Ohio PTA)

or another state board of PT (NJ, NY)

Objectives to facilitate patient/client goal achievement

1. Develop and improve empathy skills

2. Identify the link between bedside manner/patient satisfaction and health outcomes

3. Measure patient satisfaction in a valid/reliable manner

4. Apply social psychology techniques to improve patient satisfaction

5) Integrate organizational strategies to improve patient satisfaction scores

A posttest/survey will be give after live and on-demand webinars. After purchasing an on-demand webinar you will be redirected to a webpage with the webinar and posttest links. A CE certificate will be emailed following posttest completion

Effective Leadership and Communication in Rehab

A 1 hour webinar approved for CEUs by the

AOTA – #02299

NY Board of Physical Therapy

Meets Requirements for PTs/PTAs in:

AL, AR, AZ CO, GA, IA, IL, KS, NC, NE, NH, ND, NM, OR, SC, WA, WI

Objectives related to professional development

 

1. Define leadership and various leadership styles

2. Identify successful leadership styles in healthcare/rehab

3. Implement effective leadership communication strategies in rehab

A posttest/survey will be given after live and on-demand webinars. After purchasing an on-demand webinar you will be redirected to a webpage with the webinar and posttest links. A CE certificate will be emailed following posttest completion

The New World of Rehab: Addressing Burnout

A 1-hour webinar approved for CEUs by the

AOTA – #02035

NY Board of Physical Therapy

Meets Requirements for PTs/PTAs in:

AL, AR, AZ, CO, CT, DE, FL, GA, ID, IA, IL, KS, KY, MA, MD, ME, MI, MN, MO, MS,

MT, NC, ND, NH, OR, RI, SC, SD, UT, VA, VT, WA, WI, WV, WY

due to recognition by another state board of PT (NY)

Objectives related to professional development

 

1. Identify the causes of rehab burnout

2. Recognize the signs of rehab burnout

3. Apply strategies to prevent/reduce rehab burnout

A posttest/survey will be given after live and on-demand webinars. After on-demand purchase you will be redirected to a webpage with the video link/posttest link. A CEU certificate will be emailed following post-test completion