Ethics
Discuss your responses to the following case scenarios. Make sure to cite the appropriate Ethical considerations you utilized using the APTA Code of Ethics for Physical Therapists.
An out patient physical therapy clinic provides several jobs for many people in a small town where employment has been difficult to find. The company has stayed in the town even though it could grow much faster and find more competitively waged workers elsewhere. The physical therapists and staff have become loyal to the company due to the jobs and the citizens are happy to not travel hours to receive much needed care. Over the years, the company has developed a reputation in the town for taking care of its employees and being a responsible corporate citizen. You become a physical therapist in the said business and noticed that the company advertises that their therapists are doctors of physical therapy and are specialists. You noticed that only half of the PTs have their doctorate and only half have the specialties. You ask the PT Director and she replies "We have consistently provided care at the doctoral and specialist levels. Many of our older PT's have 20 years or more of experience and know more than the doctoral graduates. Besides, all our clients report high satisfaction with care, and if we were not here, there would be no local services". Describe what you would do in this situation.
The gentleman you are treating is the father of the CEO of your skilled nursing facility. He wishes to be seen a certain time and wants to utilize the NuStep machine between the hours of 3:30pm-4:30pm. Your colleagues have told you that this is the busiest time for the equipment and that the device could be utilized by at least three patients during that same time frame. You talk to your patient and he says he is only available during those hours and that he is only comfortable using that machine. Your director says it will be a few more years before a similar machine can be purchased and your colleagues want you to share the machine with them. What would you do in this situation?
You are a credentialed clinical instructor working with a physical therapy student in a multitherapy (OT's, PT's, SLP's) hospital rehabilitation facility. You are confident with your student Malcolm and he is doing great for his final week of a 10 week rotation. State guidelines require you to be 100% percent present when it comes to supervision of the student. You and your student have three more hours left in the day and 6 patients coming in during the busiest day of the week. You receive a phone call that there is a family emergency and that you need to leave the facility. How will you tackle the rest of the clinical day?
Sample Solution
Case 1: Ethical Dilemma in Advertising
Ethical Considerations:
- Veracity: Truthfulness and accuracy in advertising.
- Beneficence: Promoting the well-being of patients.
- Fidelity: Faithful to commitments made to patients and colleagues.
Analysis: The company's advertising practices are misleading and potentially harmful to patients. While the company has a positive impact on the community, it is essential to uphold professional standards and ethical principles
Full Answer Section
Actions:
- Internal Communication: I would initiate a private conversation with the PT Director, expressing my concerns about the misleading advertising and its potential consequences for patient care. I would emphasize the importance of accurate representation and the potential risks of misrepresenting the qualifications of the therapists.
- Documentation: Document the conversation with the PT Director, including the date, time, and key points discussed.
- Seek Guidance: If the issue is not resolved internally, I would consider seeking guidance from the state physical therapy board or a professional ethics committee.
- Patient Education: While addressing the company's advertising practices, I would also prioritize providing accurate information to patients about the qualifications of their therapists.
Case 2: Ethical Dilemma in Resource Allocation
Ethical Considerations:
- Beneficence: Promoting the well-being of patients.
- Justice: Fairness in distribution of resources.
- Autonomy: Respecting patient's choices.
Analysis: Balancing the needs of all patients while accommodating the CEO's father presents a challenge. The limited availability of the NuStep and the potential impact on other patients must be considered.
Actions:
- Open Communication: I would have an open and honest conversation with the patient about the equipment availability and the impact of his preferred schedule on other patients.
- Explore Alternatives: I would explore alternative exercise options that could meet the patient's needs and minimize disruption to other patients.
- Involve the Director: I would involve the director in the decision-making process to seek guidance and support.
- Prioritize Patient Care: Ultimately, the decision should prioritize the well-being of all patients, ensuring equitable access to resources.
Case 3: Ethical Dilemma in Student Supervision
Ethical Considerations:
- Beneficence: Promoting the well-being of patients.
- Nonmaleficence: Avoiding harm to patients.
- Fidelity: Faithful to commitments made to students and patients.
Analysis: The unexpected emergency creates a challenging situation that requires careful consideration of patient safety and student learning.
Actions:
- Prioritize Patient Safety: Ensure that patient care is not compromised by the absence of the supervising clinician.
- Communicate with Colleagues: Inform other therapists about the situation and request their assistance in monitoring the student's performance.
- Provide Clear Instructions: Before leaving, provide the student with clear instructions and guidance for managing the remaining patients.
- Maintain Contact: Stay in touch with the facility to address any urgent issues that may arise.
- Document the Situation: Document the circumstances surrounding the departure and any arrangements made for continued student supervision.
By following these steps, I would strive to minimize disruption to patient care while ensuring the student's continued learning and development.