Ethical Issues in Patient Care
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Questions and Answers

What characterizes a situation of distress?

  • Uncertainty about the right choice to make
  • Clear moral guidelines preventing decision-making
  • Knowledge of the right action but lack of empowerment (correct)
  • Full support from peers in taking action

    • In a situation of temptation, what is typically at stake?

  • The influence of external pressures on decision-making
  • The chance to benefit from making a wrong decision (correct)
  • A choice between two morally correct actions
  • The moral implications of silence among peers

    • What does silence in moral decision-making often indicate?

  • Open discussions about moral challenges
  • Fear of reprisal or conflict regarding values (correct)
  • Full agreement on the course of action
  • A clear consensus on ethical values

    • When faced with a morally distressing situation, which factor might hinder action?

    <p>Institutional or financial barriers</p> Signup and view all the answers

    How can multiple morally correct actions contribute to distress?

    <p>Choosing one can lead to the neglect of the other.</p> Signup and view all the answers

    What ethical concern arises when a hospital prioritizes profit over patient care?

    <p>The moral obligation to disclose the use of cheaper materials</p> Signup and view all the answers

    What does the scenario of a patient sharing a secret and requesting confidentiality illustrate?

    <p>The conflict between personal ethics and professional guidelines</p> Signup and view all the answers

    In which scenario is moral silence most likely to occur?

    <p>When there is a strong personal incentive to remain quiet</p> Signup and view all the answers

    What is the primary function of laws as described?

    <p>They create a consensus on standards of behavior.</p> Signup and view all the answers

    In the context of ethical decision-making, how do values function?

    <p>They shape our ethical frameworks and influence decisions.</p> Signup and view all the answers

    Which statement best describes the relationship between ethics and law?

    <p>While law is a minimal standard, ethics guide towards ideal behavior.</p> Signup and view all the answers

    Which scenario exemplifies being unethical but legal?

    <p>A professional accepting gifts from clients.</p> Signup and view all the answers

    What distinguishes an ethical dilemma from an ethical challenge?

    <p>Dilemmas present two courses of action that are both ethical.</p> Signup and view all the answers

    What type of ethical challenge is characterized by actions that are both unethical and illegal?

    <p>Unethical and Illegal</p> Signup and view all the answers

    Which of the following best illustrates the concept of ethical but illegal behavior?

    <p>A whistleblower exposes wrongdoing despite company policy.</p> Signup and view all the answers

    What aspect of values distinguishes them from ethics?

    <p>Values influence ethical decision-making but do not dictate it.</p> Signup and view all the answers

    What is the primary focus of the societal realm in ethical decision-making?

    <p>Population health and the good of all people</p> Signup and view all the answers

    Which of the following documents is NOT a professional document that guides ethical practices for physical therapists?

    <p>State Instruction Manual</p> Signup and view all the answers

    What limitation is highlighted regarding ethical decision-making documents?

    <p>Stated principles may often conflict.</p> Signup and view all the answers

    What role does the APTA Code of Ethics primarily serve for physical therapists?

    <p>To delineate the ethical obligations of physical therapists</p> Signup and view all the answers

    Which realm of ethical decision-making focuses on systems within organizations?

    <p>Organizational</p> Signup and view all the answers

    Why might ethical decision-making guidance sometimes be considered too general?

    <p>They apply broadly but lack specificity for unique scenarios.</p> Signup and view all the answers

    Which aspect is NOT included as part of the APTA Code of Ethics structure?

    <p>Unique patient cases</p> Signup and view all the answers

    What is the significance of the APTA Code of Ethics stating that 'no code is exhaustive'?

    <p>Ethical challenges vary greatly and require judgment.</p> Signup and view all the answers

    What is the primary ethical principle that emphasizes respect for a patient's right to make their own decisions?

    <p>Autonomy</p> Signup and view all the answers

    Which situation exemplifies a conflict between beneficence and autonomy?

    <p>Respecting a patient's choice to refuse treatment despite potential health risks.</p> Signup and view all the answers

    Which of the following statements best reflects the importance of ethical judgments in the practice of physical therapy?

    <p>Increased autonomy in health care delivery necessitates the importance of ethical judgments.</p> Signup and view all the answers

    What does the term 'ethical compass' refer to in the context of physical therapy?

    <p>A decision-making framework that helps analyze complex ethical issues.</p> Signup and view all the answers

    Which of the following best distinguishes ethics from law in the context of patient care?

    <p>Ethics involves personal values, while law dictates mandatory conduct.</p> Signup and view all the answers

    What important role does complexity in healthcare play for physical therapists?

    <p>It highlights the necessity of ethical frameworks for decision-making.</p> Signup and view all the answers

    Which of the following best defines the term 'values' in the context of ethical decision-making?

    <p>Values are subjective beliefs that influence individual choices and actions.</p> Signup and view all the answers

    What is a common ethical dilemma faced by physical therapists?

    <p>Choosing between patient satisfaction and adherence to medical guidelines.</p> Signup and view all the answers

    What is a necessary condition for a patient to achieve true autonomy?

    <p>Being well informed and free from external pressures</p> Signup and view all the answers

    Which of the following is NOT an example of self-determination in patient autonomy?

    <p>Having a family member make decisions on behalf of the patient</p> Signup and view all the answers

    Which factor can challenge a patient's autonomy when making medical decisions?

    <p>Cultural beliefs influencing health choices</p> Signup and view all the answers

    What is one criterion for a mature minor to give informed consent for treatment?

    <p>They must be capable of making informed decisions for their treatment</p> Signup and view all the answers

    In the context of patient autonomy, what role does 'do-no harm' play?

    <p>It requires healthcare providers to consider the risks of treatments</p> Signup and view all the answers

    What does the principle of beneficence entail in patient care?

    <p>Acting in the best interest of the patient by providing beneficial treatment</p> Signup and view all the answers

    Which ethical principle may conflict with a patient's desire for autonomy?

    <p>Beneficence in providing care</p> Signup and view all the answers

    For effective patient autonomy, which aspect is crucial during the informing process?

    <p>Information must be free from coercion and bias</p> Signup and view all the answers

    What is the estimated annual cost of medication errors in healthcare?

    <p>$42 billion</p> Signup and view all the answers

    What is the primary ethical principle reflected in the phrase 'Primum non nocere'?

    <p>To do no harm</p> Signup and view all the answers

    Which of the following is NOT one of the five questions recommended by Choosing Wisely?

    <p>What are the alternatives available?</p> Signup and view all the answers

    Which of the following best describes malfeasance in healthcare?

    <p>Intentional wrongdoing</p> Signup and view all the answers

    What percentage of patients are harmed during primary and ambulatory healthcare?

    <p>40%</p> Signup and view all the answers

    Which condition must be met for breaching confidentiality according to ethical standards?

    <p>The harm to identifiable third parties is serious and unavoidable.</p> Signup and view all the answers

    What is a common outcome linked to low health literacy among elderly patients?

    <p>Higher rates of hospitalization.</p> Signup and view all the answers

    Which factor is crucial for recognizing the potential for harm in patient care settings?

    <p>The perceived difference in power between the patient and clinician.</p> Signup and view all the answers

    What characterizes health equity in healthcare access?

    <p>All individuals have an equal chance of achieving full health potential.</p> Signup and view all the answers

    What was the primary finding of the 2016 systematic review regarding knee arthroscopy and exercise for degenerative medial meniscus tears?

    <p>There was no significant difference in outcomes between knee arthroscopy and exercise.</p> Signup and view all the answers

    Which group was notably absent from the multidisciplinary, international panel that developed the guideline against arthroscopy for knee treatment?

    <p>Occupational therapists</p> Signup and view all the answers

    Which of the following best illustrates a risk management strategy in patient care?

    <p>Recognizing and addressing disparities in healthcare access.</p> Signup and view all the answers

    What aspect of patient care is emphasized in the Patients' Bill of Rights?

    <p>Patients guarantee full information and consent regarding their treatment.</p> Signup and view all the answers

    In what capacity can limited screening for concussions in sports medicine be categorized?

    <p>As an example of harm in healthcare.</p> Signup and view all the answers

    What is the primary concern of the campaign that promotes the idea that 'bedrest is bad'?

    <p>It seeks to combat hospital immobility and promote active recovery.</p> Signup and view all the answers

    What must be included in the informed consent form for intramuscular manual therapy?

    <p>A statement clarifying that the patient is not receiving acupuncture</p> Signup and view all the answers

    Which of the following is NOT a component that needs to be documented regarding informed consent?

    <p>Patient's medical history</p> Signup and view all the answers

    How does the APTA Code of Ethics relate to informed consent?

    <p>It ensures that physical therapists provide information for informed decision-making.</p> Signup and view all the answers

    What aspect of informed consent is commonly misunderstood by patients?

    <p>The necessity of having ongoing consent</p> Signup and view all the answers

    In which scenario is the physical therapist at risk concerning informed consent?

    <p>Failing to document the patient's understanding of the risks</p> Signup and view all the answers

    Which principle from the APTA Code of Ethics is directly related to patient autonomy?

    <p>Beneficence</p> Signup and view all the answers

    What is the primary purpose of informed consent in physical therapy?

    <p>To enable patients to make informed decisions about their treatment</p> Signup and view all the answers

    What is a potential risk if informed consent is not adequately obtained?

    <p>Therapists might lose their professional license</p> Signup and view all the answers

    What is NOT considered a parameter of informed consent in physical therapy practice?

    <p>Insurance coverage details</p> Signup and view all the answers

    Which legislative initiative is aimed at improving access to physical therapy services?

    <p>Addition of PTs to the National Health Service Corps Loan Repayment Program</p> Signup and view all the answers

    Which of the following is a key aspect of creating a welcoming atmosphere in physical therapy clinics?

    <p>Providing multi-lingual signage and handouts</p> Signup and view all the answers

    Informed consent is vital in physical therapy as it links to which ethical principle?

    <p>Autonomy</p> Signup and view all the answers

    Which factor is NOT likely to influence the informed consent process in physical therapy?

    <p>Competency of the therapist</p> Signup and view all the answers

    Which of the following best describes a potential barrier in accessing physical therapy services?

    <p>Restricted hours of operation</p> Signup and view all the answers

    What is a common misconception about informed consent in healthcare?

    <p>It is simply signing a document</p> Signup and view all the answers

    Which of the following promotes health literacy in physical therapy settings?

    <p>Incorporating non-judgmental staff behavior</p> Signup and view all the answers

    Which statement accurately reflects the relationship between patient confidentiality and autonomy in physical therapy?

    <p>Patient confidentiality and autonomy are both essential and can coexist if handled properly.</p> Signup and view all the answers

    What type of information is classified as protected health information (PHI)?

    <p>Oral, electronic, or paper-based information that identifies an individual.</p> Signup and view all the answers

    Which action is considered a violation of the patient's right to privacy in physical therapy?

    <p>Publicly disclosing patient details without consent.</p> Signup and view all the answers

    Which of the following best illustrates a situation where the need to protect a patient could override confidentiality?

    <p>A therapist learns that a patient poses a risk to themselves or others.</p> Signup and view all the answers

    Which scenario would likely require informed consent from a patient?

    <p>Changes to a treatment plan that involve new, experimental techniques.</p> Signup and view all the answers

    How does cultural and health literacy impact the informed consent process?

    <p>Low health literacy can lead to misunderstandings that obstruct informed consent.</p> Signup and view all the answers

    Which ethical principle is most directly linked to the concept of informed consent?

    <p>Autonomy</p> Signup and view all the answers

    In what circumstances can a physical therapist disclose confidential patient information without consent?

    <p>Only when required by law or to protect individuals from harm.</p> Signup and view all the answers

    Study Notes

    • Ethical principles of autonomy and beneficence are central to patient care.
    • Clinical situations often require weighing autonomy and beneficence, which can sometimes conflict.
    • Physical therapists must apply these principles in their practice.
    • Key documents are crucial for ethical decision-making.
    • The principles of autonomy and beneficence should be applied in a balanced way, considering the various realms and contexts.

    Objectives

    • Understanding ethical principles, particularly autonomy and beneficence including their application.
    • Recognizing clinical situations where these principles intersect or conflict.
    • Applying autonomy and beneficence to physical therapy practice with careful consideration of the various realms.
    • Utilizing relevant resources, including professional documents and codes of ethics, for ethical decision-making.

    Increasing Expectations in Physical Therapy

    • Physical therapy is evolving towards a more doctor-like profession with increased autonomy and direct patient access.
    • Healthcare complexity and evidence-based practice affect ethical decision-making in the field.
    • This evolution requires therapists to be more self-aware regarding their own values, and to consider the potential for competing obligations or values associated with patient care.

    Competing Obligations or Values

    • Ethical dilemmas in physical therapy are common.
    • These dilemmas frequently involve competing obligations and values.
    • Analyzing these conflicts requires careful scrutiny of patient rights, organizational considerations, and social implications.
    • Recognizing the potential for conflicts between competing values is crucial.

    Ethics vs. Values vs. Law

    • Ethics involves rational reflection in situations with multiple courses of action, particularly when there is conflict between possible decisions.
    • Values are personal, professional, and societal standards of right and wrong, shaping ethical decision-making.
    • Laws set minimal standards for acceptable behavior, often outlining ethical principles already present within society, but not always encompassing ideal behavior.

    Laws and Ethics

    • Legal frameworks provide minimal standards for behavior, often representing societal consensus.
    • Ethics guides towards "ideal" behavior which can go beyond the legal minimum.
    • The interplay of ethical and legal standards in specific scenarios frequently presents a challenge to physical therapists.
    • Awareness of how differing realms affect the considerations.
    • A framework with a four-quadrant model illustrates possible ethical and legal combinations (ethical/legal, unethical/legal, etc.).
    • Understanding and navigating the complexities of ethical and legal considerations is paramount.
    • Recognizing potential conflicts between ethical principles and legal requirements is crucial.

    Types of Ethical Dilemmas

    • Dilemmas arise in situations where there are conflicting rights or values within decision-making processes.
    • Common types include distress (knowing right action but facing barriers) and temptation (wrong action offering personal gains).
    • The concepts of dilemma, distress, temptation, and silence are useful in analyzing and recognizing such situations in practice.

    Frameworks and Resources for Ethical Decision-Making

    • Various frameworks (e.g., APTA Code of Ethics) guide physical therapists.
    • The core values inherent to physical therapy ethics should be followed.
    • Codes of ethics, including those from professional organizations like the APTA, are an important resource.

    Realms Relevant to Ethical Issues

    • Societal: Population health (the "good of all").
    • Organizational: Organizational goals and structures.
    • Individual/Family: Rights and relationships at the individual and family level.
    • Understanding that specific ethical issues frequently pertain to multiple realms simultaneously, requiring the consideration of their interplay, is essential.

    Professional Documents

    • APTA Code of Ethics.
    • APTA Guide for Professional Conduct.
    • APTA Standards of practice, specific to each patient.
    • The Guide to Physical Therapist Practice.

    APTA Code of Ethics (2019)

    • Outlines ethical obligations of physical therapists.
    • Recognizing that no code is exhaustive for every situation, ethical decision-making often involves a thoughtful consideration of multiple competing values.
    • Built upon professional roles, core values of PT, ethical action, and responsibilities as providers.

    Limitations of Ethical Resources

    • Ethical decisions involve complex circumstances, potentially without clear answers.
    • Existing documents may not be specific to all possible dilemmas; practitioners must apply guiding principles thoughtfully in context with patient and provider needs.

    State Based Regulations

    • Example: Regulations from Maryland's Department of Health.
    • State regulations should be considered along with the professional code of ethics.
    • Variations in state regulations exist.

    MD Code of Ethics

    • Outlines a code of ethics specific to Maryland including potential examples of ethical dilemmas and consequences.

    ABCDE Ethical Principles

    • The principles form a framework for ethical decisions in physical therapy, encompassing Autonomy, Beneficence, Confidentiality, Do-No-Harm, and Equity, in dynamic interplay.

    Autonomy

    • Patient self-determination and freedom of choice are crucial (including personal agency).
    • Evidence supports that patient feelings of control improve outcomes.
    • The process of ensuring a patient's autonomy requires consideration of potential external factors that might interfere.

    Consider Considerations for Autonomy

    • Well-informed individuals are better equipped to exercise autonomy.
    • Consideration of external factors, such as potential bias, coercion, or vulnerability, is crucial to truly respect a patient's autonomy.

    Self-Determination Examples

    • Real-world situations demanding autonomous decisions.

    The ICF Framework

    • A comprehensive model considers health conditions, body functions/structures, activities, and participation.
    • This framework can be applied to understand the influence of contextual factors on a patient's decision-making.
    • Recognizing the interplay of the individual's autonomy with the contextual factors is paramount.

    Challenges to Autonomy

    • Legal and ethical issues related to age, culture, religion, mental capacity, medical paternalism, etc..
    • Illness can affect understanding, even when legal criteria are fulfilled.
    • Considering the ways in which illness, mental capacity, or other limitations might impact patients' capacities to understand and make decisions, particularly with regards to appropriate care.

    Illness and Understanding

    • Illnesses can impact a person's ability to comprehend information; this needs to be carefully considered, along with the patient's capacity for decision making in the context of their condition.

    Examples: When Should Autonomy Be Considered?

    • Decision-making surrounding treatment options, treatment plans, advance directives, and end-of-life decisions are among the key areas in which these principles should be considered and applied.

    Truth Telling: Factors to Consider

    • The process of truth-telling involves carefully considering multiple factors, such as clinical factors, patient factors (including beliefs and cognition), family and environmental context, and sociocultural nuances in order to offer informed and supportive guidance.

    “Western” view of Autonomy

    • The "Western" view stresses individual choice in a variety of situations, including in health and medicine. Its concept is that a patient's autonomy is a priority.

    Other Views of Autonomy

    • Different cultural contexts value inter-dependence which might prioritize the family's input or collective choice over individual autonomy.
    • Such differing views on autonomy highlight the need to understand the cultural perspectives of patients.

    Beneficence

    • Removing harm, doing good, pursuing societal and individual best interests.
    • Balancing those interests with respect for the individual patient.

    Beneficence and Advocacy

    • Considering how beneficence could involve societal advocacy when considering a patient's best interest, not just at an individual level.

    Beneficence and the "Do No Harm" Principle

    • Beneficence and the associated "Do No Harm" principle go hand in hand, helping to promote care while protecting patient well-being.

    Questions Regarding Beneficence

    • Exploring individual-level vs. societal-level beneficence application; factors challenging clinicians' beneficent responses; understanding the key difference between the concepts of beneficence and non-maleficence; and the role of advocacy by practitioners.

    General Points on Ethical Decision Making

    • Ethical decision-making often involves a complex interplay of professional and societal values as well as legal considerations.
    • Ethical decision-making should be approached with careful consideration of each specific scenario.
    • The concepts and principles discussed help to create a framework for analyzing and making sound decisions in ethical dilemmas.

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    Related Documents

    Ethical and Legal Issues in Patient Care PDF
    Ethics Handout-Do No Harm, Equity, Informed Consent, Confidentiality PDF

    Description

    Explore the ethical and legal principles guiding patient care in physical therapy. This quiz covers critical concepts such as autonomy and beneficence, and how they can sometimes conflict in clinical situations. Enhance your understanding of these ethics and their applications in practice.

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