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Safety is a hallmark of the physical therapy profession. Physical therapists (PTs) and physical therapist assistants must at all times protect the safety of patients, clients, peers, and team members. Because physical therapy is the science of movement, we tend to think of safety foremost in physical terms, but it has psychological and emotional dimensions, as well. Actions have consequences, but so do words. Consider the following scenario, in which a student feels threatened not only by what's said, but also by the institutional silence that follows.

Heart of Gold, or a Tin Ear?

Milton is the coordinator of clinical education (CCE) and a credentialed clinical instructor (CI) at West Side Medical Center—serving as liaison to a local doctor of physical therapy program, linking students with CIs, and sometimes taking on the instructional role himself. He greatly enjoys the opportunity, year in and year out, to share his passion for physical therapy with "the kids" as he calls them, facilitating their transition from "caterpillars to graceful butterflies."

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Resources

Ethics and Professionalism

  • Ethics documents (including the Code of Ethics for the Physical Therapist and Standards of Ethical Conduct for the Physical Therapist Assistant)
  • Ethical decision-making tools (past Ethics in Practice columns, categorized by ethical principle or standard; the Realm-Individual Process-Situation [RIPS] Model of Ethical Decision-Making; and opinions of APTA's Ethics and Judicial Committee)

February Ethics in Action 

  • "Ethical Decision Making: Terminology and Context"

 

Considerations and Ethical Decision-Making

License to practice is a privilege that is earned through hard work. It also is a responsibility that resides solely in the hands of the licensee. While Lydia may have authorized Tina to manage her license, that did not absolve her of her personal duty to do so.

Lydia has a responsibility to patients and staff to be licensed. Working without a license is illegal and must cease. It's important to note, too, that students must be supervised by a licensed practitioner.

Realm. The ethical realm here is organizational/institutional. Lydia is an administrator whose actions have implications for patients, staff, and the liability and reputation of the hospital.

Individual process. Lydia's unwillingness to take responsibility for her actions throughout this sequence of events betrays her lack of moral sensitivity.

Ethical situation. Lydia has exhibited moral silence from the start by not personally ensuring that her license remained current.

Ethical principles. The following principles of the Code of Ethics for the Physical Therapist provide guidance to how Lydia should have acted:

  • Principle 4B. Physical therapists shall not exploit persons over whom they have supervisory, evaluative, or other authority (e.g., patients/clients, students, supervisees, research participants, or employees).
  • Principle 5A. Physical therapists shall comply with applicable local, state, and federal laws and regulations.
  • Principle 7. Physical therapists shall promote organizational behaviors and business practices that benefit patients/clients and society.

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