APTA's revised Code of Ethics for the Physical Therapist and Standards of Practice for the Physical Therapist Assistant went into effect July 1, 2010. Here are answers to some frequently asked questions about the revisions to the Code and Standards.
What were the central considerations behind amending the Code and Standards?
In mid-2006, the Ethics and Judicial Committee (EJC or Committee) recommended to the APTA Board of Directors that it consider including in the 2007 budget a task force of internal and external stakeholders to develop new core ethics documents reflective of elements outlined in Vision 2020. The EJC's report explained that it had engaged in a critical evaluation of the current core documents with a focus on their ability to guide the autonomous practice of a doctoring profession. As part of this evaluation, the EJC concluded that the core documents were inadequate in that they did not:
(i) address the roles of a physical therapist (PT) as an educator, critical inquirer, consultant, and administrator, focusing instead almost entirely on the patient-client management role;
(ii) provide guidance for the expanded responsibilities of the PT related to autonomous practice;
(iii) address the complexities encountered in the contemporary health care environment;
(iv) capture adequately a contemporary notion of the relationship of the PT and the physical therapist assistant (PTA) to other health care providers; and
(v) articulate a moral self-understanding that is unique to the profession of physical therapy.
What process was undertaken to create the new Code/Standards?
The EJC recommended that a task force be created to revise the Code and Standards, with the recommendation that the task force enlist the assistance of an outside consultant with expertise in professional ethics. The Committee suggested that the task force include representatives from various groups (e.g., PT and PTA leaders and practitioners from a variety of practice settings, emerging leaders, students, regulators, consumers, and current/former EJC members).
What are some significant features of the new Code and Standards?
The new Code and Standards extend beyond the former 11 basic principles to clarify intent, meaning, and application of foundational principles. Moreover, the Principles/Standards are no longer general; they are now specific.
The new Principles/Standards can be divided into the following categories:
- Principle/Standard 1: Duty to all individuals
- Principle/Standard 2: Duty to patients/clients
- Principle/Standard 3: Accountability for sound judgments
- Principle/Standard 4: Integrity in relationships
- Principle/Standard 5: Fulfilling legal and professional obligations
- Principle/Standard 6: Lifelong acquisition of knowledge, skills, and abilities
- Principle/Standard 7: Organizational behaviors and business practices
- Principle/Standard 8: Meeting health needs of people
Will the new Code and Standards replace the Guide for Professional Conduct and Guide for Conduct of the PTA?
No. However, in light of the recent detailed amendments to the new Code and Standards, the Ethics and Judicial Committee significantly amended the Guide for Professional Conduct and Guide for Conduct of the Physical Therapist Assistant. The amended Guides are currently in effect.
Do the new Code and Standards apply to all PTs/PTAs?
Yes. The Preamble to the Code states that the Code of Ethics "delineates the ethical obligations of all physical therapists." The Preamble to the Standards states that the Standards of Ethical Conduct for the Physical Therapist Assistant "delineate the ethical obligations of all physical therapist assistants."
Are all the lettered Principles/Standards set forth in the new Code and Standards ethical obligations?
Yes. All the Principles/Standards, both numbered and lettered, contain the word "shall" and are mandatory ethical obligations.
Since all the Principles/Standards contain the word "shall" does that mean that I am more likely to be sanctioned for an ethical violation under the new Code and Standards than I would have been under the old Code and Standards?
Absolutely Not. You are not more likely to be sanctioned for violating an ethical obligation under the new Code and Standards. The reason you are not is because the language contained in the new Code and Standards is intended to provide greater clarification of existing ethical obligations. These ethical obligations predate the new Code and Standards. Although various words have changed, the obligations are the same. Consequently, the addition of the word "shall" serves to reinforce and clarify existing ethical obligations. As stated above, the new Code and Standards "extend beyond the former 11 basic principles to clarify intent, meaning, and application of foundational principles." Moreover, a significant reason why the Code and Standards were revised was to provide PTs/PTAs with a Code and Standards that were clear enough such that PTs/PTAs can read these documents standing alone without the need to seek extensive additional interpretation. The goal was to better explain and further clarify ethical obligations that existed before the Code and Standards were revised.
If something is not written in the Code and Standards does that mean that it is not an ethical obligation?
No. In the Preamble to the Code it states that "no Code of Ethics is exhaustive nor can it address every situation." In the Preamble to the Standards it states that "no document that delineates ethical standards can address every situation." Moreover, both the Code and Standard state that PTs/PTAs "are encouraged to seek additional advice or consultation in instances where the guidance of the Code and Standards may not be definitive." When considering where to seek advice or consultation, you may review the myriad of resources available on the APTA Web site. These resources are available to assist you with your ethical decision making process. Inherent in your ethical decision making process is an examination of your unique set of facts relative in the Code/Standards.
Are there tools/resources available to assist PTs/PTAs in understanding their ethical obligations?
Yes. These FAQs can assist PTs/PTAs in understanding the Code and Standards. In addition, resources already exist that can assist you in making determinations about ethical obligations in clinical practice. These resources include several EJC Opinions and several "Ethics in Action" articles, authored by Nancy R. Kirsch, PT, DPT, PhD. The "Ethics in Action" articles, soon to be titled "Ethics in Practice," present a model for ethical decision-making and then apply this model to situations in clinical practice.