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In ethical decision-making, as in using clinical judgment, physical therapists need to gather pertinent information and follow decision paths in order to reach their objectives. Ethical decision-making is complex, as the relationship between PTs and PTAs and their patients and clients doesn't occur in a bubble; it's affected by outside influences, such as the clinician’s facility and payment sources. The Realm-Individual Process-Situation model of ethical decision-making — often called the RIPS model — was developed to address the various influences on the clinician's decisions.

In the RIPS model, the context or "realm" is where the decision is made. The "individual process" comprises the elements of ethical behavior, including ethical decision making. And the "situation" is the specific scenario that demands moral action.

The original article describing the RIPS model appeared in the October 2005 issue of the Section on Health Policy and Administration's publication HPA Resource: "The Realm-Individual Process-Situation (RIPS) Model of Ethical Decision Making," by Laura Lee (Dolly) Swisher, PT, PhD, Linda Arslanian, PT, DPT, MS, and Carol Davis, PT, EdD, FAPTA.

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