KNR 273: Ethics

What are ethics?

Statements of what is right or wrong, which usually are presented as systems of valued behaviors & beliefs

Serve the purpose of governing conduct Jacobson & James, 2001

What are ethics?

Involves study of what is morally good & bad, right & wrong regarding human behavior Sylvester, Voelkl, & Ellis, 2001

Standards of behavior Govern conduct How you should act or behave

Clinical Ethics

Clinical ethics is defined as the systematic identification, analysis, and resolution of ethical problems associated with the care of particular patients.

The concern is with moral dilemmas that confront all health care professionals. (ATRA, 1998)

Code of Ethics

Written list of values & standards of conduct of a group

Framework for decision-making Are normally general statements Do not give specific answers to

every possible dilemma that might arise

Professional Ethics

System of conduct to guide the practice of a specific discipline

Applied ethics Professional & societal expectations

that those who practice TR have a duty to practice, behave & act in an ethical manner

Personal Ethics Influenced By…

Faculty/mentors Internship supervisors Professional codes of ethics Textbooks & professional materials Colleagues Family & friends Religious & moral influences

TR & Ethics

Most professions have 1 code of ethics

TR has how many? ATRA NTRS (previously) ITRS (perhaps other state

organizations) NCTRC

TR & Ethics

ATRA code does not have enforcement procedures

CTRS’ violation of professional ethics can be sanctioned by NCTRC Misconduct standard Gross or repeated violations Suspension Revocation of certification

ATRA Code of Ethics (2009)

Principle 1 & 2 both deal with protecting from harm

Principle 1:Beneficence Practitioners maximize benefits to the client and

minimize possible harm. Taking action to remove from harm

Principle 2: Non-Maleficience Use knowledge, skills, abilities & judgments to

help persons while respecting their decisions & protecting them from harm

Not inflicting harm

ATRA Code of Ethics (2009)

Principle 3:Autonomy Respect the individual's right of

CHOICE. Respect the decisions of legally

appointed guardians / advocates if client is incapacitated

ATRA Code of Ethics (2009)

Principle 4:Justice Access to services must be available to all. There

must be fairness in distribution of service based on individual need.

Consider race, creed, orientation, gender, etc.

Principle 5:Fidelity Tell the truth, the whole truth and nothing but

the truth. Do what you say you are going to do. Meet commitments Secondary obligation is to colleagues, agency, &

professions

ATRA Code of Ethics (2009)

Principle 6: Veracity Should be truthful and honest Deception, by being dishonest or

omitting what is true should be avoided

ATRA Code of Ethics (2009)

Principle 7: Informed Consent Services should be based on mutual respect and

shared decision making Provide information about service, benefits,

outcomes, length of treatment, expected activities, & limitations

Provide information about professional’s training & credentials

Information provides so person can decide to accept treatment

ATRA Code of Ethics (2009)

Principle 8:Confidentiality and Privacy Always respect people's privacy and always be

confidential with regard to patient care.

Principle 9:Competence Continually take steps to attain, maintain, and

expand your competence in Therapeutic Recreation practice.

Demonstrate current competence Maintain credential

ATRA Code of Ethics (2009)

Principle 10:Compliance with Laws and Regulations Know the laws governing the profession

and the population served. E.g. The Rehabilitation Act of 1973 ADA IDEA OSHA Patient Bill of Rights (by end of 1999)

Ethics & Confidentiality

Assume all information is confidential & may not be shared

Unless Specific permission is obtained

Or Clients pose danger to selves Clients request release of information

to 3rd party Court orders

Ethics & Confidentiality

Don’t make promises you can’t keep

Tell clients about times & conditions when information will be shared

Impact on professional relationship

Decision-Making Model for Ethical Situations

Step One: Identify the Behavior What is the behavior, action, or decision at

question?

Step Two: Determine Professional Relevance Does this pertain to the TRS professional role?

Step Three: Differentiate Personal and/or Professional Ideals and Values How are my personal values influencing my

professional judgment?

Decision-Making Model for Ethical Situations

Step Four: Consider Legal Duties Is there any law or judicial violation involved in

this dilemma?

Step Five: Assess Ethical Obligations Is there a behavior in this dilemma that

violates an ATRA Code of Ethics Principle?

Step Six: Define Action What do I do next?

What should we do?

Include code of ethics in each staff’s/volunteer’s/intern’s orientation & in-service training

Document code of ethics in written plans of operation

Discuss ethical situations in staff meetings

Attend conference sessions on ethics