Code of Ethics
Adopted by the House of
Delegates American Physical Therapy Association |
American Physical Therapy Association
Purpose
This Guide for Professional Conduct
(Guide) is intended to serve physical ther apists who are members
of the American Physical Therapy Association (Associa tion) in
interpreting the Code of Ethics (Code) and matters of professional
con duct. The Guide provides guidelines by which physical therapists
may determine the propriety of their conduct. The Code and the
Guide apply to all physical thera pists who are Association members.
These guidelines are subject to changes as the dynamics of the
profession change and as new patterns of health care deliv ery
are developed and accepted by the professional community and the
public. This Guide is subject to monitoring and timely revision
by the Judicial Committee of the Association.
Interpreting Ethical Principles
The interpretations expressed in this Guide are not to be considered
all inclu sive of situations that could evolve under a specific
principle of the Code but reflect the opinions, decisions, and
advice of the Judicial Committee. While the statements of ethical
principles apply universally, spe cific circumstances determine
their appropriate application. Input related to current interpretations,
or situations requiring interpretation, is encouraged from Association
members.
Principle 1
Physical therapists respect the rights and dignity of all
individuals.
1.1 Attitudes of Physical Therapists
A. Physical therapists shall recognize that each individual is
different from all other individuals and shall respect and be
responsive to those differences.
B. Physical therapists are to be guided at all times by concern
for the physical, psychological, and socioeconomic welfare of
those individuals entrusted to their care.
C. Physical therapists shall not engage in conduct that constitutes
harassment or abuse of, or discrimination against, col leagues,
associates, or others.
1.2 Confidential Information
A. Information relating to the physical therapist-patient relationship
is confiden tial and may not be communicated to a third party
not involved in that patient's care without the prior written
consent of the patient, subject to applicable law.
B. Information derived from component sponsored peer review shall
be held con fidential by the reviewer unless written permission
to release the information is obtained from the physical therapist
who was reviewed.
C. Information derived from the working relationships of physical
therapists shall be held confidential by all parties.
D. Information may be disclosed to appropriate authorities when
it is neces sary to protect the welfare of an individual or the
community. Such disclosure shall be in accordance with applicable
law.
1.3 Patient Relations
Physical therapists shall not engage in any sexual relationship
or activity, whether consensual or nonconsensual, with any patient
while a physical therapisVpatient relationship exists.
1.4 Informed Consent
Physical therapists shall obtain patient informed consent before
treatment, to include disclosure of: (i) the nature of the proposed
intervention; (ii) material risks of harm or complications; (iii)
reasonable alternatives to the proposed intervention; and (iv)
goals of treatment.
Principle 2
Physical therapists comply with the laws and regulations
governing the practice of physical therapy.
2.1 Professional Practice
Physical therapists shall provide consultation, evaluation, treatment,
and preventive care, in accordance with the laws and regulations
of the jurisdiction(s) in which they practice.
Principle 3
Physical therapists accept responsibility for the exercise
of sound judgment.
3.1 Acceptance of Responsibility
A. Upon accepting an individual for provision of physical therapy
services, physical therapists shall assume the responsibility
for evaluating that individual; planning, implementing, and supervising
the therapeutic program; reevaluating and changing that program;
and maintaining adequate records of the case, including progress
reports.
B. When the individual's needs are beyond the scope of the physical
therapist's expertise, or when additional services are indicated,
the individual shall be so informed and assisted in identifying
a qualified provider.
C. Regardless of practice setting, physical therapists shall maintain
the ability to make independent judgments.
D. The physical therapist shall not provide physical therapy services
to a patient while under the influence of a substance that impairs
his or her ability to do so safely.
3.2 Delegation of Responsibility
A. Physical therapists shall not delegate to a less qualified
person any activity which requires the unique skill, knowledge,
and judgment of the physical therapist.
B. The primary responsibility for physical therapy care rendered
by supportive personnel rests with the supervising physical therapist.
Adequate supervision requires, at a minimum, that a supervising
physical therapist perform the following activities:
1. Designate or establish channels of written and oral communication.
2. Interpret available information concerning the individual under
care.
3. Provide initial evaluation.
4. Develop plan of care, including shortand long-term goals.
5. Select and delegate appropriate tasks of plan of care.
6. Assess competence of supportive personnel to perform assigned
tasks.
7. Direct and supervise supportive personnel in delegated tasks.
8. Identify and document precautions, special problems, contraindications,
goals, anticipated progress, and plans for reevaluation.
9. Reevaluate, adjust plan of care when necessary, perform final
evaluation, and establish follow-up plan.
3.3 Provision of Services
A. Physical therapists shall recognize the individual's freedom
of choice in selection of physical therapy services.
B. Physical therapists' professional practices and their adherence
to ethical principles of the Association shall take preference
over business practices. Provisions of services for personal financial
gain rather than for the need of the individual receiving the
services are unethical.
C. When physical therapists judge that an individual will no longer
benefit from their services, they shall so inform the individual
receiving the services. Physical therapists shall avoid overutilization
of their services.
D. In the event of elective termination of a physical therapisVpatient
relationship by the physical therapist, the therapist should take
steps to transfer the care of the patient, as appropriate, to
another provider.
3.4 Referral Relationships
In a referral situation where the referring practitioner prescribes
a treatment program, alteration of that program or extension of
physical therapy services beyond that program should be undertaken
in consultation with the referring practitioner.
3.5 Practice Arrangements
A. Participation in a business, partnership, corporation, or other
entity does not exempt the physical therapist, whether employer,
partner, or stockholder, either individually or collectively,
from the obligation of promoting and maintaining the ethical principles
of the Association.
B. Physical therapists shall advise their employer(s) of any employer
practice which causes a physical therapist to be in conflict with
the ethical principles of the Association. Physical therapist
employees shall attempt to rectify aspects of their employment
which are in conflict with the ethical principles of the Association.
Principle 4
Physical therapists maintain and promote high standards
for physical therapy practice, education, and research.
4.1 Continued Education
A. Physical therapists shall participate in educational activities
which enhance their basic knowledge and provide new knowledge.
B. Whenever physical therapists provide continuing education,
they shall ensure that course content, objectives, and responsibilities
of the instructional faculty are accurately reflected in the promotion
of the course.
4.2 Review and Self Assessment
A. Physical therapists shall provide for utilization review of
their services.
B. Physical therapists shall demonstrate their commitment to quality
assurance by peer review and self assessment.
4.3 Research
A. Physical therapists shall support research activities that
contribute knowledge for improved patient care.
B. Physical therapists engaged in research shall ensure:
1. the consent of subjects;
2. confidentiality of the data on individual subjects and the
personal identities of the subjects;
3. well-being of all subjects in compliance with facility regulations
and laws of the jurisdiction in which the research is conducted;
4. the absence of fraud and plagiarism;
5. full disclosure of support received;
6. appropriate acknowledgment of individuals making a contribution
to the research.
7. that animal subjects used in research are treated humanely
and in compliance with facility regulations and laws of the jurisdiction
in which the research experimentation is conducted.
C. Physical therapists shall report to appropriate authorities
any acts in the conduct or presentation of research that appear
unethical or illegal.
4.4 Education
A. Physical therapists shall support quality education in academic
and clinical settings.
B. Physical therapists functioning in the educational role are
responsible to the students, the academic institutions and the
clinical settings for promoting ethical conduct in educational
activities. Whenever possible, the educator shall ensure:
1. the rights of students in the academic and clinical setting;
2. appropriate confidentiality of personal information;
3. professional conduct towards the student during the academic
and clinical educational processes;
4. assignment to clinical settings prepared to give the student
a learning expenence.
C. Clinical educators are responsible for reporting to the academic
program student conduct which appears to be unethical or illegal.
Principle 5
Physical therapists seek remuneration for their services
that is deserved and reasonable.
5.1 Fiscally Sound Remuneration
A. Physical therapists shall never place their own financial interest
above the welfare of individuals under their care.
B. Fees for physical therapy services should be reasonable for
the service performed, considering the setting in which it is
provided, practice costs in the geographic area, judgment of other
organizations and other relevant factors.
C. Physical therapists should attempt to ensure that providers,
agencies, or other employers adopt physical therapy fee schedules
that are reasonable and that encourage access to necessary services.
5.2 Business Practices/Fee Arrangements
A. Physical therapists shall not:
1. directly or indirectly request, receive, or participate in
the dividing, transferring, assigning, rebating of an unearned
fee.
2. profit by means of a credit or other valuable consideration,
such as an unearned commission, discount, or gratuity in connection
with furnishing of physical therapy services.
B. Unless laws impose restrictions to the contrary, physical therapists
who provide physical therapy services in a business entity may
pool fees and moneys received. Physical therapists may divide
or apportion these fees and moneys in accordance with the business
agreement.
C. Physical therapists may enter into agreements with organizations
to provide physical therapy services if such agreements do not
violate the ethical principles of the Association.
5.3 Endorsement of Equipment or Services
A. Physical therapists shall not use influence upon individuals
under their care or their families for utilization of equipment
or services based upon the direct or indirect financial interest
of the physical therapist in such equipment or services. Realizing
that these individuals will normally rely on the physical therapists'
advice, their best interest must always be maintained as well
as their right of free choice relating to the use of any equipment
or service. While it cannot be considered unethical for physical
therapists to own or have a financial interest in equipment companies,
or services, they must act in accordance with law and make full
disclosure of their interest whenever such companies or services
become the source of equipment or services for individuals under
their care.
B. Physical therapists may be remunerated for endorsement or advertisement
of equipment or services to the lay public, physical therapists,
or other health professionals provided they disclose any financial
interest in the production, sale, or distribution of said equipment
or services.
C. In endorsing or adverting equipment or services, physical therapists
shall use sound professional judgment and shall not give the appearance
of Association endorsement.
5.4 Gifts and Other Considerations
A. Physical therapists shall not accept nor offer gifts or other
considerations with obligatory conditions attached.
B. Physical therapists shall not accept nor offer gifts or other
considerations that affect or give an objective appearance of
affecting their professional judgment.
Principle 6
Physical therapists provide accurate information to the consumer
about the profession and about those services they provide.
6.1 Information about the Profession
Physical therapists shall endeavor to educate the public to an
awareness of the physical therapy profession through such means
as publication of articles and participation in seminars, lectures,
and civic programs.
6.2 Information about Services
A. Information given to the public shall emphasize that individual
problems cannot be treated without individualized evaluation and
plans/programs of care.
B. Physical therapists may advertise their services to the public.
C. Physical therapists shall not use, or participate in the use
of, any form of communication containing a false, plagiarized
fraudulent, misleading, deceptive, unfair, or sensational statement
or claim.
D. A paid advertisement shall be identified as such unless it
is apparent from the context that it is a paid advertisement.
Principle 7
Physical therapists accept the responsibility to protect the
public and the profession from unethical, incompetent, or illegal
acts.
7.1 Consumer Protection
A. Physical therapists shall report any conduct which appears
to be unethical, incompetent, or illegal.
B. Physical therapists may not participate m any arrangements
in which patients are exploited due to the referring sources enhancing
their personal incomes as a result of referring for, prescribing,
or recommending physical therapy.
7.2 Disclosure
The physical therapist shall disclose to the patient if the referring
practitioner derives compensation from the provision of physical
therapy. The physical therapist shall ensure that the individual
has freedom of choice in selecting a provider of physical therapy.
Principle 8
Physical therapists participate in efforts to address the health
needs of the public.
8.1 Pro Bono Service
Physical therapists should render pro bono publico (reduced or
no fee) services to patients lacking the ability to pay for services,
as each physical therapist's practice permits.
Issued by Judicial Committee
American Physical Therapy Association
October 1981
Last Amended January 1997
American Physical Therapy
Association Standards of Ethical Conduct
|
PURPOSE
This Guide for Conduct of the Affiliate Member (Guide)
is intended to serve physical therapist assistants who are affiliate
members of the American Physical Therapy Association in the interpretation
of the Standards of Ethical Conduct for the Physical Therapist
Assistant, providing guidelines by which they may determine
the propriety of their conduct. These guidelines are subject to
change as new patterns of health care delivery are developed and
accepted by the professional community and the public. This Guide
is subject to monitoring and timely revision by the Judicial Committee
of the Association.
INTERPRETING STANDARDS
The interpretations expressed in this Guide are not to be considered
all inclusive of situations that could evolve under a specil'ic
standard of the Standards of Ethical Conduct for the Physical
Therapist Assistant, but reflect the opinions, decisions,
and advice of the Judicial Committee. Although the statements
of ethical standards apply universally specific circumstances
determine their appropriate application. Input related to current
interpretations or to situations requiring interpretation is encouraged
from Association members.
STANDARD 1
Physical therapist assistants provide services under the supervision
of a physical therapist.
1.1 Supervisory Relationships
Physical therapist assistants shall work under the supervision
and direction of a physical therapist who is properly credentialed
in the jurisdiction in which the physical therapist assistant
works.
1.2 Performance of Service
A. Physical therapist assistants may not initiate or alter a treatment
program without prior evaluation by and approval of the supervising
physical therapist.
B. Physical therapist assistants may modify a specific treatment
procedure in accordance with changes in patient status.
C. Physical therapist assistants may not interpret data beyond
the scope of their physical therapist assistant education.
D. Physical therapist assistants may respond to inquiries regarding
patient status to appropriate parties within the protocol established
by a supervising physical therapist.
F. Physical therapist assistants shall refer inquiries regarding
patient prognosis to a supervising physical therapist.
STANDARD 2
Physical therapist assistants respect the rights and dignity
of all individuals.
2.1 Attitudes oF Physical Therapist Assistants
A. Physical therapist assistants shall recognize that each individual
is different from all other individuals and shall respect and
be responsive to those differences.
B. Physical therapist assistants shall be guided at all times
by concern for the dignity and welfare of those patients entrusted
to their care.
C. Physical therapist assistants shall not engage in conduct that
constitutes harassment or abuse of, or discrimination against,
colleagues, associates, or others.
2.2 Request for Release of Information
Physical therapist assistants shall refer all requests for release
of confidential information to the supervising physical therapist.
2.3 Protection of Privacy
Physical therapist assistants must treat as confidential all information
relating to the personal conditions and affairs of the persons
whom they serve.
2.4 Patient Relations
Physical therapist assistants shall not engage in any sexual relationship
or activity. whether consensual or nonconsensual, with any patient
while a physical therapist assistant/ patient relationship exists.
STANDARD 3
Physical therapist assistants maintain and promote high standards
in the provision of services, giving the welfare of patients their
highest regard.
3.1 Information About Services
A. Physical therapist assistants may provide consumers with information
regarding provision of services within the protocol established
by a supervising physical therapist.
B. Physical therapist assistants may not use, or participate in
the use of. any form of communication containing a false, fraudulent,
misleading, deceptive, unfair, or sensational statement or claim.
3.2 Organizational Employment
Physical therapist assistants shall advise their employer(s) of
any employer practice that causes them to be in conflict with
the Standards of Ethical Conduct for the Physical Therapist Assistant.
3.3 Endorsement of Equipment
Physical therapist assistants may not endorse equipment or exercise
influence on patients or families to purchase or lease equipment
except as directed by a physical therapist acting in accord with
the stipulation in paragraph 5.3.A. of the Guide for Professional
Conduct.
3.4 Financial Considerations
Physical therapist assistants shall never place their own financial
interest above the welfare of their patients.
3.5 Exploitation of Patients
Physical therapist assistants shall not participate in any arrangements
in which patients are exploited. Such arrangements include situations
in which referring sources enhance their personal incomes as a
result of referring for, delegating, prescribing, or recommending
physical therapy services.
STANDARD 4
Physical therapist assistants provide services within the limits
of the law.
4.1 Supervisory Relalionships
Physical therapist assistants shall cmnply with all aspects of
law. Regardless of the content of any law, physical therapist
assistants shall provide services only under the supervision and
direction of a physical therapist who is properly credentialed
in the jurisdiction in which the physical therapist assistant
works.
4.2 Representation
Physical therapist assistants shall not hold themselves out as
physical therapists.
STANDARD 5
Physical therapist assistants make those judgments that
are commensurate with their qualifications as physical therapist
assistants.
5.1 Patient Treatment
Physical therapist assistants shall report all untoward patient
responses to a supervising physical therapist.
5.2 Patient Safety
A. Physical therapist assistants may refuse to carry out treatment
procedures that they believe to be not in the best interest of
the patient.
B. The physical therapist assistant shall not provide physical
therapy services to a patient while under the influence of a substance
that impairs his or her ability to do so safely.
5.3 Qualifications
Physical therapist assistants may not carry out any procedure
that they are not qualified to provide.
5.4 Discontinuance of Treatment Program
Physical therapist assistants shall discontinue immediately any
treatment procedures which in their judgment appear to be harmful
to the patient.
5.5 Continued Education
Physical therapist assistants shall continue participation in
various types of educational activities which enhance their skills
and knowledge and provide new skills and knowledge.
STANDARD 6
Physical therapist assistants accept the responsibility to
protect the public and the profession from unethical, incompetent,
or illegal acts.
6.1 Consumer Protection
Physical therapist assistants shall report any conduct which appears
to be unethical or illegal.
Issued by the Judicial Committee
of the
American Physical Therapy Association
October 1981
Last Amended January 1996