¶ … Maryland PT/PTA Code of Ethics… Code of Ethics Review

Maryland Board of Physical Therapy Examiners Code of Ethics for Physical Therapists and Physical Therapy Assistants

Maryland Board of Physical Therapy Examiners Code of Ethics for Physical Therapists and Physical Therapy Assistants

This work will briefly review a sample code of ethics for the profession of physical therapy. The chosen sample code of ethics is a state adopted code of ethics for several reasons; one the code of ethics is focused on scope of standards rather than ideals, two the code demonstrates a realistic guideline on several important issues, and three it provides enforceable penalties. In comparison, on the second note above the American Physical Therapy Association Code of Ethics (APTA), which theoretically encompasses a national standard for all physical therapists is demonstrative of an expression of practice ideals, rather than on practicable standards of practice and offers no guidance for enforcement and/or penalties. (APTA, 2005) The Maryland example conversely offers standards with the assumption that the individual knows the practice parameters of his or her role as a physical therapist or physical therapy aide as a product of their education, licensure and experience. Though this may not always be the case the role of licensure procedures are assumed to have been met and therefore are assumed to be utilized by the individual. Conversely one can also assume that the APTA code of ethics is also utilized by the physical therapist and the physical therapist assistant because of the national nature of the organization and its recognized role as a standard bearer for the practice (Kirsch, 2010)

The work states a few essential practice rules regarding non-discrimination, patient treatment and/or intervention only in the best interest of the patient, patient confidentiality and provision of fees to patient upon request. The code also briefly identifies the obligation of physical therapists to report when a colleague is practicing unsafely or when his or her own license from another state is suspended or limited. The work then goes on to address the manner in which the physical therapist must conduct him or herself with regard to legal standards of investigation and enforcement by the Board of Physical Therapy Examiners, provides a lengthy and comprehensive list defining sexual misconduct on the part of the physical therapist or physical therapists assistant and then finally describes the penalties for conduct violations.

Clarity of Goals

The goals of the Maryland code of ethics sample are clear, to address the scope of responsibilities of the Physical Therapist or Assistant within the confines of the Maryland law to retain licensure. The work is relatively short in comparison to other state codes of ethics but clearly demonstrates a succinct and comprehensive description of the ethical/legal ramifications of practice and/or violation of legal practice. The work does not have a lengthy list of ideal ethical principles and/or define circumstances that are within the scope of practice of physical therapy but instead limits itself to describing concepts that are outside the scope of ethical practice.

Clearly the Maryland example demonstrates a comprehensive view of sexual misconduct. Given the very physical nature of the interactions between physical therapists and assistants with clients this could clearly be a situation of important consideration in need of intense definitions. The work describes and defines sexual misconduct in a way that is both specific and detailed leaving almost no page unturned in the possibility of patient, colleague, student and/or other health care professional involved sexual misconduct, which includes both physical and verbal interactions and in particular completely eliminates patients as possible sexual/intimate partners, if relationship is initiated by the physical therapist. Though it is likely questionable if the scope of this sexual misconduct definition could be fully enforces, especially given that even consensual relationships are excluded, again if initiated by the physical therapist or assistant but it does offer the state reasonable grounds for both referral, investigation and possible license censure if misconduct is suspected. The importance of this is that the state has a legal ground to stand on with regard to a whole host of possible unprofessional behaviors on the part of the physical therapist and if it is found that the individual is doing harm or is perceived to be doing harm within the confines of his or her professional practice the action can be sanctioned.

Identified Ethical Principles

Ethical principles are not openly and clearly defined but are implied within the content of the work. The code defines those things which are outside of professional, i.e. discriminatory practices in treatment, treatment outside the patients best interest, questionable billing, record keeping and/or treatment practices, failure to report misconduct of others, obstruction of investigations by the board or other civil or criminal entity as well as sexual impropriety within the confines of...

The ethical principles applied here are nondiscrimination, professionalism, core service quality issues and practicing within the confines of the limits of the license of the individual.
Grievance Procedures

There seems to be no mention of the right of the physical therapist of assistant to file grievance procedures regarding sanctions and/or actions of the licensing board. Additionally, the code does not outline the procedure for filing grievance against a colleague or other. The board also does not specify the procedure for itself filing grievance against a licensed physical therapist or assistant. These grievance procedures are likely absent because they are present in another document associated with code enforcement given that the entity is a state board and is highly regulated by legal precedence and other issues written into state documents, constitutions, license requirements and/or charters for licensed service provision. It is likely that the Maryland Board of Physical Therapy Examiners would prefer that an individual contact the Board directly with concerns so an individual there can determine if grievance procedures need to be followed through on the part of any entity.

Feasibility of Enforcement and Recommendations

As was stated previously there is a sense that the very comprehensive definition of sexual misconduct could be difficult to enforce but otherwise the document offers the state a good fundamental basis for investigating and enforcing the rules and codes within it. This work would likely be strengthened by the inclusion of at least a few practice guidelines, limited to practice location and/or other licensure issues. The section on sexual misconduct might also be in need of review, with the intent of eliminating consensual relationships as examples of sexual misconduct. The code could also be stronger if the ethical principles were more clearly defined and if such principles served as the heading on subsections of the code. Without the inclusion of the above recommendations the work has a tendency to imply that the core principles are first generic and then directed by near exclusive treatment of sexual misconduct as the most important challenge to the ethics of physical therapists and physical therapy assistants.