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KNR 273: Ethics
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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
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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
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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)
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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
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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
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Personal Ethics Influenced By…
Faculty/mentors Internship supervisors Professional codes of ethics Textbooks & professional materials Colleagues Family & friends Religious & moral influences
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TR & Ethics
Most professions have 1 code of ethics
TR has how many? ATRA NTRS (previously) ITRS (perhaps other state
organizations) NCTRC
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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
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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
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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
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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
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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
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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
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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
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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)
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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
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Ethics & Confidentiality
Don’t make promises you can’t keep
Tell clients about times & conditions when information will be shared
Impact on professional relationship
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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?
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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?
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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