1 Ethics: Basic Principles of Health Care Ethics and its implications to Physical Therapy Practice

Basic Principles of Health Care Ethics and its as a physical therapist or an occupational 3. Presumed consent: therapeutic
implications to Physical Therapy Practice therapist, as the case issued by the Board of privilege, presume mon a papayag siya kasi
Morality Ethics Examiner for PT/OT. makakabuti sakanya.
Is what people Is the critical - Ethical daw pag nag paalam sa doctor niya. 4. Substitute decision maker:
believe to be right reflection about PURPOSE OF AN INFORMED CONSENT in cases with patient mental illness/
and good morality and the - Protect patient from unnecessary medical legal
rational analysis of it procedure 5. Educated consent: explain mo sakanya
INDIVIDUALITY SOCIETAL - Protect PT from consequence for failure to yung benefits lang.
comply with legal requirements WHO ARE AUTHORIZED TO GIVE CONSENT?
BASIC PRINCIPLES OF ETHICS - Requisites of an informed consent - Patient
1. Autonomy o Informed or an enlightened consent - Spouse
2. Beneficence o Given by patient voluntarily - Parents
3. Non-maleficence o Subject matter must be legal - Grandparents
4. Veracity - Elements: - Eldest sibling of right age
5. Justice o Presentation or disclosure - Minor if mature enough to
AUTONOMY o Understanding voluntariness - Court
- self-governance o Competence INSANTCES WHERE CONSENT IS NOT
Ethical Principles o Permission giving NECESSARY
• Informed consent Factors that makes and individual incapable of - Emergency
providing competent consent
• Therapeutic Privilege - Law made it compulsory to everyone to
- Mental illness or retardation
• Benevolent Deception submit to procedure
- Alcohol or drug intoxication
• Paternalism Implications to PT practice
- Altered mental status
• Fiduciary Relationship The ff should be clearly explained to pt.:
- Brain injury
- 3 basic elements
- Too young to make legal decisions • Evaluation
- RIGHT TO DECIDE
concerning health care, legally 18 y/o • WORLD MEDICAL ASSOCIATION
- ACT UPON THE DECISION DECLARTION OF HELSINKI
nakakapag decide.
- RESPECT INDIVIDUAL’S AUTONOMY o Ethical principles for medical research
TYPES OF INFORMED CONSENT:
RA 5680: PT/OT LAW 1. Mere/Ordinary Consent: parang mabilisan involving human subject
Section 12: inhibition against the practice of PT mol ang sinabi. Hindi niya pa gets yung THERAPEUTIC PRIVILIGE
and OT – no person shall practice or offer to whole intention mo. - Gagawin mo ‘to sakanya kasi makakabuti
practice physical therapy and occupational 2. Informed consent: dapat may elements sakanya e.
therapy in the Philippines as defined in this act, BENEVOLENT DECEPTION
without the prescription of a duly registered
- WHITE LIES
physician and a valid certificate of registration
2 Ethics: Basic Principles of Health Care Ethics and its implications to Physical Therapy Practice

PATERNALISM o Abortion
- Intentional limitation of autonomy of one • “Physical will apply measure for the SECURITY OF MEDICAL RECORDS
person over the other benefit of the sick” -Hippocratic Oath • 15 yrs daw yung records
- Considered justifiable: NON-MALIFICENCE • Risk management personnel should review
o The lie benefits the one lied to • Ethical Principles a record before being examined by pt/ pt
o The individual should want to be lied to o Principle of double effect/lesser evil representative
o Assuming equal circumstances ▪ “gawin mo, if the good outweighs the • Original medical record should not be
FIDUCIARY RELATIONSHIP harm. DO IT SO” permitted to be taken from hospital’s
- What is to be done when the patient o “I will never use treatment to injure or premises expect pursuant to a legal process
chooses a path away from health? wrong the sick.” -Hippocratic Oath or defined hospital procedure
- Does the patient have the right to be Beneficence Non-maleficence • Pt. and pt. representative are not allowed
wrong? to examine medical records alone
- It exists if: RESEARCH
o Competent individual
CONFIDENTIALITY - Research results should be presented while
VERACITY patient remains anonymous
• The patient has the right to expect that all
• Ethical Principle - Only those involved in the study will have
communications and records pertaining to
• (n.) truthfulness access to raw data
his care should be treated as confidential
o Placebo - Safeguard to protect patient’s privacy will
• Ethical Principle
▪ Practitioner must engage in non- be
o Legitimate Interest
disclosure and deception for the practice JUSTICE
o Research
work.
• CONFEDENTIALITY: LEGITIMATE INTEREST • An eye for an eye; a tooth for a tooth
▪ 2 groups: 1 group KT LANG, yung isang
o Pt/client right to quality PT services • Theories:
group, KT+analgesics!!!
o PT/client right to information o Egalitarian: health care models worth
RULES FOR PLACEBO THERAPY emulating is those in UK and Canada
o Pt/client right to informed
• Placebo with active agents that may have o WHO CAN ACCESS? ▪ Any deviation from absolute equality in
harmful side effects are not acceptable ▪ Pt distribution is UNJUST
• Placebos should not be given to pt. without ▪ Authorized representatives o Utilitarian: greatest good for greatest
their consent ▪ Attending physicians number
BENEFICENCE ▪ Hospital staff member ▪ Kung saan mas maraming tao, mas dun
• Ethical Principle ▪ Duly appointed quality care auditors yung madaming budget for health care (
• Weigh the “BENEFIT” promoting for the ▪ Governmental 3rd party payers for example lang)
welfare o Others who can access: o Libertarian: personal rights to social and
o DNR Order ▪ Insurance companies economic liberty
o Euthanasia HIPPA LEGISLATION (1996) ▪ Choice of allocation is freely chosen
3 Ethics: Basic Principles of Health Care Ethics and its implications to Physical Therapy Practice

▪Freedom to choose, yung mga

ROLE OF FIDELITY
• Ethical Principles
o Gate keeping
o Whistle blowing
o Scope of Practice
o Practitioner-pt sexual relationship

ASSIGNMENT: READ
STANDARDS OF PRACTICE THE PHYSICAL
THERAPY ASSOCIATION