1. KNR 273: Ethics

2. 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

3. 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

4. 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)

5. 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

6. 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

7. Personal Ethics Influenced By…  Faculty/mentors  Internship supervisors  Professional codes of ethics  Textbooks & professional materials  Colleagues  Family & friends  Religious & moral influences

8. TR & Ethics  Most professions have 1 code of ethics  TR has how many? ATRA NTRS (previously) ITRS (perhaps other state organizations) NCTRC

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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)

17. 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 3 rd party Court orders

18. Ethics & Confidentiality  Don’t make promises you can’t keep  Tell clients about times & conditions when information will be shared  Impact on professional relationship

19. 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?

20. 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?

21. 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