Do occupational therapists face ethical issues in adult rehabilitation settings?
Feb 25, 2021 · In the article, the researchers state that common ethical issues include “ineffective treatment, unethical/incompetent colleagues, priorities in treatment, causing pain and discomfort, treating patients despite refusal, and misleading the patient and confidentiality.”. The researchers focused their article on how occupational therapists can complete discharge …
Are there ethical issues in rehabilitation care?
To characterize the array of clinical ethical issues in occupational therapy, we asked OTs in a free-standing academic rehabilitation hospital to describe in some detail up to three scenarios or situations from their clinical practice that raised morally troubling questions. A coding system was developed to preserve the richness of the detail ...
Why conduct ethics research in occupational therapists?
with ethical issues include an inherent affective component in the form of moral distress and a strong sense of caring. The impact of systemic/organizational and relational forces is a reality that contemporary occupational therapists must negotiate in order to provide occupation-based and ethical practice.
How does the rehabilitation practice context impact Occupational Behavior?
Dec 22, 2018 · Occupational therapy in the acute inpatient rehab setting requires a lot of patience, empathy, thinking on your feet, time management, the ability to grade tasks and activities to fit many different needs, communication skills, as well as a deep understanding of how a disease or diagnosis may impact one’s occupational performance.
What are ethical dilemmas in occupational therapy?
In the article, the researchers state that common ethical issues include “ineffective treatment, unethical/incompetent colleagues, priorities in treatment, causing pain and discomfort, treating patients despite refusal, and misleading the patient and confidentiality.”Feb 25, 2021
What are some of the ethical concerns with rehabilitation?
Members of the Association of Rehabilitation Nurses (ARN) have identified several ethical issues that are of concern to those practicing rehabilitation nursing, including the following:Patients' rights, including the rights of minors. ... The use of restraints.Do-not-resuscitate orders.More items...
What are factors that challenge your ability to practice ethically occupational therapy?
Seven primary themes were identified which highlighted ethical tensions: resource and systemic issues, upholding ethical principles, client safety, working with vulnerable clients, interpersonal conflicts, upholding professional standards and practice management.
What are some current issues facing the occupational therapy profession?
The challenges facing occupational therapists include proving our value in an economic trend of downsizing, competing within the medical profession, developing and affiliating with new payer sources, and reengineering our careers to meet the needs of the new, nontraditional health care marketplace.
What are ethical issues Name different ethical issues?
Ethical Issues in BusinessHarassment and Discrimination in the Workplace. ... Health and Safety in the Workplace. ... Whistleblowing or Social Media Rants. ... Ethics in Accounting Practices. ... Nondisclosure and Corporate Espionage. ... Technology and Privacy Practices.Feb 19, 2020
What is ethics in rehabilitation?
Ethics in physiotherapy can be defined as the moral code of conduct that defines the relationship between the therapist and her patient or client, and the therapist and other healthcare professionals based on mutual respect and trust.
Why is ethics important in occupational therapy?
The first principle of occupational therapy ethics calls for concern for the safety and well-being of individuals who receive therapeutic services. For instance, occupational therapists must provide appropriate evaluations and intervention plans for their clients, specifically to meet their individual needs.May 24, 2018
Why there is a need for professional and ethical standards within occupational therapy?
Maintaining these standards will enable the occupational therapists to be safe, effective and ethical practitioners providing a high-quality and inclusive service. They will also help members to meet the registration requirements of their regulatory body - the Health and Care Professions Council.
What is a complex ethical dilemma?
An ethical dilemma is a situation or problem facing an individual that involves complex and often conflicting principles of ethical behavior. Ethical dilemmas. Situations in which there is a choice to be made between two options, neither of which resolves the situation in an ethically acceptable fashion.
Why is occupational therapy overlooked?
How OT is considered less important than PT. Occupational Therapy is also overlooked by medical professionals because OT focuses on activities that appear less important. For instance, self-care activities such as dressing, personal hygiene, and bathing may appear less important than walking (PT).Jun 23, 2021
Why is it important to advocate for occupational therapy?
The role of advocacy for occupational therapists is to share the distinct value of occupational therapy, speak out to achieve reform in healthcare policies, and help patients receive needed services when they encounter obstacles.
What are the benefits of being an occupational therapist?
Benefits generally include medical, dental, life, and vision insurance as well as vacation, sick leave, and retirement plans. Occupational Therapists who are self-employed must provide for their own benefits and retirement.
What is the right to refuse treatment?
Respect for patient autonomy during rehabilitation includes the right to refuse treatment. Occasionally this can present the physiatrist with an ethical dilemma, as illustrated in an article published in 1989 documenting the case of a C3 quadriplegic admitted to a rehabilitation unit who decided that he preferred to die rather than live as a quadriplegic. 9,10 Thus, an ethical conflict arises due to the patient refusing nutrition while the rehabilitation team is aware that there may be a clinical improvement over a period of weeks or months. Therefore, it is incumbent on the physician and rehabilitation staff to discuss these factors with the patient and family so that they can make decisions regarding future quality of life with a realistic perspective. When refusal of treatment has potentially dire or even fatal implications, immediate referral for bioethics and legal consultation is indicated.
What is a physiatrist?
Physiatrists are rehabilitation specialists trained to care for patients with complex medical conditions, including brain injury, neuromuscular disorders, spinal cord injury, musculoskeletal injuries, pain syndromes and cardiopulmonary disorders. As the leader of an interdisciplinary team, physiatrists are accustomed to actively engaging multiple clinicians simultaneously and empowering patients in key decision-making processes. Because this unique paradigm is not typically employed in other areas of medicine, it is imperative that physiatrists have a firm understanding of the possible ethical scenarios they may encounter. This article will provide an overview of bioethical principles and how they are applied within the field of physical medicine and rehabilitation.
What is Whyte 14?
Whyte 14 has explored some of the ethical ramifications of rehabilitation research as illustrated by efficacy studies. The concept of clinical equipoise is central to such research, meaning that there is a real uncertainty about whether or not a treatment is beneficial. The three concepts of autonomy, beneficence, and justice, as enumerated by Blustein 1 need to be scrupulously observed. Selection bias in the choice of subjects and selective use of inappropriate statistics to influence conclusions are particularly to be avoided.
What is informed consent?
Informed consent represents an interactive process between the physician performing the procedure and the patient. This process provides patients with information regarding the purpose of treatment, treatment options, risks and benefits of the procedure, and the opportunity for them to indicate their understanding prior to giving or withholding consent. Once consent is provided, a document reflecting this discussion is signed by both patient and physician and is included in the medical record.
What is consent for research?
Consent for research purposes is obtained in order to carry out research studies in an informed setting. Research consent includes a description of the investigational study, the possible risks and benefits, contact information for study staff, and status of the study being reviewed by an institutional review board.
What is PCEAM R?
In 2013, Hunt and Ells 17 developed the Patient-Centered Care Ethics Analysis Model for Rehabilitation (PCEAM-R) to guide ethical rehabilitative care given the complexity of the care team, patient’s degree of impairment/disability and a variety of possible interventions.
What is occupational therapy?
Occupational therapy’s distinct value is to improve health and quality of life through facilitating participation and engagement in occupations, the meaningful, necessary, and familiar activities of everyday life. Occupational therapy is client-centered, achieves positive outcomes, and is cost-effective. “.
What is pediatric acute inpatient rehabilitation?
A:In pediatric acute inpatient rehabilitation, we treat children ages 0-21 with a multitude of diagnoses including, but not limited to: non-accidental trauma, brain injury, spinal cord injury, stroke, cerebral palsy, cancer, cardiac conditions/complications, orthopedic injuries, burns, and amputations. Our inpatient team also consists of liaisons at local hospitals at well as major hospitals throughout the state that treat pediatrics patients. The liaisons identify any child who may be appropriate and will benefit from acute inpatient rehabilitation. We also have an in-house nurse dedicated to conversing with hospitals in other states to facilitate care and transition from the hospital to our inpatient rehabilitation program. Both the liaisons and in-house nurse will coordination insurance verification and approval. If the family is unable to pay, there are options for financial assistance and this is typically discussed with the social worker. – Marissa
What is the role of psychology in therapy?
Psychology typically evaluates all clients. All therapy staff works closely with psychology and complete co-treatments, when appropriate, in order to address any behavioral or psychosocial barriers that may be impacting a client’s ability to participate in therapy sessions.
Assessing Safety in Preparation for Discharge
Patients will either go to their home, short term rehab, or back to a long-term care facility where they reside.
Resumption of Daily Activities
While OTs in this setting do not usually have enough time in the plan of care to focus on IADLs or leisure, they do help patients get started on returning to their previous level of functioning as it pertains to self-care and ADLs; this is crucial because patients will need this jump start on rehabilitation whether they are transferred to a short-term rehab facility before going home or they return directly to their home and begin home care or outpatient services..
Ordering Durable Medical Equipment (DME)
Some patients may not need much rehabilitation following short hospital stays, but a lot of people who are in the hospital for a brief period of time are those who recently had surgery or another medical procedure.
What About Acute Rehab?
In acute rehab, patients must be recommended for these services while in acute care, since acute rehab is far more intense than other OT services. Sometimes this takes place in a separate part of a hospital with one part being acute care and another portion other dedicated to acute rehabilitation.
Common Diagnoses OTs in Inpatient Settings Will See
The Centers for Medicare and Medicaid Services have a list of qualifying diagnoses that at least 60% of acute rehabilitation patients must have in order for the facility to receive reimbursement. There are thirteen diagnoses that include:
Common Interventions for Inpatient OTs
As you can see, there is quite a big difference between the intensity of these two practice settings. But the good news is that there is not much delineation between the types of treatment they provide. Therapists in both inpatient care settings and acute rehabilitation settings both engage patients in treatments that address:
Methods
The Delphi technique was used to reach consensus among expert occupational therapists regarding service delivery and interventions commonly used in an ideal clinical setting. Data were analysed from three rounds of surveys and the percentage of agreement between clinicians were calculated.
Results
Twenty-six participants completed round one survey, with 24 completing subsequent surveys (92% response rate). Fifteen commonly used interventions were identified, including showering/dressing, light meal preparation and home assessment.
Conclusion
Results generated may assist in guiding occupational therapists in the attributes of service delivery and the type of interventions currently considered best practice when working with deconditioned older adults in a rehabilitation setting. The information provides preliminary data for effectiveness studies.
A. Informed Consent and Decisional Capacity
- Informed consent and decisional capacity are virtually inseparable; together they constitute the foundation for ethical clinical practice. Informed consent represents an interactive process between the physician performing the procedure and the patient. This process provides patients with information regarding the purpose of treatment, treatment options, risks and benefits of th…
B. Refusing Or Discontinuing Treatment
- Respect for patient autonomy during rehabilitation includes the right to refuse treatment. Occasionally this can present the physiatrist with an ethical dilemma, as illustrated in an article published in 1989 documenting the case of a C3 quadriplegic admitted to a rehabilitation unit who decided that he preferred to die rather than live as a quadriplegic.9,10Thus, an ethical conflict ari…
C. Ethics in Patient Centered Medical Care and Justice
- In their role as the leader of an interdisciplinary team, physiatrists develop personalized plans of care for patients with disabilities in order to optimize their quality of life. Physiatrists must carefully and judiciously consider the following seven core elements of patient centered care outlined by the New England Journal of Medicine in 2017:11 1. Mission and values aligned with …
D. Ethics in Research and Education
- Whyte14 has explored some of the ethical ramifications of rehabilitation research as illustrated by efficacy studies. The concept of clinical equipoise is central to such research, meaning that there is a real uncertainty about whether or not a treatment is beneficial. The three concepts of autonomy, beneficence, and justice, as enumerated by Blustein1 need to be scrupulously observ…
E. Future Trends in Rehabilitation Ethics
- In 2013, Hunt and Ells17 developed the Patient-Centered Care Ethics Analysis Model for Rehabilitation (PCEAM-R) to guide ethical rehabilitative care given the complexity of the care team, patient’s degree of impairment/disability and a variety of possible interventions. The six steps of the PCEAM-R are: 1. Identify the ethical issue(s) to address: What is at stake and for wh…