Elizabeth Osantowski

PTH 695
Ethical Components of the Professional Role

Section I. Personal Values and Ethics 

My core values in ranking order include morality, love, and loyalty. The description of

morality includes “believing and keeping ethical standards, personal honor, and integrity.”1 The

core value of love is defined as “wanting, caring, unselfish devotion that freely accepts another

in loyalty and seeks the other's good.”1 My last core value is loyalty, which is maintaining

“allegiance to a person, group, or institution.”1 These three values are the core of who I am as a

person and will attribute who I am as a future clinician. 

I believe my core values have been instilled in me by the people who raised me, my

parents. I was blessed to have my dad (stepdad) come into my life when I was young, and I truly

believe if he didn’t enter my life when he did, I would not be where I am today. He was able to

provide for us and make things possible while emulating high moral and ethical standards.

Together, my mom and dad have raised me to have high integrity in everything I pursue or

accomplish. From a young age, this was instilled in me as I would feel guilty about any little

thing that could be wrong, so I would have to tell them. Although this could seem toxic, my

parents handled the situation in a way where they were able to show and guide me to have ethical

standards and personal honor as the forefront to overcome these challenges.

Some people are not fortunate enough to have a strong support system, but I am. Having

a robust support system to show me the value of love is the reason why it is my second core

value. My entire family, including immediate and extended, have shown me the true meaning of

caring unselfishly for others. The relationships I have been able to build with my loved ones,

including grandparents, great grandparents, aunts, uncles, and cousins, have all played a vital

role in this core value. As an extremely close, but big family, we have experienced a lot together

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from deaths to celebrations, but each of them has shown how endless love is. No matter what the

situation is, we have always loved each other. Their love has shown me how to love others, so I

attribute this core value to every one of them.

My support system has not only shown me the value of love but loyalty as well. Growing

up, I learned that not everyone is as loyal as I am, which caused me to get hurt along the way by

several people. Though it can make me guarded at times, I have learned from my support system

that those who give loyalty will receive it back. It may appear as a possible weakness, but I have

learned that it is okay not to have it always reciprocated. However, I will give loyalty to those I

care about until they have broken it. If the other person breaks it, which has happened before, I

can still hold my head high and my shoulders unweighted because I know I remained loyal to

that person. An instance where this has happened is with my older brother who gets into legal

trouble. Although it has caused a lot of pain to my family, I remain loyal to him because he has

always reciprocated it to me, despite him not being loyal to the rest of my family. My family

does not hound me for remaining loyal to him, which proves that they are the ones who taught

me this core value.

All three of these values have significant importance in shaping who I am today and who

I continue to strive to be. I will always utilize these core values in the physical therapy profession

with my patients since it is who I am. I intend to keep my ethical standards high in my

performance and documentation, show love to my patients and coworkers, and demonstrate

loyalty to my patients by advocating for my patients. These specific values are similar to the

American Physical Therapy Association (APTA) core values, which are accountability, altruism,

compassion/caring, excellence, integrity, professional duty, and social responsibility.2 Each of

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PTH 695
the APTA core values matches my core values to some degree. For instance, accountability,

integrity, and morality are comparable in the aspect of responsibility and high ethical standards.

Furthermore, love has similarities to social responsibility and compassion/caring through

the emotional aspects of the physical therapy profession. Lastly, altruism and professional duty

are related to loyalty as obligations to your patient. Although it may appear that I am lacking the

core value of excellence, I believe my knowledge and skills will still lead me to share this value

with the APTA. Overall, my core values align with the core values of the APTA well, so I intend

to uphold both core values when I’m a physical therapist.

Despite my core values being aligned with many APTA core values, there could be

potential conflicts that arise to the duties and professional values of physical therapy. For

instance, a potential conflict could arise with my value of morality if my boss or employer starts

pushing high productivity standards rather than giving the best care possible to patients. It has

become a trend in big companies to be more concerned with filling the time slots by overbooking

physical therapists to make as much money as possible for the company. The conflict would

arise with my ethical standards on wanting to treat my patients with the best care possible since I

see my patients as someone in need of my services. If I were to get in a tight spot between the

employer and my patients from my core values, that would ultimately result in me having an

ethical dilemma to work through.

Another realistic conflict could arise with my values of love and loyalty to my patients

interfering with my commitment to my family and friends. If I had set obligations to my family

and friends, but work runs late due to documentation or a patient coming in late, then my

commitments to my family and friends could be a distraction and interfere in how I treat the

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patient. Even though these are potential conflicts, my values are the core of who I am and will

impact how I treat patients.

Section II. Ethical Theories and Use in Ethical Deliberation  

In clinical practice, ethical decision-making is used to determine and address ethical

concerns that arise every day. A person makes a moral decision by using either ethics of conduct

or ethics of character. Ethics of conduct is a principle-based approach where the individual

weighs the pros and cons of the situation and focuses primarily on actions. Ethics of conduct

have two sub-categories, including deontology and utilitarianism. However, someone who

utilizes ethics of character uses a person-oriented approach where the individual acts out of good

moral character. Ethics of character has two sub-categories, including the virtue of ethics and

ethics of care.3

Upon choosing the ethics of conduct approach, a person will have to further decide

between the ethical theories of deontology or utilitarianism in their decision-making. Deontology

is focused on following the rules. A person must do the right thing, which is the result of the

right kind of rules. For one to do this, a person must figure out what the "right rules" are. To

determine what the "right rules" are, the individual will use rules of reversibility and autonomy.

Reversibility is putting themselves in the other's shoes and seeing from the opposite point of

view if they would be okay with the situation. Autonomy is treating others with respect and

ration. After testing these rules, the person will act out of what they believe is right, which will

show what the moral worth of their actions is. Other components of deontology include keeping

your commitments, being truthful and honest, and being impartial as everyone's concerns count

equally. An example of this theory would be that it is wrong to kill, even if it were in self-

defense.

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Utilitarianism is seeking the highest pursuit of happiness for everyone by weighing the

consequences. When using this principle, a person believes doing the right action will bring the

highest balance of benefit over harm. Utilitarianism considers the impact of a decision has on a

person through actions and their consequences. This ethical theory specifically looks at whether

a person experiences pleasure or pain from the decision. Two sub-principles, including

beneficence (acting to benefit another) and non-maleficence (above all, "do no harm"), are in this

specific approach of ethics of conduct. It is noteworthy to mention that this is in our Hippocratic

Oath as healthcare professionals.3 An example of this theory is choosing to lie, which is

considered right if it endorses more good than bad.

However, if choosing to use the ethics of character approach, a person will further decide

which ethical theory to use between the virtue of ethics or ethics of care. The virtue of ethics

focuses on determining what kind of person you are based on what kind of moral character traits

you have. More specifically, a virtuous person will do the right actions, whereas a vicious person

does the wrong actions. A virtue of ethics approach emphasizes character and development but

focuses on the final goal as ultimate happiness. Aristotle listed “wisdom, prudence, justice,

fortitude, courage, liberality, magnificence, and magnanimity”4 as the most important virtues for

one to have. An example of virtue ethics is a doctor who exhibits compassion and understanding

to a patient’s wishes despite their medical advice. In comparison, the ethics of care theory

focuses on humans as relational beings, who need interpersonal relationships to flourish. The

ethics of care theory uses a caring response and compromises to make ethical decisions. This

ethical theory requires someone to acknowledge other people's needs, have sympathetic

understanding and responsibility towards others, and observe other's responses.3 An example of

this theory is healthcare professionals who deal with caring for others.

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Each of these ethical theories are useful in addressing different domains within clinical

practice. When making laws, rules, and regulations in the healthcare profession, the ethics of

conduct approach, including deontology and utilitarianism, would be most beneficial and

appropriate. Since these two theories focus on action, rules, and consequences, the ethics of

conduct approach is suitable to set guidelines and define our role and responsibility as a physical

therapist regarding HIPAA and blood-borne pathogens regulations. When physical therapists

have interpersonal relationships with patients and demonstrate patient-centered care through a

caring response, the ethics of character approach, including the virtue of ethics and ethics of care,

is most appropriate. Physical therapists inevitably build relationships with patients from treating

them several times per week over weeks, months, or sometimes years. It is our duty as physical

therapists to be active listeners and provide a caring response to our patients throughout every

treatment session.

In my own opinion and beliefs, I have ranked the ethical theories that are most suitable

and useful to me. In fourth place is the virtue of ethics because I have a lot more goals for myself

to accomplish before I can achieve ultimate happiness. Additionally, this ethical theory is the

least important because Aristotle’s nine virtues are not the most important to me, especially

when compared to other theories. Ranked in third place is utilitarianism because it focuses on

right from wrong based on the outcomes, primarily from the consequences of actions. Although I

try to think of every possible outcome in situations, it is impossible to predict the future, which

makes this ethical theory of less importance to me. In the second place, I chose deontology.

Following the rules has been instilled in me since I was born, but the most appealing component

of deontology is putting yourself in the other person's shoes and seeing it from the opposite point

of view. This law of reversibility attracts my attention because I always try to do this in any

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PTH 695
conflict or decision I make. I also believe I demonstrate deontology often with my actions, which

shows how important my moral worth is.

Ranked in the first place is ethics of care as I am a person who needs interpersonal

relationships in my life. I chose this as number one because the caring response component in

this theory is something we should always be utilizing as physical therapists and healthcare

providers. Ethics of care means the most to me because of the requirements to acknowledge

other people's needs, have sympathetic understanding and responsibility towards others, and

observe other's responses. These are qualities I would want my physical therapist to live and

make ethical decisions by. My decision to rank these ethical theories in this order was a tough

decision to make. However, I chose to list them based on my own beliefs and standards that I

expect myself to use as a future physical therapist.

Section III. Ethical Role of the Physical Therapist  

      Physical therapists have prolonged contact with patients, restore or change people's lives,

interact with patients during their most vulnerable and dependent times, and are involved in

personal components of a patient's life. These interactions and duties make physical therapists

have a unique ethical role that creates moral responsibility. This role includes being a moral

agent. Physical therapists spend years not only developing hands-on technical skills but, learning

interaction skills and how outcomes depend on patient response to the interaction. Another

unique role of physical therapists is that they dedicate their lives to continuing education as

research and technology are always advancing in healthcare. As moral agents, our role is defined

by the relationship between the physical therapist and the patient. 

Physical therapists have duties and responsibilities of advocacy, patient centering,

partnership, return to function, and benefit to our patients. Physical therapists are responsible for

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PTH 695
advocating for the best interest of their patients through learning about the patient's needs,

understanding their constraints, and assisting the patient to achieve the best possible outcomes.

This may involve speaking to insurance companies and doctors' offices to get more visits for the

patient. We must place the patient's needs above our own and always have the patient's best

interest through patient centering. Although this could involve taking extra time to create unique

and modified home exercise programs, patient compliance will increase if they are interested.

Physical therapists are obligated to work in a partnership with their patients by

collaborating on decisions that involve them. In doing so, this ensures that the patient is an active

participant in their rehabilitation. A physical therapist's goal is to provide each patient with the

functional ability to help themselves. Ultimately, it is up to the patient's discretion if they want to

get better but, physical therapists will play a vital role in this through education, advice, and

motivation for the patient to function independently. Lastly, physical therapists have a unique set

of skills that are valuable to patients. Specifically, physical therapists will help patients address

their problems to improve and return to function to improve their quality of life.

Upon evaluating where these duties and responsibilities mentioned above come from and

who determined them, my initial thought is from the relationships we develop with our patients.

Since our defined role is dependent on the physical therapist/patient relationship, this would

appear to fit. However, after more consideration, I think these duties and responsibilities are also

from a few more places. First and foremost, I believe these responsibilities are determined by the

patient's expectations they have of their physical therapist. Secondly, I think a physical therapist

also sets their standards for themselves, which should align with the core values of the APTA.

Lastly, the APTA also plays a role since they set regulations and guidelines for physical

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PTH 695
therapists. I think all of these mentioned have influences on the physical therapist’s duties and

responsibilities.

As a future physical therapist, my duties and responsibilities are not only to my patients

but other individuals and organizations, including physical therapy peers, healthcare colleagues,

and social agencies and society as well. My obligation to other physical therapy peers is essential

to strengthen the profession and assist one another with skills and expertise. My responsibility to

healthcare colleagues is fundamental to work in collaboration to maximize the patient's

outcomes, communicate clearly and effectively despite the use of abbreviations or a completely

different language, and to respect the skills and opinions of other healthcare professionals. My

social agencies and social duty are also essential to address the health care needs of society,

provide services to members of the community, and provide insight into governmental policies to

ensure they are in the best interest of society.

Anyone who is involved in the patient's rehabilitation process will fall into one of those

three categories. For example, this includes colleagues, other rehab specialists, physicians,

employers, insurance companies, third-party payers, and society. All of them have rights that

affect how we practice physical therapy since they directly affect the patient and their treatment.

Their role is extremely important in physical therapy as it takes a collaborative and binding effort

from all involved, including the patient, to aid in their rehabilitation. Each of these people

involved has obligations to the patient, whether it is paying for patient visits, treating patients, or

employing physical therapists to administer treatment. Physical therapy is dependent upon others

to listen to our professional opinions and work collaboratively to improve a patient's quality of

life.

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 Elizabeth Osantowski
PTH 695
References

1. Chapter 3 “Values as Determinants of Behavior.” In: Davis CM, Musolino GM. Patient
Practitioner Interaction: An Experiential Manual for Developing the Art of Health Care.
6th Ed. Slack Incorporated; 2016.
2. PROFESSIONALISM IN PHYSICAL THERAPY: CORE VALUES. American Physical
Therapy Association; 2009:1-4.
https://www.apta.org/uploadedfiles/aptaorg/about_us/policies/bod/judicial/professionalis
minpt.pdf. Accessed February 17, 2020.
3. Doherty RF, Purtilo RB. Ethical Dimensions In The Health Professions. 6th ed. St. Louis:
Elsevier; 2016:75-100.
4. Virtue ethics. En.wikipedia.org. https://en.wikipedia.org/wiki/Virtue_ethics. Published
2020. Accessed March 22, 2020.

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