The Rationale for Code of Ethics and Rule of Conduct.
The Code of Ethics and Rule of Conduct are designed primarily for physiotherapists in the UAE to:
i) Protect the health care professionals and the public
ii) Guide physiotherapists’ professional behaviour
iii) Serve as reference to potential ethical or behavioural issues.
The Code or Ethics & Rule of Conduct can also be used as a tool by members of the public, Physiotherapy educators, and the Emirates Physiotherapy Society.
Every physiotherapist has to comply with the Code of Ethics and Rule of Conduct.
As a member of a self-regulated health profession, the UAE physiotherapists are required to perform within the scope of the Code of Ethics & Rule of Conduct set by the Emirates Physiotherapy Society. Physiotherapists must be able to demonstrate the professional behaviours described in this working document, and maintain the standards for both (a) the services delivered, either alone or in collaboration with a multidisciplinary team; and, (b) any services rendered under one’s direction and supervision.
How the Code of Ethics & Rule of Conduct were developed.
The Code of Ethics & Rule of Conduct were developed following a survey of a variety of regional and international associations of Physiotherapy and the World Confederation of Physical Therapy (WCPT) documentation.
The physiotherapists shall: 1. TITLE USE
11.1 Use only titles that correctly describe their professional status or expertise.
11.2 Use the title “physiotherapist”, “physical therapist”, “registered physiotherapist”, or acronyms such as “PT” after one’s name, only if he/she has a diploma or Bachelor in Physiotherapy officially recognised in the UAE.
2. LAW & REGULATIONS
6.1 Be legally responsible for his or her actions.
6.2 Comply with all laws & regulations of the UAE and the Emirates Physiotherapy Society pertaining to the practice of physiotherapy and strive to effect changes that benefit patient/client.
6.3 Have adequate personal professional indemnity insurance when accessible.
6.4 Report to the appropriate authorities any member of the profession who appears to be incompetent or whose conduct of practice appears to be unethical or illegal.
3.1 Respect the client’s dignity, needs, wishes, customs, values, social, legal, moral, emotional and spiritual beliefs of patients/ service users.
3.2 Recognise each client’ unique mix of characteristics, including gender, age, ethnic origin, religion, culture, language, sexual orientation, health status and need for physiotherapy services as well as customs, values and psychological status.
3.3 Recognise the client’ right to have his or her physical modesty and psychological privacy protected.
3.4 Introduce him/herself to patients/ service users in an appropriate manner.
3.5 Respect the client’s right to make decisions about health providers, facilities and services.
3.6 Ensure that the client is addressed and treated respectfully, and that he or she receives attention according to individual needs.
3.7 Recognise the client’s right to expect a client-therapist relationship based on confidence and trust.
3.8 Recognise the power imbalance inherent in all physiotherapist-client relationships, respect professional boundaries, and refrain from any type of client abuse.
3.9 Refrain from making remarks or gestures that may be interpreted as sexually demeaning and from engaging in any sexual relationship or activity with the client.
3.10 Adopt, and revise as needed, a personal ethical framework for use in making decisions about fairness to clients.
3.11 Provide appropriate information to patients/legal guardians regarding their condition, proposed physiotherapy interventions/ procedures/programmes, including expected benefits, perceived risks, alternatives, costs and fees, to enable them to make or withhold an informed decision and consent.
3.12 Refrain from coercing the client’s consent or penalising the client if he or she refuses an intervention prior to, during or following a treatment.
3.13 Refrain from withdrawing necessary services without providing the client with reasonable advance notice and/or taking steps to transfer the client’s care to another physiotherapist.
3.14 Acknowledge the client’s right to complain and to have the complaint managed sensitively and appropriately.
4. COMPETENCE & SAFETY
4.1 Have the right to professional independence and autonomy; act independently and self-sufficiently, using their own judgment and operational freedom in their field.
4.2 Assume full responsibility and accountability for all care they provide and exercise sound professional judgment based upon his/her education and knowledge.
4.3 Confine themselves to clinical diagnosis and management in those aspects of physiotherapy in which they have been educated and which are recognised by the profession.
4.4 Provide information required to help clients make informed decisions about physiotherapy services, e.g., the purpose and effect of specific interventions, potential risks, and the anticipated frequency and duration of service, and cost.
4.5 Provide information in a ways that will prevent harm to the client and provide needed emotional support.
4.6 Answer client’s questions truthfully, objectively and as completely as possible.
4.7 Maintain on-going and constructive communication with the client and, where appropriate, with the client’s family.
4.8 Seek the assistance of appropriate health care practitioners to answer client questions beyond the scope of physiotherapy practice, e.g., when asked to communicate a diagnosis.
4.9 Perform and document the client’s subjective information and physiotherapist’s objective findings, clinical diagnosis, treatment plan and procedures, explanations to the client, progress notes and discharge summary. Records must be complete, legible, and understandable and held secure for at least the period of time required by the law/ clinical site.
4.10 Use physiotherapy equipment only where it is effective in achieving therapeutic goals.
4.11 With the client or legal guardian’s consent, delegate specific aspects of care of that client to a person deemed by the physiotherapist to be competent to carry the care safely and effectively; and, accept responsibility for all treatment provided by others acting under his/her supervision.
4.12 Inform and discharge the client when the goals have been achieved or further benefits can no longer be obtained.
4.13 Refrain from treating clients with medical diagnosis where physiotherapy is not warranted or is contraindicated.
4.14 Refrain from practising outside his or her level of competence; recognize the limits of his/her professional skills and refer the client to other competent assistance if necessary.
4.15 Request consultation from, or refer clients to, colleagues or members of health professions when, in the opinion of the physiotherapist, such action is in the best interest of the client.
4.16 Where a referring medical practitioner specifies the treatment goal which is not in accord with the judgment of the physiotherapist, consult with the medical practitioner.
4.17 When referring a client to another physiotherapist or facility, inform the client of:
(i) the reason(s) for the referral;
(ii) the relative cost of services, if known;
(iii) the information that will be shared with the practitioner;
(iv) any interest or involvement in the referral.
4.18 Ensure that all components of physiotherapy care comply with the profession’s Standards of Practice of the Emirates Physiotherapy Society.
4.19 Refrain from performing any duties while under the influence of any intoxicating substance.
5. INTEGRITY & CONFIDENTIALITY
5.1 Present professional qualifications honestly.
5.2 Provide an honest, competent and accountable professional service.
5.3 Treat all patients equally and perform the appropriate intervention/ procedures without any form of discrimination.
5.4 Refrain from providing a service that would violate his or her fundamental ethical values.
5.5 Make known possible conflicts between personal values and those of employers, agencies or third-party payers and, where possible, attempt to resolve such differences.
5.6 Refrain from entering in physiotherapist-client relationships in which the physiotherapist’s judgment, regarding the client, could be biased.
5.7 Not accept any gift, favour or hospitality that might be interpreted as seeking to exert undue influence or to obtain preferential treatment.
5.8 Refrain from exploiting the physiotherapist-client relationship to enhance his/her own personal income, e.g., by failing to disclose financial interests in services recommended to clients or sell, supply, endorse or promote the sale of services or goods in ways which exploit the professional relationships with clients.
5.9 Avoid over-utilisation of his or her services by:
(i) ensuring that the type and duration of treatment reflect current scientific evidence;
(ii) discontinuing treatments when they are no longer necessary or effective.
5.10 Prior to initiating service, explain any foreseeable limitations on preserving the confidentiality of information to the client, e.g., legal obligation to report when an examination is conducted on behalf of a third party.
5.11 Respect all client information as confidential. Such information shall not be communicated to any person without the consent of the client or legal guardian except when requested by law.
5.12 Maintain the privacy and security of the clinical record and keep confidential information pertaining to the client’s personal conduct and affairs, e.g., identity, personal life, therapy, etc.
5.13 Ensure that all staff under his/her supervision also respect client confidentiality and security of clinical record.
5.14 Discuss the client’s personal information to a third party, only with his or her permission or as law permits to protect the welfare of the individual or the community.
6. ADVOCACY FOR CLIENT & FOR QUALITY CARE
6.1 Within the health care system, on the client’s behalf, when necessary, act as an advocate for the client’ well-being, to ensure that others respect the client’s rights and dignity and to ensure that relevant concerns are addressed by those responsible for providing service to the client.
6.2 Refrain from ‘taking-over’ the patient/ legal guardian’s rights to own decision-making (dis-empowering the patient/ legal guardian).
6.3 Recognise their responsibility to improve standards of health care.
6.4 Advocate for quality physiotherapy settings.
6.5 Advocate the adoption of laws, regulations and policies by providers, employers, third party payers and legislatures to provide and improve access to necessary health care services for all individuals.
6.6 Advocate for change towards improved health care services, in case an employer is not a health-care professional and may not understand the standards of practice for physiotherapists or how quality could be compromised by some policies.
6.7 Demonstrate commitment to continuous quality improvement, e.g., by participating fully in quality management programmes.
6.8 Participate in peer review and other forms of practice evaluation for the purpose of continuous quality improvement and shall have the right to limit the disclosure of related information.
6.9 Participate in the planning and implementation of services designed to provide optimum health care for the community; and, work toward achieving justice in the provision of equitable health care for all people.
6.10 Contribute to the development and implementation of health services that enhance the health status of the community.
7. PROFESSIONAL RELATIONSHIP
7.1 Act in a manner that reflects well on the physiotherapy profession.
7.2 Be truthful and transparent in his/ her professional activities.
7.3 Refrain from assigning to non-physiotherapists any activity that requires the unique judgment, skill and knowledge of a physiotherapist and be responsible for all duties they delegate.
7.4 Recognise and respect the rights, knowledge and skills/expertise of colleagues and other members of the health care team; and refrain from offending the competence or character of colleagues.
7.5 Communicate and cooperate with other physiotherapists and health care professionals as requested or needed.
7.6 Share information and collaborate with team members, provided client consent is obtained where required, in the planning and evaluation of client care.
7.7 Refrain from providing care in cases where a second practitioner is treating the client and:
(i) the services constitute a duplication;
(ii) the second practitioner is known to have conflicting treatment philosophies or client care objectives;
(iii) the second practitioner has a similar scope of practice and client care objectives, but there is no communication or consultation between practitioners.
7.8 Refrain from personal conduct detrimental to the reputation of the profession.
Examples of such misconduct are: personal misuse or abuse of drugs or alcohol, dishonesty and indecent or violent behaviour. 7.9 Refrain from engaging in behaviour that could be construed as harassment or abuse (verbal, non-verbal, sexual, discriminatory, etc.) of colleagues, associates or employees.
7.10 Intervene, as needed, if any member of the health care team appears to be providing service to the client in an incompetent, incapacitated or unethical manner.
8. ADMINISTRATION/ RENUMERATION
8.1 Serve the employer fairly and honestly.
8.2 Understand and comply with policies guiding distribution of resources in the workplace and help improve such policies when necessary.
8.3 Seek only such remuneration as is deserved and reasonable for physiotherapy services.
8.4 Where a direct fee is charged, inform clients, in advance, of the fee that will be commensurate with the service provided.
8.5 May receive remuneration for endorsement or advertisement of products or services to the public, physiotherapists, or other health care professionals provided he/she discloses any financial interest in the production, sale, or distribution of products or services, considering the setting in which it is provided, practice costs in the geographic area, judgment of other organizations, and other relevant factors.
8.6 Refrain from directly or indirectly requesting, receiving or participating in dividing, transferring, assigning or rebating an unearned fee; and, not profit by means of a credit or other valuable consideration, such as unearned commission, for physiotherapy services provided.
9. EDUCATION (self & others)
9.1 Engage in continuing education for growth and development through life-long learning to continually improve practice.
9.2 Take every opportunity to maintain and update his/her knowledge, skills and professional competence.
9.3 Support the professional development of colleagues.
9.4 Evaluate the efficacy and effectiveness of information and techniques presented in continuing education programmes before integrating them into his/her practice.
9.5 Be competent in a specific content area to provide continuing education.
9.6 Support high-quality education in academic and clinical settings.
9.7 Be willing and diligent to act as preceptor/supervisor in the education of physiotherapy students.
9.8 Ensure that undergraduate and continuing education for physiotherapists includes reference to the study and observance of the profession’s ethical values.
9.9 Demonstrate ethical practice in all aspects of clinical education.
9.10 Respect the rights of individual students and interact with them in a professional manner, both in clinical and academic settings.
9.11 Help ensure physiotherapy students attain a high standard of client care by participating, when ever possible, in educational and mentoring opportunities, e.g., student clinical education and supervised practice.
9.12 Report to the appropriate authorities any illegal or unethical conduct among administrators, educators or students.
10.1 Support and promote physiotherapy research, including the measurement and evaluation of the outcomes of physiotherapy treatment, which contributes to improved client care, and the incorporation of resulting evidence into practice.
10.2 Have a duty to develop the practice of his/her profession by engaging in approved research that meet the following steps:
Approval from the appropriate ethics committee must be obtained.
Research protocols respect the rights of the research subjects and are in compliance with standards accepted by the scientific community.
The results of all research under taken must be reported and widely disseminated.
The anonymity of subjects must be protected in the reporting of research results.
All people involved in the research must be appropriately acknowledged.
10.3 Evaluate new and current physiotherapy approaches based on scientific knowledge.
10.4 Observe the principles of research ethics and prevailing ethical standards.
10.5 Report to appropriate authorities any acts in the conduct or presentation of research that appears to be unethical or illegal, or violates the organisation’s established research protocols or the laws of the jurisdiction in which the research is conducted.
11. PUBLIC EDUCATION
12.1 Provide accurate information about physiotherapy to clients and the general community.
12.2 Inform the public about the benefits of the profession and about who is qualified to provide physiotherapy services.
12.3 When providing public information or education outside his or her regular practice, when addressing individual problems, emphasise that individual problems cannot be treated without individualised examination and plans of care.
12.4 Consider acting as consultant to schools, governments, charities, industries and other organisations within the public and private sectors.
12. PHYSIOTHERAPY SOCIETY - STANDARDS OF PRACTICE
12.1 Abide by the policies of the Society and support its mission.
12.2 Conduct themselves in a manner as to merit the respect of the Society, profession and members.
12.3 Stay well informed of, be guided by, and assist the Society in improving its standards and values.
12.4 Report to the Society, explicitly, any reservations concerning the standards or values of employers, and attempt to rectify practices that are in conflict with the Society ethical principles.
13. BUSINESS: SELLING & ADVERTISING (PT services & education)
13.1 Apply fair and reasonable business principles when dealing with clients and others.
13.2 When entering into a partnership, operate within the ethical boundaries of the Emirates Physiotherapy Society.
13.3 Ensure that their professional judgment and integrity are not compromised by the motives and profit, and enter into contract agreements only when professional integrity can be maintained.
13.4 Never place his/her financial interest above the welfare of individuals under his/her care.
13.5 Ensure that any advertisement of their services is accurate, verifiable, in professional norms of the time, and does not bring the profession into dispute.
13.6 Avoid advertising or signing any advertisement using his/her professional qualifications to encourage the sale or purchase of commercial products.
13.7 When placing a paid advertisement article, identify it as such unless it is apparent from the context that it is paid advertisement.
13.8 Refrain from using any form of promotional communication that contains false, misleading or sensational claims; makes reference to a product, fee or commercial promotion; or, solicits the patronage of clients known to be under the care of another member.
13.9 When providing continuing education, ensure that course content, objectives, faculty credential and responsibilities of the instructor(s) are accurately stated in the promotional and instructional materials; and, ensure that the instructor(s) is (are) not undermining the practice or professional standards of physiotherapy.