decisions based on ethics. In the case provided, the recreational therapist is faced with a
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1 Brackett 1 Kassie Brackett The Ethical Problem Professionals are faced with situations all the time that force them to make decisions based on ethics. In the case provided, the recreational therapist is faced with a tough dilemma. Jane is a recreational therapist that provides challenge course opportunities. She is working with a special education class and typically meets with the class before starting the course. This time she did not have the chance to meet them but took the teachers word about the group being typical of other classes. When the class arrived, Jane noticed that Tom, a student, did not have the physical abilities required to participate. Tom is 12 years old diagnosed with cerebral palsy. He uses a wheelchair, has limited mobility of his arms and legs and has limited communication skills. The course was a 60-foot climbing tower. Jane judged the situation and did not think that Tom should participate. After realizing that he was already dressed in the safety equipment and his peers were encouraging him, she made adjustments and let him take part in the course. What I gather from this case is that Jane is a professional who wants to please people. Although she knows that putting Tom on the element would be a safety hazard, she puts more value on fair treatment. Tom s emotions toward this element were unknown. Jane practices by the Challenge by Choice principle but this challenge was not a choice made by Tom. Even if Tom showed interest in this element, his limited mobility posed another issue. Jane s first instinct was to not allow Tom to take part. Her judgment was challenged when she saw the reaction of others. In this situation, Jane
2 Brackett 2 would be the person at fault and Tom is the person that was harmed. After considering all aspects of this situation, there were definite ethical issues and possible legal issues. When it comes to legal issues, Jane could have gotten herself into a lot of trouble. Luckily, everything went smoothly and Tom was taken to the top and back down without a problem. The method used to lift him does not seem like the safest. After reading that Tom had to be hoisted and have assistance from Jane the whole time, it does not seem like this approach was the best. His physical limitations made this more dangerous. He did not have control over what he was doing and could not voice if he felt safe. This poses the legal issue of being sued by Tom s family. If something happened, Jane would be completely responsible and they would have every right to sue. On the ethical side of things, there are a couple ethical principles that were violated. In this case, Tom was not given the chance to make the decision for himself. Not only is this an ethical violation, it also goes against the principle that Jane practices by. Jane did not do everything possible to keep Tom safe. Although she knew it was not a good idea, she let him do it anyway. In this case, she prioritized fairness over safety. Ethical Decision Making Process When applying the ethical decision making process, step one is to define the problem (Connolly, 2017, slide 37). The first problem is that Jane did not look out for the safety of Tom. Although there were adjustments made for him and the activity was completed safely, Tom did not have the physical requirements necessary and the adjustments made were not the safest. The second problem is that Tom was not given the chance to make the decision to participate or not. His emotions were unknown due to his
3 Brackett 3 condition and his legal representative, which would be his parent or legal guardian, was not there to help decide. Both of these actions are violations of the ATRA Code of Ethics. The second step of the ethical decision making process is to generate feasible options (Connolly, 2017, slide 37). There are several things that Jane needs to do after this. She needs to be grateful that everything went smoothly on the course. If something would have happened and he would have been injured, Jane would have another legal problem on her hands. She needs to understand that she performed actions that do not follow that ATRA Code of Ethics. She needs to remember this in case something similar happens again. Jane also needs to come up with a plan for the future. She needs to have a set plan on what to do if someone does not meet requirements for an activity. Jane should have guidelines for each activity and should follow those no matter the circumstance. Along with this, Jane should make it a point to meet with all her participants prior to an activity. If this had taken place, Tom and his peers would not have had such high expectations. In the case that Tom s parent or guardian gets upset about Tom being put in danger, Jane should take responsibility for her actions and let them know her reasoning behind her decisions. Step number three is to identify ethical problems involved. This step is done while recognizing legal, contextual, and environmental influences (Connolly, 2017, slide 37). Jane has broken two principles in the ATRA Code of Ethics. The first principle that has been broken is number nine, competence. This is described as an obligation to use their knowledge, skills, abilities, and judgment to help persons while respecting their decisions and protecting them from harm (Connolly, 2017, slide 26). Jane made the decision that Tom should not participate but after seeing that he was prepared with equipment and had
4 Brackett 4 people cheering for him, she was unable to say no. This shows that Jane did not have the strong communication skills to say that he should not participate. She gave into the pressure of the environment and let him do a dangerous activity. The second principle that was broken was number three, autonomy. This is having the duty to preserve and protect the right of each individual to make his/her own choices (Connolly, 2017, slide 27). Everyone has the right to make their own choices unless they are unable. In this case, Tom was not given the chance to make his own decision, which is a violation. The fourth step in the ethical decision making process is to prioritize values where conflicts exist (Connolly, 2017, slide 37). Jane needs to prioritize what she knows is the right thing over what others are wanting her to do. She needs to prioritize Tom s safety and his right to decide over the excitement of his peers. Instead of letting Tom take part in this course, Jane should have considered the safety of the course and Tom s right to decide. Step five is to make a plan to address the problem (Connolly, 2017, slide 37). The first thing I would do it make Jane revisit the ATRA Code of Ethics and make sure she knows them and knows how to carry them out. Next, I would get her to make a list of guidelines for activities that she plans to do. She needs to be able to clearly tell if a client can participate. Jane should do full assessments on all clients before letting them take part in the intervention. Deciding if a client can participate should be a clear yes or no answer. After creating guidelines for all activities, I would get Jane appropriate help to practice communication skills that will help her talk to people and tell them what the rules are. She could learn these skills from talking with other professionals who might have to deal with this. Jane would then have to complete a self-evaluation on what she values most
5 Brackett 5 when working with clients. Does she value their safety or does she value fairness? I would also remind Jane of her own principle of practice. Jane would have to refer back to these every time she is put into a tough situation. The sixth and final step is to implement the plan (Connolly, 2017 slide 37). Jane needs to immediately begin making guidelines for her activities so she is prepared for next time. She also needs to begin thinking about what she did and take responsibility for making a mistake. Jane should know that she not only broke the ATRA Code of Ethics, but also went against her own principle. I believe this was mostly an ethical issue but could lead to legal issues as well. Jane violated the ATRA Code of Ethics by violating two key principles. Tom s participation did not break any laws; she just did not do what was ethically right. Even though nobody was harmed, this could have led to legal issues if Tom was injured. It could have caused Jane to be sued by Tom s family for not considering his right to choose or his safety when deciding if he should participate. If I were the recreational therapist, I would not have let Tom participate in the tower. I would have explained to everyone that Tom did not physically have the ability needed to support himself. I would suggest other courses for him to do. If everyone was adamant about Tom participating and I had the right safety equipment, I would then be sure to ask Tom how he felt. If he was unable to respond, I would get the teacher to contact his legal representative. By doing this, Tom would participate if he wanted and there would not be legal issues if something happened. This would be a way to avoid any ethical issues as well. Ethics and Recreational Therapy Services
6 Brackett 6 Ethics are one of the most important aspects of healthcare. Treating someone with the best possible care is the main purpose of the ATRA Code of Ethics. By following these, we can insure that we are doing whatever we can to effectively treat clients, while also keeping them safe and respecting them. Not only does the Code of Ethics benefit our clients, it also gives us guidelines to follow if there is a question as to how we treated a patient. As long as we follow these principles, we are protected if an ethical issue arises. As an RT manager, I would make sure that my employees are doing whatever they can to follow these principles. I would be sure that I am following the Code of Ethics so that my employees can learn from my example. I would also treat my employees with these same principles in mind. If they are experiencing the benefits of following the Code of Ethics then they will be more motivated to follow them with clients. I would have myself and all employees attend conferences or seminars discussing ethics. This would keep the principles fresh in their minds while they are providing services. I also believe that I would somehow incorporate an ethics review session. This would be held once a month and employees would be given the chance to discuss situations that could have become ethical issues if not handled properly. We would then discuss these scenarios as a group and come to a conclusion on what would be the best approach if faced with this situation again. This would allow everyone to have experience with difficult cases and would hopefully lessen the chance of making an ethical mistake. References Connolly, Peg. (2017). Code of ethics and ethical practice. Retrieved from: &content_id=_ _1&course_id=_85822_1
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