In April 1987 this Committee held its first meeting and Mr. Hall was elected Chairman. It was planned to evolve a record of principles of professional conduct which would be available to members through the Newsletter.
In April 1987 this Committee held its first meeting and Mr. Hall was elected Chairman. It was planned to evolve a record of principles of professional conduct which would be available to members through the Newsletter.
Later in 1987 the Ethical Committee prepared a discussion document on the proposed ethical rules and sent it to the NZPPA and the HPA and MRC for comment.
The 1987 Annual Report stated that the Committee had three roles
The draft guidelines about members association with or employment of persons practising as other than physiotherapists were tabled in April 1988.
Mrs. Lamb tabled an article from “Physiotherapy “ entitled “informed consent” - Ethical Implications for Physiotherapy “. The Ethics Committee were to study it. The Society decided in December 1988 that they should have one comprehensive set of research ethics. Gay Wood forwarded material to form the basis of these, comments were sought from SIGs, and they were incorporated into later revisions of the Code.
A sub-committee of Mrs. Monro, Miss Randle, Mr. Gee, Mr Hall (lay person) and Mr. Wild (legal counsel) spent a lot of time in 1988 drafting the new rules to discuss with the Commerce Commission. Most related to canvassing, advertising and sale of goods. In April 1988 draft guidelines about members association with or employment of persons practising as other than physiotherapists were tabled. In September 1988 a small sub-Committee was formed (Mr. Drok, Mr. Wild legal advisor, and Mrs. Tedder.) which met with the Commerce Commission and to formulate any necessary rule changes at the 1989 annual general meeting. Mr Wild then produced a further draft, which was discussed by Executive and returned to the sub Committee for comment. It was circulated to branches as a notice of Motion at the annual general meeting. In December 1988 guidelines prepared by the ethical Committee were sent to branch secretaries to include in the Manual.
Protracted discussion with the Commerce Commission continued through 1989. In September 1989 the Commerce Commission were advised of NZSP Role changes and in a letter have replied as follows - “We note that there have been significant changes made to the Rules/ Advertising Ethics. At the same time, there remain some provisions about which, in competition terms, we still have reservations. We have detailed these in our letter -
We do not propose to take further action at this time, but will monitor the effect of those revisions in the market place. Should any constraints on competition become apparent, the Commission will re-examine the matter and may litigate if a breach of the Commerce Act is evidenced. We would emphasise that the question of the Society’s risk under the Commerce Act is a matter for the Society to assess. It is our intention, as a matter of course, to re-examine the rules/ advertising in 12 months time. Our view, above, on the revised rules’ Advertising Ethics remains an opinion for only the Courts are able to determine if the Commerce Act has been breached. There also remains the possibility of private enforcement through the Courts.
Informed Consent was considered in December 1989. A discussion paper and draft standard for patient care services - was tabled and Executive agreed that comments should be available before 30 September.
It was moved in December 1989 “that the Society’s Ethical Committee produce a leaflet informing the public of the
actual constitution of the Ethical Committee which was reviewed in April 1989 when the idea of appointing a second y person was considered. In June 1990 Mrs. Lianne Wright agreed to take this appointment.
It was agreed that when ethical matters pertaining to the public were involved the Ethical Committee should be given the power to co-opt an extra lay person. The Ethical Committee were advised that when the issues discussed were intra professional the present composition was adequate.
Mr. Gee attended a conference on Ethics and Computer Security, NZMA Conference in 1987 and his report was sent to branches. Margot Skinner attended a Bioethics seminar in 1993. Matters covered at the seminar included cultural, legal and political issues. Of particular interest was the role of the Ethics Committee of a variety of health professionals. Many soon discovered that their own professions were invariably outmoded in regard to the ethical and disciplinary sections and voiced support for reviews of the Act to take place as soon as possible. [1]
The Government took the view that the consumer should make informed choices concerning their selection of professional services. The result for the Ethical Committee was a move away from enforcing compliance with strict rules to one of exercising reasonable judgement on broad principles of professional standard and ethical behaviour.[2]
These rules changed the emphasis on advertising and publicity from a position where advertising was forbidden except in very narrow and prescribed circumstances to a position where advertising was permitted provided it complied with certain standards and was within certain constraints.
In April 1991 the ethical rules of the Society were amended to include a rule on product endorsement. In November 1991 the ethical Committee considered a Code of Ethics should be prepared of the membership. It was agreed “that the Society establish an ethical code of principles and request the Ethical Committee to proceed with the writing of a draft. It will then be viewed by Executive and sent to branches. The Ethical Committee prepared this in 1992 and sent it to branches and SIGs for viewing. The draft was considered in 1993 and 1994, and accepted at the AGM 1995. The preamble to the Code stated that the paramount intent of the code and guidelines was to protect patients/clients, close relatives and caregivers. A Policy about Professional Sexual Abuse Policy was included, as well as an Adverse reporting system.
Following a suggestion by the Ethical Committee contained in a proposal prepared by M Lamont in August 1992, the Board discussed the establishment of a new committee in the disciplinary process. The Committee, to be called the Preliminary Investigation Committee, would assess all complaints concerning physiotherapists whether addressed to the Society or the Board. This Committee would comprise 1 physiotherapist, 1 physiotherapist nominated by NZSP 1 lay person. The Board is seeking legal advice on this proposal and Executive endorsed the proposal subject to an affirmative legal opinion. In July 1993 it was decided that it should be policy that the findings of the Ethical Advisory Committee be published for distribution to all members of the Society.
In June 1994 the Executive Director, as Secretary of the Committee discussed the need for legal representation of the Committee, and was authorised to contact law firms specialising in health and obtain preliminary costs.
It was agreed in November 1995 that the Ethical Committee had a responsibility without prejudice in any way to the Committee’s consideration of the complaint, to advise complainants of their right to lodge a claim with the ACC in respect of medical misadventure or medical error.
It was agreed in February 1995 that a new rule should be developed to tie in the proposed Code of Ethics and that this rule should be vetted by a lawyer. The Code was duly presented at the 1995 AGM, the preamble to the Code states that the paramount intent of the code and guidelines is to protect patients/clients, close relatives and caregivers.
No 1. Code of Ethics - Physiotherapists act in the best interest of their patients; they respect the rights and dignity of all individuals; they comply with all legislation that governs and impacts upon the practice of physiotherapy; they practice in accordance with acceptable professional standards; they accept responsibility to uphold the integrity of the profession.
No 2 These principles were further developed by a set of guidelines. They are not definitive, they are subject to changes as the dynamics of the profession change and as new patterns of health care delivery are developed and accepted by the professional community and the public. The review of guidelines will be ongoing, and carried out biennially.
No. 3 - Policy on sexual abuse. That members endorse the definition of professional sexual abuse as contained in the Discussion Document on Professional Sexual Abuse Policy - This is the exploitation of a current patient/client, particularly within a sexual contact. The physiotherapist relationship is not one of equality. In seeking assistance , guidance and treatment the patient is vulnerable.
No 4 Members confirmed the remainder of the Discussion Document on the Professional Sexual Abuse Policy.
No 5 Members accept the use of the Discussion Document of Professional Sexual Abuse as an explanatory memorandum.
No 6. - Adverse Reporting System - That the NZSP establish and run an Adverse Reaction Reporting scheme for members.
No 7. - That the members adopt the management structure for the NZSP as contained in the document “Management Structure, NZSP”.
This Code of Ethics was adopted by the Physiotherapy Board in 1996 which meant it applied to all physiotherapists registered and working in New Zealand.
The Ethical Committee’s Terms of Reference for 1996 were reviewed and confirmed, when they also considered the issue of professional boundaries. As a result a survey was sent out attracting more than 1200 replies from members. An education programme on the subject was available from October 1998. The Ethical Committee had raised questions regarding publication, distribution and charging for a publication incorporating the Society’s Ethical Rules, Code of Ethics and Professional Sexual Abuse Policy, for non NZSP members. National Executive agreed that the Physiotherapy Board should bear the cost of such a publication - Executive Officer to discuss with the Board.
Many areas to do with Ethics are hard to define, in an effort to help the membership a column on ethics was started in the Newsletter in July 1996. The first issue defined ethics and the tools that can be used to make decisions. Following issues posed thought provoking hypothetical situations with some questions to consider. This columns continued in the rest of the 1996 issues, four issues in 1997 and all of the 1988 issues. At the Biennial Conference in Napier in 1998 Sandy Elkin and Lynley Anderson presented a paper “Ethics and Physiotherapy : An Introduction”. In this paper they considered what ethics is and gave a brief history of Health care ethics. They then mentioned areas physiotherapists sometimes have to deal with such as patients who cannot communicate, the need to deal with an incompetent colleague, to give a painful procedure to a patient who doesn’t want it, or to get ethics approval for research.[3]
It was suggested in October 1998 that with increasing competitiveness in the health sector it may be timely to repeat the Ethics Committee addition to the NZSP Communications guideline regarding comments about colleagues.
Action - Feature “Be kind to your Colleague” article in the NZSP Newsletter.
[1] Newsletter February 1994
[2] Annual Report 1989
[3] NZJP December 1998
comments powered by Disqus