Patient Care

PREAMBLE

Rehabilitation counselors are committed to facilitating the personal, social, and economic independence of individuals with disabilities. In fulfilling this commitment, rehabilitation counselors work with people, programs, institutions, and service delivery systems. Rehabilitation counselors provide services within the Scope of Practice for Rehabilitation Counseling (see the Scope of Practice document) and recognize that both action and inaction can be facilitating or debilitating. It is essential that rehabilitation counselors demonstrate adherence to ethical standards and ensure that the standards are enforced vigorously. The Code of Professional Ethics for Rehabilitation Counselors, henceforth referred to as the Code, is designed to facilitate these goals.

The fundamental spirit of caring and respect with which the Code is written is based upon five principles of ethical behavior 1 . These include autonomy, eneficence, nonmaleficence, justice, and fidelity, as defined below:

 

Autonomy: To honor the right to make individual decisions.
Beneficence: To do good to others.
Nonmaleficence: To do no harm to others.
Justice: To be fair and give equally to others.
Fidelity: To be loyal, honest, and keep promises.

The primary obligation of rehabilitation counselors is to their clients, defined in the Code as individuals with disabilities who are receiving services from ehabilitation counselors. Regardless of whether direct client contact occurs or whether indirect services are provided, rehabilitation counselors are obligated to adhere to the Code. At times, rehabilitation counseling services may be provided to individuals other than those with disabilities, such as a student population. In all instances, the primary obligation remains with the client and adherence to the Code is required.

The basic objective of the Code is to promote public welfare by specifying ethical behavior expected of rehabilitation counselors. The Enforceable Standards within the Code are the exacting standards intended to provide guidance in specific circumstances and will serve as the basis for processing ethical complaints initiated against certificants.

Rehabilitation counselors who violate the Code are subject to disciplinary action. Since the use of the Certified Rehabilitation Counselor (CRC ® ) and Canadian Certified Rehabilitation Counselor (CCRC ® ) designations are a privilege granted by the Commission on Rehabilitation Counselor Certification (CRCC ® ), CRCC reserves unto itself the power to suspend or to revoke the privilege or to approve other penalties for a violation. Disciplinary penalties are imposed as warranted by the severity of the offense and its attendant circumstances. All disciplinary actions are undertaken in accordance with published procedures and penalties designed to assure the proper enforcement of the Code within the framework of due process and equal protection under the law.

CRCC is a registered service mark of the Commission on Rehabilitation Counselor Certification. All rights reserved.
CRC is a registered certification mark of the Commission on Rehabilitation Counselor Certification. All rights reserved.
CCRC is a registered certification mark of the Commission on Rehabilitation Counselor Certification. All rights reserved.

1 Beauchamp, T.L., & Childress, J.F. (1994), 4 th Ed. Principles of Biomedical Ethics. Oxford: Oxford University Press. Kitchener,
K.S. (1984). Ethics in Counseling Psychology: Distinctions and Directions. Counseling Psychologists, 12 (3), 43-55..2

ENFORCEABLE STANDARDS OF ETHICAL PRACTICE
SECTION A: THE COUNSELING RELATIONSHIP
A.1. CLIENT WELFARE
a. DEFINITION OF CLIENT. The primary obligation of rehabilitation counselors will be to their clients, defined as individuals with disabilities who are receiving services from rehabilitation counselors.

b. REHABILITATION AND COUNSELING PLANS. Rehabilitation counselors will work jointly with their clients in devising and revising integrated, individual rehabilitation and counseling plans that contain realistic and mutually agreed upon goals and are consistent with abilities and circumstances of clients.

c. CAREER AND EMPLOYMENT NEEDS. Rehabilitation counselors will work with their clients in considering employment that is consistent with the overall abilities, vocational limitations, physical restrictions, psychological limitations, general temperament, interest and aptitude patterns, social skills, education, general qualifications, and cultural and other relevant characteristics and needs of clients. Rehabilitation counselors will neither place nor participate in placing clients in positions that will result in damaging the interest and the welfare of clients, employers, or the public.

d. AUTONOMY. Rehabilitation counselors will respect the autonomy of the client if actions such as involuntary commitment or initiation of guardianship are taken that diminish client autonomy. The assumption of responsibility for decision-making on behalf of the client will be taken only after careful deliberation. The rehabilitation counselor will advocate for client resumption of responsibility as quickly as possible.

A.2. RESPECTING DIVERSITY
a. RESPECTING CULTURE. Rehabilitation counselors will demonstrate respect for clients' cultural backgrounds.

b. INTERVENTIONS. Rehabilitation counselors will develop and adapt interventions and services to incorporate consideration of clients' cultural perspectives and recognition of barriers external to clients that may interfere with achieving effective rehabilitation outcomes.

c. NON-DISCRIMINATION. Rehabilitation counselors will not condone or engage in discrimination based on age, color, culture, disability, ethnic group, gender, race, religion, sexual orientation, marital status, or socioeconomic status.

A.3. CLIENT RIGHTS
a. DISCLOSURE TO CLIENTS. When counseling is initiated, and throughout the counseling process as necessary, rehabilitation counselors will inform clients, preferably through both written and oral means, of their credentials, the purposes, goals, techniques, procedures, limitations, potential risks, and benefits of services to be performed, and other pertinent information. Rehabilitation counselors will take steps to ensure that clients understand the implications of diagnosis, the intended use of tests and reports, fees, and billing arrangements. Clients have the right to (1) expect confidentiality and will be provided with an explanation of its limitations, including disclosure to supervisors and/or treatment team professionals; (2) obtain clear information about their case records; (3) actively articipate in the development and implementation of rehabilitation counseling plans; and (4) refuse any recommended services and be advised of the consequences of such refusal..3

b. THIRD PARTY REFERRAL. Rehabilitation counselors who have direct contact with a client at the request of a third party will define the nature of their relationships and role to all rightful, legal parties with whom they have direct contact. Direct contact is defined as any written, oral, or electronic communication. Legal parties may include clients, legal guardians, referring third parties, and attorneys actively involved in a matter directly related to rehabilitation services.

c. INDIRECT SERVICE PROVISION. Rehabilitation counselors who are employed by third parties as case consultants or expert witnesses, and who engage in communication with the individual with a disability, will fully disclose to the individual with a disability and/or his or her designee their role and limits of their relationship. Communication includes all forms of written or oral interactions regardless of the type of communication tool used. When there is no pretense or intent to provide rehabilitation counseling services directly to the individual with a disability, and where there will be no communication, disclosure by the rehabilitation counselor is not required. When serving as case consultants or expert witnesses, rehabilitation counselors will provide unbiased, objective opinions. Rehabilitation counselors acting as expert witnesses will generate written documentation, either in the form of case notes or a report, as to their involvement and/or conclusions.

d. FREEDOM OF CHOICE. To the extent possible, rehabilitation counselors will offer clients the freedom to choose whether to enter into a counseling relationship and to determine which professional(s) will provide counseling. Restrictions that limit choices of clients will be fully explained. Rehabilitation ounselors will honor the rights of clients to consent to participate and the right to make decisions with regard to rehabilitation services. Rehabilitation counselors will inform clients or the clients' legal guardians of factors that may affect decisions to participate in rehabilitation services, and they will obtain written consent or will acknowledge consent in writing after clients or legal guardians are fully informed of such factors.

e. INABILITY TO GIVE CONSENT. When counseling minors or persons unable to give voluntary informed consent, rehabilitation counselors will obtain written informed consent from legally responsible parties. Where no legally responsible parties exist, rehabilitation counselors will act in the best interest of clients. f. INVOLVEMENT OF SIGNIFICANT OTHERS. Rehabilitation counselors will attempt to enlist family understanding and involvement of family and/or ignificant others as a positive resource if (or when) appropriate. The client or legal guardian's permission will be secured prior to any involvement of family and/or significant others.

A.4. PERSONAL NEEDS AND VALUES
In the counseling relationship, rehabilitation counselors will be aware of the intimacy and responsibilities inherent in the counseling relationship, maintain respect or clients, and avoid actions that seek to meet their personal needs at the expense of clients.

A.5. SEXUAL INTIMACIES WITH CLIENTS
a. CURRENT CLIENTS. Rehabilitation counselors will not have any type of sexual intimacies with clients and will not counsel persons with whom they have had a sexual relationship.

b. FORMER CLIENTS. Rehabilitation counselors will not engage in sexual intimacies with former clients within a minimum of 5 years after terminating the counseling relationship. Rehabilitation counselors who engage in such relationship after 5 years following termination will have the responsibility to examine and document thoroughly that such relations do not have an exploitative nature, based on factors such as duration of counseling, amount of time since counseling, termination circumstances, client's personal history and mental status, adverse impact on the client, and actions by the counselor suggesting a plan to initiate a sexual relationship with the client after termination. Rehabilitation counselors will seek peer consultation prior to engaging in a sexual relationship with a former client..4

A.6. NON-PROFESSIONAL RELATIONSHIPS WITH CLIENTS
a. POTENTIAL FOR HARM. Rehabilitation counselors will be aware of their influential positions with respect to clients, and will avoid exploiting the trust and dependency of clients. Rehabilitation counselors will make every effort to avoid non-professional relationships with clients that could impair professional judgment or increase the risk of harm to clients. (Examples of such relationships include, but are not limited to, familial, social, financial, business, close personal relationships with clients, or volunteer or paid work within an office in which the client is actively receiving services.) When a non-professional relationship cannot be avoided, rehabilitation counselors will take appropriate professional precautions such as informed consent, consultation, supervision, and documentation to ensure that judgment is not impaired and no exploitation occurs.

b. SUPERIOR/SUBORDINATE RELATIONSHIPS. Rehabilitation counselors will not accept as clients, superiors or subordinates with whom they have administrative, supervisory, or evaluative relationships.

A.7. MULTIPLE CLIENTS
When rehabilitation counselors agree to provide counseling services to two or more persons who have a relationship (such as husband and wife, or parents and children), rehabilitation counselors will clarify at the outset, which person or persons are clients and the nature of the relationships they will have with each involved person. If it becomes apparent that rehabilitation counselors may be called upon to perform potentially conflicting roles, they will clarify, adjust, or withdraw from such roles appropriately.

A.8. GROUP WORK
a. SCREENING. Rehabilitation counselors will screen prospective group counseling/therapy participants. To the extent possible, rehabilitation counselors will elect members whose needs and goals are compatible with goals of the group, who will not impede the group process, and whose well being will not be jeopardized by the group experience.

b. PROTECTING CLIENTS. In a group setting, rehabilitation counselors will take reasonable precautions to protect clients from physical or psychological trauma.

A.9. TERMINATION AND REFERRAL

a. ABANDONMENT PROHIBITED. Rehabilitation counselors will not abandon or neglect clients in counseling.
Rehabilitation counselors will assist in making appropriate arrangements for the continuation of treatment, when necessary, during interruptions such as vacations, and following termination.

b. INABILITY TO ASSIST CLIENTS. If rehabilitation counselors determine an inability to be of professional assistance to clients, they will avoid entering or immediately terminate a counseling relationship.

c. APPROPRIATE TERMINATION. Rehabilitation counselors will terminate a counseling relationship, securing client agreement when possible, when it is reasonably clear that the client is no longer benefiting, when services are no longer required, when counseling no longer serves the client's needs or interests, or when there is failure to pay fees according to Section J of this document.

 

d. REFERRAL UPON TERMINATION. Rehabilitation counselors will be knowledgeable about referral resources and suggest appropriate alternatives. If clients decline the suggested referral, rehabilitation counselors have the right to discontinue the relationship..5

A.10. COMPUTER TECHNOLOGY

a. USE OF COMPUTERS. When computer applications are used in counseling services, rehabilitation counselors will ensure that (1) the client is intellectually, emotionally, and physically capable of using the computer application; (2) the computer application is appropriate for the needs of the client; (3) the client understands the purpose and operation of the computer applications; and (4) a follow-up of client use of a computer application is provided to correct possible misconceptions, discover inappropriate use, and assess subsequent needs.

b. EXPLANATION OF LIMITATIONS. Rehabilitation counselors will ensure that clients are provided information as a part of the counseling relationship that adequately explains the limitations of computer technology.

c. ACCESS TO COMPUTER APPLICATIONS. Rehabilitation counselors will provide reasonable access to computer applications in counseling services.

SECTION B: CONFIDENTIALITY

B.1. RIGHT TO PRIVACY
a. RESPECT FOR PRIVACY. Rehabilitation counselors will respect clients' rights to privacy and will avoid illegal and unwarranted disclosures of confidential information.

b. CLIENT WAIVER. Rehabilitation counselors will respect the right of the client or his/her legally recognized representative to waive the right to privacy.

c. EXCEPTIONS. When disclosure is required to prevent clear and imminent danger to the client or others, or when legal requirements demand that confidential information be revealed, the general requirement that rehabilitation counselors keep information confidential will not apply. Rehabilitation counselors will consult with other professionals when in doubt as to the validity of an exception.

d. CONTAGIOUS, FATAL DISEASES. Rehabilitation counselors will become aware of the legal requirements for disclosure of contagious and fatal diseases in their jurisdiction. In jurisdictions where allowable, a rehabilitation counselor who receives information will confirm that a client has a disease known to be communicable and/or fatal. If allowable by law, the rehabilitation counselor will disclose this information to a third party, who by his or her relationship with the client is at high risk of contracting the disease. Prior to disclosure, the rehabilitation counselor will ascertain that the client has not already informed the third party about his or her disease and that the client is not intending to inform the third party in the immediate future.

e. COURT-ORDERED DISCLOSURE. When court ordered to release confidential information without a client's permission, rehabilitation counselors will request to the court that the disclosure not be required due to potential harm to the client or counseling relationship.

f. MINIMAL DISCLOSURE. When circumstances require the disclosure of confidential information, rehabilitation counselors will endeavor to reveal only essential information. To the extent possible, clients will be informed before confidential information is disclosed.

g. EXPLANATION OF LIMITATIONS. When counseling is initiated and throughout the counseling process as necessary, rehabilitation counselors will inform clients of the limitations of confidentiality and will identify foreseeable situations in which confidentiality must be breached.

h. WORK ENVIRONMENT. Rehabilitation counselors will make every effort to ensure that a confidential work environment exists and that subordinates including employees, supervisees, clerical assistants, and volunteers maintain the privacy and confidentiality of clients..6

i. TREATMENT TEAMS. If client treatment will involve the sharing of client information among treatment team members, the client will be advised of this fact and will be informed of the team's existence and composition.

j. CLIENT ASSISTANTS. When a client is accompanied by an individual providing assistance to the client (e.g., interpreter, personal care assistant, etc.), rehabilitation counselors will ensure that the assistant is apprised of the need to maintain confidentiality.

B.2. GROUPS AND FAMILIES

a. GROUP WORK. In group work, rehabilitation counselors will clearly define confidentiality and the parameters for the specific group being entered, explain its importance, and discuss the difficulties related to confidentiality involved in group work. The fact that confidentiality cannot be guaranteed will be clearly communicated to group members.

b. FAMILY COUNSELING. In family counseling, unless otherwise directed by law, information about one family member will not be disclosed to another member without permission. Rehabilitation counselors will protect the privacy rights of each family member.

B.3. RECORDS

a. REQUIREMENT OF RECORDS. Rehabilitation counselors will maintain records necessary for rendering professional services to their clients and as required by laws, regulations, or agency or institution procedures.

b. CONFIDENTIALITY OF RECORDS. Rehabilitation counselors will be responsible for securing the safety and confidentiality of any counseling records they create, maintain, transfer, or destroy whether the records are written, taped, computerized, or stored in any other medium.

c. PERMISSION TO RECORD OR OBSERVE. Rehabilitation counselors will obtain and document written or recorded permission from clients prior to electronically recording or observing sessions. When counseling clients who are minors or individuals who are unable to give voluntary, informed consent, written or recorded permission of guardians must be obtained.

d. CLIENT ACCESS. Rehabilitation counselors will recognize that counseling records are kept for the benefit of clients, and therefore provide access to records and copies of records when requested by clients, unless prohibited by law. In instances where the records contain information that may be sensitive or etrimental
to the client, the rehabilitation counselor has a responsibility to adequately interpret such information to the client. In situations involving multiple clients, access to records will be limited to those parts of records that do not include confidential information related to another client.

e. DISCLOSURE OR TRANSFER. Rehabilitation counselors will obtain written permission from clients to disclose or transfer records to legitimate third parties unless exceptions to confidentiality exist as listed in Section

B.4. CONSULTATION

a. RESPECT FOR PRIVACY. Information obtained in a consulting relationship will be discussed for professional purposes only with persons clearly concerned with the case. Written and oral reports will present data germane to the purposes of the consultation, and every effort will be made to protect client identity and to avoid undue invasion of privacy.

 

b. COOPERATING AGENCIES. Before sharing information, rehabilitation counselors will make efforts to ensure that there are defined policies in other agencies serving the counselor's clients that effectively protect the confidentiality of information.

 

B.5. ALTERNATIVE COMMUNICATION

Rehabilitation counselors will make every effort to ensure that methods of exchanging information that utilize alternative means of communication (i.e., facsimile, cellular telephone, computer, or videoconferencing) will be conducted in such a manner that ensures protection of client confidentiality. If confidentiality cannot be
ensured, client or guardian permission must be obtained.

 

SECTION C: ADVOCACY AND ACCESSIBILITY

C.1. ADVOCACY

a. ATTITUDINAL BARRIERS. Rehabilitation counselors will strive to eliminate attitudinal barriers, including stereotyping and discrimination, toward individuals with disabilities and to increase their own awareness and sensitivity to such individuals.

 

b. ADVOCACY WITH COOPERATING AGENCIES. Rehabilitation counselors will remain aware of actions taken by cooperating agencies on behalf of their clients and will act as advocates of such clients to ensure effective service delivery.

 

c. EMPOWERMENT. Rehabilitation counselors will provide the client with appropriate information and will support their efforts at self-advocacy both on an individual and an organizational level.

C.2. ACCESSIBILITY

a. COUNSELING PRACTICE. Rehabilitation counselors will demonstrate, in their practice, an appreciation of the need to provide necessary accommodations, including accessible facilities and services, to individuals with disabilities.

 

b. BARRIERS TO ACCESS. Rehabilitation counselors will identify physical, communication, and transportation barriers to clients and will communicate information on barriers to public and private authorities to facilitate removal of barriers to access.

 

c. REFERRAL ACCESSIBILITY. Rehabilitation counselors, as advocates for individuals with disabilities, will ensure, prior to referring clients to programs, facilities, or employment settings, that they are appropriately accessible.

SECTION D: PROFESSIONAL RESPONSIBILITY

D.1. PROFESSIONAL COMPETENCE

a. BOUNDARIES OF COMPETENCE. Rehabilitation counselors will practice only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience. Rehabilitation counselors will demonstrate a commitment to gain knowledge, personal awareness, sensitivity, and skills pertinent to working with a diverse client population. Rehabilitation counselors will not misrepresent their role or competence to clients.

 

b. REFERRAL. Rehabilitation counselors will refer clients to other specialists as the needs of the clients dictate.

 

c. NEW SPECIALTY AREAS OF PRACTICE. Rehabilitation counselors will practice in specialty areas new to them only after appropriate education, training, and supervised experience. While developing skills in new specialty areas, rehabilitation counselors will take steps to ensure the competence of their work and to
protect clients from possible harm.

 

d. RESOURCES. Rehabilitation counselors will ensure that the resources used or accessed in counseling are credible and valid (e.g., web link, books used in Bibliotherapy, etc.).

 

e. QUALIFIED FOR EMPLOYMENT. Rehabilitation counselors will accept employment only for positions for which they are qualified by education, training, supervised experience, state and national professional credentials, and appropriate professional experience. Rehabilitation counselors will hire only individuals
who are qualified and competent for professional rehabilitation counseling positions.

 

f. MONITOR EFFECTIVENESS. Rehabilitation counselors will take reasonable steps to seek peer supervision to evaluate their efficacy as rehabilitation counselors.

 

g. ETHICAL ISSUES CONSULTATION. Rehabilitation counselors will take reasonable steps to consult with other rehabilitation counselors or related professionals when they have questions regarding their ethical obligations or professional practice.

 

h. CONTINUING EDUCATION. Rehabilitation counselors will engage in continuing education to maintain a reasonable level of awareness of current scientific and professional information in their fields of activity. They will take steps to maintain competence in the skills they use, will be open to new techniques, and will
develop and maintain competence for practice with the diverse and/or special populations with whom they work.

 

i. IMPAIRMENT. Rehabilitation counselors will refrain from offering or rendering professional services when their physical, mental, or emotional problems are likely to harm the client or others. They will seek assistance for problems, and, if necessary, will limit, suspend, or terminate their professional responsibilities.

D.2. LEGAL STANDARDS

 

a. LEGAL VERSUS ETHICAL. Rehabilitation counselors will obey the laws and statutes of the legal jurisdiction in which they practice unless there is a conflict with the Code, in which case they should seek immediate consultation and advice.

 

b. LEGAL LIMITATIONS. Rehabilitation counselors will be familiar with and observe the legal limitations of the services they offer to clients. They will discuss these limitations as well as all benefits available to clients they serve in order to facilitate open, honest communication and avoid unrealistic expectations.

D.3. ADVERTISING AND SOLICITING CLIENTS

 

a. ACCURATE ADVERTISING. Advertising by rehabilitation counselors shall not be restricted. Rehabilitation counselors will advertise or will represent their services to the public by identifying their credentials in an accurate manner that is not false, misleading, deceptive, or fraudulent. Rehabilitation counselors will only advertise the highest degree earned which is in counseling or a closely related field from a college or university that was accredited when the degree was awarded by one of the regional accrediting bodies recognized by the Council on Higher Education Accreditation.

 

b. TESTIMONIALS. Rehabilitation counselors who use testimonials will not solicit them from clients or other persons who, because of their particular circumstances, may be vulnerable to undue influence. Full disclosure of uses and the informed consent of the client or guardian will be obtained. Use of estimonials will be for a specified and agreed upon period of time.

 

c. STATEMENTS BY OTHERS. Rehabilitation counselors will make reasonable efforts to ensure that statements made by others about them or the profession of rehabilitation counseling are accurate.

 

d. RECRUITING THROUGH EMPLOYMENT. Employed rehabilitation counselors will not use their institutional affiliations or relationship with their employers to recruit clients, supervisees, or consultees for their separate private practices.

 

e. PRODUCTS AND TRAINING ADVERTISEMENTS. Rehabilitation counselors who develop products related to their profession or conduct workshops or training events will ensure that the advertisements concerning these.9 products or events are accurate and disclose adequate information for consumers to make informed choices.

 

f. PROMOTING TO THOSE SERVED. Rehabilitation counselors will not use counseling, teaching, training, or supervisory relationships to promote their products or training events in a manner that is deceptive or would exert undue influence on individuals who may be vulnerable. Rehabilitation counselors may adopt textbooks they have authored for instructional purposes.

D.4. CREDENTIALS

 

a. CREDENTIALS CLAIMED. Rehabilitation counselors will claim or will imply only professional credentials possessed and are responsible for correcting any known misrepresentations of their credentials by others. Professional credentials include graduate degrees in counseling or closely related fields, accreditation of
graduate programs, national voluntary certifications, government-issued certifications or licenses, or any other credential that might indicate to the public specialized knowledge or expertise in counseling.

 

b. CREDENTIAL GUIDELINES. Rehabilitation counselors will follow the guidelines for use of credentials that have been established by the entities that issue the credentials.

 

c. MISREPRESENTATION OF CREDENTIALS. Rehabilitation counselors will not attribute more to their credentials than the credentials represent, and will not imply that other rehabilitation counselors are not qualified because they do not possess certain credentials.

 

d. DOCTORAL DEGREES FROM OTHER FIELDS. Rehabilitation counselors who hold a master's degree in counseling or a closely related field, but hold a doctoral degree from other than counseling or a closely related field, will not use the title "Dr." in their practices and will not announce to the public in relation to their practice or status as a rehabilitation counselor that they hold a doctorate.

D.5. CRC CREDENTIAL

 

a. ACTING ON BEHALF OF CRCC. Certified Rehabilitation Counselors will not write, speak, nor act in ways that lead others to believe the counselor is officially representing CRCC unless the Commission has granted permission in writing.

 

b. SUPPORT OF CANDIDATES. Certified Rehabilitation Counselors will not initiate or support the candidacy of an individual for certification by CRCC if the individual is known to engage in professional practices that violate the Code of Professional Ethics for Rehabilitation Counselors.

D.6. PUBLIC RESPONSIBILITY

 

a. SEXUAL HARASSMENT. Rehabilitation counselors will not engage in sexual harassment. Sexual harassment is defined as sexual solicitation, physical advances, or verbal or nonverbal conduct that is sexual in nature, that occurs in connection with professional activities or roles, and that either (1) the rehabilitation counselor knows or is told the act is unwelcome, offensive, or creates a hostile workplace environment; or (2) is sufficiently severe or intense to be perceived as harassment to a reasonable person within the context in which it occurs. Sexual harassment may consist of a single intense or severe act or multiple persistent or pervasive acts.

 

b. REPORTS TO THIRD PARTIES. Rehabilitation counselors will be accurate, timely, and objective in reporting their professional activities and opinions to appropriate third parties including courts, health insurance companies, those who are the recipients of evaluation reports, and others.

 

c. MEDIA PRESENTATIONS. When rehabilitation counselors provide advice or comment by means of public lectures, demonstrations, radio or television programs, prerecorded tapes, printed articles, mailed material, or other media, they will take reasonable precautions to ensure that (1) the statements are based on appropriate professional counseling literature and practice; (2) the statements are otherwise consistent with the Code of Professional Ethics for Rehabilitation Counselors; and (3) the recipients of the information are not encouraged to infer that a professional rehabilitation counseling relationship has been established.

 

d. CONFLICTS OF INTEREST. Rehabilitation counselors will not use their professional positions to seek or receive unjustified personal gains, sexual favors, unfair advantage, or unearned goods or services.

 

e. DISHONESTY. Rehabilitation counselors will not engage in any act or omission of a dishonest, deceitful or fraudulent nature in the conduct of their professional activities.

D.7. RESPONSIBILITY TO OTHER PROFESSIONALS

 

a. DISPARAGING COMMENTS. Rehabilitation counselors will not discuss in a disparaging way the competency of other professionals or agencies, or the findings made, the methods used, or the quality of rehabilitation plans.

b. PERSONAL PUBLIC STATEMENTS. When making personal statements in a public context, rehabilitation counselors will clarify that they are speaking from their personal perspectives and that they are not speaking on behalf of all rehabilitation counselors or the profession.

 

c. CLIENTS SERVED BY OTHERS. When rehabilitation counselors learn that their clients have an ongoing professional relationship with another rehabilitation or treating professional, they will request release from clients to inform the other professionals and strive to establish positive and collaborative professional relationships. File reviews, second-opinion services, and other indirect services are not considered ongoing professional services.

SECTION E: RELATIONSHIPS WITH OTHER PROFESSIONALS

E.1. RELATIONSHIPS WITH EMPLOYERS AND EMPLOYEES

 

a. NEGATIVE CONDITIONS. Rehabilitation counselors will alert their employers to conditions that may be potentially disruptive or damaging to the counselor's professional responsibilities or that may limit their effectiveness.

 

b. EVALUATION. Rehabilitation counselors will submit regularly to professional review and evaluation by their supervisor or the appropriate representative of the employer.

 

c. DISCRIMINATION. Rehabilitation counselors, as either employers or employees, will engage in fair practices with regard to hiring, promotion, or training.

 

d. EXPLOITATIVE RELATIONSHIPS. Rehabilitation counselors will not engage in exploitative relationships with individuals over whom they have supervisory, evaluative, or instructional control or authority.

 

e. EMPLOYER POLICIES. In those instances where rehabilitation counselors are critical of policies, they will attempt to affect change through constructive action within the organization. Where such change cannot be affected, rehabilitation counselors will take appropriate further action. Such action may include referral to appropriate certification, accreditation, or state licensure organizations or termination of employment..11

E.2. CONSULTATION

 

a. CONSULTATION AS AN OPTION. Rehabilitation counselors may choose to consult with professionally competent persons about their clients. In choosing consultants, rehabilitation counselors will avoid placing the consultant in a conflict of interest situation that will preclude the consultant from being a proper party to the counselor's efforts to help the client. If rehabilitation counselors are engaged in a work setting that compromises this consultation standard, they will consult with other professionals whenever possible to consider justifiable alternatives.

 

b. CONSULTANT COMPETENCY. Rehabilitation counselors will be reasonably certain that they have, or the organization represented has, the necessary competencies and resources for giving the kind of consulting services needed and that appropriate referral resources are available.

E.3. AGENCY AND TEAM RELATIONSHIPS

 

a. CLIENT AS A TEAM MEMBER. Rehabilitation counselors will ensure that clients and/or their legally recognized representative are afforded the opportunity for full participation in their own treatment team.

 

b. COMMUNICATION. Rehabilitation counselors will ensure that there is fair mutual understanding of the rehabilitation plan by all agencies cooperating in the rehabilitation of clients and that any rehabilitation plan is developed with such mutual understanding.

 

c. DISSENT. Rehabilitation counselors will abide by and help to implement team decisions in formulating rehabilitation plans and procedures, even when not personally agreeing with such decisions, unless these decisions breach the Code.

 

d. REPORTS. Rehabilitation counselors will attempt to secure from other specialists appropriate reports and

evaluations, when such reports are essential for rehabilitation planning and/or service delivery.

SECTION F: EVALUATION, ASSESSMENT, AND INTERPRETATION

F.1. INFORMED CONSENT

 

a. EXPLANATION TO CLIENTS. Prior to assessment, rehabilitation counselors will explain the nature and purposes of assessment and the specific use of results in language the client (or other legally authorized person on behalf of the client) can understand. Regardless of whether scoring and interpretation are
completed by rehabilitation counselors, by assistants, or by computer or other outside services, rehabilitation counselors will take reasonable steps to ensure that appropriate explanations are given to the client.

 

b. RECIPIENTS OF RESULTS. The client's welfare, explicit understanding, and prior agreement will determine the recipients of test results. Rehabilitation counselors will include accurate and appropriate interpretations with any release of test results.

F.2. RELEASE OF INFORMATION TO COMPETENT PROFESSIONALS

 

a. MISUSE OF RESULTS. Rehabilitation counselors will not misuse assessment results, including test results and interpretations, and will take reasonable steps to prevent the misuse of such by others.

 

b. RELEASE OF RAW DATA. Rehabilitation counselors will ordinarily release data (e.g., protocols, counseling or interview notes, or questionnaires) in which the client is identified only with the consent of the client or the client's legal representative. Such data will be released only to persons recognized by rehabilitation
counselors as competent to interpret the data..12

F.3. RESEARCH AND TRAINING

 

a. DATA DISGUISE REQUIRED. Use of data derived from counseling relationships for purposes of training, research, or publication will be confined to content that is disguised to ensure the anonymity of the individuals involved.

 

b. AGREEMENT FOR IDENTIFICATION. Identification of a client in a presentation or publication will be permissible only when the client has agreed in writing to its presentation or publication.

F.4. PROPER DIAGNOSIS OF MENTAL DISORDERS

 

a. PROPER DIAGNOSIS. Rehabilitation counselors qualified to provide proper diagnosis of mental disorders will take special care when doing so. Assessment techniques (including personal interview) used to determine client care (e.g., locus of treatment, type of treatment, or recommended follow-up) will be carefully selected and appropriately used.

 

b. CULTURAL SENSITIVITY. Disability, socioeconomic, and cultural experience of clients will be considered when diagnosing mental disorders.

F.5. COMPETENCE TO USE AND INTERPRET TESTS

 

a. LIMITS OF COMPETENCE. Rehabilitation counselors will recognize the limits of their competence and perform only those testing and assessment services for which they have been trained. They will be familiar with reliability, validity, related standardization, error of measurement, and proper application of any technique utilized. Rehabilitation counselors using computer-based test interpretations will be trained in the construct being measured and the specific instrument being used prior to using this type of computer application.
Rehabilitation counselors will take reasonable measures to ensure the proper use of psychological assessment techniques by persons under their supervision.

 

b. APPROPRIATE USE. Rehabilitation counselors will be responsible for the appropriate application, scoring, interpretation, and use of assessment instruments, whether they score and interpret such tests themselves or use computerized or other services.

 

c. DECISIONS BASED ON RESULTS. Rehabilitation counselors will be responsible for decisions involving individuals or policies that are based on assessment results and will have a thorough understanding of educational and psychological measurement, including validation criteria, test research, and guidelines for test development and use.

 

d. ACCURATE INFORMATION. Rehabilitation counselors will provide accurate information and avoid false claims or misconceptions when making statements about assessment instruments or techniques. Special efforts will be made to avoid utilizing test results to make inappropriate diagnoses or inferences.

F.6. TEST SELECTION

 

a. APPROPRIATENESS OF INSTRUMENTS. Rehabilitation counselors will carefully consider the validity, reliability, psychometric limitations, and appropriateness of instruments when selecting tests for use in a given situation or with a particular client.

 

b. REFERRAL INFORMATION. If a client is referred to a third party provider for testing, the rehabilitation counselor will provide specific referral questions and sufficient objective data about the client so as to ensure that appropriate test instruments are utilized.

 

c. CULTURALLY DIVERSE POPULATIONS. Rehabilitation counselors will be cautious when selecting tests for disability or culturally diverse populations to avoid inappropriateness of testing that may be outside of socialized behavioral or cognitive patterns or functional abilities..13

 

d. NORM DIVERGENCE. Rehabilitation counselors will be cautious in using assessment techniques, making evaluations, and interpreting the performance of populations not represented in the norm group on which an instrument was standardized and will disclose such information.

F.7. CONDITIONS OF TEST ADMINISTRATION

 

a. ADMINISTRATION CONDITIONS. Rehabilitation counselors will administer tests under the same conditions that were established in the test standardization. When tests are not administered under standard conditions, as may be necessary to accommodate modifications for clients with disabilities or when unusual behavior or irregularities occur during the testing session, those conditions will be noted in interpretation.

 

b. COMPUTER ADMINISTRATION. When a computer or other electronic methods are used for test administration, rehabilitation counselors will be responsible for ensuring that programs function properly to provide clients
with accurate results.

 

c. UNSUPERVISED TEST-TAKING. Rehabilitation counselors will not permit unsupervised or inadequately supervised use of tests or assessments unless the tests or assessments are designed, intended, and validated for self-administration and/or scoring.

F.8. TEST SCORING AND INTERPRETATION

 

a. REPORTING RESERVATIONS. In reporting assessment results, rehabilitation counselors will indicate any reservations that exist regarding validity or reliability because of the circumstances of the assessment or the inappropriateness of the norms for the person tested.

 

b. DIVERSITY IN TESTING. Rehabilitation counselors will place test results and their interpretations in proper perspective considering other relevant factors including age, color, culture, disability, ethnic group, gender, race, religion, sexual orientation, marital status, and socioeconomic status.

 

c. RESEARCH INSTRUMENTS. Rehabilitation counselors will exercise caution when interpreting the results of research instruments possessing insufficient technical data to support respondent results. The specific purposes for the use of such instruments will be stated explicitly to the examinee.

 

d. TESTING SERVICES. Rehabilitation counselors who provide test scoring and test interpretation services to support the assessment process will confirm the validity of such interpretations. The interpretation of assessment data will be related to the particular goals of evaluation. Rehabilitation counselors will accurately describe the purpose, norms, validity, reliability, and applications of the procedures and any special qualifications applicable to their use.

 

e. AUTOMATED TESTING SERVICES. The public offering of an automated test interpretation service will be considered a professional-to-professional consultation. The formal responsibility of the consultant will be to the consultee, but the ultimate and overriding responsibility will be to the client.

F.9. TEST SECURITY

Rehabilitation counselors will maintain the integrity and security of tests and other assessment techniques consistent with legal and contractual obligations. Rehabilitation counselors will not appropriate, reproduce, or modify published tests or parts thereof without acknowledgment and permission from the publisher.

 

F.10. OBSOLETE TESTS AND OUTDATED TEST RESULTS

Rehabilitation counselors will not use data or test results that are obsolete or outdated for the current purpose.
Rehabilitation counselors will make every effort to prevent the misuse of obsolete measures and test data by others.

 

F.11. TEST CONSTRUCTION

Rehabilitation counselors will use established scientific procedures, relevant standards, and current professional knowledge for test design in the development, publication, and utilization of educational and psychological assessment techniques.

F.12. FORENSIC EVALUATION

When providing forensic evaluations, the primary obligation of rehabilitation counselors will be to produce objective findings that can be substantiated based on information and techniques appropriate to the evaluation, which may include examination of the individual with a disability and/or review of records. Rehabilitation
counselors will define the limits of their reports or testimony, especially when an examination of the individual with a disability has not been conducted.

 

SECTION G: TEACHING, TRAINING, AND SUPERVISION

G.1. REHABILITATION COUNSELOR EDUCATORS AND TRAINERS

a. RELATIONSHIP BOUNDARIES WITH STUDENTS AND SUPERVISEES. Rehabilitation counselors will clearly define and maintain ethical, professional, and social relationship boundaries with their students and supervisees. They will be aware of the differential in power that exists and the student or supervisee's possible incomprehension of that power differential. Rehabilitation counselors will explain to students and supervisees the potential for the relationship to become exploitive.

 

b. SEXUAL RELATIONSHIPS. Rehabilitation counselors will not engage in sexual relationships with students or supervisees and will not subject them to sexual harassment.

 

c. SUPERVISION PREPARATION. Rehabilitation counselors will supervise only within the boundaries of their competence, based on their education, training, supervised experience, state and national professional credentials, and appropriate professional experience. Rehabilitation counselors who are doctoral students serving as practicum or internship supervisors will be adequately prepared and supervised by the training program.

 

d. RESPONSIBILITY FOR SERVICES TO CLIENTS. Rehabilitation counselors who supervise the rehabilitation counseling services of others will perform direct supervision sufficient to ensure that rehabilitation counseling services provided to clients are adequate and do not cause harm to the client.

 

e. ENDORSEMENT. Rehabilitation counselors will not endorse students or supervisees for certification, licensure, employment, or completion of an academic or training program if they believe students or supervisees are not qualified for the endorsement. Rehabilitation counselors will take reasonable steps to assist students or supervisees who are not qualified for endorsement to become qualified.

G.2. REHABILITATION COUNSELOR EDUCATION AND TRAINING PROGRAMS

 

a. ORIENTATION. Prior to admission, rehabilitation counselor educators will orient prospective students to the counselor education or training program's expectations, including but not limited to the following: (1) the type and level of skill acquisition required for successful completion of the training, (2) subject matter to be covered, (3) basis for evaluation, (4) training components that encourage self-growth or self-disclosure as part of the training process, (5) the type of supervision settings and requirements of the sites for required clinical field experiences, (6) student evaluation and dismissal policies and procedures, and (7) up-to-date employment prospects for graduates.

 

b. EVALUATION. Rehabilitation counselor educators will clearly state, in advance of training, to students and internship supervisees, the levels of competency expected, appraisal methods, and timing of evaluations for both didactic and experiential components. Rehabilitation counselor educators will provide students and internship supervisees with periodic performance appraisal and evaluation feedback throughout the training program.

 

c. TEACHING ETHICS. Rehabilitation counselor educators will teach students and internship supervisees the ethical responsibilities and standards of the profession and the students' and supervisees' professional ethical responsibilities.

 

d. PEER RELATIONSHIPS. When students are assigned to lead counseling groups or provide clinical supervision for their peers, rehabilitation counselor educators will take steps to ensure that students placed in these roles do not have personal or adverse relationships with peers and that they understand they have the same ethical obligations as counselor educators, trainers, and supervisors. Rehabilitation counselor educators will make every effort to ensure that the rights of peers are not compromised when students are assigned to lead counseling groups or provide clinical supervision.

 

e. VARIED THEORETICAL POSITIONS. Rehabilitation counselor educators will present varied theoretical positions so that students may make comparisons and have opportunities to develop their own positions. Rehabilitation counselor educators will provide information concerning the scientific bases of professional
practice.

 

f. FIELD PLACEMENTS. Rehabilitation counselor educators will develop clear policies within their training program regarding field placement and other clinical experiences. Rehabilitation counselor educators will provide clearly stated roles and responsibilities for the student and the site supervisor. Rehabilitation counselor educators will confirm that site supervisors will be qualified to provide supervision and are informed of their professional and ethical responsibilities in this role. Rehabilitation counselor educators will not accept any form of professional services, fees, commissions, reimbursement, or remuneration from a site for student placement.

 

g. DIVERSITY IN PROGRAMS. Rehabilitation counselor educators will respond to their institution and program's recruitment and retention needs for training program administrators, faculty, and students with diverse backgrounds and special needs.

G.3. STUDENTS AND SUPERVISEES

 

a. LIMITATIONS. Rehabilitation counselors, through ongoing evaluation and appraisal, will be aware of the academic and personal limitations of students and supervisees that might impede performance. Rehabilitation counselors will assist students and supervisees in securing remedial assistance when needed, and will dismiss students or supervisees who are unable to provide competent service due to academic or personal limitations. Rehabilitation counselors will seek professional consultation and document their decision to dismiss or to refer students or supervisees for assistance. Rehabilitation counselors will advise students and supervisees of appeals processes as appropriate.

 

b. SELF-GROWTH EXPERIENCES. Rehabilitation counselor educators, when designing training groups or other experiences conducted by the rehabilitation counselor educators themselves, will inform students of the potential risks of self-disclosure. Rehabilitation counselor educators will respect the privacy of students by not requiring self-disclosure that could reasonably be expected to be harmful and student evaluation criteria will not include the level of the student's self-disclosure.

 

c. COUNSELING FOR STUDENTS AND SUPERVISEES. If students or supervisees request counseling, supervisors or rehabilitation counselor educators will provide them with acceptable referrals. Supervisors or rehabilitation counselor educators will not serve as rehabilitation counselors to students or supervisees
over whom they hold administrative, teaching, or evaluative roles unless this is a brief role associated with a training experience.

 

d. CLIENTS OF STUDENTS AND SUPERVISEES. Rehabilitation counselors will make every effort to ensure that clients are aware of the services rendered and the qualifications of the students and supervisees rendering those services. Clients will receive professional disclosure information and will be informed of the limits of confidentiality. Client permission will be obtained in order for the students and supervisees to use any information concerning the counseling relationship in the training process.

 

e. PROFESSIONAL DEVELOPMENT. Rehabilitation counselors who employ or supervise individuals will provide appropriate working conditions, timely evaluations, constructive consultations, and suitable opportunities for experience and training.

SECTION H: RESEARCH AND PUBLICATION

H.1. RESEARCH RESPONSIBILITIES

 

a. USE OF HUMAN PARTICIPANTS. Rehabilitation counselors will plan, design, conduct, and report research in a manner that reflects cultural sensitivity, is culturally appropriate, and is consistent with pertinent ethical principles, federal and state/provincial laws, host institutional regulations, and scientific standards
governing research with human participants.

 

b. DEVIATION FROM STANDARD PRACTICES. Rehabilitation counselors will seek consultation and observe stringent safeguards to protect the rights of research participants when a research problem suggests a deviation from standard acceptable practices.

 

c. PRECAUTIONS TO AVOID INJURY. Rehabilitation counselors who conduct research with human participants will be responsible for the participants' welfare throughout the research and will take reasonable precautions to avoid causing injurious psychological, physical, or social effects to their participants.

 

d. PRINCIPAL RESEARCHER RESPONSIBILITY. While ultimate responsibility for ethical research practice lies with the principal researcher, rehabilitation counselors involved in the research activities will share ethical obligations and bear full responsibility for their own actions.

 

e. MINIMAL INTERFERENCE. Rehabilitation counselors will take precautions to avoid causing disruptions in participants' lives due to participation in research.

 

f. DIVERSITY. Rehabilitation counselors will be sensitive to diversity and research issues with culturally diverse populations and they will seek consultation when appropriate.

H.2. INFORMED CONSENT

 

a. TOPICS DISCLOSED. In obtaining informed consent for research, rehabilitation counselors will use language that is understandable to research participants and that (1) accurately explains the purpose and procedures to be followed; (2) identifies any procedures that are experimental or relatively untried; (3) describes the attendant discomforts and risks; (4) describes the benefits or changes in individuals or organizations that might reasonably be expected; (5) discloses appropriate alternative procedures that would be advantageous for participants; (6) offers to answer any inquiries concerning the procedures; (7) describes any limitations of confidentiality; and (8) instructs that participants are free to withdraw their consent and to discontinue participation in the project at any time.

 

b. DECEPTION. Rehabilitation counselors will not conduct research involving deception unless alternative procedures are not feasible and the prospective value of the research justifies the deception. When the methodological requirements of a study necessitate concealment or deception, the investigator will be required to explain clearly the reasons for this action as soon as possible..17

 

c. VOLUNTARY PARTICIPATION. Participation in research is typically voluntary and without any penalty for refusal to participate. Involuntary participation will be appropriate only when it can be demonstrated that participation will have no harmful effects on participants and is essential to the investigation.

 

d. CONFIDENTIALITY OF INFORMATION. Information obtained about research participants during the course of an investigation will be confidential. When the possibility exists that others may obtain access to such information, ethical research practice requires that the possibility, together with the plans for protecting confidentiality, will be explained to participants as a part of the procedure for obtaining informed consent.

 

e. PERSONS INCAPABLE OF GIVING INFORMED CONSENT. When a person is incapable of giving informed consent, rehabilitation counselors will provide an appropriate explanation, obtain agreement for participation, and obtain appropriate consent from a legally authorized person.

 

f. COMMITMENTS TO PARTICIPANTS. Rehabilitation counselors will take reasonable measures to honor all commitments to research participants.

 

g. EXPLANATIONS AFTER DATA COLLECTION. After data are collected, rehabilitation counselors will provide participants with full clarification of the nature of the study to remove any misconceptions. Where scientific or human values justify delaying or withholding information, rehabilitation counselors will take reasonable measures to avoid causing harm.

 

h. AGREEMENTS TO COOPERATE. Rehabilitation counselors who agree to cooperate with another individual in research or publication will incur an obligation to cooperate as agreed.

 

i. INFORMED CONSENT FOR SPONSORS. In the pursuit of research, rehabilitation counselors will give sponsors, institutions, and publication channels the same opportunity for giving informed consent that they accord to individual research participants. Rehabilitation counselors will be aware of their obligation to future researchers and will ensure that host institutions are given feedback information and proper acknowledgment.

H.3. REPORTING RESULTS

 

a. INFORMATION AFFECTING OUTCOME. When reporting research results, rehabilitation counselors will explicitly mention all variables and conditions known to the investigator that may have affected the outcome of a study or the interpretation of data.

 

b. ACCURATE RESULTS. Rehabilitation counselors will plan, conduct, and report research accurately and in a manner that minimizes the possibility that results will be misleading. They will provide thorough discussions of the limitations of their data and alternative hypotheses. Rehabilitation counselors will not engage in
fraudulent research, distort data, misrepresent data, or deliberately bias their results.

 

c. OBLIGATION TO REPORT UNFAVORABLE RESULTS. Rehabilitation counselors will make available the results of any research judged to be of professional value even if the results reflect unfavorably on institutions, programs, services, prevailing opinions, or vested interests.

 

d. IDENTITY OF PARTICIPANTS. Rehabilitation counselors who supply data, aid in the research of another person, report research results, or make original data available will take due care to disguise the identity of respective participants in the absence of specific authorization from the participants to do otherwise.

 

e. REPLICATION STUDIES. Rehabilitation counselors will be obligated to make sufficient original research data available to qualified professionals who may wish to replicate the study..18

H.4. PUBLICATION

a. RECOGNITION OF OTHERS. When conducting and reporting research, rehabilitation counselors will be familiar with and give recognition to previous work on the topic, observe copyright laws, and give full credit to those to whom credit is due.

 

b. CONTRIBUTORS. Rehabilitation counselors will give credit through joint authorship, acknowledgment, footnote statements, or other appropriate means to those who have contributed significantly to research or concept development in accordance with such contributions. The principal contributor will be listed first and minor technical or professional contributions are acknowledged in notes or introductory statements.

 

c. STUDENT RESEARCH. For an article that is substantially based on a student's dissertation or thesis, the student will be listed as the principal author.

 

d. DUPLICATE SUBMISSION. Rehabilitation counselors will submit manuscripts for consideration to only one journal at a time. Manuscripts that are published in whole or in substantial part in another journal or published work will not be submitted for publication without acknowledgment and permission from the previous publication.

 

e. PROFESSIONAL REVIEW. Rehabilitation counselors who review material submitted for publication, research, or other scholarly purposes will respect the confidentiality and proprietary rights of those who submitted it.

 

SECTION I: ELECTRONIC COMMUNICATION AND EMERGING APPLICATIONS

I.1. COMMUNICATION

a. COMMUNICATION TOOLS. Rehabilitation counselors will be held to the same level of expected behavior as defined by the Code of Professional Ethics for Rehabilitation Counselors regardless of the form of communication they choose to use (i.e., cellular phones, electronic mail, facsimile, video, audio-visual).

 

b. IMPOSTERS. In situations where it is difficult to verify the identity of the rehabilitation counselor, the client, or the client's guardian, rehabilitation counselors will take steps to address imposter concerns, such as using code words, numbers, or graphics.

 

c. CONFIDENTIALITY. Rehabilitation counselors will ensure that clients are provided sufficient information to adequately address and explain the limits of: (1) computer technology in the counseling process in general; and (2) the difficulties of ensuring complete client confidentiality of information transmitted through
electronic communication over the Internet through on-line counseling.

I.2. COUNSELING RELATIONSHIP

 

a. ETHICAL/LEGAL REVIEW. Rehabilitation counselors will review pertinent legal and ethical codes for possible violations emanating from the practice of distance counseling and supervision. Distance counseling is defined as any counseling that occurs at a distance through electronic means, such as web-counseling,
tele-counseling, or video-counseling.

 

b. SECURITY. Rehabilitation counselors will use encryption methods whenever possible. If encryption is not made available to clients, clients must be informed of the potential hazards of unsecured communication on the Internet. Hazards may include authorized or unauthorized monitoring of transmissions and/or
records of sessions.

 

c. RECORDS PRESERVATION. Rehabilitation counselors will inform clients whether the records are being preserved, how they are being preserved, and how long the records are being maintained.

 

d. SELF-DESCRIPTION. Rehabilitation counselors will provide information about themselves as would be available if the counseling were to take place face-to-face (e.g., possibly ethnicity or gender)..19

 

e. CONSUMER PROTECTION. Rehabilitation counselors will provide information to the client regarding all appropriate certification bodies and licensure boards to facilitate consumer protection, such as links to websites.

 

f. CRISIS CONTACT. Rehabilitation counselors will provide the name of at least one agency or counselor-on-call for purposes of crisis intervention within the client's geographical region.

 

g. UNAVAILABILITY. Rehabilitation counselors will provide clients with instructions for contacting them when they are unavailable through electronic means.

 

h. INAPPROPRIATE USE. Rehabilitation counselors will mention at their websites or in their initial contacts with potential clients those presenting problems they believe to be inappropriate for distance counseling.

 

i. TECHNICAL FAILURE. Rehabilitation counselors will explain to clients the possibility of technology failure and will provide an alternative means of communication.

 

j. POTENTIAL MISUNDERSTANDINGS. Rehabilitation counselors will explain to clients how to prevent and address potential misunderstandings arising from the lack of visual cues and voice intonations from the counselor or client.

SECTION J: BUSINESS PRACTICES

J.1. BILLING

 

Rehabilitation counselors will establish and maintain billing records that accurately reflect the services provided and the time engaged in the activity, and that clearly identify who provided the service.

J.2. TERMINATION

 

Rehabilitation counselors in fee for service relationships may terminate services with clients due to nonpayment of fees under the following conditions: a) the client was informed of payment responsibilities and the effects of nonpayment or the termination of payment by a third party, and b) the client does not pose an imminent danger to self or others. As appropriate, rehabilitation counselors will refer clients to another qualified professional to address issues unresolved at the time of termination.

J.3. CLIENT RECORDS

 

a. ACCURATE DOCUMENTATION. Rehabilitation counselors will establish and will maintain documentation that accurately reflects the services provided and that identifies who provided the service. If case notes need to be altered, it will be done so in a manner that preserves the original note and will be accompanied by the date of change, information that identifies who made the change, and the rationale for the change.

 

b. SUFFICIENT DOCUMENTATION. Rehabilitation counselors will provide sufficient documentation in a timely manner (e.g., case notes, reports, plans).

 

c. PRIVACY. Documentation generated by rehabilitation counselors will protect the privacy of clients to the extent that it is possible and appropriate, and will include only relevant information..20

 

d. MAINTENANCE. Rehabilitation counselors will maintain records necessary for rendering professional services to their clients and as required by applicable laws, regulations, or agency/institution procedures. Subsequent to file closure, records will be maintained for the number of years consistent with jurisdictional requirements or for a longer period during which maintenance of such records is necessary or helpful to provide reasonably anticipated future services to the client. After that time, records will be destroyed in a manner assuring preservation of confidentiality.

J.4. FEES AND BARTERING

 

a. ADVANCE UNDERSTANDING. Rehabilitation counselors will clearly explain to clients, prior to entering the counseling relationship, all financial arrangements related to professional services including the use of collection agencies or legal measures for nonpayment.

 

b. ESTABLISHING FEES. In establishing fees for professional rehabilitation counseling services, rehabilitation counselors will consider the financial status and locality of clients. In the event that the established fee structure is inappropriate for a client, assistance will be provided in attempting to find comparable services of acceptable cost.

 

c. BARTERING DISCOURAGED. Rehabilitation counselors will ordinarily refrain from accepting goods or services from clients in return for rehabilitation counseling services because such arrangements create inherent potential for conflicts, exploitation, and distortion of the professional relationship. Rehabilitation counselors will participate in bartering only if the relationship is not exploitative, if the client requests it, if a clear written contract is established, and if such arrangements are an accepted practice in the client's community or culture.

J.5. FEES FOR REFERRAL

 

a. ACCEPTING FEES FROM AGENCY CLIENTS. Rehabilitation counselors will not accept a private fee or other remuneration for rendering services to persons who are entitled to such services through the rehabilitation counselor's employing agency or institution. However, the policies of a particular agency may make explicit provisions for agency clients to receive rehabilitation counseling services from members of its staff in private practice. In such instances, the clients will be informed of other options open to them should they seek private rehabilitation counseling services.

 

b. REFERRAL FEES. Rehabilitation counselors will neither give nor receive commissions, rebates or any other form of remuneration when referring clients for professional services.

SECTION K: RESOLVING ETHICAL ISSUES

K.1. KNOWLEDGE OF STANDARDS

 

Rehabilitation counselors are responsible for learning the Code and should seek clarification of any standard that is not understood. Lack of knowledge or misunderstanding of an ethical responsibility will not be used as a defense against a charge of unethical conduct.

K.2. SUSPECTED VIOLATIONS

 

a. CONSULTATION. When uncertain as to whether a particular situation or course of action may be in violation of the Code of Professional Ethics for Rehabilitation Counselors, rehabilitation counselors will consult with other rehabilitation counselors who are knowledgeable about ethics, with colleagues, and/or with appropriate authorities, such as CRCC, state licensure boards, or legal counsel..

 

b. ORGANIZATION CONFLICTS. If the demands of an organization with which rehabilitation counselors are affiliated pose a conflict with the Code of Professional Ethics for Rehabilitation Counselors, rehabilitation counselors will specify the nature of such conflicts and express to their supervisors or other responsible officials their commitment to the Code of Professional Ethics for Rehabilitation Counselors. When possible, rehabilitation counselors will work toward change within the organization to allow full adherence to the Code of Professional Ethics for Rehabilitation Counselors.

 

c. INFORMAL RESOLUTION. When rehabilitation counselors have reasonable cause to believe that another rehabilitation counselor is violating an ethical standard, they will attempt to resolve the issue informally with the other rehabilitation counselor if feasible, providing that such action does not violate confidentiality rights that may be involved.

 

d. REPORTING SUSPECTED VIOLATIONS. When an informal resolution is not appropriate or feasible, rehabilitation counselors, upon reasonable cause, will take action such as reporting the suspected ethical violation to state or national ethics committees or CRCC, unless this action conflicts with confidentiality
rights that cannot be resolved.

 

e. UNWARRANTED COMPLAINTS. Rehabilitation counselors will not initiate, participate in, or encourage the filing of ethics complaints that are unwarranted or intended to harm a rehabilitation counselor rather than to protect clients or the public.

K.3. COOPERATION WITH ETHICS COMMITTEES

Rehabilitation counselors will assist in the process of enforcing the Code of Professional Ethics for Rehabilitation Counselors. Rehabilitation counselors will cooperate with investigations, proceedings, and requirements of the CRCC Ethics Committee or ethics committees of other duly constituted associations or
boards having jurisdiction over those charged with a violation.

 

Acknowledgements - CRCC recognizes the American Counseling Association for permitting the Commission to adopt, in part, the ACA Code of Ethics and Standards of Practice.

A copy of CRCC's Guidelines and Procedures for Processing Complaints along with a Complaint Form may be obtained from CRCC's web site at Hwww.crccertification.comH or by contacting CRCC at:

 

CRCC
300 N. Martingale Road, Suite 460

Schaumburg, IL 60173
(847) 944-1325

Adopted: 6/01
Effective: 1/02 21

 

 

Preamble
These Principles of professional conduct for pharmacists are established to guide the pharmacist in his relationship with patients, fellow practitioners, other health professionals and the public.

 

A Pharmacist should hold the health and safety of patients to be of first consideration; he should render to each patient the full measure of his ability as an essential health practitioner.

 

A Pharmacist should never knowingly condone the dispensing, promoting or distributing of drugs or medical devices, or assist therein, which are not of good quality, which do not meet standards required by law or which lack therapeutic value for the patient.

 

A Pharmacist should always strive to perfect and enlarge his professional knowledge. He should utilize and make available this knowledge as may be required in accordance with his best professional judgment.

 

A Pharmacist has the duty to observe the law, to uphold the dignity and honor of the profession, and to accept its ethical principles. He should not engage in any activity that will bring discredit to the profession and should expose, without fear or favor, illegal or unethical conduct in the profession.

 

A Pharmacist should seek at all times only fair and reasonable remuneration for his services. He should never agree to, or participate in, transactions with practitioners of other health professions or any other person under which fees are divided or which may cause financial or other exploitation in connection with the rendering of his professional services.

 

A Pharmacist should respect the confidential and personal nature of his professional records; except where the best interest of the patient requires or the law demands, he should not disclose such information to anyone without proper patient authorization.

 

A Pharmacist should not agree to practice under terms or conditions which tend to interfere with or impair the proper exercise of his professional judgment and skill, which tend to cause a deterioration of the quality of his service or which require him to consent to unethical conduct.

 

A Pharmacist should strive to provide information to patients regarding professional services truthfully, accurately, and fully and should avoid misleading patients regarding the nature, cost, or value of the pharmacist's professional services.

 

A Pharmacist should associate with organizations having for their objective the betterment of the profession of pharmacy; he should contribute of his time and funds to carry on the work of these organizations.

 

Approved by APHA Active and Life members August 1969

Amended December 1975
Revised July 1981

Adopted by the FDI General Assembly: September 1997 - SEOUL

 

These International Principles of Ethics for the Dental Profession should be considered as guidelines for every dentist.

 

These guidelines cannot cover all local, national, traditions, legislation or circumstances.

 

The professional dentist:

• will practice according to the art and science of dentistry and to the principles of humanity
• will safeguard the oral health of patients irrespective of their individual status

The primary duty of the dentist is to safeguard the oral health of patients. However, the dentist has the right to decline to treat a patient, except for the provision of emergency care, for humanitarian reasons, or where the laws of the country dictate otherwise.

• should refer for advice and/or treatment any patient requiring a level of competence beyond that held

The needs of the patient are the overriding concern and the dentist should refer for advice or treatment any patient requiring a level of dental competence greater than he/she possesses.

 

• must ensure professional confidentiality of all information about patients and their treatment

The dentist must ensure that all staff respect patients confidentiality except where the laws of the country dictate otherwise.

 

• must accept responsibility for, and utilise dental auxiliaries strictly according to the law

The dentist must accept full responsibility for all treatment undertaken, and no treatment or service should be delegated to a person who is not qualified or is not legally permitted to undertake this.

 

• must deal ethically in all aspects of professional life and adhere to rules of professional law
• should continue to develop professional knowledge and skills

The dentist has a duty to maintain and update professional competence through continuing education through his/her active professional life.

• should support oral health promotion

The dentist should participate in oral health education and should support and promote accepted measures to improve the oral health of the public.

 

• should be respectful towards professional colleagues and staff

The dentist should behave towards all members of the oral health team in a professional manner and should be willing to assist colleagues professionally and maintain respect for divergence of professional opinion.

 

• should act in a manner which will enhance the prestige and reputation of the profession.

 

Preamble

The Standards of Ethics of the American Registry of Radiologic Technologists shall apply solely to persons holding certificates from ARRT who either hold current registrations by ARRT or formerly held registrations by ARRT (collectively, "Registered Technologists", and to persons applying for examination and certification by ARRT in order to become Registered Technologists ("Candidates"). Radiologic Technology is an umbrella term that is inclusive of the disciplines of radiography, nuclear medicine technology, radiation therapy, cardiovascular-interventional radiography, mammography, computed tomography, magnetic resonance imaging, quality management, sonography, bone densitometry, vascular sonography, cardiac-interventional radiography, vascular-interventional radiography, breast sonography and radiologist assistant. The Standards of Ethics are intended to be consistent with the Mission Statement of ARRT, and to promote the goals set forth in the Mission Statement.

A. Code of Ethics

The Code of Ethics forms the first part of the Standards of Ethics. The Code of Ethics shall serve as a guide by which Registered Technologists and Candidates may evaluate their professional conduct as it relates to patients, health care consumers, employers, colleagues and other members of the health care team. The Code of Ethics is intended to assist Registered Technologists and Candidates in maintaining a high level of ethical conduct and in providing for the protection, safety and comfort of patients. The Code of Ethics is aspirational.

 

1. The radiologic technologist conducts herself or himself in a professional manner, responds to patient needs and supports colleagues and associates in providing quality patient care.

 

2. The radiologic technologist acts to advance the principal objective of the profession to provide services to humanity with full respect for the dignity of mankind.

 

3. The radiologic technologist delivers patient care and service unrestricted by the concerns of personal attributes or the nature of the disease or illness, and without discrimination on the basis of sex, race, creed, religion, or socioeconomic status.

 

4. The radiologic technologist practices technology founded upon theoretical knowledge and concepts, uses equipment and accessories consistent with the purposes for which they were designed, and employs procedures and techniques appropriately.

 

5. The radiologic technologist assesses situations; exercises care discretion and judgment; assumes responsibility for professional decisions; and acts in the best interest of the patient.

 

6. The radiologic technologist acts as an agent through observation and communication to obtain pertinent information for the physician to aid in the diagnosis and treatment of the patient and recognizes that interpretation and diagnosis are outside the scope of practice for the profession.

 

7. The radiologic technologist uses equipment and accessories, employs techniques and procedures, performs services in accordance with an accepted standard of practice, and demonstrates expertise in minimizing radiation exposure to the patient, self, and other members of the health care team.

 

8. The radiologic technologist practices ethical conduct appropriate to the profession and protects the patient's right to quality radiologic technology care.

 

9. The radiologic technologist respects confidences entrusted in the course of professional practice, respects the patient's right to privacy, and reveals confidential information only as required by law or to protect the welfare of the individual or the community.

 

10. The radiologic technologist continually strives to improve knowledge and skills by participating in continuing education and professional activities, sharing knowledge with colleagues, and investigating new aspects of professional practice.

B. Rules of Ethics

The Rules of Ethics form the second part of the Standards of Ethics. They are mandatory standards of minimally acceptable professional conduct for all present Registered Technologists and Candidates. Certification is a method of assuring the medical community and the public that an individual is qualified to practice within the profession. Because the public relies on certificates and registrations issued by ARRT, it is essential that Registered Technologists and Candidates act consistently with these Rules of Ethics. These Rules of Ethics are intended to promote the protection, safety and comfort of patients. The Rules of Ethics are enforceable. Registered Technologists and Candidates engaging in any of the following conduct or activities, or who permit the occurrence of the following conduct or activities with respect to them, have violated the Rules of Ethics and are subject to sanctions as described hereunder:

 

1. Employing fraud or deceit in procuring or attempting to procure, maintain, renew, or obtain reinstatement of certification or registration as issued by ARRT; employment in radiologic technology; or a state permit, license, or registration certificate to practice radiologic technology. This includes altering in any respect any document issued by the ARRT or any state or federal agency, or by indicating in writing certification or registration with the ARRT when that is not the case.

 

2. Subverting or attempting to subvert ARRT's examination process. Conduct that subverts or attempts to subvert ARRT's examination process includes, but is not limited to:

 

(i) conduct that violates the security of ARRT examination materials, such as removing or attempting to remove examination materials from an examination room, or having unauthorized possession of any portion of or information concerning a future, current or previously administered examination of ARRT; or disclosing information concerning any portion of a future, current, or previously administered examination of ARRT; or disclosing what purports to be, or under all circumstances is likely to be understood by the recipient as, any portion of or "inside" information concerning any portion of a future, current, or previously administered examination of ARRT;

(ii) conduct that in any way compromises ordinary standards of test administration, such as communicating with another Candidate during administration of the examination, copying another Candidate's answers, permitting another Candidate to copy one's answers, or possessing unauthorized materials; or

(iii) impersonating a Candidate or permitting an impersonator to take the examination on one's own behalf.

 

3. Convictions, criminal proceedings, or military court-martials as described below:

 

(i) Conviction of a crime, including a felony, a gross misdemeanor, or a misdemeanor, with the sole exception of speeding and parking violations. All alcohol and/or drug related violations must be reported. Offenses that occurred while a juvenile and that are processed through the juvenile court system are not required to be reported to ARRT.

(ii) Criminal proceeding where a finding or verdict of guilt is made or returned but the adjudication of guilt is either withheld, deferred, or not entered or the sentence is suspended or stayed; or a criminal proceeding where the individual enters a plea of guilty or nolo contendere (no contest),

(iii) Military court-martials that involve substance abuse, any sex-related infractions, or patient-related infractions.

 

4. Failure to report to the ARRT that:

 

(i) charges regarding the person's permit, license, or registration certificate to practice radiologic technology or any other medical or allied health profession are pending or have been resolved adversely to the individual in any state, territory, or country, (including, but not limited to, imposed conditions, probation, suspension or revocation); or

(ii) that the individual has been refused a permit, license, or registration certificate to practice radiologic technology or any other medical or allied health profession by another state, territory, or country.

 

5. Failure or inability to perform radiologic technology with reasonable skill and safety.

 

6. Engaging in unprofessional conduct, including, but not limited to:

 

(i) a departure from or failure to conform to applicable federal, state, or local governmental rules regarding radiologic technology practice; or, if no such rule exists, to the minimal standards of acceptable and prevailing radiologic technology practice;

(ii) any radiologic technology practice that may create unnecessary danger to a patient's life, health, or safety; or

(iii) any practice that is contrary to the ethical conduct appropriate to the profession that results in the termination from employment. Actual injury to a patient or the public need not be established under this clause.

 

7. Delegating or accepting the delegation of a radiologic technology function or any other prescribed health care function when the delegation or acceptance could reasonably be expected to create an unnecessary danger to a patient's life, health, or safety. Actual injury to a patient need not be established under this clause.

 

8. Actual or potential inability to practice radiologic technology with reasonable skill and safety to patients by reason of illness; use of alcohol, drugs, chemicals, or any other material; or as a result of any mental or physical condition.

 

9. Adjudication as mentally incompetent, mentally ill, a chemically dependent person, or a person dangerous to the public, by a court of competent jurisdiction.

 

10. Engaging in any unethical conduct, including, but not limited to, conduct likely to deceive, defraud, or harm the public; or demonstrating a willful or careless disregard for the health, welfare, or safety of a patient. Actual injury need not be established under this clause.

 

11. Engaging in conduct with a patient that is sexual or may reasonably be interpreted by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning to a patient; or engaging in sexual exploitation of a patient or former patient. This also applies to any unwanted sexual behavior, verbal or otherwise, that results in the termination of employment. This rule does not apply to pre-existing consensual relationships.

 

12. Revealing a privileged communication from or relating to a former or current patient, except when otherwise required or permitted by law.

 

13. Knowingly engaging or assisting any person to engage in, or otherwise participating in, abusive or fraudulent billing practices, including violations of federal Medicare and Medicaid laws or state medical assistance laws.

 

14. Improper management of patient records, including failure to maintain adequate patient records or to furnish a patient record or report required by law; or making, causing or permitting anyone to make false, deceptive, or misleading entry in any patient record.

 

15. Knowingly aiding, assisting, advising, or allowing a person without a current and appropriate state permit, license, or registration certificate or a current certificate of registration with ARRT to engage in the practice of radiologic technology, in a jurisdiction which requires a person to have such a current and appropriate state permit, license, or registration certificate or a current and appropriate certification of registration with ARRT in order to practice radiologic technology in such jurisdiction.

 

16. Violating a rule adopted by any state board with competent jurisdiction, an order of such board, or state or federal law relating to the practice of radiologic technology, or any other medical or allied health professions, or a state or federal narcotics or controlled substance law.

 

17. Knowingly providing false or misleading information that is directly related to the care of a former or current patient.

 

8. Practicing outside the scope of practice authorized by the individual's current state permit, license, or registration certificate, or the individual's current certificate of registration with ARRT.

 

19. Making a false statement or knowingly providing false information to ARRT or failing to cooperate with any investigation by ARRT or the Ethics Committee.

 

20. Engaging in false, fraudulent, deceptive, or misleading communications to any person regarding the individual's education, training, credentials, experience, or qualifications, or the status of the individual's state permit, license, or registration certificate in radiologic technology or certificate of registration with ARRT.

 

 

21. Knowing of a violation or a probable violation of any Rule of Ethics by any Registered Technologist or by a Candidate and failing to promptly report in writing the same to the ARRT.

 

22. Failing to immediately report to his or her supervisor information concerning an error made in connection with imaging, treating, or caring for a patient. For purposes of this rule, errors include any departure from the standard of care that reasonably may be considered to be potentially harmful, unethical, or improper (commission). Errors also include behavior that is negligent or should have occurred in connection with a patient's care, but did not (omission). The duty to report under this rule exists whether or not the patient suffered any injury.

C. Administrative Procedures

These Administrative Procedures provide for the structure and operation of the Ethics Committee; they detail procedures followed by the Ethics Committee and by the Board of Trustees of ARRT in handling challenges raised under the Rules of Ethics, and in handling matters relating to the denial of an application for certification (for reasons other than failure to meet the criteria as stated in Article II, Sections 2.03 and 2.04 of the Rules and Regulations of ARRT, in which case, there is no right to a hearing) or the denial of renewal or reinstatement of a registration. All Registered Technologists and Candidates are required to comply with these Administrative Procedures; the failure to cooperate with the Ethics Committee or the Board of Trustees in a proceeding on a challenge may be considered by the Ethics Committee and by the Board of Trustees according to the same procedures and with the same sanctions as failure to observe the Rules of Ethics.

 

1. Ethics Committee

 

(a) Membership and Responsibilities of the Ethics Committee.

The President, with the approval of the Board of Trustees, appoints at least three Trustees to serve as members of the Ethics Committee, each such person to serve on the Committee until removed and replaced by the President, with the approval of the Board of Trustees, at any time, with or without cause. The President, with the approval of the Board of Trustees, will also appoint a fourth, alternate member to the Committee. The alternate member will participate on the Committee in the event that one of the members of the Ethics Committee is unable to participate.

 

The Ethics Committee is responsible for

(1) investigating each alleged breach of the Rules of Ethics and determining whether a Registered Technologist or Candidate has failed to observe the Rules of Ethics in the Standards, and determining an appropriate sanction; and

(2) periodically assessing the Code of Ethics, Rules of Ethics and Administrative Procedures in the Standards and recommending any amendments to the Board of Trustees.

 

(b) The Chair of the Ethics Committee.

The President, with the approval of the Board of Trustees, appoints one member of the Ethics Committee as the Committee's Chair to serve for a term of two years as the principal administrative officer responsible for management of the promulgation, interpretation, and enforcement of the Standards of Ethics. The President may remove and replace the Chair of the Committee, with the approval of the Board of Trustees, at any time, with or without cause. The Chair presides at and participates in meetings of the Ethics Committee and is responsible directly and exclusively to the Board of Trustees, using staff, legal counsel, and other resources necessary to fulfill the responsibilities of administering the Standards of Ethics.

 

(c) Preliminary Screening of Potential Violation of the Rules of Ethics.

The Chair of the Ethics Committee shall review each alleged violation of the Rules of Ethics that is brought to the attention of the Ethics Committee. If in the sole discretion of the Chair

(1) there is insufficient information upon which to base a charge of a violation of the Rules of Ethics, or

(2) the allegations against the Registered Technologist or Candidate are patently frivolous or inconsequential, or

(3) the allegations if true would not constitute a violation of the Rules of Ethics, the Chair may summarily dismiss the matter. The Chair may be assisted by staff and/or legal counsel of ARRT. The Chair shall report each such summary dismissal to the Ethics Committee.

 

(d) Alternative Dispositions.

At the Chair's direction and upon request, the Executive Director of ARRT shall have the power to investigate allegations and to enter into negotiations with the Registered Technologist or Candidate regarding the possible settlement of an alleged violation of the Rules of Ethics. The Executive Director may be assisted by staff members and/or legal counsel of ARRT. The Executive Director is not empowered to enter into a binding settlement, but rather may recommend a proposed settlement to the Ethics Committee. The Ethics Committee may accept the proposed settlement, make a counterproposal to the Registered Technologist or Candidate, or reject the proposed settlement and proceed under these Administrative Procedures.

 

(e) Summary Suspensions.

If an alleged violation of the Rules of Ethics involves the occurrence, with respect to a Registered Technologist, of an event described in paragraph 3 of the Rules of Ethics, or any other event that the Ethics Committee determines would, if true, potentially pose harm to the health, safety, or well being of any patient or the public, then, notwithstanding anything apparently or expressly to the contrary contained in these Administrative Procedures, the Ethics Committee may, without prior notice to the Registered Technologist and without a prior hearing, summarily suspend the registration of the Registered Technologist pending a final determination under these Administrative Procedures with respect to whether the alleged violation of the Rules of Ethics in fact occurred. Within five working days after the Ethics Committee summarily suspends the registration of a Registered Technologist in accordance with this provision, the Ethics Committee shall, by certified mail, return receipt requested, give to the Registered Technologist written notice that describes

 

(1) the summary suspension,

(2) the reason or reasons for it, and

(3) the right of the Registered Technologist to request a hearing with respect to the summary suspension by written notice to the Ethics Committee, which written notice must be received by the Ethics Committee not later than 15 days after the date of the written notice of summary suspension by the Ethics Committee to the Registered Technologist. If the Registered Technologist requests a hearing in a timely manner with respect to the summary suspension, the hearing shall be held before the Ethics Committee or a panel comprised of no fewer than three members of the Ethics Committee as promptly as practicable, but in any event within 30 days after the Ethics Committee's receipt of the Registered Technologist's request for the hearing. The applicable provisions of paragraph 2 of these Administrative Procedures shall govern all hearings with respect to summary suspensions, except that neither a determination of the Ethics Committee, in the absence of a timely request for a hearing by the affected Registered Technologist, nor a determination by the Ethics Committee or a panel following a timely requested hearing is appealable to the Board of Trustees.

 

2. Hearings

Whenever the ARRT proposes to take action in respect to the denial of an application for certification (for reasons other than failure to meet the criteria as stated in Article II, Sections 2.03 and 2.04 of the Rules and Regulations of ARRT, in which case there is no right to a hearing) or of an application for renewal or reinstatement of a registration, or in connection with the revocation or suspension of a certificate or registration, or the censure of a Registered Technologist for an alleged violation of the Rules of Ethics, it shall give written notice thereof to such person, specifying the reasons for such proposed action. A Registered Technologist or a Candidate to whom such notice is given shall have 30 days from the date the notice of such proposed action is mailed to make a written request for a hearing. The written request for a hearing must be accompanied by a nonrefundable hearing fee in the amount of $100. In rare cases, the hearing fee may be waived, in whole or in part, at the sole discretion of the Ethics Committee. Failure to make a written request for a hearing and to remit the hearing fee (unless the hearing fee is waived in writing by the ARRT) within such period shall constitute consent to the action taken by the Ethics Committee or the Board of Trustees pursuant to such notice. A Registered Technologist or a Candidate who requests a hearing in the manner prescribed above shall advise the Ethics Committee of his or her intention to appear at the hearing. A Registered Technologist or a Candidate who requests a hearing may elect to appear by a written submission which shall be verified or acknowledged under oath.

 

Failure to appear at the hearing or to supply a written submission in response to the charges shall be deemed a default on the merits and shall be deemed consent to whatever action or disciplinary measures which the Ethics Committee determines to take. Hearings shall be held at such date, time, and place as shall be designated by the Ethics Committee or the Executive Director. The Registered Technologist or the Candidate shall be given at least 30 days' notice of the date, time, and place of the hearing.

 

The hearing is conducted by the Ethics Committee with any three or more of its members participating, other than any member of the Ethics Committee whose professional activities are conducted at a location in the approximate area of the Registered Technologist or the Candidate in question. In the event of such disqualification, the President may appoint a Trustee to serve on the Ethics Committee for the sole purpose of participating in the hearing and rendering a decision. At the hearing, ARRT shall present the charges against the Registered Technologist or Candidate in question, and the facts and evidence of ARRT in respect to the basis or bases for the proposed action or disciplinary measure. The Ethics Committee may be assisted by legal counsel. The Registered Technologist or Candidate in question, by legal counsel or other representative if he or she desires (at the sole expense of the Registered Technologist or Candidate in question), shall have the right to call witnesses, present testimony, and be heard in his or her own defense; to hear the testimony of and cross-examine any witnesses appearing at such hearing; and to present such other evidence or testimony as the Ethics Committee shall deem appropriate to do substantial justice. Any information may be considered which is relevant or potentially relevant. The Ethics Committee shall not be bound by any state or federal rules of evidence. A transcript or an audio recording of the hearing is made. The Registered Technologist or Candidate in question shall have the right to submit a written statement at the close of the hearing.

 

In a case where ARRT proposes to take action in respect to the denial of an application for certification (for reasons other than failure to meet the criteria as stated in Article II, Sections 2.03 and 2.04 of the Rules and Regulations of the ARRT) or the denial of renewal or reinstatement of a registration, the Ethics Committee shall assess the evidence presented at the hearing and make its decision accordingly, and shall prepare written findings of fact and its determination as to whether grounds exist for the denial of an application for certification or renewal or reinstatement of a registration, and shall promptly transmit the same to the Board of Trustees and to the Registered Technologist or Candidate in question.

 

In the case of alleged violations of the Rules of Ethics by a Registered Technologist, the Ethics Committee shall assess the evidence presented at the hearing and make its decision accordingly, and shall prepare written findings of fact and its determination as to whether there has been a violation of the Rules of Ethics and, if so, the appropriate sanction, and shall promptly transmit the same to the Board of Trustees and to the Registered Technologist in question. Potential sanctions include denial of renewal or reinstatement of a registration with ARRT, revocation or suspension of a certification or registration or both with ARRT, or the public or private reprimand of a Registered Technologist.

 

Unless a timely appeal from any findings of fact and determination by the Ethics Committee is taken to the Board of Trustees in accordance with paragraph 3 below, the Ethics Committee's findings of fact and determination in any matter (including the specified sanction) shall be final and binding upon the Registered Technologist or Candidate in question.

 

3. Appeals

Except as otherwise noted in these Administrative Procedures, the Registered Technologist or Candidate may appeal any decision of the Ethics Committee to the Board of Trustees by submitting a written request for an appeal within 30 days after the decision of the Ethics Committee is mailed. The written request for an appeal must be accompanied by a nonrefundable appeal fee in the amount of $250. In rare cases, the appeal fee may be waived, in whole or in part, at the sole discretion of the Ethics Committee.

 

In the event of an appeal, those Trustees who participated in the hearing at the Ethics Committee shall not participate in the appeal. The remaining members of the Board of Trustees shall consider the decision of the Ethics Committee, the files and records of ARRT applicable to the case at issue, and any written appellate submission of the Registered Technologist or Candidate in question, and shall determine whether to affirm or to overrule the decision of the Ethics Committee or to remand the matter to the Ethics Committee for further consideration. In making such determination to affirm or to overrule, findings of fact made by the Ethics Committee shall be conclusive if supported by any evidence. The Board of Trustees may grant re-hearings, hear additional evidence, or request that ARRT or the Registered Technologist or the Candidate in question provide additional information, in such manner, on such issues, and within such time as it may prescribe.

 

All hearings and appeals provided for herein shall be private at all stages. It shall be considered an act of professional misconduct for any Registered Technologist or Candidate to make an unauthorized publication or revelation of the same, except to his or her attorney or other representative, immediate superior, or employer.

 

4. Publication of Adverse Decisions

Final decisions that are adverse to the Registered Technologist or Candidate will be communicated to the appropriate authorities of all states and provided in response to inquiries into a person's registration status. ARRT shall also have the right to publish any adverse decisions and the reasons therefore. For purposes of this paragraph, a "final decision"; means and includes: a determination of the Ethics Committee relating to a summary suspension, if the affected Registered Technologist does not request a hearing in a timely manner; a non-appealable decision of the Ethics Committee or a panel relating to a summary suspension that is issued after a hearing on the matter; an appealable decision of the Ethics Committee from which no timely appeal is taken; and, in a case involving an appeal of an appealable decision of the Ethics Committee in a matter, the decision of the Board of Trustees in the matter.

 

5. Procedure to Request Removal of a Sanction

Unless a sanction imposed by ARRT specifically provides for a shorter or longer term, it shall be presumed that a sanction may only be reconsidered after at least three years have elapsed since the sanction first became effective. At any point after a sanction first becomes eligible for reconsideration, the individual may submit a written request ("Request") to ARRT asking the Ethics Committee to remove the sanction. The Request must be accompanied by a nonrefundable fee in the amount of $250. A Request that is not accompanied by the fee or which is submitted before the matter is eligible for reconsideration will be returned to the individual and will not be considered. In rare cases, the fee may be waived, in whole or in part, at the sole discretion of the Ethics Committee.

The Request, the fee, and all documentation in support of the Request must be received by ARRT at least 45 days prior to a meeting of the Ethics Committee in order to be included on the agenda of that meeting. If the Request is received less than 45 days before the meeting, the Request will be held until the following meeting. The Ethics Committee typically meets three times a year. The individual is not entitled to make a personal appearance before the Ethics Committee in connection with a request to remove a sanction.

Although there is no required format, the Request must include compelling reasons justifying the removal of the sanction. It is recommended that the individual demonstrate at least the following:

 

(1) an understanding of the reasons for the sanction,

(2) an understanding of why the action leading to the sanction was felt to warrant the sanction imposed, and

(3) detailed information demonstrating that his or her behavior has improved and similar activities will not be repeated.

 

Letters of recommendation from individuals who are knowledgeable about the person's current character and behavior, including efforts at rehabilitation, are advised. If a letter of recommendation is not on original letterhead or is not duly notarized, the Ethics Committee shall have the discretion to ignore that letter of recommendation.

Removal of the sanction is a prerequisite to applying for reinstatement of certification and registration. If the Ethics Committee, in the exercise of its sole discretion, removes the sanction, the individual will be allowed to pursue reinstatement via the policies and procedures in place at that time, which may require the individual to take and pass the current certification examination. There is a three-attempt limit for passing the examination and a three-year limit within which the three attempts must be completed. Individuals requesting reinstatement will not be allowed to report CE credits completed while under sanction in order to meet the CE requirements for registration. ARRT reserves the right to change its policies and procedures from time to time and without notice to anyone who is under a sanction or is in the process of seeking to remove a sanction.

 

If the Ethics Committee denies removal of the sanction, the decision is not subject to a hearing or to an appeal, and the Committee will not reconsider removal of the sanction for as long as is directed by the Committee.

 

American Registry of Radiologic Technologists 

PREAMBLE

Catholic health facilities witness to the saving presence of Christ and His Church in a variety of ways: by testifying to transcendent spiritual beliefs concerning life, suffering, and death; by humble service to humanity and especially to the poor; by medical competence and leadership; and by fidelity to the Church's teachings while ministering to the good of the whole person.

 

The total good of the patient, which includes his higher spiritual as well as his bodily welfare, is the primary concern of those entrusted with the management of a Catholic health facility. So important is this, in fact, that if an institution could not fulfill its basic mission in this regard, it would have no justification for continuing its existence as a Catholic health facility. Trustees and administrators of Catholic health facilities should understand that this responsibility affects their relationship with every patient, regardless of religion, and is seriously binding in conscience.

A Catholic-sponsored health facility, its board of trustees, and administration face today a serious difficulty as, with community support, the Catholic health facility exists side by side with other medical facilities not committed to the same moral code, or stands alone as the one facility serving the community. However, the health facility identified as Catholic exists today and serves the community in a large part because of the past dedication and sacrifice of countless individuals whose lives have been inspired by the Gospel and the teachings of the Catholic Church.

And just as it bears responsibility to the past, so does the Catholic health facility carry special responsibility for the present and future. Any facility identified as Catholic assumes with this identification the responsibility to reflect in its policies and practices the moral teachings of the Church, under the guidance of the local bishop. Within the community the Catholic health facility is needed as a courageous witness to the highest ethical and moral principles in its pursuit of excellence.

 

The Catholic-sponsored health facility and its board of trustees, acting through its chief executive officer, further, carry an overriding responsibility in conscience to prohibit those procedures which are morally and spiritually harmful. The basic norms delineating this moral responsibility are listed in these Ethical and Religious Directives for Catholic Health Facilities. It should be understood that patients and those who accept board membership, staff appointment or privileges, or employment in a Catholic health facility will respect and agree to abide by its policies and these Directives. Any attempt to use a Catholic health facility for procedures contrary to these norms would indeed compromise the board and administration in its responsibility to seek and protect the total good of its patients, under the guidance of the Church.

 

These Directives prohibit those procedures which, according to present knowledge, are recognized as clearly wrong. The basic moral absolutes which underlie these Directives are not subject to change, although particular applications might be modified as scientific investigation and theological development open up new problems or cast new light on old ones.

 

In addition to consultations among theologians, physicians, and other medical and scientific personnel in local areas, the Committee on Health Affairs of the United States Catholic Conference, with the widest consultation possible, should regularly receive suggestions and recommendations from the field, and should periodically discuss any possible need for an updated revision of these Directives.

The moral evaluation of new scientific developments and legitimately debated questions must be finally submitted to the teaching authority of the Church in the person of the local bishop, who has the ultimate responsibility for teaching Catholic doctrine.

 

I. ETHICAL AND RELIGIOUS DIRECTIVES

Directive

1. The procedures listed in these Directives as permissible require the consent, at least implied or reasonably presumed, of the patient or his guardians. This condition is to be understood in all cases.

2 No person may be obliged to take part in a medical or surgical procedure which he judges in conscience to be immoral; nor may a health facility or any of its staff be obliged to provide a medical or surgical procedure which violates their conscience or these Directives.

3 Every patient, regardless of the extent of his physical or psychic disability, has a right to be treated with a respect consonant with his dignity as a person.

4 Man has the right and the duty to protect the integrity of his body together with all of its bodily functions.

5. Any procedure potentially harmful to the patient is morally justified only insofar as it is designed to produce a proportionate good.

6. Ordinarily the proportionate good that justifies a medical or surgical procedure should be the total good of the patient himself.

7. Adequate consultation is recommended, not only when there is doubt concerning the morality of some procedure, but also with regard to all procedures involving serious consequences, even though such procedures are listed here as permissible. The health facility has the right to insist on such consultations.

8 Everyone has the right and the duty to prepare for the solemn moment of death. Unless it is clear, therefore, that a dying patient is already well-prepared for death as regards both spiritual and temporal affairs, it is the physician's duty to inform him of his critical condition or to have some other responsible person impart this information.

9 The obligation of professional secrecy must be carefully fulfilled not only as regards the information on the patients' charts and records but also as regards confidential matters learned in the exercise of professional duties. Moreover, the charts and records must be duly safeguarded against inspection by those who have no right to see them.

10. The directly intended termination of any patient's life, even at his own request, is always morally wrong.

11 From the moment of conception, life must be guarded with the greatest care. Any deliberate medical procedure, the purpose of which is to deprive a fetus or an embryo of its life, is immoral.

12. Abortion, that is, the directly intended termination of pregnancy before viability, is never permitted nor is the directly intended destruction of a viable fetus. Every procedure whose sole immediate effect is the termination of pregnancy before viability is an abortion, which, in its moral context, includes the interval between conception and implantation of the embryo.

13. Operations, treatments, and medications, which do not directly intend termination of pregnancy but which have as their purpose the cure of a proportionately serious pathological condition of the mother, are permitted when they cannot be safely postponed until the fetus is viable, even though they may or will result in the death of the fetus. If the fetus is not certainly dead, it should be baptized.

14. Regarding the treatment of hemorrhage during pregnancy and before the fetus is viable: Procedures that are designed to empty the uterus of a living fetus still effectively attached to the mother are not permitted; procedures designed to stop hemorrhage (as distinguished from those designed precisely to expel the living and attached fetus) are permitted insofar as necessary, even if fetal death is inevitably a side effect.

15. Cesarean section for the removal of a viable fetus is permitted, even with risk to the life of the mother, when necessary for successful delivery. It is likewise permitted, even with risk for the child, when necessary for the safety of the mother.

16. In extrauterine pregnancy the dangerously affected part of the mother (e.g., cervix, ovary, or fallopian tube) may be removed, even though fetal death is foreseen, provided that: a. the affected part is presumed already to be so damaged and dangerously affected as to warrant its removal, and that b. the operation is not just a separation of the embryo or fetus from its site within the part (which would be a direct abortion from a uterine appendage); and that c. the operation cannot be postponed without notably increasing the danger to the mother.

17. Hysterectomy, in the presence of pregnancy and even before viability, is permitted when directed to the removal of a dangerous pathological condition of the uterus of such serious nature that the operation cannot be safely postponed until the fetus is viable.

 

II. PROCEDURES INVOLVING REPRODUCTIVE ORGANS AND FUNCTIONS

Directive

1. Sterilization, whether permanent or temporary, for men or for women, may not be used as a means of contraception.

2. Similarly excluded is every action which, either in anticipation of the conjugal act, or in its accomplishment, or in the development of its natural consequences, proposes, whether as an end or as a means, to render procreation impossible.

3. Procedures that induce sterility, whether permanent or temporary, are permitted when: a. They are immediately directed to the cure, diminution, or prevention of a serious pathological condition and are not directly contraceptive (that is, contraception is not the purpose); and b. a simpler treatment is not reasonably available. Hence, for example, oophorectomy or irradiation of the ovaries may be allowed in treating carcinoma of the breast and metastasis therefrom; and orchidectomy is permitted in the treatment of carcinoma of the prostate.

4. Because the ultimate personal expression of conjugal love in the marital act is viewed as the only fitting context for the human sharing of the divine act of creation, donor insemination and insemination that is totally artificial are morally objectionable. However, help may be given to a normally performed conjugal act to attain its purpose. The use of the sex faculty outside the legitimate use by married partners is never permitted even for medical or other laudable purpose, e.g., masturbation as a means of obtaining seminal specimens.

5. Hysterectomy is permitted when it is sincerely judged to be a necessary means of removing some serious uterine pathological condition. In these cases, the pathological condition of each patient must be considered individually and care must be taken that a hysterectomy is not performed merely as a contraceptive measure, or as a routine procedure after any definite number of Cesarean sections.

6. For a proportionate reason, labor may be induced after the fetus is viable.

7. In all cases in which the presence of pregnancy would render some procedure illicit (e.g. curettage), the physician must make use of such pregnancy tests and consultation as may be needed in order to be reasonably certain that the patient is not pregnant. It is to be noted that curettage of the endometrium after rape to prevent implantation of a possible embryo is morally equivalent to abortion.

8. Radiation therapy of the mother's reproductive organs is permitted during pregnancy only when necessary to suppress a dangerous pathological condition.

III OTHER PROCEDURES

Directive

1. Therapeutic procedures which are likely to be dangerous are morally justifiable for proportionate reasons.

2. Experimentation on patients without due consent is morally objectionable, and even the moral right of the patient to consent is limited by his duties of stewardship.

3. Euthanasia ("mercy killing") in all its forms is forbidden. The failure to supply the ordinary means of preserving life is equivalent to euthanasia. However, neither the physician nor the patient is obliged to the use of extraordinary means.

4. It i not euthanasia to give a dying person sedatives and analgesics for the alleviation of pain, when such a measure is judged necessary, even though they may deprive the patient of the use of reason, or shorten his life.

5. The transplantation of organs from living donors is morally permissible when the anticipated benefit to the recipient is proportionate to the harm done to the donor, provided that the loss of such organ(s) does not deprive the donor of life itself nor of the functional integrity of his body.

6. Post-mortem examinations must not be begun until death is morally certain. Vital organs, that is, organs necessary to sustain life, may not be removed until death has taken place. The determination of the time of death must be made in accordance with responsible and commonly accepted scientific criteria. In accordance with current medical practice, to prevent any conflict of interest, the dying patient's doctor or doctors should ordinarily be distinct from the transplant team.

7. Ghost surgery, which implies the calculated deception of the patient as to the identity of the operating surgeon, is morally objectionable.

8. Unnecessary procedures, whether diagnostic or therapeutic, are morally objectionable. A procedure is unnecessary when no proportionate reason justifies it. A fortiori, any procedure that is contra-indicated by sound medical standards is unnecessary.

Section 11
THE RELIGIOUS CARE OF PATIENTS

Directive

1. The administration should be certain that patients in a health facility receive appropriate spiritual care.

2. Except in cases of emergency (i.e., danger of death), all requests for baptism made by adults or for infants should be referred to the chaplain of the health facility.

3. If a priest is not available, anyone having the use of reason and proper intention can baptize. The ordinary method of conferring emergency baptism is as follows: The person baptizing pours water on the head in such a way that it will flow on the skin, and, while the water is being poured, must pronounce these words audibly: I baptize you in the name of the Father, and of the Son, and of the Holy Spit-it. The same person who pours the water must pronounce the words.

4. When emergency baptism is conferred, the chaplain should be notified.

5. It is the mind of the Church that the sick should have the widest possible liberty to receive the sacraments frequently. The generous cooperation of the entire staff and personnel is requested for this purpose.

6. While providing the sick abundant opportunity to receive Holy Communion, there should be no interference with the freedom of the faithful to communicate or not to communicate.

7. In wards and semi-private rooms, every effort should be made to provide sufficient privacy for confession.

8. When possible, one who is seriously ill should be given the opportunity to receive the Sacraments of the Sick, while in full possession of his rational faculties. The chaplain must, therefore, be notified as soon as an illness is diagnosed as being so serious that some probability of death is recognized.

9. Personnel of a Catholic health facility should make every effort to satisfy the spiritual needs and desires of non-Catholics. Therefore, in hospitals and similar institutions conducted by Catholics, the authorities in charge should, with the consent of the patient, promptly advise ministers of other communions of the presence of their communicants and afford them every facility for visiting the sick and giving them spiritual and sacramental ministrations.

10. If there is a reasonable cause present for not burying a fetus or member of the human body, these may be cremated in a manner consonant with the dignity of the deceased human body.

 

Professional ethics involve the basic principle for right action.

 

This document is intended as a guide to conduct appropriate to the professional situation in which the occupational therapist is involved.

 

An occupational, therapist should possess the personal qualities of integrity, reliability, loyalty and sincerity of purpose in professional relationships.

 

I. Responsibility to the Patient

(a) In accepting his share of responsibility for the physical and mental well-being of the patient the occupational therapist should at all times strive to give treatment of the highest level of professional skill

(b) The occupational therapist must respect information that of a confidential nature regarding the patient, and, should discuss only pertinent facts with other professional persons involved in the treatment programme.

 

II. Responsibility to the Physician

1. The occupational therapist should treat only patients referred by the physician and should cooperate in achieving the established goals.

2. Reports and records should be kept clearly and concisely for the physician's information and for legal purposes.

III Responsibility to Professional Colleagues

The occupational therapist must show concern for, and loyalty to those practicing the same or other professional skills, recognizing that only by achieving and fostering mutual respect and understanding can the greatest service be rendered to the patient.

IV. Responsibility to the Employer

The occupational therapist should be loyal to his employing institution and should assist in interpretation of its functions within the community. He must accept his proper share of responsibility for the organization and administration of the department to which he is appointed

V. Responsibility to the Profession of Occupational Therapy

The occupational therapist must recognize his responsibilities in contributing to the growth and development of his profession through the exchange of information, raising of treatment and educational standards, and improving conditions of employment by supporting his professional organizations at the local, national and international levels.

VI. Responsibility to the Community

The occupational therapist should promote information and understanding relative to the functions and procedures of occupational therapy. He should at all times recognize the fact that in the eyes of the public, the attitude and philosophy he presents portrays the profession.

Because of their specialised knowledge and expertise, doctors have a professional responsibility to maintain and improve the health of their patients who, either in a vulnerable state of illness or for the maintenance of their health, entrust themselves to medical care.

 

Over the centuries, doctors have held to a body of ethical principles developed primarily to guide their behaviour towards patients, their professional peers and society. The Hippocratic Oath was an initial expression of such a code. These codes of ethics guide doctors to promote the health and well being of their patients and prohibit doctors from behaving, if opportunities arise, in their own self interest.

 

The Australian Medical Association accepts the responsibility for setting the standard of ethical behaviour expected of all doctors. The Australian Medical Association Code of Ethics represents the core of fundamental principles which should guide doctors in their professional conduct.

 

Advancing the scope of medical management brings with it new and challenging ethical problems. The Ethics and Professional Conduct Comittee of the Australian Medical Association will address these issues and provide revisions of the AMA Code of Ethics from time to time, as appropriate.

 

THE DOCTOR AND THE PATIENT

 

Standards of Care

Practise the science and art of medicine to the best of your ability and within the limits of your expertise.

 

Continue self education to improve your personal standards of medical care.

 

Evaluate your patient completely and thoroughly, maintain accurate contemporaneous clinical records.

 

Ensure that doctors and other health professionals who assist in the care of your patient are properly qualified and fully competent to carry out the care.

Respect for Patients

Ensure that your professional conduct is above reproach.

 

Do not exploit your patient for sexual, emotional or financial reasons.

 

Treat your patient with compassion and respect for human dignity.

Responsibilities to Patients

Do not deny treatment to any patient on the basis of colour, race, religion, political beliefs or nature of illness.

 

Respect your patient's right to choose their doctor freely, to acceptor reject advice and to make their own educated decisions about treatment or procedures.

 

To enable them to make decisions, educate your patient about the nature of any illness from which they are known to suffer, the probable causes and the available treatments, together with their likely benefits and risks.

 

In general, keep in confidence information derived from your patient, or from a colleague regarding your patient, and divulge it only with the patient's permission, except when a court demands.

 

Recommend only those diagnostic procedures which seem necessary to assist in the care of your patient and only that therapy which seems necessary for their well being,

 

Recommend to your patient that additional opinions and services be obtained when treatment is not within your expertise.

 

Upon request by your patient, make available to another doctor a report of your findings and treatment.

 

Continue to provide services for an acutely ill patient until your services are no longer required, or until the services of another suitable doctor have been obtained.

 

When a personal moral judgment or religious conscience alone prevents the recommendation of some form of therapy, inform your patient so that they may seek alternative care.

 

Recognise that an established relationship between doctor and patient has a value,which dictates

that it should not be disturbed without compelling reasons.

 

Recognise that you may refusals treat a patient only in non-emergency situations, where the patient is given adequate notice of this intention and alternative care is reasonably available. However, the first rule under "Responsibilities to Patients" cannot be overridden.

 

Be responsible in setting an appropriate value on your services, and consider the personal service rendered when determining any fee.

 

Where possible, ensure that your patient is aware of your fees. Be prepared to discuss fees with your patient.

 

Do not refer patients to institutions or services in which you have a financial interest without full disclosure of such interest.

 

Clinical Research

Where possible, accept a responsibility to further medical progress by participating in properly developed clinical research studies involving human subjects.

 

Before participating in such studies, ensure that a responsible independent committee appraises the scientific merit of the clinical research, and that an institutional ethics committee evaluates its ethical implications.

 

Recognise that the well being of subjects always takes precedence over the interests of science or society.

 

Obtain prior consent of all research subjects or their agents, but only after explaining the purpose of the clinical research and any reasonably foreseen health hazards.

 

Inform treating doctors of the involvement of their patients in any research project, the nature of the project and its ethical basis.

 

Recognise that subjects should be allowed to  withdraw from a study at any time.

 

Do not allow a refusal to participate at any stage interfere with the doctor-patient relationship or appropriate treatment and care.

 

Protect the right of doctors perscribe, and any patient to recieve any new treatment which may offer hope of saving life, re-establishing health or alleviating Isuffering. In all such cases, fully inform subjects about the drug, including the new or unorthodox nature of the drug, where applicable.

 

Ensure that research results are communicated through recognised scientific channels to enable their balanced presentation to the profession.

Clinical Teaching

Pass on your professional knowledge and skills to junior colleagues.

 

Before embarking on any clinical teaching involving patients,  explain the nature of the teaching methods a patient's agreement.

 

Do not allow a refusal to participate in teaching with the doctor-patient relationship.

 

In any teaching exercise, ensure that your patient the best proven diagnostic and therapeutic met your patient's comfort and dignity are maintaied

The Dying Patient

Always bear in mind the obligation of preserving but, allow death to occur with dignity and comfort, is deemed to be inevitable and where curative appears to be futile.

Transplantation

Accept that when brain death has occurred (defined as the irreversible cessation of all functioning of the including brain stein, unless otherwise defined cellular life in the body may be supported if some parts of the body may be used to prolong life or to improve other people.

 

Recognise the responsibility to provide to the do relatives a full disclosure of the intent to transplant organs, the purpose of the procedure and, in the case donor, the risks of the procedure.

 

Ensure that the determination of the time of death of any donor patientis made by doctors who are in no way concerned with the transplant procedure or associated with the proposed recipient in a way that may exert any influence upon existance made.

Preface

The Principles listed in the Ethical Standards of Practice of Dance Therapists Registered, members of the Academy of Dance Therapists Registered, and members of the American Dance Therapy Association are principles which embody a professional level in the practice of dance/movement therapy. Concomitant with the Code of Ethical Practice, the Standards are guidelines for personal conduct, and serve as a model for practicing dance/movement therapists.

Principles

Principle 1: EDUCATION AND TRAINING. In the interest of the public and profession as a whole, an individual practices dance/movement therapy only after adequate preparation.

 

A. Dance: Intensive and extensive dance experience is fundamental and should include a wide range of movement skills to include teaching, performing, and choreography.

 

B. Dance Therapy Training: Training including academic education and fieldwork with supervision by a member of the Academy of Dance Therapists Registered (ADTR) or a person who has the equivalent qualifications, is essential. It is A.D.T.A.. policy that courses at the professional or training level should be taught by a person with a minimum of an ADTR.

 

B.1. Education:

 

a. There are formal educational requirements.

b. For specific information on competencies and course content refer to Standards for Graduate Dance Therapy Programs.

 

B.2. Internship/Fieldwork: Dance/movement therapy skills are developed in a clinical setting* under overall supervision by a member of the Academy of Dance Therapists Registered (ADTR). For specific skills refer to the document cited above.

 

PRINCIPLE 2: THERAPEUTIC RESPONSBILITIES. A dance/movement therapistestablishes a therapeutic alliance with the client, which includes the following:

 

A. Establishment with the responsible parties (client where possible, parent, guardian, or appropriate authority), of a mutually acceptable contract, regarding treatment goals, methods of implementation, relation to other therapists, and conditions of termination.

 

B. Provision of an appropriate setting for clinical work with reasonable standards of safety, security and privacy.

 

C. Referral of the client to the appropriate professional or agency when circumstances might result in either ineffective or harmful treatment.

 

D. Maintenance of systematic clinical reports containing discreet but pertinent information which can be available for evaluation by supervisors and other professionals for case presentations and personal review. See Principle 6A.

 

E. Does not work with clients in a role that is either exploitive or decreases objectivity. Is aware of the potentially powerful role between therapists and persons such as clients, students, and subordinates and avoids exploitation of the trust and dependency of such persons.

 

E.1. Does not solicit or accept requests from individuals with whom the therapist is in a dual relationship where one of these roles represents conflicting or competitive interests. Examples of such dual relationships, include but are not limited to, research and treatment with students, supervisory, friends, employees, or relatives.

 

E.2. Sexual intimacies with clients are unethical.

 

F. Collaborate with other professionals when appropriate.

 

PRINCIPLE 3: COGNIZANCE AND COMPLIANCE WITH LAWS AND REGULATIONS. The dance/movement therapist has the responsibility to know and follow state and national laws regulating therapeutic practice. Such knowledge and compliance assures the protection of research subjects, client welfare and confidentiality. Client's privacy and confidentiality is considered of the highest priority except when there is clear and imminent danger to an individual or society.

 

PRINCIPLE 4: SUPERVISION. Supervision refers to the interaction necessary to clarify and improve the treatment process. Professional supervision varies with the development of a dance/movement therapist's professional skills.

 

A. Specifics of Supervision:

 

A.1. Upon completion of training (see Principle 1) and Dance Therapy Registry (DTR), a practicing dance/movement therapist should have ongoing supervision by a member of the Academy of Dance Therapists Registered (ADTR) or qualified supervisor** in a clinical setting.

 

A.2. A member of the Academy of Dance Therapists Registered (ADTR) functions with peer review, self-evaluation, and consultation or supervision.

 

A.3. A member of the Academy of Dance Therapists Registered (ADTR) engaged in private practice has additional responsibilities regarding supervision (see Principle 5).

 

PRINCIPLE 5: PRIVATE PRACTICE. A member of the Academy of Dance Therapists Registered (ADTR) in private practice respects the following guidelines:

 

A. Entrance into Private Practice:

 

A.1. The individual is sanctioned by the American Dance Therapy Association to engage in private practice of dance/movement therapy only when identified by that professional organization as a member of the Academy of Dance Therapists Registered (ADTR).

 

A.2. A member of the Academy of Dance Therapists Registered (ADTR) in private practice follows all aspects of the Code of Ethical Practice, specifically those regarding knowledge of state and federal regulations required to meet the qualifications recognized for independent practice.

 

A.3. A member of the Academy of Dance Therapists Registered (ADTR) in private practice establishes financial arrangements for professional services consistent with the fees charged by other professionals for comparable work.

 

B. On-Going Training and Supervision:

 

B.1. An understanding of psychotherapy through intense study is essential.

 

B.2. on-going supervision with a member of the Academy of Dance Therapists Registered (ADTR) or another qualified supervisor** is recommended.

 

PRINCIPLE 6: LEGAL AND PERSONAL RIGHTS. A dance/movement therapist protectsand respects clients' rights.

 

A. Maintains the confidentiality of written records.

 

B. Engages in discussion of clients for professional purposes only, and avoids identity of client except when essential.

 

C. Obtains permission before using any client information contained within audio or video tapes.

 

D. Respects right of informed consent and other legal requirements when involving clients, client's records or videotapes for research purposes.

 

E. Preserves the client's anonymity outside the clinical setting.

 

F. Refrains from discriminating because of race, color, religion, age, sex, national origin, marital status, sexual orientation of clients, and physical or mental disability.

PRINCIPLE 7: AFFILIATIONS. . A dance/movement therapist should not affiliate professionally with individuals or organizations who oppose or are in conflict with the stated purposes and ethical standards of the American Dance Therapy Association.

 

PRINCIPLE 8: PROFESSIONAL CONDUCT AND REPRESENTATION. A dance/movement therapist supplying information to the public, either directly or indirectly, about the field of dance/movement therapy or the services, qualification and affiliations of dance/movement therapists, has an obligation to report fairly and accurately. For example:

 

A. A dance/movement therapist does not use affiliation with the American Dance Therapy Association for purposes that are misleading to the public.

 

A.1. A dance/movement therapist may not use the title Dance Therapist Registered (DTR) or member of the Academy of Dance Therapists Registered (ADTR) without having received the appropriate Certificate of Registration from the American Dance Therapy Association.

 

A.2. A dance/movement therapist may not use membership in the American Dance Therapy Association to imply exact experience or qualifications, or to suggest misleading levels of status or professional performance.

 

B. The use of the initials "D.T." or any variations thereof, to mislead the public, is unethical.

 

C. A dance/movement therapist assists the public in identifying dance/movement therapists competent to give dependable professional service.

 

C.1. Reports on substandard services rendered by fellow professionals only when professionally, legally, or ethically required.

 

C.2. Reports legal or ethical violations or professional concerns of fellow professionals to the appropriate person(s) or committee within the organization.

 

D. Adheres to professional rather than commercial standards in announcingservices.

PRINCIPLE 9: TREATMENT LIMITATIONS. A dance/movement therapist recognizes the boundaries of competency and limits of responsibility.

 

A. Practices within the limitations of the therapist's training, expertise, and area of specialization.

 

B. Consults with other specialists when necessary, and/or refers clients to them.

PRINCIPLE 10: THE TREATMENT ORIENTATION. A dance/movement therapistunderstands and follows the procedures and treatment orientation of the facility with which the therapist chooses to associate, and functions accordingly.

A. The dance/movement therapist adheres to the agreed upon employment contract with the employing facility.

B. The dance/movement therapist respects the rights and reputation of the employing facility and acts accordingly.

* A clinical setting should be a licensed or accredited treatment facility which provides clinical experience and in-service education.

** A qualified supervisor is a person with clinical competencies and experience at least equivalent to a member of the Academy of Dance Therapists Registered (ADTR).

Approved, ADTA Board of Directors; October 1977

Revised, May, 1979, October, 1981, October, 1983, October,. 1985, November, 1988, April, 1996

Policies and Procedures Governing Violations of the Code of Ethical Practice of the American Dance Therapy Association are available upon request.

AMERICAN DANCE THERAPY ASSOCIATION, INC. Suite 108, 2000 Century Plaza Columbia, Maryland 21044

I. Rules of Conduct

A. Propriety
The doula should maintain high standards of personal conduct in the capacity or identity as Labor Support Provider.

 

B. Competence and Professional Development
The doula should strive to become and remain proficient in the professional practice and the performance of professional functions through continuing education, affiliation with related organizations, and associations with other Labor Support Providers.

 

C. Integrity
The doula should act in accordance with the highest standards of professional integrity.

II. Ethical Responsibility to Clients

 

A. Primacy of Client's Interests
The doula's primary responsibility is to her clients.

 

B. Rights and Perogatives of Clients
The doula should make every effort to foster maximum self-determination on the part of her clients.

 

C. Confidentiality and Privacy
The doula should respect the privacy of clients and hold in confidence all information obtained in the course of professional service.

 

D. Obligation to Serve
The doula should assist each client seeking labor support either by providing services or making appropriate referrals.

 

E. Reliability
When the doula agrees to work with a particular client, her obligation is to do so reliably, without fail, for the term of the agreement.

 

F. Fees
When setting fees, the doula should ensure that the are fair, reasonable, considerate, and commensurate with service performed and with due regard for the client's ability to pay.

III. Ethical Responsibility to Colleagues

 

A. Respect, Fairness, and Courtesy
The doula should treat colleages with respect, courtesy, fairness and good faith.

 

B. Dealing with Colleages' Clients
The doula has the responsibility to relate to the clients of colleages with full professional consideration.

IV. Ethical Responsibility to the Labor Support Profession

 

A. Maintaining the Integrity of the Profession
The doula should uphold and advance the values, ethics, knowledge, and mission of the profession.

 

B. Community Service
The doula should assist the profession in making labor support services available to the general public.

V. Ethical Responsibility to Society.

 

A.Promoting Maternal and Child Welfare
The doula should promote the general health of women and their babies, and whenever possible, that of their family and friends as well.

 

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