Any professionalism violation may be considered to constitute grounds for disciplinary action in the discretion of the SPC, including academic probation or dismissal from the program. It is expected that this will be a rare event. Students must be respectful in their communication with peers, faculty and staff, the preceptor, patients and family members concerning these events and must never contradict a supervisor in a public setting. Disrespectful, demeaning, or otherwise inappropriate or unprofessional communication will not be tolerated and students violating this standard may be dismissed for the day.
Students who violate this standard may be referred to the SPC. Students are expected to act in accordance with standards in the following six domains: Excellence Accepts responsibility for educational challenges and self-learning. Accepts corrections and feedback graciously and corrects shortcomings.
Respects instructors and their teaching endeavors. Submits work of the highest standards of competence and skill. Humanism and Cultural Competency Engages in relationships with the external world. Demonstrates respect, compassion and empathy for others. Demonstrates sensitivity and responsiveness to culture, gender, age, disabilities and ethnicity of others.
Establishes cooperative relationships with others who have differences in opinion, philosophy, religion, creed, gender, sexual orientation, culture, race, ethnicity and language. Accountability Punctual and prepared for all obligations. Completes assigned tasks on time. Maintains professional appearance in professional settings Contributes to group work in a timely manner Interpersonal and Communication Skills Able to effectively relate to patients, peers and colleagues.
Maintains composure during adverse interactions or situations.
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Communicates at a level that is appropriate for a given audience. Demonstrates cooperation and collaboration, works well with authority figures, classmates and patients. Ethical Behaviors Maintains confidentiality standards. Private exchanges may include determining whether the patient feels safe and well cared for; eliciting fears or concerns; obtaining the names of other family caregivers the patient might want the physician to contact; and determining whether the patient requires legal or social services.
Patients should be evaluated for neglect and physical, emotional or financial abuse apart from the caregiver or family members. Physicians must be familiar with specific state reporting statutes and the implications of reporting patient neglect or abuse. Adequate information generates feelings of preparedness and confidence and sets the stage for success and cooperation.
Ethics and professionalism : a guide for the physician assistant
Patients have the right to make decisions regarding their medical treatment, but they may need to consider other caregiving alternatives if the burden of those decisions is too much for the family caregiver. Conflicts about treatment decisions may stem from disagreement about treatment risks or goals, or from the implications of a treatment for the caregiver. The physician may wish to refer the patient and caregiver s for assistance or counseling when conflicts persist. Advance care planning facilitates implementing patient wishes and surrogate decision making. This planning should be part of routine preventive medical services with every adult patient.
Patients generally wait for the physician to initiate advance care planning discussions. This dialogue will better prepare the clinician and caregiver for decision making in the event it becomes necessary.
The medical power of attorney, or durable power of attorney, another type of advance directive, identifies the person the patient has empowered to make health care decisions if needed. Physicians should encourage the patient to inform key family members and friends about end-of-life preferences. Physicians should also discuss making advance directives accessible to clinicians in all care settings including placement in the medical record. Discussions that focus on cultural beliefs, values, goals and outcomes rather than on the desire for particular interventions and treatments contribute to a more satisfactory decision-making process.
Caregivers are valuable members of the health care team, helping patients manage and cope with illness.
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Patient information provided by the caregiver may be as pertinent and reliable as the medical record. Acknowledgement of the caregiver contribution is vital to ongoing trust and continued collaboration providing patient care. Caregiver concerns about failing to meet expectations to manage care cause significant stress that can impede decision-making regarding end-of-life care, utilization of outside services and institutional placement. In addition to technical aspects of care, for example, parental administration of medication, caregiver education also includes identification and management of treatment side effects, nonpharmacologic symptom management and signs of advancing disease.
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Family caregivers face overwhelming physical, emotional and financial demands that may make them especially vulnerable to injury, depression and other stress-related conditions. Family caregivers often lack the time and energy to prepare meals, exercise, or obtain their own recommended preventive medical care.
Referrals to support groups, training and community and social services, can help sustain successful caregiving. In order to ease the burden on the caregiver, appointments may occur in tandem but not simultaneously.
The number of long distance family caregivers, defined as those who provide care from more than an hour from the family member, is increasing. Hospice and palliative care are often seen as interchangeable, but the goal of palliative care services is to prevent and relieve suffering and support the best possible quality of life for patients and their families regardless of disease stage. Patients and their caregivers may need reassurance that palliative care can be integrated with treatment of incurable chronic disease.
Ethics and Professionalism : A Guide for the Physician Assistant - F.A. Davis Company
Hospice may be considered appropriate for patients with a life expectancy of six months or less. This will allow caregivers and families the opportunity to make final arrangements, resolve differences, reach closure and say goodbye. When death is preceded by a long period of intense successful caregiving, the caregiver often experiences fewer negative effects. When death occurs, the physician should personally communicate with the family caregiver, answer questions, and acknowledge the loss and its significance.
Although limited data exist, 56 anecdotal literature suggests that when the family caregiver is a health professional, caregiving may bring added or unique pressures and ethical challenges. Patients and family members need to be informed that it is generally not appropriate for physician caregivers to treat family members and they should not place the physician-caregiver in compromising emotional and professional positions in non-emergent situations.
The physician-caregiver should be careful not to function as, or appear to be, a treating physician. However, he or she can facilitate and improve communication between the treating physician, the patient, and other family members as well as assist in monitoring and delivering care as directed by the treating physician. In this role, the physician-caregiver can improve continuity of care and ameliorate the many potential adverse consequences of the fragmented medical system.
The ethical guidance outlined in this paper is intended to heighten physician awareness of the importance and complexity of the patient—physician—family caregiver relationship, to maximize the benefits of those relationships and to minimize the burdens on family caregivers. This guidance builds on general principles of medical ethics and professionalism, extending them to family caregivers for the benefit of the patients. An appendix of resources related to family caregivers is available online to assist physicians in implementing these principles to build effective partnerships with family caregivers.
The ACP Ethics, Professionalism and Human Rights Committee would like to thank and acknowledge the following reviewers of this position paper who provided valuable insights and suggestions: Patient and medical education on complementary and alternative care: In Snyder L ed. Complementary and Alternative Medicine: Ethics, the Patient and the Physician.
No other conflicts of interest were disclosed. Members of the Committee were Virginia L. Shelhamer, DO; Barbara J. National Center for Biotechnology Information , U. J Gen Intern Med. Published online Jan 9. Author information Article notes Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Abstract Family caregivers play a major role in maximizing the health and quality of life of more than 30 million individuals with acute and chronic illness. Please verify that you are not a robot.
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Professional Standards of Conduct Policy
Your rating has been recorded. Write a review Rate this item: Preview this item Preview this item. English View all editions and formats Summary: Ethics content has become more of a priority in Physician Assistant education due to its increased emphasis on the certification exam and as a stated criteria element for accreditation. The authors' intent is to create a "first of its kind" case-based ethics text for the PA market that is dedicated to addressing the uniqueness of the PA role in the practice of medicine and the specific dilemmas and issues that confront Physician Assistants every day.
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Find a copy in the library Finding libraries that hold this item Electronic books Additional Physical Format: Document, Internet resource Document Type: Includes case studies that focus on critical thinking and the clinical application of ethics and professionalism; ethical considerations of vulnerable patients; and contributions by noted PAs, MDs, and PhDs.
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