Respiratory therapists are required to possess excellent clinical skills in order to deliver high-quality care to their patients. However, they must also provide services in an ethical way in accordance with the law.
This can be difficult to do, as there are many implications that need to be considered when providing respiratory care. RTs must regularly make choices that have both ethical and legal consequences.
This article will help you develop a better understanding of this topic, whether you’re a student or a licensed respiratory therapist.
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How to be an Ethical Respiratory Therapist?
There are several practices that respiratory therapists can adhere to in order to ensure that they are acting ethically and lawfully while on the job. Here are a few examples, as outlined by the AARC:
1. Be Objective, Trustworthy, and Reflect Integrity
Be honest. That’s what it all boils down to. Integrity is the quality of being honest and having strong moral principles in everything you do.
Trust your co-workers to fulfill their job duties competently, and you do the same. This goes a long way with your patients and other members of the healthcare team.
2. Never Stop Learning
This is required, so you might as well embrace it. Life-long education is important in all aspects of life. We should always strive to gain knowledge and learn new skills in the field of respiratory care.
Depending on the state of your licensure, you will be required to obtain a certain amount of continuing education units (CEUs) each year. This is not only something everyone should do; it is a requirement in order to maintain licensure.
3. Provide Care within Your Scope of Practice
What this basically means is that you should stay in your lane. You wouldn’t want a nurse to stick an ABG for you, so you shouldn’t be trying to start an IV for them.
You get the idea. Even if it’s something small, if it’s not within your scope of practice, don’t do it. This not only protects yourself, it also ensures the safety of your patients.
4. Protect the Personal Rights of the Patient
This goes without saying, but always keep your patient’s information private. This means that you should never share any patient information without their consent unless it’s required by law.
Unfortunately, this is something that occurs far too often amongst healthcare workers.
5. Don’t Discriminate
You should treat all patients equally and provide high-quality care, no matter their background. Here’s a simple rule of thumb:
Treat each patient as if they were your family member.
Because remember, they are someone’s loved one. And it is your job to care for all patients equally.
6. Promote Disease Prevention and Wellness
You must do your part in disease prevention, and it’s not that hard.
Wash your hands before and after each patient interaction. Scrub in, and scrub out whenever necessary. Wear a mask, gown, and other PPE when it’s required.
It goes without saying, but this not only protects the patient, it also protects your health and wellbeing.
7. Participate in No Illegal or Unethical Acts
I mean, yeah. Don’t do illegal things at work. Got it?
Seriously, though. Don’t steal from your employer. Don’t give yourself a breathing treatment while at work. Don’t show up to work under the influence. Use common sense, people.
This also includes reporting unlawful acts that you may witness.
Now, it may be difficult, especially if it’s a co-worker who is also a friend. However, if you see that their actions can bring harm to a patient, it is your ethical and legal obligation to report the actions to a superior.
8. Comply with State and Federal Laws
We all must abide by the same federal laws in order to maintain the credentials that give us the right to practice respiratory care.
However, some states may have laws that vary slightly from others.
It’s your responsibility to learn and uphold the laws of the state in which you choose to practice. This applies to acquiring and maintaining your license to practice in that state as well.
9. Avoid Conduct that Creates a Conflict of Interest
A conflict of interest arises when a person has a personal interest that could influence their professional judgment.
For example, a respiratory therapist might have a financial interest in a company that manufactures respiratory equipment. If they were to recommend this equipment to their patients, they would be engaging in a conflict of interest.
The best way to avoid this is to be transparent with your patients. To be safe, simply avoid taking any action that could be interpreted as a conflict of interest.
10. Promote Stewardship of Resources
One way to promote stewardship of resources is to use equipment and supplies in a responsible manner. For example, you should use materials in a way that minimizes waste and maximizes the benefit for your patients.
You can also make sure to use the most up-to-date and evidence-based practices. Doing so helps ensure that you are providing high-quality respiratory care.
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Practice Questions about the Ethical and Legal Implications of Respiratory Care:
1. If a respiratory therapist refers a medicare patient to a home care company and receives a finder’s fee in return, this is an example of what?
This is an example of medicare fraud.
2. What simple question does ethics try to answer?
“How should we act?”
3. What ethical issue is a significant concern for respiratory therapists and all healthcare providers due to a recent congressional act?
The patient’s right to privacy
4. In most professions, specific guidance in resolving ethical dilemmas is provided by what?
A code of ethics
5. The AARC code of ethics holds professionals to what principles?
Actively maintaining and improving one’s competence, following sound scientific procedures and ethical principles in research, promoting disease prevention and wellness, striving to improve the access, efficacy, and cost of patient care, and respecting and protecting the rights of the patients they treat
6. Contemporary ethical principles have evolved from all of the following sources EXCEPT?
7. The primary guiding principle in contemporary ethical decision-making includes what?
Nonmaleficence, autonomy, justice, and role fidelity
8. Which ethical principle obliges a respiratory therapist to uphold a patient’s right to refuse treatment?
9. A healthcare professional who withholds the truth from a patient, saying it is for her own good, is engaged in what?
10. What ethical principle can be used to justify the pain that might occur in drawing blood from a patient for a diagnostic test?
11. The debate over prolongation of life vs. relief of suffering in elderly patients involves differing opinions regarding what ethical principle?
12. What type of advance directives can patients use to help resolve ethical dilemmas involving their life-sustaining care?
Durable power of attorney and living will
13. Under what conditions can the principle of confidentiality be breached?
When the welfare of the community or a vulnerable individual is at stake
14. The moral basis for rationing healthcare services falls under what ethical principle?
15. What has played a major role in increasing the cost of healthcare?
16. When a respiratory therapist defers a patient’s questions about a condition to the attending physician, what ethical principle is being practiced?
17. A clinician who justifies support for withdrawing life support from a patient because “in the end, it would be best for all involved” is applying what ethical viewpoint?
18. A clinician who justifies not billing a poor patient for services rendered because “that’s what a professional should do” is applying what ethical viewpoint?
19. Before making any ethical decision, you should do what?
Identify the individuals that are involved, identify what ethical principles apply, identify who should make the decision, and consider the alternatives
20. The division of public law includes what?
Administrative and criminal
21. What branch of law is concerned with the recognition and enforcement of the rights and duties of private individuals and organizations?
22. What is the term for a civil wrong committed against an individual or property for which a court provides a remedy in the form of damages?
23. When should patient information be discussed?
Only in private and with persons who have a legitimate reason and need to know.
24. In a case of professional negligence, all of the following are required to support a claim of “res ipsa loquitur” EXCEPT?
Evidence must exist to show that the defendant acted with malfeasance or intent.
25. A respiratory therapist who participates in active euthanasia is committing what type of malpractice?
Did someone say, "5 of PEEP?" I think so! Order your own PEEP t-shirt today.
26. A respiratory therapist who practices below a reasonable standard of care is committing what type of malpractice?
27. A respiratory therapist who engages in questionable business practices is committing what type of malpractice?
28. All of the following are considered intentional torts EXCEPT?
29. When a practitioner performs a procedure that involves physical contact without the patient’s consent, it can result in what charge?
30. Which of the following are legitimate defenses against an intentional tort?
Lack of intent to harm a patient and informed consent given by the patient
31. A physician specifies an incorrect dose in a prescription for a powerful bronchodilator drug to be given to an asthmatic patient. When the respiratory therapist gives the dose, the patient suffers a fatal response and dies. Based on the principle of duty, against whom could a suit of negligence be brought?
Everyone involved, including the respiratory therapist, attending physician, and the dispensing pharmacist
32. What does PHI stand for?
Protected health information
33. What legal doctrine holds superiors responsible for the actions of their workers?
34. What conditions are necessary to incur liability under the doctrine of respondeat superior?
The injury caused must be the result of an act of negligence. The act must occur within the subordinate’s scope of employment.
35. All of the following are common elements in a professional practice act EXCEPT?
Professional code of ethics
36. What is an advanced directive?
A legal document that allows a patient to specify what medical care they do or do not wish to receive if they were no longer able to make decisions on their own
37. What is assault?
Wrongdoing that is considered to be intentional
38. What is autonomy?
A principle that acknowledges a patient’s personal liberty and their right to decide their own course of treatment
39. What is battery?
Placing another person in fear of bodily harm
40. What is professional malpractice?
Negligence in which a professional has failed to provide the care expected, resulting in harm to a patient; some examples include performing tasks beyond the practitioner’s skill level, failure to perform duties that were assigned, or failure to perform the duty correctly
41. What is benevolent deception?
The truth is withheld for the patient’s own good.
42. What is a breach of contract?
Failure to carry out the terms of the contract
43. What is compensatory justice?
The recovery of damage by the action of others
44. What is confidentiality?
The act of respecting a patient’s right to privacy; healthcare workers are not permitted to share a patient’s medical history with others
45. What is consequentialism?
The act is judged to be right or wrong based on its consequence, which aims to promote the greatest general good
46. What is a decision-making model?
A model that combines formalism, consequentialism, and modern decision-making theory
47. What is distributive justice?
The proper allotment of benefits
48. What is the double effect?
The first intent is good; then, it’s harmful (unintended)
49. Ethical dilemmas in respiratory care often involve what?
The scope of practice, confidentiality, working within levels of professional responsibility, professional development issues, staffing patterns, and recordkeeping
50. When do ethical dilemmas occur?
When there are two equally desirable or equally undesirable choices, which may also involve situations that are either legal or illegal
51. What is formalism?
The viewpoint that relies on rules and principles; an act is justifiable if it upholds the rules or principles that apply
52. What is HIPAA?
It’s an act that establishes standards for the privacy of a patient’s identifiable health information. The primary goal of the act was to strike a balance between protecting an individuals’ health information while not impeding the exchange of information needed to provide quality care.
53. What is informal consent?
Consent to treat a patient
54. What is intuitionism?
An ethical viewpoint that states that there are certain self-evident truths, usually based on moral maxims
55. What is justice?
Fair distribution of care that indicates that a balance must be made between expenses and the ability to pay for them
56. What is libel?
The written defamation of character
57. What is a living will?
A patient’s health care preferences in writing
58. What is negligent tort?
Failure to perform one’s duties competently as a healthcare provider
59. What is non-maleficence?
It obligates healthcare providers to avoid harm whenever possible. The problem occurs whenever treatment has serious side effects or a double effect.
60 What is a plaintiff?
Someone who brings a complaint
61. What is res ipsa loquitur?
A rule of evidence of negligence
62. What is role duty?
A term that refers to a healthcare provider’s ability to understand the limits of their role and to practice with fidelity. For example, the respiratory therapist must not perform duties outside of their defined role.
63. What is rule utilitarianism?
A rule for the greatest good of a person
64. What is slander?
Verbal defamation of character
65. What is tort?
It is a civil wrong against an individual or property for which the court provides a remedy. It is an act that violates another’s interests.
66. What is veracity?
It binds a healthcare provider and patient to tell the truth.
67. What are professional codes of ethics?
Guidelines established to identify ideal behavioral parameters by members of a professional group
68. What is an example of a respiratory therapist providing care within their scope of practice?
A nurse should never attempt to stick an arterial blood gas (ABG), and a respiratory therapist should never attempt to start an IV.
69. What are the three malpractice classifications?
Criminal malpractice, civil malpractice, and ethical malpractice
70. What are the two basic ethical theories?
Formalism and consequentialism
71. What are the two general defenses against intentional torts?
(1) There was no intent to do harm, and (2) The patient gave consent to the action, knowing the risk involved
72. What do civil or private laws protect?
Private citizens and organizations from others who might seek to take unfair and unlawful advantage of them
73. What does a professional license provide?
It provides a framework under which a licensee carries out his or her duties. It also acts to define who can perform specified duties. It is expected that the duties will be performed in a professional manner to provide safety.
74. What does administrative law deal with?
It is the second major branch of public law for government agencies. Healthcare facilities are inundated by a host of administrative and agency rules that affect almost every aspect of operation.
75. What does civil law deal with?
It involves the recognition and enforcement of the rights and duties of private individuals and organizations.
What are the Ethical Implications of Respiratory Care?
The ethical implications of respiratory care relate to the ways in which RTs can provide care in an ethical manner. This includes considering the needs of patients, respecting their autonomy, and making sure that they receive the best possible care.
It also includes ensuring that respiratory therapists adhere to professional standards, act in accordance with the law, and avoid conflicts of interest.
What are the Legal Implications of Respiratory Care?
The legal implications of respiratory care relate to the ways in which a respiratory therapist must provide care in accordance with the law. This includes ensuring that they have the necessary qualifications and licenses to practice and that they follow all relevant laws and regulations.
It also includes making sure that respiratory therapists do not engage in any illegal activities, such as providing care that is outside of their scope of practice.
How Can Respiratory Therapists Make Ethical and Legal Choices?
When making choices that have both ethical and legal implications, a respiratory therapist must consider both sets of rules carefully. They should make sure that they are qualified to provide the care that they are offering and that they are following all relevant laws and regulations.
They should also make sure that their choices are in line with the professional standards that they are required to uphold. If they are unsure about whether a particular choice is ethical or legal, they should seek guidance from a supervisor or another expert.
What is an Advance Directive?
Every patient should have an active role in determining the medical care that they receive. Unfortunately, sometimes this is not possible due to an event such as an accident or sudden illness.
This is when an advance directive comes into play.
An advance directive is a legal document that allows a patient to specify what medical care they do or do not want to receive if they’re no longer able to make a decision on their own. The two types include a living will or durable power of attorney.
What is a Living Will?
A living will is a legal document that outlines the patient’s wishes for their end-of-life care. It can cover things such as what kind of medical treatment the patient does or does not want to receive and whether they want to be resuscitated if their heart stops beating.
The living will only comes into effect if the patient is unable to make their own decisions, such as if they are in a coma. Therefore, it is important for the patient to discuss their wishes with their family and friends so that they are aware of their wishes.
What is a Durable Power of Attorney?
A durable power of attorney is a legal document that gives someone else the authority to make decisions on the patient’s behalf. This person is known as their “agent” or “attorney-in-fact.”
The durable power of attorney can be used for financial and legal matters or for health care decisions. It is important for the patient to choose someone they trust to be their agent, as they will be making decisions that could have a significant impact on their life.
What is HIPPA?
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects the privacy of patient health information. HIPAA requires medical professionals to keep patient health information confidential, and to only share it with those who need to know.
Failure to comply with HIPAA can result in serious penalties, including fines and jail time. It is important for respiratory therapists to be familiar with HIPAA so that they can make sure they are complying with the law.
The ethical and legal implications of respiratory care are serious matters that should not be taken lightly. If you are a respiratory therapist, it is important that you always act in the best interests of your patients and within the bounds of the law.
Doing so ensures that the patient is receiving high-quality care, which is an important code to adhere to.
If you have any questions about what is considered ethical or legal in your state, you should consult with an attorney. Thanks for reading and, as always, breathe easy, my friend.
John Landry, BS, RRT
John Landry is a registered respiratory therapist from Memphis, TN, and has a bachelor's degree in kinesiology. He enjoys using evidence-based research to help others breathe easier and live a healthier life.
- Faarc, Kacmarek Robert PhD Rrt, et al. Egan’s Fundamentals of Respiratory Care. 12th ed., Mosby, 2020.
- “AARC Guide to Professionalism American Association for Respiratory Care.” AARC, 13 May 2020, www.aarc.org/resources/professional-documents/whitepapers/professionalism.
- “Code of Ethics and Guidance Document for the Respiratory Care Practitioner.” NCRCB, 12 Oct. 2017, www.ncrcb.org/ethics.
- “Resources.” The National Board of Respiratory Care, www.nbrc.org/resources.