The field of respiratory therapy is a critical component of healthcare, responsible for the evaluation, treatment, and care of patients with breathing or other cardiopulmonary disorders.
Given the sensitive and life-sustaining nature of their work, respiratory therapists are expected to adhere to a strict “Code of Ethics.”
These ethical guidelines not only provide a framework for professional conduct but also serve as a foundation for decision-making in complex clinical scenarios.
This article breaks down the critical aspects of the respiratory therapist code of ethics, illuminating its importance while providing insights for both practitioners and stakeholders in healthcare.
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How to Be an Ethical Respiratory Therapist
Being an ethical respiratory therapist involves more than simply having the technical skills to manage respiratory conditions.
The role requires a strong ethical foundation that influences decision-making, interactions with patients, colleagues, and other healthcare professionals, as well as compliance with regulations.
Here are some key points to consider:
- Adhere to the Code of Ethics: Familiarize yourself with and rigorously adhere to the respiratory therapist code of ethics provided by your professional organization. These guidelines lay down the moral and ethical standards that you are expected to follow.
- Prioritize Patient Welfare: Always act in the best interest of the patient. Provide the highest standard of care, be it through administering treatments, conducting assessments, or making recommendations for further interventions.
- Maintain Confidentiality: Respect patient confidentiality at all times. Only share medical information with professionals who are directly involved in the patient’s care, and always abide by the HIPAA guidelines and other relevant regulations.
- Stay Updated: Ethical practice requires competence. Continuously update your skills and knowledge through professional development courses, workshops, and by staying current with the latest research and guidelines in respiratory care.
- Be Honest and Transparent: Whether it’s with patients, families, or colleagues, always communicate honestly and transparently. This includes acknowledging any errors or lapses in treatment and taking corrective actions promptly.
- Advocate for the Patient: Stand up for the rights and needs of your patients, especially when they are unable to advocate for themselves. This may involve communicating with other members of the healthcare team or even stepping in when you notice unethical behavior.
- Practice Cultural Sensitivity: Provide care that is respectful of, and responsive to, individual patient preferences, needs, and values, regardless of race, religion, or cultural background.
- Collaborate and Communicate: Work effectively as a member of the healthcare team. Good communication and collaboration with nurses, physicians, and other healthcare providers are essential for ensuring optimal patient care.
- Record Keeping: Maintain accurate, clear, and timely records of all respiratory care services provided. Good documentation is not just a professional requirement but also a legal and ethical necessity.
- Self-Regulate: Take the time to reflect on your own practice and actions, and be open to feedback. If you find yourself in an ethical dilemma, consult your Code of Ethics, seek advice from trusted colleagues or an ethics committee, and take responsible action.
Note: By following these principles and continually striving to uphold ethical standards, you not only contribute positively to the well-being of your patients but also elevate the standards and reputation of the respiratory care profession as a whole.
Practice Question About the Respiratory Therapist Code of Ethics
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?
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 is when 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 individual’s health information and 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.
FAQs About the Legal Implications of Respiratory Care
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 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.
Understanding and adhering to the respiratory therapist code of ethics is non-negotiable for professionals in this field. The guidelines encapsulate the principles of patient welfare, competence, legal and ethical behavior, and collaborative healthcare.
Upholding these ethical standards is vital for ensuring that patients receive the highest quality of care while maintaining the integrity of the profession.
A respiratory therapist’s failure to abide by these principles can result in not just professional repercussions but, more crucially, can compromise patient well-being.
Therefore, continuous education, self-assessment, and a commitment to ethical practice are imperative for anyone involved in the field of respiratory care.
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.
- “Code of Ethics and Guidance Document for the Respiratory Care Practitioner.” NCRCB, 12 Oct. 2017.
- “Resources.” The National Board of Respiratory Care.