Jeff King

Any person’s core values are developed within them based on their interactions with their

external environment growing up. I believe this to be true for every person, at least initially. The

core values that have the most importance to them typically mimic their parent’s values and

reflect how they were raised. However, this is not to say that a child with “bad” parents can’t

grow up to have strong, ideal morals and values. I also believe if there were ever a time in your

life where you struggled with a core value or experienced a lack of that value, it becomes much

more appreciated in your life. These two principles of parental influence and personal

experiences are the sources of my own values and behaviors.

The specific core values that I believe I developed through my upbringing and parental

influence are love, religious faith, wisdom, and achievement. These values were engraved in me

at a young age as they are clearly important to my parents as well. Additionally, there are values

that are important to me based on how my life has gone so far. These are emotional well-being,

health, and recognition. These beliefs altogether drive my behaviors and lifestyle as a person and

future professional. It’s hard for me to determine a specific ranking for each of these individual

values as they all influence my decision making uniquely. However, I do know that love,

religious faith, and emotional well-being are the foundation of my behaviors in life. Love and

religious faith are principles I developed through my upbringing, whereas emotional well-being

is a value I’ve learned to cherish over time as it is something I have struggled with in the past. I

believe this mix of my most important values from both my parents and my own life experiences

reinforce my previously stated point: parental influence and personal experiences will shape your

own values as you go through life.

The core values through the APTA are as follows: accountability, altruism, collaboration,

compassion & caring, duty, excellence, integrity, and social responsibility.1 Although this list
Jeff King

does not share similar core values as my own, I still feel I have these principles within me. I

believe all aspiring and current physical therapists have these traits within them, some more than

others. All physical therapists are similar people morally and ethically so it would be assumed

that they would all agree with this list to some extent. Personally, I realize that this list does not

match up with mine, but I still hold the APTA’s values as my own. Every value listed is a

principle I find important to myself and my future career so I would say my values correspond

fairly well. Admittedly, my own list is more self-centered than the APTA’s, but that is not

surprising to me. I think the values they created are for what they deem an idealistic physical

therapist should be. I think they realize that they developed these values as something for

physical therapist’s to always strive for, especially if their own values do not correspond much. I

don’t think a person should mindlessly copy the values set forth by the APTA because then it

would not be genuine. It is important to find a balance between your own values and the ones

you are supposed to have through your profession so that you stay true to yourself while also

trying to improve on areas you lack.

Something that I have always appreciated about human beings is our innate uniqueness.

Unfortunately, that means personal values may not always line up with the ideals and beliefs of

our professional guidelines. I believe putting others above our own interest is a value that is an

inherent characteristic of all physical therapists. Although this is true for myself, I know I must

take care of my own well-being in order to continue giving my best to the people of need. This

means that there will be times where my own personal values will drive my decisions over the

values of the profession. Specifically, emotional well-being and health come to mind. These

values for me will typically drive my decisions over the profession’s values such as altruism,

social responsibility, and excellence. I’m not sure everyone would agree with that, but I think
Jeff King

deep down everyone has to have their own interest above all. The professional values of physical

therapy are attainable but not realistic to not include self-interest. I would include all of the

values through this profession, but this does not lessen the importance of my own principles.

There will be times where I will face internal conflicts and have to make a decision that may

favor my own values over the best interests of my patients. For example, if I am starting to feel

ill, I will face the decision of continuing to work and potentially getting worse or taking care of

myself and taking the time off. If in this scenario I did not get my patients sick, it would be in

their best interest for me to come to work. However, me choosing to take the day off would

benefit my own health and well-being, thus allowing me to give my best to my patients of the

future. This could be applied to taking vacation time to prevent burnout as well. Taking time to

get my mind in the right place with a needed break would only benefit my patients in the future.

Another example along the same lines of self-interest, perhaps the best treatment for a patient is

primarily manual techniques that would strain my body if I continued doing them. I would have

to assess whether I should do the best treatment option for that patient or choose to try something

similar that would not negatively affect my own body. I don’t view it selfish to choose a self-

preservation approach when there are other viable options because it would allow you to have a

longer career and help more patients throughout the years. The positive side of leaning towards

your own values is that I think it benefits everyone in the long run. Initially it will primarily

benefit myself, but it would allow me to return to work healthy and motivated to help my

patients while being in the right mindset. By taking care of myself I will essentially be helping

my future patients by preserving the best version of myself I can give to them.

We’ve explored multiple ethical theories throughout this semester, each with its own unique

differences. These theories include utilitarianism, deontology, virtue ethics, and ethics of care. I
Jeff King

would describe utilitarianism in simple terms as making decisions based on the “greater good.”

These decisions do not take into account self-interest or the interests of specific individuals. On

the contrary, the actions of this approach are developed on the basis of which decision would

create the most desirable result for the most amount of people. It is not thought of as the moral

“right or wrong” but as deciding what the correct decision is based on the outcomes and/or

consequences for the majority. This approach guides actions by choosing the most positive

outcome for the largest amount of people.

Opposite of the idea of right and wrong being based on consequences and outcomes,

deontology focuses decision making based on a moral code or a set of rules. It does not

necessarily weigh the costs and benefits of a problem like utilitarianism does. Instead, it relies on

a previously developed set of guidelines to follow such as law. Simply put, “right” actions are

determined based on following the correct laws or rules, while “wrong” actions are those that do

not obey ethical rules. It follows rules such as not lying, stealing, or cheating regardless of

positive outcomes or limited consequences.

Instead of rules or consequences being used to determine ethical decision making, virtue

ethics emphasizes an individual’s moral character. Virtues are characteristics or traits that our

society has universally deemed “good” and are qualities people strive to be considered a

righteous person. Virtue ethics simply relies on moral principles to drive decisions and does not

define such virtues according to another theory. For example, deontology would define virtues as

characteristics of those who follow rules and fulfill their duties and utilitarian’s would define

virtues as traits that develop good outcomes. Virtue ethics focuses on the individual’s character

and how they live through their virtues, so it essentially is individual-based rather than action-

based.
Jeff King

Finally, ethics of care is the most contextual based of all the approaches. It is based on

relationships between people and understanding the needs of that individual. It appreciates that

people depend on each other in varying degrees and that ethical decision making is centered

around the care of people within your own encounters. It guides you to approach each situation

based on the context of your relationship with that person. You determine your obligation to help

that person of need and doing what you believe you are obligated to do based on the relationship

that you have with that particular individual. It is a balance of caring for individuals while

maintaining yourself. Your level of care or help can essentially be determined by the strength or

type of relationship you have with that person.

I can appreciate that different and unique ethical theories can point to certain ethical

approaches rather than others. Some ethical dilemmas involve one individual while others

involve the majority, so it is important to choose a theory that fits the situation most

appropriately. When it comes to determining law, I believe the utilitarian approach is most

useful. Whether related to the entire population or just physical therapy, laws should benefit the

most amount of people while limiting consequences. Laws should never be out of self-interest

but in the interest of the majority, which follows the ideals of utilitarianism. For example,

deciding on allowing direct access for patients could have been guided by the utilitarian

approach because that direct contact to a physical therapist would benefit a lot of potential

people with relatively no harm to others. There could be potential dilemmas because a physical

therapist has a duty to both the individual patient and society, so situations where breeches of

confidentiality may occur. Likewise, informed consent may have to be broken in cases of

mentally handicapped or unresponsive patients. Even though you “shouldn’t” do that, it may be

necessary for the benefit of that patient. This situation would favor ethics of care over
Jeff King

deontology. Similarly, deontology may have to be ignored if a patient did something illegal but

reporting them would cause greater harm than not. Regarding patient interactions, I believe

virtue ethics or ethics of care would resolve ethical dilemmas the best. With a patient in need,

using your own virtues to guide you or your obligation to care for that patient based on your

relationship with them seems most appropriate.

I think it’s important to emphasize that the way I rank these approaches does not

necessarily mean it should be the same opinions for others to use. I don’t personally believe there

is a correct order to these, but I believe I can see an order for which I could use them to guide my

own decision making. Before discussing in full, I would place these four theories in order of

most valuable to me personally as: virtue ethics, ethics of care, utilitarianism, and finally

deontology. I appreciate the principles of virtue ethics the most because it seems to be the only

one focused on the individual. It seems that it is more about who you are as a person instead of

the actions you choose to do. Virtue ethics seems the most natural to me. For example, if you

were faced with an ethical dilemma and had to decide immediately, I think most people would

rely on their virtues. I believe the other theories require thinking through how to obey the

guidelines of each approach. I believe the majority of people rely on virtue ethics to make the

majority of their ethical decisions because it is the only approach that focuses on your own self.

Ethics of care resonates with me because it drives on a trait that all health care

professionals possess: caring and compassion. Where virtue ethics would be the basis of my

daily living moral choices, ethics of care would most likely take over during my working career.

This approach appeals to me because you make your decisions in a case by case basis and is

much more contextual than the others. Your obligation of care to people is dependent on your

relationship with them and yourself.

Jeff King

In a much less individual-based approach, utilitarianism has value when deciding matters

of the “greater good.” I would find this theory very valuable whenever making decisions for the

majority and that’s the reason for its appeal to me. I think whenever I were faced with a decision

involving a lot of people, I would instinctively direct my decision making to this approach. It

logically makes sense to try to create the most good for the most people and seems to be used

quite frequently by people who make large decisions for the majority.

I think deontology is the most challenging approach to follow because it can go against

instincts. It seems slightly robotic in nature to me depending upon which set of rules you follow.

If you chose to follow legal rules as a basis for decision making, all you have to do is look into

the past to understand why deontology has its limitations. Laws have been re-written and taken

away because we as a population have realized they were “wrong.” I’m a believer that moral and

ethical decision making should be an inherent characteristic within you. Just because we as

humans follow a large set of laws does not mean they are all morally correct. A deontologist

wouldn’t steal as that is illegal but there are instances where that may be appropriate and/or

necessary for someone’s survival without causing any harm to others.

There obviously could be a bias when I talk about the uniqueness of a physical therapist, but

I think it can be agreed upon by all, nonetheless. Moral responsibility arises for physical

therapists as they are unique health care providers in that they have a moral obligation to the

patient, the public, and other organizations. A physical therapist interacts with patients in a one-

on-one environment for long periods of time, often while they are in a vulnerable state. They are

depending on us to make them better and improve their lives and this arises a moral obligation

for us to do our best because we essentially have their quality of life in our hands. Because this

can be an emotional journey, a trust is built between patient and therapist. Physical therapy can
Jeff King

be a less intimidating, more comfortable environment for patients as opposed to interactions with

doctors, etc. For these reasons, we end up being arguably the closest relationship to the patients

compared to any other of their health care providers. Additionally, we have a moral obligation to

society to promote public health and advocate for better quality of life for all. It really should be

a physical therapist’s goal to not want patients to have to come see them. We are obligated to be

active in our communities and stand up for the best interest of the society. Finally, we have a

moral obligation to our employers to provide honest work with integrity. It’s a moral obligation

to balance giving the appropriate care to patients and billing them a fair amount for both parties

involved.

As previously mentioned, we have responsibilities to society, our patients, and our

organizations. Our duties to society were developed as a moral obligation when we signed up for

this career. If we care about the greater good for our patients, we have a duty to advocate and

provide accurate information to the general public. We have responsibilities to our patients to

have their best interest in mind. We grow close to our patient’s, but we have a duty to not let that

relationship sway what we think is best for them. They put their future in our hands, trusting that

we will do our best for them and it would be unmoral not to do so. We additionally have

responsibilities to our employers and organizations that we agreed upon when taking on a new

job. We have a duty to provide the best version of ourselves and remain honest and reliable even

in difficult times. Our colleagues and other professionals have the right to their own input into

what they think is best and it is important to not overstep any boundaries. These rights must be

just as deserved and appreciated as our own because we all possess different skills in the

treatment process. We have a moral obligation to our colleagues to be resourceful, respectful,

Jeff King

and helpful when needed because it is a collaborative effort with the same goal in mind: improve

our patients’ quality of life and provide the best united care possible.

References:

1. Professionalism in Physical Therapy: Core Values. American Physical Therapy Association;

2009:1-4.

https://www.apta.org/uploadedfiles/apta.org/about_us/policies/bod/judicial/professionalism.pdf

Accessed March 19, 2020