Law Review Module 1.2: Ethical and Professional Conduct Christopher Logsdon
Ohio Respiratory Care Board Executive Director
http://www.respiratorycare.ohio.gov
 
Law Review Module 1

Law Review Module 1.2: Professional Code of Ethics

 

Instructor

Ohio Respiratory Care Board
77 South High Street, 16th Floor
Columbus, OH 43215-6108
Phone: (614) 752-9218
Fax: (614) 728-8691

Web: http://respiratorycare.ohio.gov

 

Ohio Respiratory Care Board

Law Review Module 1.2: Ethical and Professional Conduct

 

Topic: Review of Laws and Rules establishing the Code of Ethical and Professional Conduct for the Respiratory Care profession in Ohio.

 

All respiratory care professionals and limited permit holders issued under ORC 4761.05 (B)(b) are required to complete continuing education to meet renewal requirements for the authorization type held. As of July 1, 2008, these standards were modified to include a new requirement that at least one of the required contact hours include a course on respiratory care practice law or professional ethics. This module is not intended to be a course on professional or medical ethics. Instead, this course will review the laws and rules that establish the actual code of ethics and the authority of the Board to impose discipline upon persons that violation the profession code. This continuing education module is designed to:

 

  1. Review the laws and rules that establish the Code of Ethical and Professional Conduct for Respiratory Care providers in Ohio;

  2. Provide information on the application of Ethical and Professional Conduct in actual practice;

  3. Inform respiratory care providers of the Board's authority to impose disciplinary sanctions against a licensee or limited permit holder; and

  4. Provide 1 contact hour of continuing education meeting the respiratory care jurisprudence (law) requirements.

 

INTRODUCTION:

 

The Ohio Respiratory Care Practice Act, Chapter 4761 of the Ohio Revised Code, was enacted in March of 1989. This law governs the practice of respiratory care in the State of Ohio. The law is supported by Administrative Rules (referred to as “Rule”) adopted under the Board authority provided in Section 4761.03 (A) of the Ohio Revised Code. The Rules are titled under Chapter 4761 of the Ohio Administrative Code. The Laws and Rules are accessible through the Board’s Website at http://respiratorycare.ohio.gov or through the State of Ohio home website by looking for the Ohio Revised Code or Ohio Administrative Code and search for Chapter 4761.

 

Although few changes have been made to the Law, the Administrative Rules are revised frequently and at least every five (5) years as required by law. Changes can be substantive and licensees should maintain continual awareness of these changes to the Laws and Rules that govern their practice to assure compliance with them.

 

In order to encourage Ohio respiratory care providers to maintain an updated understanding of the laws and rules governing the practice of respiratory care; or understand the concept and application of medical or professional ethics, the Ohio Respiratory Care Board now requires licensed respiratory care professionals or experienced-based limited permit holders to obtain one contact hour of continuing education on Ohio respiratory care laws/rule review or medical/professional ethics.

 

GENERAL LAW AND RULES:

 

The Ohio Respiratory Care Board is granted authority to impose disciplinary action against a licensed respiratory care professional or limited permit holder if the holder is proven to have engaged in specific conduct that would be grounds for imposing the sanction(s). This authority is found in Section 4761.09 of the Ohio Revised Code. This section states, in part:

(A) The Ohio respiratory care board may refuse to issue or renew a license or a limited permit, may issue a reprimand, may suspend or permanently revoke a license or limited permit, or may place a license or limited permit holder on probation, on any of the following grounds:

    1. A plea of guilty to, a judicial finding of guilt of, or a judicial finding of eligibility for intervention in lieu of conviction for an offense involving moral turpitude or of a felony, in which case a certified copy of the court record shall be conclusive evidence of the matter;

    2. Violating any provision of this chapter or an order or rule of the board;

    3. Assisting another person in that person’s violation of any provision of this chapter or an order or rule of the board;

    4. Obtaining a license or limited permit by means of fraud, false or misleading representation, or concealment of material facts or making any other material misrepresentation to the board;

    5. Being guilty of negligence or gross misconduct in the practice of respiratory care;

    6. Violating the standards of ethical conduct adopted by the board, in the practice of respiratory care;

    7. Engaging in dishonorable, unethical, or unprofessional conduct of a character likely to deceive, defraud, or harm the public;

    8. Using any dangerous drug, as defined in section 4729.01 of the Revised Code, or alcohol to the extent that the use impairs the ability to practice respiratory care at an acceptable level of competency;

    9. Practicing respiratory care while mentally incompetent;

    10. Accepting commissions, rebates, or other forms of remuneration for patient referrals;

    11. Practicing in an area of respiratory care for which the person is clearly untrained or incompetent or practicing in a manner that conflicts with section 4761.17 of the Revised Code;

    12. Employing, directing, or supervising a person who is not authorized to practice respiratory care under this chapter in the performance of respiratory care procedures;

    13. Misrepresenting educational attainments or authorized functions for the purpose of obtaining some benefit related to the practice of respiratory care;

    14. Assisting suicide as defined in section 3795.01 of the Revised Code.

 

OHIO RESPIRATORY CARE LAWS/RULE ON PROFESSIONAL ETHICS AND CONDUCT

Although each of the aforementioned grounds is considered illegal conduct, three of the grounds either directly or indirectly address the concept of professional or ethical conduct:

Directly

ORC 4761.09 (A)(6): Violating the standards of ethical conduct adopted by the board, in the practice of respiratory care;

ORC 4761.09 (A)(7): Engaging in dishonorable, unethical, or unprofessional conduct of a character likely to deceive, defraud, or harm the public;

Indirectly

 

ORC 4761.09 (A)(2): Violating any provision of this chapter or an order or rule of the board;

Obviously sections 4761.09 (A)(6) and 4761.09 (A)(7) would be a violation of law, but what does the ORC 4761.09 (A)(2) mean by stating a violation or this chapter or rule would be grounds for discipline. The word "chapter" is referring to chapter 4761 of the Ohio Revised Code (the Respiratory Care Practice Act). Any violation of a specific requirement contained in the Ohio Respiratory Care Practice Act could be grounds for discipline. Likewise, the Board adopts rules to amplify or explain the requirements of the law. Among the rules adopted by the Board are rules 4761-10-01 and 4761-10-02 of the Ohio Administrative Code. These two rules are specifically written to establish the Code of Ethics and Professional Conduct for the practice of respiratory care. Violating these standards would likely constitute a violation of ORC 4761.09 (A)(6), ORC 4761.09 (A)(7), and ORC 4761.09 (A)(2).

In their entirety, these rules state:

OAC 4761-10-01 states:

A licensee and a permit holder shall provide professional services with objectivity and with respect for the unique needs and values of the health care recipient, as follows:

(A) A licensee or permit holder shall not discriminate on the basis of factors that are irrelevant to the provision of professional services including, but not limited to race, creed, sex, national origin, age or medical condition.

(B) Prior to a licensee or permit holder entering into a contractual relationship with a health care recipient, the licensee or permit holder shall provide sufficient information to enable the health care recipient to make an informed decision to enter into a contractual relationship. Sufficient information shall include any fees and arrangements for payment which might affect the decision.

(C) A licensee or permit holder shall not mislead the public and colleagues about services and shall not advertise in a misleading manner.

(D) A licensee or permit holder shall not engage in any activities that seek to meet their personal needs at the expense or detriment of the health care recipient.

(E) A licensee or permit holder shall not leave an assignment without being properly relieved by appropriate personnel.

(F) A licensee or permit holder shall not receive or give a commission or rebate or any other form of direct or indirect remuneration or benefit for the referral of patients/clients for professional services.

(G) A licensee or permit holder shall disclose to health care recipients any interest in commercial respiratory care enterprises which the licensee promotes for the purpose of direct or indirect personal gain or profit.

(H) A licensee or permit holder shall not accept gratuities for any reason including but not limited to preferential consideration of the health care recipient.

(I) A licensee or permit holder shall practice respiratory care within the scope of respiratory care as set forth in division (A) of section 4761.01 of the Revised Code and in accordance with acceptable and prevailing professional standards or guidelines and shall not endeavor to extend his/her practice beyond his/her competence and the authority vested in him/her under division (B) of section 4761.01 of the Revised Code.

(1) The board may determine adherence to acceptable and prevailing professional standards and guidelines for respiratory care practice by using:

(a) Current respiratory care literature recognized by the board;

(b) Position statements, standards of practice, or guidelines for respiratory care written by the board or other recognized national respiratory care professional organizations;

(c) Board member expertise;

(d) An expert witness;

(J) A licensee shall not employ, direct, or supervise a person who is not authorized to practice respiratory care under this chapter in the performance of respiratory care procedures.

(K) A licensee or permit holder shall cooperate to the extent permitted by law with other licensed health care professionals responsible for providing care to cardiopulmonary patients, including:

(1) Consulting with appropriate licensed practitioners responsible for prescribing therapy, treatment, or diagnostic services;

(2) Notifying other care givers and the prescribing practitioner when a prescribed therapy, treatment, or diagnostic service is not administered due to reasons contained in paragraph (L) of this rule;

(3) Recommending to other care givers and the prescribing practitioner when prescribed therapy, treatment, or diagnostic service needs to be altered to obtain optimal patient care.

(L) A licensee or permit holder shall not implement an order that that the respiratory care professional or limited permit holder believes or should have reason to believe is:

(1) Inaccurate;

(2) Not properly authorized;

(3) Harmful, or potentially harmful to a health care recipient; or

(4) Contraindicated by other documented information.

(M) A licensee or permit holder shall disclose health care recipient information only with other health care professionals responsible for providing care to the health care recipient with whom the licensee or permit holder is responsible. At all other times, a licensee or permit holder shall hold as confidential all patient information which the licensee or permit holder has knowledge.

(N) A licensee or permit holder shall access only health care recipient information which is necessary and relevant to their function and authority as a respiratory care provider.

(O) A licensee or limited permit holder shall not falsify any health care recipient record or any other document prepared or utilized in the course of treating or rendering respiratory care.

(P) A licensee or limited permit holder shall not engage in fraudulent billing for respiratory therapy or treatment.

(Q) A licensee or permit holder shall not engage in behavior that may cause physical, verbal, mental, or emotional abuse to a health care recipient.

(R) A licensee or permit holder shall not engage in behavior that may be reasonably interpreted as physical, verbal, mental, or emotional abuse to a health care recipient.

(S) A licensee or permit holder shall not:

(1) Engage in sexual conduct with a health care recipient under their care;

(2) Engage in conduct in the course of practice that may be reasonably interpreted as sexual conduct;

(3) Engage in verbal behavior in the course of practice that is seductive, or sexually demeaning to a health care recipient.

 

OAC 4761-10-02 states:

(A) A licensee or permit holder shall not misrepresent any professional qualifications or credentials or provide any information that is false, deceptive or misleading in connection with his/her own application for employment or work as a respiratory care provider.

(B) A licensee or permit holder shall not delegate the use of his/her name or signature on documentation for services unless he/she actually provided these services and has given permission to another individual for such documentation, or unless he/she appropriately supervised those services.

In addition to the provisions listed in these rules, the Board may also consider professional standards of ethics and conduct published by the professional association of the practice. The American Association for Respiratory Care (AARC), for example, publishes a code of ethics for its members. Under paragraph (I) of this rule, the Board may consider the AARC's Code of Ethics to be a prevailing professional standard a professional standard when considering whether a specific act is a violation of the rules on Ethical and Professional Conduct.

 

The AARC lists its Statement on Ethical and Professional Conduct on its website as follows:

In the conduct of professional activities, the Respiratory Therapist shall be bound by the following ethical and professional principles. Respiratory Therapists shall:

  • Demonstrate behavior that reflects integrity, supports objectivity, and fosters trust in the profession and its professionals.
  • Seek educational opportunities to improve and maintain their professional competence and document their participation accurately.
  • Perform only those procedures or functions in which they are individually competent and which are within their scope of accepted and responsible practice.
  • Respect and protect the legal and personal rights of patients, including the right to privacy, informed consent and refusal of treatment.
  • Divulge no protected information regarding any patient or family unless disclosure is required for the responsible performance of duty authorized by the patient and/or family, or required by law.
  • Provide care without discrimination on any basis, with respect for the rights and dignity of all individuals.
  • Promote disease prevention and wellness.
  • Refuse to participate in illegal or unethical acts.
  • Refuse to conceal, and will report, the illegal, unethical, fraudulent, or incompetent acts of others.
  • Follow sound scientific procedures and ethical principles in research.
  • Comply with state or federal laws which govern and relate to their practice.
  • Avoid any form of conduct that is fraudulent or creates a conflict of interest, and shall follow the principles of ethical business behavior.
  • Promote health care delivery through improvement of the access, efficacy, and cost of patient care.
  • Encourage and promote appropriate stewardship of resources.

 

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