Law Review Module 1
Law Review Module 1.2: Professional
Code of Ethics
Ohio Respiratory Care Board
77 South High Street, 16th Floor
Columbus, OH 43215-6108
Phone: (614) 752-9218
Fax: (614) 728-8691
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:
Review the laws and rules that establish the Code of Ethical and Professional Conduct for Respiratory Care providers in Ohio;
- Provide information on the application of Ethical and Professional Conduct in
- Inform respiratory care providers of the Board's authority to impose disciplinary
sanctions against a licensee or limited permit holder; and
- Provide 1 contact hour of continuing education meeting the respiratory
care jurisprudence (law) requirements.
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:
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;
Violating any provision of this chapter
or an order or rule of the board;
Assisting another person in that person’s
violation of any provision of this chapter or an order or rule of the
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
Being guilty of negligence or gross misconduct
in the practice of respiratory care;
Violating the standards of ethical conduct
adopted by the board, in the practice of respiratory care;
Engaging in dishonorable, unethical, or
unprofessional conduct of a character likely to deceive, defraud, or harm
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;
Practicing respiratory care while mentally
- Accepting commissions, rebates, or other forms of remuneration
for patient referrals;
- 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;
- Employing, directing, or supervising a person who is not
authorized to practice respiratory care under this chapter in the performance
of respiratory care procedures;
- Misrepresenting educational attainments or authorized functions
for the purpose of obtaining some benefit related to the practice of respiratory
- Assisting suicide as defined in section 3795.01 of the Revised
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:
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;
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
(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
(a) Current respiratory care literature recognized by
(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:
(2) Not properly authorized;
(3) Harmful, or potentially harmful to a health care
(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
- Demonstrate behavior that reflects
integrity, supports objectivity, and fosters trust in the profession and
- Seek educational opportunities
to improve and maintain their professional competence and document their
- 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
- Provide care without discrimination
on any basis, with respect for the rights and dignity of all individuals.
- Promote disease prevention
- 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.