Ethics and Professionalism: A Guide for the Physician Assistant

Ethics and professionalism : a guide for the physician assistant

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Physicians should encourage the patient to inform key family members and friends about end-of-life preferences.

Physicians should also discuss making advance directives accessible to clinicians in all care settings including placement in the medical record. Discussions that focus on cultural beliefs, values, goals and outcomes rather than on the desire for particular interventions and treatments contribute to a more satisfactory decision-making process.

Caregivers are valuable members of the health care team, helping patients manage and cope with illness. Patient information provided by the caregiver may be as pertinent and reliable as the medical record.

Acknowledgement of the caregiver contribution is vital to ongoing trust and continued collaboration providing patient care. Caregiver concerns about failing to meet expectations to manage care cause significant stress that can impede decision-making regarding end-of-life care, utilization of outside services and institutional placement. In addition to technical aspects of care, for example, parental administration of medication, caregiver education also includes identification and management of treatment side effects, nonpharmacologic symptom management and signs of advancing disease.

Family caregivers face overwhelming physical, emotional and financial demands that may make them especially vulnerable to injury, depression and other stress-related conditions. Family caregivers often lack the time and energy to prepare meals, exercise, or obtain their own recommended preventive medical care. Referrals to support groups, training and community and social services, can help sustain successful caregiving. In order to ease the burden on the caregiver, appointments may occur in tandem but not simultaneously. The number of long distance family caregivers, defined as those who provide care from more than an hour from the family member, is increasing.

Hospice and palliative care are often seen as interchangeable, but the goal of palliative care services is to prevent and relieve suffering and support the best possible quality of life for patients and their families regardless of disease stage. Patients and their caregivers may need reassurance that palliative care can be integrated with treatment of incurable chronic disease.

Hospice may be considered appropriate for patients with a life expectancy of six months or less. This will allow caregivers and families the opportunity to make final arrangements, resolve differences, reach closure and say goodbye. When death is preceded by a long period of intense successful caregiving, the caregiver often experiences fewer negative effects. When death occurs, the physician should personally communicate with the family caregiver, answer questions, and acknowledge the loss and its significance.

Professional Standards of Conduct Policy

Although limited data exist, 56 anecdotal literature suggests that when the family caregiver is a health professional, caregiving may bring added or unique pressures and ethical challenges. Patients and family members need to be informed that it is generally not appropriate for physician caregivers to treat family members and they should not place the physician-caregiver in compromising emotional and professional positions in non-emergent situations.

The physician-caregiver should be careful not to function as, or appear to be, a treating physician. However, he or she can facilitate and improve communication between the treating physician, the patient, and other family members as well as assist in monitoring and delivering care as directed by the treating physician.

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In this role, the physician-caregiver can improve continuity of care and ameliorate the many potential adverse consequences of the fragmented medical system. The ethical guidance outlined in this paper is intended to heighten physician awareness of the importance and complexity of the patient—physician—family caregiver relationship, to maximize the benefits of those relationships and to minimize the burdens on family caregivers. This guidance builds on general principles of medical ethics and professionalism, extending them to family caregivers for the benefit of the patients.

An appendix of resources related to family caregivers is available online to assist physicians in implementing these principles to build effective partnerships with family caregivers. The ACP Ethics, Professionalism and Human Rights Committee would like to thank and acknowledge the following reviewers of this position paper who provided valuable insights and suggestions: Patient and medical education on complementary and alternative care: In Snyder L ed. Complementary and Alternative Medicine: Ethics, the Patient and the Physician.

No other conflicts of interest were disclosed. Members of the Committee were Virginia L.

Physician Assistant Studies

Shelhamer, DO; Barbara J. National Center for Biotechnology Information , U. J Gen Intern Med. Published online Jan 9. Author information Article notes Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Abstract Family caregivers play a major role in maximizing the health and quality of life of more than 30 million individuals with acute and chronic illness.

Electronic supplementary material The online version of this article doi: The Physician Should be Alert for Signs of Distress in the Family Caregiver and Suggest Appropriate Referrals Family caregivers face overwhelming physical, emotional and financial demands that may make them especially vulnerable to injury, depression and other stress-related conditions. Physicians Should Recognize that Geographically Distant Caregivers May Face Unique Challenges The number of long distance family caregivers, defined as those who provide care from more than an hour from the family member, is increasing.

The Physician Should Define a Palliative Care Plan that Focuses on Maximizing Patient and Caregiver Quality of Life Hospice and palliative care are often seen as interchangeable, but the goal of palliative care services is to prevent and relieve suffering and support the best possible quality of life for patients and their families regardless of disease stage.

When the Caregiver is a Healthcare Professional, the Physician Should Draw Appropriate Boundaries to Ensure that the Caregiver is not Expected to Function in a Professional Capacity in Relation to the Patient and that the Caregiver Receive Appropriate Support, Referrals and Services Although limited data exist, 56 anecdotal literature suggests that when the family caregiver is a health professional, caregiving may bring added or unique pressures and ethical challenges.

Acknowledgement The ACP Ethics, Professionalism and Human Rights Committee would like to thank and acknowledge the following reviewers of this position paper who provided valuable insights and suggestions: Options for supporting family caregivers. A policy paper of the Family Caregiver Alliance. Introduction to family caregiving: On Aging —; A toolkit to help practitioners assess the needs of family caregivers.

Accessed November 11, You already recently rated this item. Your rating has been recorded. Write a review Rate this item: Preview this item Preview this item. English View all editions and formats Summary: Ethics content has become more of a priority in Physician Assistant education due to its increased emphasis on the certification exam and as a stated criteria element for accreditation. The authors' intent is to create a "first of its kind" case-based ethics text for the PA market that is dedicated to addressing the uniqueness of the PA role in the practice of medicine and the specific dilemmas and issues that confront Physician Assistants every day.

Allow this favorite library to be seen by others Keep this favorite library private. Find a copy in the library Finding libraries that hold this item Electronic books Additional Physical Format: Document, Internet resource Document Type: Includes case studies that focus on critical thinking and the clinical application of ethics and professionalism; ethical considerations of vulnerable patients; and contributions by noted PAs, MDs, and PhDs. Reviews User-contributed reviews Add a review and share your thoughts with other readers.

Add a review and share your thoughts with other readers. Similar Items Related Subjects: Physicians' assistants -- Training of -- Moral and ethical aspects. Physician Assistants -- ethics. User lists with this item 2 Things to Check Out 2 items by yahimab updated Accountability Punctual and prepared for all obligations. Completes assigned tasks on time.

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Maintains professional appearance in professional settings Contributes to group work in a timely manner Interpersonal and Communication Skills Able to effectively relate to patients, peers and colleagues. Maintains composure during adverse interactions or situations. Communicates at a level that is appropriate for a given audience.

Demonstrates cooperation and collaboration, works well with authority figures, classmates and patients. Ethical Behaviors Maintains confidentiality standards. Upholds the ethical principles of the PA profession.

Does not engage in plagiarism, cheating, manipulating or falsehoods. No evidence of substance abuse. Complies with applicable laws and regulations. Self-Awareness Capacity to identify personal weaknesses and poor habits and seeks help from support services. Demonstrates emotional resilience and stability, adaptability, flexibility. Tolerance for ambiguity and anxiety, open to new experiences.

Each student is required to follow the dress code as outlined below: Clothing in professional settings should not be torn, ripped, tight, short, see through, low cut or expose the trunk with movement. Jeans, sweatshirts, and T-shirts are not considered professional attire and are not appropriate for patient care. Men are expected to wear ties at clinical sites unless instructed otherwise.

Open toed shoes are not appropriate for patient care. No perfumes, after-shave or colognes in clinical settings. No excessive jewelry so as not to interfere with patient care.

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