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Toni Talks about PT Today

It's Legal but Is It Ethical?

Published February 12, 2013 10:58 AM by Toni Patt

Someone was fired last week. The rumor is going around that she was fired because she didn't smile. I don't know if that's true or not but in Texas it is legal. Here an employer can fire an employee for any reason, even if they make it up. Nor do they have to prove it's true. There are no laws preventing it. Maybe the woman smiled. Maybe she didn't. She's still fired.

Last year I was the victim of something similar. I've become very familiar with Texas labor laws. When I've brought the topic up with lawyers, everyone gives me the same answer. It might be legal but it's very unethical. Those same lawyers tell me there are no laws against unethical behavior. You're just supposed to know better.

I looked through the Texas practice act. It covers every kind of professional behavior; charging, documenting, conflict of interest, interaction with patients etc., except ethicality. It says PTs are to behave in a professional manner. The APTA does have a code of conduct. It touches on ethical issues although it's somewhat vague. Nowhere could I find anything concerning enforcement of ethical behavior.

I don't know who acts as the ethics police for physical therapy. Physicians have a process in place. I couldn't find anything specific for nursing but they spell things out much more clearly. Apparently we're just supposed to know better. I'm here to tell you, that isn't true. Some people either don't know, don't care or don't think it applies to them.

Maybe ethicality falls under professionalism. I can see that argument. A professional should behave in an ethical manner. I can think of a few PTs I've worked with over the years who did nothing overtly wrong but didn't behave in a professional manner, although I'd say they were ethical. I worked under a manager who was blatantly unethical but was professional in appearance.

We need a better definition of both for our profession. Which brings me back to my original question of who functions as the ethical police for physical therapy? To whom do we report unethical behavior? More importantly, how do we enforce it? I have no clue. I think we're generally a very ethical bunch but there's always someone who takes advantage of a position for personal gain or wrongly uses information.

This is going to become a larger problem as we continue to grow as a profession. The more responsibility we take on, the more careful we must be.


Hello Sathya, I forwarded your question to Toni Patt and this is her response: "The practice act of any state describes the practice of physical therapy in that state. It covers such things as supervision of support staff, documentation, reassessments, etc. It does not address legal issues.

Legal issues, such as hiring and firing employees, is determined by state law. Texas is a right-to-work state. As such, workers have no real protection from employers. You can be fired at any time for any reason, including one they make up. Generally employers have practices in place to protect workers to some extent. In the case I mentioned in my blog, the director of the facility wanted to fire that person. Not smiling was the reason she put on the paperwork.

There should be a site for the work force commission for your state. That is where you can find specific information. In essence, what the manager did was unethical but legal under Texas law."

Brian Ferrie, ADVANCE for PT May 23, 2013 10:00 AM

Can your tell me . how do you compare this in Michigan practice act?

Sathya May 20, 2013 4:24 PM
Detroit MI

The APTA has a Code of Ethics and a Guide for Professional Conduct.  They can be found via links at  It is difficult to determine if in fact any ethical lines were crossed since the facts are not necessarily known.  That would be a poor reason to fire someone however but perhaps it was used as an easier reason rather than stating other things such as performance, etc.  If the person that was fired was providing poor customer service which perhaps was leading to poor outcomes or the lack of smiling was affecting the relationship among the staff would that have been a more justifiable reason?

Keep in mind that the APTA holds their members to these standards and therefore if a PT is not a member they are not even aware that these standards exist despite the fact that in legal matters they may be held to them regardless of whether or not they are a member.  Since APTA has no legal authority against ones license to practice, they can sanction a member in a variety of different ways one being to ban them from the Association.  Ethical issues are handled by the Ethics and Judicial Committee (EJC).  My understanding that if they found due cause of any legal matter that they would refer that case to the state PT Board.  The other difficulty is that if a non-PT is the one who did the firing than there is really nothing that the APTA could do.

Sounds like a really unfortunate situation but there may be more to the story than what is known by some.

Dan February 14, 2013 11:13 PM

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