Chapter 2: The Evolution of the Code of Ethics for Physical Therapists and the Standards of Ethical Conduct of the Physical Therapist Assistant

There have been many attempts to provide a simple explanation or definition of the word profession and the individual who is a professional. The attempt always seems to center around an ethical foundation within an established expertise and established body of information. A profession has aptly been defined as a “disciplined group of individuals who adhere to ethical standards (Australian Council of Professions, 2022; Professional Standards Councils, 2022). A professional is an individual who identifies with a certain profession and adheres to the ethical standards of that group (Creuss et al., 2004).

A profession must have at its foundation a Code of Ethics that reflects the activities of the profession and the behaviors expected of the members of that profession. The Code of Ethics of a health care profession demands a higher standard of behavior in respect to the services provided to the public and the responsibility the health care provider has to the public and to professional colleagues (Bernard 2016; Evetts, 2011).

Having a distinct Code of Ethics is a mark of being a professional. Professionals bound by a Code of Ethics accept the right and obligations to accept the standards set, and to embrace the challenge of self-regulation of behavior and actions. Collectively the membership of an organization through its Code of Ethics upholds the profession’s image and reputation.

The profession of physical therapy had its nascent beginnings in 1921 when a small group of women founded what would soon be called The American Physical Therapy Association, but it was not until 14 years later in 1935 that the first Code of Ethics and Discipline was adopted at the Physical Therapy Association’s annual meeting in Atlantic City, New Jersey. The initial Code explicitly defined the responsibilities of the PT, but also drew a clear picture of behaviors expected of physical therapists. The Code provided direction at that time that later evolved over the years as the profession grew and developed. In 1935 the following specific guidance was provided for the practicing PT.

1. The physician’s prescription has primacy in carrying out physical therapy treatments.

2. It is prohibited to procure patients through advertising.

3. Physical therapists cannot criticize physicians and colleagues in the presence of patients.

The Code of Ethics reflected the early practice patterns of the profession, PT was provided by referral only. Physical therapists practiced only under the direction of a physician with no practice autonomy or independent decision-making. It was another 13 years before the next revision of the Code of Ethics in 1948. Physical therapy had proven its importance during and following World War II, and soon after the war found itself at the epicenter of care during the polio epidemic that began in the early 1950s and spanned the first part of the decade. The 1948 revision of the Code of Ethics reflected little growth in professional autonomy on the part of the PTs. While still far from ...