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Practicing ethically as an athletic trainer

This is an excerpt from Management Strategies in Athletic Training 5th Edition by Jeff Konin & Richard Ray.

The following recommendations are intended to serve as a functional guide to ethical practice in athletic training. The guidelines in this list should minimize the occurrence of ethical conflicts and facilitate the resolution of those that do occur.

• Study the relevant professional codes of ethics.Begin with the code of ethics of NATA and then review the codes of ethics of organizations that apply to your specific employment setting and the roles you play in that setting.
• Learn to recognize situations in which ethical concerns are present or might appear to be present.This undertaking requires careful consideration of how all your personal and professional relationships might affect the athletes or other physically active patients whom you treat.
• Increase your sensitivity to situations in which ethical concerns are present.Remember that ethics are relative and that the athletic trainer needs to be aware of how a situation may appear to persons viewing it from their own social or cultural perspective. Sensitivity requires that you be able to appreciate a situation from the point of view of others who are affected, particularly the patients under your care. Beyond that, you should treat every ethical concern seriously, or you will be perceived as insensitive and uncaring - and there is no better formula for professional trouble than that.
• Consult with others whenever there are questions, especially when the answers are not clear or when they are not clearly defensible. Good consultation serves to protect the athletic trainer as well as the patient because it provides an outside, objective perspective on the situation of concern. In addition, a small group often has more wisdom than an individual does.
• Refer when the concern is beyond your legal scope of practice or your competence.Everyone's best interests are served when athletic trainers make prudent use of referrals in critical, complicated, and difficult cases. To do this, however, athletic trainers must be acutely aware of their own limitations and must be sure to follow prescribed protocols for referral.
• Refer when you become a primary party in an ethical dilemma or when you might be perceived by a patient or outside observers to be a primary party. When an athletic trainer becomes a primary party in a situation of ethical concern, both the professional and the patient are at risk and the situation might become worse. In addition, even the perception of such a situation can be destructive. Referral to a health care professional not involved in the conflict is generally considered necessary and prudent in such situations.
• Document carefully and often. As in all areas of practice, careful, accurate documentation is essential. This includes documentation of all policies and procedures that have been read and agreed to by all those that the guidelines pertain to.
• Follow your conscience. A clear conscience requires knowledge and awareness. For the athletic trainer, good conscience requires knowledge of the moral and ethical standards applicable to the profession, and it requires awareness of the individual circumstances that each patient faces. Athletic trainers most often fail to be conscientious not so much because they lack knowledge but because they lack awareness. To be aware, they must be reflective and considerate, which takes time and effort. As athletic trainers, we must guard against becoming too busy or too routinized to allow ourselves the time and energy to be reflective and considerate. Otherwise we risk failing to be conscientious.
• Fully disclose to a patient all your roles.More than anything else, disclosure is an ethically critical component for informed consent in an athletic trainer's relationship with an athlete or other physically active patient. Identify all the roles you assume that might involve the athlete directly or indirectly. Avoid circumstances in which you are responsible for roles that present conflicting interests regarding the patient (Riendeau et al. 2015). Examples of the types of situations that warrant disclosure include, but are not limited to, the following:
  • You should be sure that athletes understand that you also have responsibility for other athletes on a team and that you might be obligated to use or act on information that affects their health or safety.
  • The organization that an athlete plays for often employs the athletic trainer. The athlete needs to understand this potential conflict of interest, because the practitioner might be required or might have strong incentives to act in the best interest of the organization rather than of the athlete.
  • Athletic trainers often make available services, referrals, or goods in which they have a financial interest. The athletic trainer should disclose this conflict of interest to the athlete or other physically active patient and provide alternatives.
  • Patients should be informed that an athletic trainer also has social and legal obligations that might require her to divulge information that could be in conflict with the patient's own best interest. If a patient tells her about certain illegal activities, the law might require her to report that information. Furthermore, the patient should be informed that information might be divulged when it indicates that the patient or others are in imminent danger.
• Consider possible courses of action carefully.When confronting an ethical dilemma, (1) identify the greatest variety of choices possible, including those that might seem extreme; (2) investigate each of the possible choices identified; and (3) judge your choices from an other-centered perspective rather than from a self-centered or egocentric perspective.
• Allow patients to make their own fully informed choices rather than imposing solutions on them.An informed perspective requires exploration of the positive and negative implications of every conceivable choice. Having relevant information allows athletes or other physically active patients to judge which course of action is in their best interest and is a necessary prerequisite to self-determination. Allowing patients to make their own choices helps them take responsibility for their destiny.

These actions, when combined, dramatically reduce the occurrence of ethical conundrums.

Learn more about Management Strategies in Athletic Training, Fifth Edition.

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