Ethical considerations in Physical Therapy.

Oct. 3, 2011 - PRLog -- Health care ethics involves the unique relationship between health care practitioners and their patients. Persons who enter the health care system allow strangers access to their personal information as well as to their bodies. When patients come to our clinic, they usually come as strangers, but they very often provide us detailed histories of their problems and their lives. Further, within a short period of time, most patients allow us to touch their backs, necks, or extremities in ways that would not occur in society in general. The reason that patients so willingly provide this access to their information and bodies is due to their trust in the health care provider and the system. Because physical therapists and assistants are entrusted with the care of others, we must not take advantage of this position. We often have more knowledge about the patient's anatomy and specific disorder than the patient does. An inequity of power between the patient and the therapist exists based on this difference of knowledge and information. The power differential is also heightened by our access to the patients' information and bodies. When we are making ethical decisions in health care, we must be cognizant at all times of this imbalance of power and of the trust that the patient has placed in us.
Patients come to us when they are vulnerable. They are often physically and psychologically affected by their health care concerns. Patients may enter the health care system with impaired cognition and may be physically affected by pain, loss of control, or dysfunction. We should also remember that financial considerations also often play a role in our patients' mental status. Due to these physical, mental, psychological, and financial concerns, patients are vulnerable and place their trust in us to do what is right for them. Many patients experience a loss of control when they are in a state that is different from their normally "healthy state." It is important to remember that what constitutes a "normal" state may vary among patients. Having a sprained ankle may be devastating to an athlete, but of minor concern to a computer analyst. Conversely, a fractured wrist could limit an office worker's ability to make a living.
The health care system, especially the inpatient environment, limits patients' autonomy. When we, as strangers, ask patients personal questions, they trust that the information is being recorded accurately. Patients relinquish their personal belongings, they are assigned a number, and they are provided "gowns" to wear. They are told what and when to eat and often are placed in a room with a stranger. Too often in the past passive patients were considered the "good" patients. In other words, the less patients had to say about their health care treatment, the better. As we will see, one of the basic ethical principles promotes patients having as much autonomy in decision-making as possible. We must keep in mind, however, that the health care system itself limits this principle. We must be aware of this as we practice within this environment.
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