Research Paper: Professional Ethics in Physiotherapy: Existing Challenges and Flaws (original) (raw)
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Physiotherapists’ ethical behavior in professional practice: a qualitative study
Frontiers in Medicine, 2023
Background: In health professions, ethics is considered a fundamental competence. The increase in clinical autonomy in the field of physiotherapy is associated with an increase in ethical situations in their clinical practice. Objective: To explore the ethics of the clinical relationship between physiotherapists and patients, the ethics training received by physiotherapists, and if in the clinical context, physiotherapists identify the necessary attitudes and apply the ethical recommendations of the profession for the ethical situations they experience. Methods: A qualitative exploratory and descriptive study was performed with physiotherapists. Data were collected through semi-structured interviews. The data were analyzed using content analysis, as proposed by Krippendorf. The study protocol was approved by the University of Valencia Ethics Committee of Human Research. Results: This study included 15 physiotherapists (66.66% women, average age = 42.2 years), which was sufficient to reach data saturation. We identified four categories: (i) Ethics of the clinical relationship (ethical values, principles, and norms; type of clinical relationship), (ii) Ethics training received (during the physiotherapy studies; current training of students; low importance of ethics in the curriculum), (iii) Necessary attitudes for professional ethical practice (main attitudes were identified: personal attitudes and professional attitudes); (iv) Experiences from professional practice (general; public sector vs. private sector). Conclusion: The ethics of the clinical relationship between physiotherapists and patients is determined by the attitudes of the practitioner, which are the result of his or her values and previous experiences; and are very centered on ethics of indication (founded mainly on the principles of Beneficence and Non-Maleficence). It is necessary to improve the ethical training received by physiotherapists, which is poorly focused on professional attitudes.
Iranian Physiotherapists’ Perceptions of the Ethical Issues in Everyday Practice
Iranian Rehabilitation Journal, 2020
Objectives: Considering the significant role of physiotherapists in the process of rehabilitation, their ethical commitment is essential to successful interaction and care provision. However, investigations on the medical professional ethics in Iran are limited. Generally, research in this regard is rare in Asia. Thus, such studies could improve the moral knowledge of the Iranian physiotherapy community. Accordingly, this study aimed to explore professional ethics issues in physiotherapy to provide a platform concerning the challenges of professional ethics in physiotherapy in Iran. Methods: This qualitative study was conducted in 2016-2017 using the content analysis method. The study samples were recruited through purposive sampling approach until data saturation (12 physiotherapists). The required data were gathered by an in-depth semi-structured interview. All of the interviews were transcribed and analyzed, inductively. Results: Physiotherapists in Ahvaz and Tehran cities, Iran experienced challenges in 6 different categories during daily practice. These aspects included the following: therapists' self-interest-craving, observing patients' rights, maintaining professional competence, the effect of workplace on ethical conduct, personal ethical outlook, and insufficient professional ethics education. This study implicated the existence of a trend of kick-backs in the physiotherapy community; a problematic trend in the medical community, i.e. addressed by physicians in several articles. Additionally, the lack of receiving ethical education leads to ethical judgments based on personal values rather than ethical codes. According to the current research findings, it To increase the visibility of the article as well as to increase the citation of your article, we suggest that Latin keywords be based on the MeSH list. See: https://meshb.nlm.nih.gov/search was problematic for practitioners. Discussion: Three subcategories of the incompetence of the healthcare system, the lack of supervision on ethical principles, and the impact of poor insurance system on patient admission are related to the endemic conditions of the health system of the country. These issues require serious interventions from executive powers.
Indian Journal of Medical Ethics, 2021
The code of ethical conduct for physiotherapy services must be compatible with the local culture. The ethical guidelines proposed here were developed through a literature review, focus group discussions, and finally a modified Delphi technique to achieve consensus after the data were analysed. At first, the collection of different ethical codes yielded 132 items. In the second stage, repetitive items were discarded, some new items were added, and the various codes were categorised into three domains. Overall, 175 items were considered in the Delphi stage. Subsequently, the items were reduced to 134 in total – 59 in the treatment domain, 41 in research, and 34 in the education domain. The resulting code of ethics will support patients, researchers, students, and teachers in the field of physical therapy with sensitivity to current Iranian legislation and culture.
Physiotherapy Theory and Practice, 2013
Background: An important aspect of physiotherapy professional autonomy is the ethical code of the profession, both collectively and for the individual member of the profession. The aim of this study is to explore and add additional insight into the nature and scope of ethical issues as they are understood and experienced by Danish physiotherapists in outpatient, private practice. Methods: A qualitative approach was chosen and semistructured interviews with 21 physiotherapists were carried out twice and analyzed, using a phenomenological hermeneutic framework. Results: One main theme emerged: The ideal of being beneficent toward the patient. Here, the ethical issues uncovered in the interviews were embedded in three code-groups: 1) ethical issues related to equality; 2) feeling obligated to do one's best; and 3) transgression of boundaries. Conclusions: In an ethical perspective, physiotherapy in private practice is on a trajectory toward increased professionalism. Physiotherapists in private practice have many reflections on ethics and these reflections are primarily based on individual common sense arguments and on deontological understandings. As physiotherapy by condition is characterized by asymmetrical power encounters where the parties are in close physical and emotional contact, practiced physiotherapy has many ethical issues embedded. Some physiotherapists meet these issues in a professional manner, but others meet them in unconscious or unprofessional ways. An explicit ethical consciousness among Danish physiotherapists in private practice seems to be needed. A debate of how to understand and respect the individual physiotherapist's moral versus the ethics of the profession needs to be addressed.
Ethical competence of a physiotherapist : Concept and evaluation
fi=Turun yliopisto|en=University of Turku|, 2020
Interest in physiotherapy ethics and ethical competence have internationally increased during the last ten years. Physiotherapy raises ethical issues that should be actively discussed-ethical competence is a key area of professional expertise in physiotherapy. The aim of the study was to identify ethical problems that physiotherapists encounter and to analyse the concept of ethical competence in order to clarify and verify the definition of the concept in physiotherapy. The aim was also to develop an instrument to assess physiotherapists' ethical competence. This study included four Phases. In the Identification phase I, a descriptive and correlational study design was chosen to describe ethical problems that physiotherapists encounter, and to find out how the demographic data influence encountering ethical problems (n=116). The Theoretical phase II consisted of a concept analysis of the concept ethical competence. The results of the Theoretical phase formed the basis for the development of the instrument. In the Empirical phase III, a newly developed, mainly structured instrument (PECET) was used to evaluate ethical competence of a physiotherapist (n=839). The Analytical phase IV included verification of the concept ethical competence. The conceptualisation was based on the Hybrid model by Schwartz-Barcott and Kim. Based on the results, physiotherapists encounter ethical problems related to everyday ethics even weekly. Ethical competence is needed to solve these issues. The concept of ethical competence is defined in terms of character strength, ethical awareness, moral judgement skills and willingness to do good. As these attributes were all illustrated in physiotherapists' responses, the concept was verified in physiotherapy. Measured with the PECET, most of the respondents evaluated themselves highly ethically competent. Ethical codes of conduct were not well known among the respondents. The results of the study provide a theoretical framework for the concept of ethical competence and the development of the PECET, a thought-provoking tool as a part of ethical reflection, to evaluate the ethical competence of health professionals. In the future, research on ethical competence should be continued with more extensive data. It is also necessary to look at patients' views on ethical care and the importance of guidelines in ethical decision-making, in practice and during education.
The Ethical Code of Conduct for Physiotherapists—An Axiological Analysis
International Journal of Environmental Research and Public Health
The goal of the article is an axiological analysis of the Ethical Code of Conduct for Physiotherapists. The basic ethical values constituting the axiological basis of physiotherapy are care, professionalism, responsibility, fairness, professional integrity, respect for a patient/client’s dignity and autonomy. Those values have been selected from the theory and practice of physiotherapy, but also from socio-cultural conditions influencing the relations and interdependencies between physiotherapists and other professional groups or society as a whole. Those values can exist as qualities of a subject (a physiotherapist) or as functions realised by them (acting for the welfare of a patient/client, society, profession). Some of the analysed values have been directly enumerated in the Ethical Code of Conduct for Physiotherapists, while others must be deduced from the rules included in this document. The analysed values should be internalised by the physiotherapists during their training a...
BMC Medical Ethics, 2011
In the course of the last four decades, the profession of physiotherapy has progressively expanded its scope of responsibility and its focus on professional autonomy and evidence-based clinical practice. To preserve professional autonomy, it is crucial for the physiotherapy profession to meet society's expectations and demands of professional competence as well as ethical competence. Since it is becoming increasingly popular to choose a carrier in private practice in Denmark this context constitutes the frame of this study. Physiotherapy in private practice involves mainly a meeting between two partners: the physiotherapist and the patient. In the meeting, power asymmetry between the two partners is a condition that the physiotherapist has to handle. The aim of this study was to explore whether ethical issues rise during the first physiotherapy session discussed from the perspective of the physiotherapists in private practice. Methods: A qualitative approach was chosen and semi-structured interviews with 21 physiotherapists were carried out twice and analysed by using a phenomenological framework. Results: Four descriptive themes emerged: general reflections on ethics in physiotherapy; the importance of the first physiotherapy session; the influence of the clinical environment on the first session and; reflections and actions upon beneficence towards the patient within the first session. The results show that the first session and the clinical context in private practice are essential from an ethical perspective. Conclusions: Ethical issues do occur within the first session, the consciousness about ethical issues differs in Danish physiotherapy private practice, and reflections and acts are to a lesser extent based on awareness of ethical theories, principles and ethical guidelines. Beneficence towards the patient is a fundamental aspect of the physiotherapists' understanding of the first session. However, if the physiotherapist lacks a
Pakistan BioMedical Journal
Ethics are broad range of thinking about expressional interdependence behaviors of human being and about situational balance between right and wrong as moral duty. Objective: The purpose of this study was to figure out ethical issues in clinical practice of physical therapy practice. Methods: A cross sectional study was conducted at various clinical setups in Lahore enrolling practicing physical therapists via non-probability convenience sampling technique. A sample of 249 physical therapists was extracted using sample size calculator (Confidence interval 95%). Participants were selected on the basis of inclusion criteria and responses were recorded using self-structured questionnaire whose content validity was assessed using Lynn, M.R (1986) method. The questionnaire consisted of set of opinions regarding multidimensional aspects of ethics in patient care. The data was analyzed by SPSS version 20. The analysis was based on descriptive statistics such as frequency percentages and me...