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ETHICAL DECISION-MAKING IN PHYSIOTHERAPY: HOW DO HEALTH CARE ETHICS CONCERN THE PHYSIOTHERAPIST?
There has been a growing concern with the ethical issues associated with medicine and health care; numerous texts have been written in this area, and there are a number of academic journals devoted to ethical and other philosophical questions in health care. Where, then, do physiotherapists fit into this picture? With which aspects of this wide-ranging subject should they be concerned? At first sight, it may seem that many of the dramatic, 'headline-grabbing' issues that one reads about in the newspapers, and which are the subject of television documentaries, have little to do with the practice of physiotherapy. Indeed, matters such as embryo research, organ transplantation, abortion, and in vitro fertilization are scarcely the everyday concern of the clinical physiotherapist. The sort of ethical questions that arise in physio-;rapy tend to be of a more everyday nature:
1 Are some patients more deserving of treatment than others, and if so on what grounds?
2 How should we set treatment priorities within a caseload?
3 Should we obtain informed consent before treating a patient, and if so how 'informed' must this consent be, and what form should it take?
4 Can we justify persevering with treatment that is proving ineffective, just because continued treatment has been recommended?
5 Under what circumstances is it permissible to cause patients discomfort or pain?
6 Should we ever deliberately mislead patients as to their diagnoses, or the nature of the treatment they are being given?
7With whom is it permissible to discuss the details of a patient's case?
8 What action should we take with respect to colleagues whom we perceive as incompetent, or whose conduct we regard as unethical?
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