Ethical Issue:Rresponsibilities of a physical therapist when deciding between what treatments the patient wants versus what treatment would actually be beneficial for them
Autonomy vs. Profession.
Why I chose my topic.
My prime topic of research materializes upon Kinesiology predominantly because this field plays a significant role in the reduction of costly fall-related injuries in the fast increasing population of older adults. There exists a critical need to implement theory-based frameworks in planning on efficient movement based interventions. Furthermore, professionals are encouraged to join in on prominent organizations that deal with the act of advancing national initiatives that aim at reducing disability. Traditional exercise based products existed before newer laboratory techniques all effective in teaching critical recovery strategies that follow an artificially induced loss of balance (Rikli, 2012).
As a physical therapist, there are some responsibilities expected as of The World Confederation of Physical Therapists (WCPT). The members organizations are expected to hold a code of ethics and conduct, promote these values that benefit the members and the general public as well as have necessary procedures for monitoring the practice of their members. Members are expected to have with them principles of conduct that array WCPT as a major organization that supports the development of codes of ethics to other agencies. Among these principles lays the responsibility to exercise sound judgment. Physical therapists have regards as independent and autonomous practitioners who make judgments in the act of providing services in which they have knowledge about (Bury, 2011). This brings the research topic down to a research problem that is common within this field.
“Deciding between patient wants and rightful medical procedures during treatment raises disputes between autonomy and professionalism in the field of physical therapy.”
The research question that arises from the problem statement has to do with the attempt to come up with research findings that explain methods by which this problem is handled, more or less, the reasons for its existence. The research questions follow below.
What is the responsibility of a physical therapist in deciding between autonomy and professionalism?
First and foremost, the formulation of a hypothesis is mandatory in giving guidance as of the conduction of this research. The theory formulated in the attempt to route the paths by which would answer the research question is as follows. If the physical therapist fails to decide properly between autonomy and professionalism during treatment, then the patients have a higher frequency of developing disputes with the therapist in the process.
A search for valid information on the topic involved the use of secondary sources of data. This method implies that previously written articles on the research topic have to be accessed as well as interpreted to fit in with coming up with relevant information. Further on into the matter of interest, the conduction of this research had to go through a qualitative method of collecting data from the field. Majorly, the events undertaken in this part of the study involved the conduction of open-ended interviews during collection of information on the research topic.
One major dispute in physical therapy that is about decision-making centers on the tension matters between autonomy and beneficence. This concept of beneficence can conflict with autonomy once a health care professional‘s assessment of a client’s best interests conflicts with their assessments. In the end, the qualified patients’ autonomous decisions regarding care in health are respected and observed by the medical team (Baldinger, 1982).
Physical therapy is an internationally widely known health profession that should only be practiced by properly qualified therapists. They are entitled to hold forth a license to practice physical therapy and use the title to hold a valid registration pass. In the absence of regular legislation, physical therapists are recognized through their eligibility for their membership in established organizations found in the country. Physical therapists are encouraged to work towards a system that focused on the interest of the public over their own. This act in turn will promote trust and confidence in the profession (Rki, 2005).
As for the secondary sources, an article on the ethical responsibility of a therapist in decision making states that a physical therapist is required to undertake required assessments that initiate the development of a diagnosis. During this diagnosis of the patient, relevant information about the patient’s goals is used to determine the prognosis of care and implement the treatment. After the achievement of objectives, further benefits to the patient can no longer be offered. Discharging the client from services is achieved at this level. However, instances where the diagnosis is not clear or the treatment fails to fall within the realm of the therapists practice, a reference to other therapists is granted to the patient. Also, the physical therapist is required to expect and accept co-operations from other work colleagues (Rikli, 2012).
Another article on the research topic explains that disputes and ethical dilemmas arise during physical therapy due to loyalty matters between patients and employers. Such a conflict is universal. This issue is a result of the choice between patient autonomy and medical paternalism. In this case, the therapists are bound to assume higher responsibility. This responsibility increase deals with the obligation to recognize and confront the ethical dilemmas in the therapeutic practice. There exist theories that are used in solving this dilemma through a logical examination assumptions and principles (Carpenter,1994). On the interviews conducted by two physical therapists in Southern California Sports Rehabilitation, the research showed that there existed specific situations whereby actions done while treating a patient and the procedure of handling controversies between autonomy and professionalism all lay in the particular strategy.
The other physical therapist who underwent the interview through an email process had formerly interned at The Dynamic Care Physical Therapy Facility. Questions regarding the modes of handling autonomy versus professionalism were answered. The feedback claimed that the therapist had learned of ways of handling this problem while still a student taking up the study of physical therapy. The main book of a study was Code of Ethics for the Physical Therapist.
The codes of ethics for a physical therapist is majors upon five roles that are, managing patients and clients, offering consultations, education and researching on cases, and administering proper services. Physical therapy follows a set of core values that namely are, having accountability for any actions, altruism, having compassion and care for patients, excellence, integrity, having a professional duty in actions, and having the proper social responsibility. Among the principles of conduct for a physical therapist, a bunch of roles falls under each category. There exists a general obligation to the therapist to only empower, give knowledge, and enable the patients with impairments activity limits, and participatory limits to become independent and healthy with better quality livelihoods (Irimia, 2011).
The conduction of this searching process suffered from a few challenges that mostly lay in the secondary sourcing of information from articles. These challenges were because most items and available pieces arrayed themselves out as based upon a particular opinion. In as much as this was a challenge, a huge advantage to this problem was that it provides a light show of different sides and reflections upon the ethical issue of whether physical therapists should treat patients on what they want or on what the therapist thinks is necessary for treatment.
The market for Physical Therapists is growing despite the presence of this issue on deciding between autonomy and professionalism. Highly educated professionals appear to be stronger with the potential to increase the demand further in the future. Being a recession proof job known to the popular magazines and online articles, Physical Therapists are speaking sense with the strong job markets for health care positions.
The dilemma has a lot to do with coordination and communication between the therapist and the patient. Communicating and coordinating with the patient is an essential responsibility of the physical therapist. The therapist has another responsibility of ensuring that the patient feels safe from initial interventions to the final discharge. This responsibility is recognized in all settings involved during the procedures of treatment. An advance address on previous care methods from directives and programs happening before new treatment that is to deal with the patient’s positive mindset at the beginning. In addition to this, professionalism in physical therapy deals with accountability of the patient as well as the therapist with which expects integrity and social responsibility. To carry on with these values, physical therapists are expected to have graduated from accredited programs (Lattanzi &Purnell, 2006).
The research findings on the responsibilities of a physical therapist concerning autonomy and professionalism were that many therapists decide on how they want to treat the patients according to how they assess their patients levels of satisfaction with care. Due to the expansive knowledge of skills involved for the existent diverse populations and settings, most physical therapists have a primary focus on divisions of their expertise that enable them to concentrate more. Physical therapists have a common respect for their complementary roles in patient care. Due to this understanding, direct access to services that do not require the referral of a therapist fails to alter this mutual relationship. In the end, this circumstance allows the collaboration and cooperation to be initiated by the physical therapist (Scott &Petrosino, 2008).
The challenge of deciding between autonomy and professionalism is likely to come to a solution due to the hard push toward expanding the physical therapy’s evidence base. The scientifically proven interventions will benefit patients since they are likely to produce practical outcomes if provided appropriately.
Some of the most difficult ethical issues to deal with in physical therapy are to do with a patient’s autonomous decision conflicts with the therapeutic duty. The physical therapist’s view is to look out for the patient’s best interests in health. A good example is that of a patient who has just had a bypass surgery and wants to continue to smoke. Another patient, in this case, has had pneumonia and refused to take antibiotics for curing drugs. These cases array the autonomous choices that patients make and conflict the physicians duties of beneficence. However, the ethical principles in medicine would lead to a different path of dealing with such conflicts that ought to come first in the medical strategies in use. The patient WHO meets the criteria of making autonomous decisions, eventually gains freedom and respect of making decisions from the physician (Halpern, 2001).
During care for the patient at the time of discharge, the physical therapists measure the impact of the physical therapy interventions by using evidence-based measurement tools. The most widely and standard tool used in this process has been tested for maximum reliability and validity. This Act has helped in the provision of accurate assessment of how well this process is active during the physical interventions (Everett, Mehta & Mucilli, 2002).
It is the role of professionals to outline and promote expected levels of quality when it comes to patient care. The physical therapy profession has a commitment to the society in promoting health and proper functioning of individuals in the communities. This role can only be achievable through a pursuit of excellence in the patient care. Profession statements of conditions and performances that have been credited essential in high-quality professional services to people in the society are established by the primary representative body for The Physical Therapy Profession. This acts him to secure an assessment of physical therapy.
In the present century, the physical therapy profession has continued to grow substantially and further developed by the scientific basis for its services. It is a role of the physical therapist to outline and promote the expected level of quality in care. A therapist’s commitment to the society is to promote optimal health and proper functioning in individuals through personal excellence. The ongoing evolution of the physical therapist world is in response to the societal needs in rehabilitation, prevention as well as wellness sides that are in conjunction with sociopolitical crises (Scott, 2002). The advancement of the profession to its doctoral degree was not limited entirely to the next generation of the individuals practicing it. It was a developed mechanism for the licensed practicing individuals so as to obtain the knowledge in the content divisions whereby the curriculum explains in order about earning a post-professional degree. The next century and later the profession transitioned its entry into level education from a short technical training program through a highly internalized knowledge and skill usage to a more comprehensive, mobile as well as intensive professional education. This program entirely follows a completion of an undergraduate degree of which culminates into the awarding of a doctor in physical therapy damage (Scott, 2002).
The dilemma between autonomy and professionalism is not easily solvable due to highly diverse occasions of injury that can be present in a particular wound. The method as to which problems are solved in the events requires the usage of the principles of conduct that the therapist acquires during training and acquisition of knowledge in the field. Communication is also an important method of solving disputes between the physical therapist and the patient (Deliggio, 2006). Through the understanding of patient needs presented at the beginning of treatments these conflicts and dilemmas are not relevant in some cases. However, it is the responsibility of the physical therapist to acknowledge the expectations of the patient before beginning the treatment that assists greatly in deciding on the strategies of treatment. A further reference on the issue of choosing between autonomy and professionalism has been a frequent occurrence in other medical fields. Therefore, the solution to any challenges that come up during treatment majorly lay in the hands of the professional practitioner.
Baldinger, A. (1982). Decision-Making, Autonomy, Valid Consent, and Guardianship. In Geriatrics. Berlin: Springer-Verlag.
Bury, T. (2011, December 11). WCPT (World Confederation for Physical Therapy) Declarations of Principle. Retrieved October 20, 2015, from https://www.scribd.com/doc/12318027/WCPT-World-Confederation-for-Physical-Therapy-Declarations-of-Principle
Carpenter, C. (1994). Dilemmas of Practice as Experienced by Physical Therapists in Rehabilitation Settings. Physiotherapy Canada Physiother. Can., 63-63.
Deliggio, B. (2006). Communicating Without Speech: Practical Augmentative & Alternate Communication. Pediatric Physical Therapy, 222-223.
Everett, C., Mehta, R., Mucilli, P., Obert, B., & Patel, R. (2002). Poster Board 5: Patient Expectations And Practitioner Selection In Physical Therapy. American Journal of Physical Medicine & Rehabilitation, 207-207.
Halpern, J. (2001). Respecting Patient Autonomy. Humanizing Medical Practice From Detached Concern to Empathy, 101-128.
Irimia, O. (2011). Code of Ethics for the Physical Therapist. In Introduction to physical therapy for physical therapist assistants (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.
Lattanzi, J., & Purnell, L. (2006). Developing cultural competence in physical therapy practice. Philadelphia: F.A. Davis.
Rikli, R. (2012). Impact on the society. In Kinesiology research: its impact on society. Fullerton, California: The National Academy of Kinesiology.
Rki, A. (2005). Professionalism in physical therapy. In Physiotherapy for the functioning of breast cancer patients: Studies of the effectiveness of physiotherapy methods and exercise, of the content and timing of postoperative education and the experienced functioning and disability. Jyväskylä: University of Jyväskylä.
Scott, R. (2002). The growth of physical therapy in professionalism. In Foundations of Physical Therapy: A 21st century-focused view of the profession. New York: McGraw-Hill, Medical Pub. Division.