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nani: 28 Sep : 04:31 AM

plz pleasec tell me where to do phd in india

Nikhilphysio: 02 Jun : 03:55 AM

I am working as physiotherapist in Shalby hospital ahmedabad for 4 years. I have passed out from Rajiv gandhi university of health and sciences Bangalore. I want to apply for Newzealand physiotherapy board registration so anyone there from India who got registered as physiotherapist in new zealand please help me.

Arun: 10 May : 12:36 AM

Hi Priyank, welcome. Feel free to go through these forum threads returned by search [link]

Priyank: 09 May : 10:28 PM

Hi..need advice. What are the options in Australia after MPT?

Arun: 04 Mar : 02:01 AM

Happy birthday Boopathi and somasimple


Ethics in Physical Therapy.

Thursday 16 December 2010 - 17:32:03


images_2.jpgHealth 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.
Physical therapists must also consider how stressful it is for patients when they come to us for care. We have many opportunities to care for our patients as individuals and help them maintain as much control of their situation as possible. When we actively assist patients to retain control of their situation, a trusting relationship can develop between the therapist and patient. Before a therapist meets a patient, there is an opportunity to establish a caring and supportive environment for the patient. Consider the manner in which your patients are addressed from the first contact they have with your clinic. Your supportive clerical staff will be the ones who first interact with patients, and they should be included in ethical discussions so that they are aware of the impact that they can make on a patient. Be sure that when your patients arrive at your clinic, that their personal information is kept confidential and that questions are not asked of them where other people can overhear. Consider the impact of the comfort of your waiting room and the length of time patients wait to be seen. Patients should be treated with respect. The next time you reach out to touch a new patient, consider how much information you have provided the patient prior to that first touch. These preliminary acts demonstrating respect toward your patients have also been shown to reduce the likelihood of a lawsuit if you make a mistake with your patient.
There are many types of ethical situations in health care that we face each day. As a physical therapist or assistant you may find that patients entrust you with information that may not be relevant to their specific care. Because we spend so much time with patients and their families, patients often confide in us regarding other concerns. Common ethical concerns include beginning of life issues (neonatal problems, infertility, genetic engineering), end of life decisions (withholding/withdrawing life-sustaining treatments, pain control, physician-assisted suicide), and life changing decisions (pregnancy, abortion, dialysis, organ transplants, AIDS). Although most of the ethical decisions that you will face as a physical therapist will not involve these specific issues, many of your patients may be involved in these dilemmas. You will be making decisions on a daily basis that will affect the lives of others. You should consider the ethical ramifications of the following situations: how you treat persons who are different from yourself, truth-telling, issues of confidentiality, what to do when you make a mistake, dealing with colleagues who are abusing substances, reimbursement concerns, marketing, managed care, using supportive personnel, sexual harassment and many others that you will face in your practice.
Practicing ethically in today's health care environment may be a challenge for many who are experiencing a reduction in the numbers of patient visits, smaller profit margins, or fewer career opportunities. As individuals and as a professional group we should be able to remain true to our ethical roots if we always keep our patients as our focus. Remember that our patients place their trust in us to make the best decisions possible on their behalf. We should use ethical tools to help us make decisions based on analysis and thoughtful consideration. One of the reasons that the profession of physical therapy has persevered in previous times when challenged by outside forces is because it has remained grounded in an ethical awareness. It will continue to flourish in these times of cost containment if the profession continues to hold fast to its ethical center.
By Susan McPhail Wittjen, PT, PhD on www.tpta. org.

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