Ethical issues in physiotherapy – Reflected from the perspective of physiotherapists in private practice

Abstract

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 semi-structured 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.

Acknowledgments

We thank the physiotherapists who participated in this study for their enthusiasm, honesty, and commitment to the profession. We thank Søren Holm, Pia Jørgensen, and Anne-Marie Wium for valued and essential comments, discussions, and support and Claus Fenger for language proofing.

Declaration of interest: This study has received funding from The Association of Danish Physiotherapists and The Department of Physiotherapy, Metropolitan University College, Copenhagen, Denmark and The Danish Rheumatism Association. The authors report no declaration of interests.