Approaches to conflicts between treatment recommendations and patients’ decisions in physiotherapy: a case study

Abstract

The purpose of this paper is to analyze various ethical arguments occasioned by patient–doctor conflicts in a physiotherapy case study concerning an elite athlete.

A case outline is presented and arguments are followed in a disagreement between treatment recommendations of a physiotherapist and a patient’s decisions. The physiotherapist argues that her responsibility must be to aim at the protection of the athlete’s health; for his part, the patient argues that health is only a part of what he considers welfare and has little value to him for its own sake.

The paper analyzes the respective arguments as proceeding from distinct and equally valid understandings of health and welfare which demands an approach to medical ethics able to reconcile the opposing points of view. Possible consequences are calculated and the importance of respecting the patient’s prerogative to his/her own notion of welfare is discussed and defended.

Keywords:

• Physiotherapy ethics
• Case study
• Welfare