Abstract
BackgroundLittle is known about the ethical situations which physiotherapists encounter internationally. This lack of knowledge impedes the ability of the profession to prepare and support physiotherapists in all world regions in their ethical practice. The purpose of the study was to answer the following research questions: What types of ethical issues are experienced by physiotherapists internationally? How frequently are ethical issues experienced by physiotherapists internationally? Can the frequency and type of ethical issue experienced by physiotherapists be predicted by sociodemographic, educational or vocational variables?MethodsAn observational study was conducted in English using an online survey from October 2018 to May 2019. Participants were 1212 physiotherapists and physiotherapy students located internationally which represented less than 1% of estimated number of physiotherapists worldwide at that time. The survey questionnaire contained 13 items requesting demographic detail and knowledge of ethical codes and decision-making, and 46 items asking what frequency participants experienced specific ethical issues in four categories: (A) Physiotherapist and patient interaction (19 items), (B) Physiotherapist and other health professionals including other physiotherapists (10 items), (C) Physiotherapists and the system (5 items) and (D) Professional and economic ethical situations (12 items).ResultsThe two most frequently experienced ethical issues were ‘Scarce resources and time affecting quality of physiotherapy treatment’ and ‘Physiotherapy not accessible to all people in society who need it’. These items were experienced, on average, more often than monthly. Interprofessional practice also presented frequent ethical issues for participants. Ethical issues related to the context of ‘Physiotherapists and the system’ were most frequently experienced for all world regions. Working longer years in physiotherapy and learning about ethics in basic physiotherapy education was associated with participants reporting lower frequencies of ethical issues across all contexts.ConclusionThis study provides the first global profile of ethical issues experienced by physiotherapists. Societal and cultural systems are key influences on physiotherapists’ ethical practice. Physiotherapists globally need support from their work organisations, academic institutions and professional associations, and robust ethical training, to assist them to be active moral agents in their practice.
Highlights
Little is known about the ethical situations which physiotherapists encounter internationally
A study of ethical issues experienced by physiotherapists internationally can inform which ethical obligations are challenged in everyday practice
This paper reports findings from the ESPI-Study (Ethical Situations in Physiotherapy Internationally), which aimed to describe the ethical landscapes for physiotherapists internationally
Summary
Little is known about the ethical situations which physiotherapists encounter internationally. What we do know from existing research is that ethical issues are part of everyday physiotherapy practice across fields of the physiotherapy profession, causing moral distress for practitioners and affecting quality and outcomes of care [1, 2, 4, 9]. This part of professional practice cannot be ignored, rather it needs to be understood to be addressed appropriately and effectively. Lack of knowledge impedes the ability of the profession to prepare and support physiotherapists in all world regions in their ethical practice
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