Ethical Decision-Making in Physical Therapy |
Theories of Decision-MakingAlthough ethics and morality have been the subject of philosophers for millennia, health care ethics as a field of study only began in the 1960's. Our culture underwent some significant changes during those years, especially with regards to individual rights. Patient rights grew out of the movements for civil rights, women's rights, students' rights, and a general emphasis on individual rights. Over the last 30 years patients have gained the abilities and rights to be a part of the decision-making about their health care. As the development of medical technology grew, especially life-sustaining treatments, there has been an increased focus on health care ethics. Some of the first ethical decisions had to be made about who would be able to use the limited kidney dialysis units at the time. Decisions had to be made about neonates who now could survive when they would have previously died. We have the ability to extend persons' lives or to put off death by the use of ventilators, antibiotics, feeding tubes, and CPR. Ethical questions address whether it is necessary to use all of these technological developments because they are available. Physical therapists also make critical decisions about patient care. There are many theories about how we make decisions, but the four that will be discussed are decisions based on consequences, duties, virtue and care. As these theories are presented, you should consider how you tend to make most decisions. You probably use a combination of all of these theories, but by thinking about how you might use these in your practice, you might be better prepared to face difficult ethical decisions. Each of these theories has been described and studied by many authors, and the following discussion is only a superficial description. You should refer to the reference list if you are interested in further study of these theories. |