Resolving tensions between philosophical, professional and social conceptions of ethical issues: a therapist - patient conundrum

摘要

In this case study of an elite football player, who wishes to return early to training against the wishes and advice of the physical therapist, the author eloquently invites us to consider one of the central moral conundrums of physical therapy practice.1 And that is where two different perspectives, the therapist's and the patient's, both having reason and validity, nevertheless, come in to conflict with each other. Resolving a situation in which there is a 'right' versus 'right' is so much harder than making a moral judgement in cases of'right' versus 'wrong'. Of course, few would dispute the existence of scenarios involving a moral 'right' and an immoral 'wrong' either in society at large or in physical therapy practice in particular. And yet, the author reminds us that, as clinicians, we need to proceed carefully in our analyses of therapist-patient conflicts and not to be too quick to frame such dilemmas in polarised terms, where there exist absolutist 'right' and 'wrong' solutions and courses of action. An inability, or even an unwillingness, to recognize the ambiguities in dilemmas of clinical practice such as this, or legalistic interpretations of professional roles and responsibilities, might conceivably provide clinicians with a greater sense of certainty in their decision making, but at the expense of understanding the validity of other perspectives and ultimately, therefore, of arriving at a fair and just outcome.