Views of physiotherapists on factors that play a role in ethical decision-making: an international online survey study

Abstract

Background There is a lack of knowledge about the ways physiotherapists around the world learn about professional code of ethics and ethical decision-making frameworks. The profession has a gap in the understanding about physiotherapists’ views on factors that play a role in ethical decision-making and whether these views differ between World Physiotherapy regions. Methods An online survey study in English was conducted from October 2018 to October 2019. Participants included 559 physiotherapists located in 72 countries. The self-designed survey questionnaire contained 13 items asking about demographic information and means of learning about ethical codes and decision-making frameworks. A further 30 items were presented which included statements underpinned with individual, organisational, situational and societal factors influencing ethical decision-making. Participants were asked to express their level of agreement or disagreement using a 5-point-Likert-scale. Results Participants’ highest rated responses endorsed that the professional role of physiotherapists is linked to social expectations of ethical behaviour and that ethical decision-making requires more skills than simply following a code of ethics. A recognisable organisational ethical culture was rated as supporting good ethical decisions. Comparing responses by World Physiotherapy regions showed significant differences in factors such as culture, religion, emotions, organisational values, significant others, consequences of professional misconduct and professional obligations. Entry level education was not perceived to provide a solid base for ethical decision-making in every World Physiotherapy region. Participants reported multiple sources for learning about a professional code of ethics and ethical decision-making frameworks. What’s more, the number of sources differed between World Physiotherapy regions. Conclusions Multiple factors play a role in physiotherapists’ ethical decision-making internationally. Physiotherapists’ ethical knowledge is informed by, and acquired from, several learning sources, which differ in both quality and quantity amongst World Physiotherapy regions. Easily accessible knowledge and education about professional codes of ethics and ethical decision-making can foster continuing professional development for physiotherapists. The establishment of constructive ethical cultures in workplaces can improve ethical decision-making, and should acknowledge the influence of individual, organisational, situational and societal factors. The establishment of collaborative learning environments can support knowledge translation which acknowledges practice-based methods of knowing and learning.

Anstand und Berufsstand – Berufsethik im internationalen Vergleich

“…Die Komplexität individueller ethischer Landschaften beeinflusst die ethische Entscheidungsfindung. Weil dieser Aspekt auch für die Physiotherapie gilt und bis dato noch nicht untersucht worden war, konnten in einer zweiten Umfrage 30 Statements zu individuellen, organisationalen, situationalen und gesellschaftlichen Faktoren, die in ethischen Entscheidungen anderer Fachrichtungen eine Rolle spielen, beurteilt werden 11 . Die Bewertung dieser Statements auf einer fünfteiligen Likert-Skala gab Aufschluss über deren Relevanz für die physiotherapeutische Entscheidungsfindung.…”

“…Ethische Kodizes reichen nicht aus, um den komplexen ethischen Herausforderungen im physiotherapeutischen Alltag gerecht zu werden 14 , 15 . Die Befragten des zweiten Survey stimmten klar der Aussage zu, dass ethische Entscheidungsfindung mehr erfordert als nur das Befolgen ethischer Regeln und Prinzipien 11 . Zeitgemäßer Ethikunterricht muss um Aspekte ergänzt werden, die deutlich über moralphilosophische Theorien hinausgehen und für die alltägliche physiotherapeutische Praxis relevant sind.…”