Informed consent practices of physiotherapists in the treatment of low back pain

Our purpose was to explore and describe physiotherapists' informed consent practices in the treatment of clients with low back pain. Forty-four physiotherapists were assigned to six focus group interviews. Focus group interaction elicits insights that are less accessible in individual interviews and which can be corroborated immediately through inbuilt checks and balances. Participating physiotherapists described not only fulfilling but also exceeding their regulatory and ethical duty to obtain explicit and implicit informed consent from clients according to professional guidelines. Client autonomy could not always take precedence in the fast-paced and seamless therapy session. A shared decision-making process of embodied, implicit consent or refusal was embedded in a reciprocal client-therapist care relationship of trust and rapport. A typology of modes of consent is provided. A process for obtaining a more explicit consent alongside implicit consent that does not interrupt the continuity of physiotherapy treatment is outlined.