Ethical and bioethical issues in physical therapy: A systematic scoping review

Area of Science:

• Integrates bioethics and physical therapy research.
• Focuses on ethical and bioethical considerations within healthcare professions.

Background:

• Ethical and bioethical issues are fundamental to physical therapy practice and identity.
• A comprehensive understanding of these issues is vital for advancing education, clinical practice, and professional reflection.

Purpose of the Study:

• To systematically map ethical and bioethical issues within the physical therapy literature.
• To describe the methodologies used in studying these issues.
• To identify gaps in the literature to inform education, practice, and policy.

Main Methods:

• Conducted a systematic literature search across multiple databases (Medline, Embase, CINAHL, etc.) up to October 2024.
• Included 108 studies employing normative and descriptive approaches.
• Utilized narrative synthesis for data extraction and theme mapping.

Main Results:

• Identified major themes including ethical reasoning, education, theories, care relationships, justice, equity, and codes of ethics.
• Key challenges highlighted include physical touch, informed consent, professional boundaries, and moral distress.
• Found that ethical reasoning is often situational, and formal codes may be perceived as disconnected from clinical practice.

Conclusions:

• Ethical complexities in physical therapy stem from its embodied, relational, and context-sensitive nature.
• Significant variability exists in ethics education and application, with underexplored areas like digital health and DEI.
• Emphasizes the need for enhanced ethics education, better application of codes of ethics, and organizational support for ethical deliberation.