Patient Autonomy in Physical Therapist Practice: Defining the Limits

Patient autonomy has long been considered a foundational principle in biomedical ethics and has been defined, in its most basic form, as a right to self-governance or self-determination. The emphasis that is placed on patient autonomy results in a necessary attention to a patient's values, expressed wishes, and decision making in a medical context. However, in an era of healthcare consumerism, where healthcare may be treated like any other good, the line between patient-centered care and patient-directed care becomes blurred, potentially resulting in a mindset that the patient (as a consumer) is 'always right.' There are limits on what a patient can reasonably request in the course of their healthcare journey, including the provision of services from a physical therapist. When considering instances of provider denial or constraining patient autonomy, physical therapists should collaborate with other healthcare providers, consult Ethics Committees where available or appropriate, and make explicit their clinical and ethical reasoning to support their decision.