Informed consent in physiotherapy practice: it is not what is said but how it is said

Abstract

This paper discusses the concept of informed consent in the context of contemporary biomedical ethics. A change in UK law regarding what information should be provided to patients has brought to the fore the role of physiotherapists in the process of gaining informed consent. It is important that physiotherapists are aware of how this change in the law will affect their practice. For an individual to consent, they need to have both the capacity and freedom to exercise rational thought. These concepts are challenged in contemporary biomedical ethics. An individual's ability to make rational decisions has been increasingly questioned by empirical evidence from behavioural psychology. In addition, the concept of freedom in contemporary neoliberal societies has also been critically examined. Liberal paternalism has been advocated by some as a means of helping patients to make better decisions about their care. Actualised as a 'nudge', liberal paternalism has been influential in a number of health policies, and has recently been discussed as a means of gaining consent from patients for assessments and treatments. Physiotherapists engage directly with patients and, through this engagement, construct a therapeutic environment that aims to build mutual trust. This paper questions the legitimacy of informed consent, and presents the argument that, through communicative actions, physiotherapists nudge patients into consenting to assessments and treatments.

A modern way to teach and practice manual therapy

“…People should be given the opportunity to discuss their understanding of the diagnosis and options for treatment and rehabilitation. The decision-making process is dialogical, in which alternative options to the offered therapy should also be discussed with the comparative risks and benefits of all available management options, including doing nothing [ 113 , 114 ].…”

Physiotherapists perceptions on informed consent and role in the healthcare system, in Europe

“…A percent of 24.20% (n=60) 34 are still considering IC a simple patient information process, while 23.40% (58) have linked IC with 35 ethically and legally issues, 21.67% (n=51) of physiotherapists are minimizing their role in healthcare at 36 restoring physical independence, while 6.91% (n=27) are aware of their multidisciplinary role. The 37 country comparison analysis revealed that physiotherapists from UK and Italy are more aware regarding 38 IC and that physiotherapists from Belgium and France are better oriented regarding their role in 39 healthcare. Introduction…”

“…In addition to 260 legal and deontological considerations, obtaining IC is a useful tool that allows physiotherapists to 261 establish a connection and a relationship with the patient. (32) (39) 262…”