Closing the Gap Between Ethics Knowledge and Practice Through Active Engagement: An Applied Model of Physical Therapy Ethics (Perspective) (Report‪)‬

Physical therapists are rehabilitation experts who provide health services within health care dimensions of promotion, prevention, and intervention to people, communities, and populations. (1,2) The physical therapy profession began as an adjunct to medical practice. (3-5) This link extended to a reliance on the clinical and ethical decisions of the referring physician. (6) With increasing professional autonomy and independence in clinical decision making and judgments, physical therapists face increasingly complex ethical issues in their professional practice. (7) These ethical issues include understanding and balancing the needs of patients and those of the patients' families and other professionals and working within the constraints and opportunities afforded by health policies and institutional systems and structures. (7,8) In this context, physical therapists have moved away from a reliance solely on the medical profession to guide their ethics knowledge and decisionmaking frameworks. They have built their own body of literature about the nature and scope of ethics and ethical decision making in different areas of practice. (9-13) In this article, we identify the development and focus of ethics knowledge in physical therapy over the last several decades and highlight links and gaps between ethics knowledge as discussed in the literature and the specific ethical dimensions of physical therapist practice. We then propose an applied ethics model, titled the "active engagement model," that seeks to integrate clinical and ethical dimensions of practice. Finally, we use that model to analyze a clinical ethics case scenario.